Government Needs To Issue Regulations For Pharmaceutical Industry To Make MCI Regulations On Medical Ethics Workable: President

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Medical Ethics Conundrum – The Road Ahead, seminar held at India Islamic Cultural Centre, Lodhi Road, New Delhi on Tuesday.

NEW DELHI, Feb 17TH, 2010: The recently issued MCI regulations governing the conduct of medical professionals in the country seem to have stirred a hornet’s nest. Speculations are rife about the impact these are going to have on the way Medicine is practiced in the country in general and on the Pharmaceutical Industry in particular. The issues surrounding the promulgation of these regulations came up for extensive discussions at a seminar held at India Islamic Cultural Centre, Lodhi Road, New Delhi on Tuesday. Medical Ethics Conundrum – The Road Ahead, saw leading lights of the medical profession, top honchos from the pharmaceutical Industry and legal experts putting their heads together to deliberate on the ways to bring about a strict implementation of these regulations.

Said Dr. Ketan Desai, the President of MCI, “In the interests of the country it is the duty of all the stakeholders to make sure that the regulations are implemented in letter and spirit. As the apex body responsible for regulating the conduct of medical professionals in the country, MCI has issued these regulations to make sure that the noble ideals this profession espouses are upheld. Having said that, it is also important that the conduct of Pharmaceutical companies be regulated. Only then can the regulations be implemented successfully. I have written to the Government to issue similar regulations for the Pharmaceutical Industry. I want to clarify here that the regulations are open to modification and we would welcome suggestions to make the guidelines more realistic and implementable provided patient interests are kept paramount. As it is, these regulations are to be seen as the backbone of a ‘code of ethics’ in – the – making.”

Organized by HEAL, a not for profit organization dedicated to spreading awareness on health – related issues in association with FoxMandal Little, the seminar brought to the fore a range of issues that are expected to affect, directly or indirectly a strict implementation of the MCI regulations. The prevailing sentiment was that for an effective implementation of the MCI directives, it is absolutely vital for all stakeholders to understand clearly the issues involved.

Prominent among others who attended the seminar were Dr. Ketan Desai and Mr. Shivinder Mohan Singh, Managing Director, Fortis Healthcare Ltd. The speakers at the seminar included eminent doctors, legal luminaries, top regulators and leading lights of the pharmaceutical industry.

The daylong seminar had been segmented into four sessions, covering different aspects of the issue. Dr. Ashok Seth, Chairman, Escorts Heart Institute, New Delhi who co- chaired the first session with Dr. Ajay Kumar, Member, Medical Ethics Committee, World Medical Association spoke on the Global Best Practices in Medical Ethics and Etiquettes. He spoke, in the main about the Royal College guidelines as also about the practices followed in USA, Australia, Spain and France. Dr. Ajay Kumar spoke about the MCI regulations, dwelling at length on the reasons that prompted MCI to come out with the regulations. He expressed hope that discussions at the seminar would throw up some ideas on what more can be done to ensure strict implementation of the regulations. He also said that it is quite possible to improve on the regulations either by adding more clauses or by deleting some provided this facilitates the practical implementation of the code of conduct MCI wants doctors to observe. Dr. Sameer Kaul, President, Breast Cancer Patients Benefit Foundation, spoke about the existing code of conduct for medical professionals in the country.

The second session on Current Practice in Medical Ethics and Etiquettes in India generated some interesting debate. Dr. Arun Aggarwal, Dean, Maulana Azad Medical College and President of the Delhi Medical Council who chaired the session stressed on the importance of incorporating ethics and etiquettes in medical curricula. This, he said, is of prime importance what with 24,000 people graduating in medicine every year and with the number expected to go up to 34,000 soon. Dr. Amar Jesani, Coordinator, Centre for studies in Ethics and Research, Mumbai spoke about the vulnerability of doctors to the promotional strategies of the Pharma companies. He also spoke about self – regulation and wondered whether it could work in India. Dr. G. Wakankar, Executive Director, Indian Drug Manufacturers Association spoke about self regulation by the pharmaceutical Industry and emphasized that undue inducement can only bring the Industry into disrepute. He however pointed out that gifts cannot and should not be ruled out completely. Ruling out even small gifts would make the guidelines unworkable.

The sessions were followed by panel discussions that generated some interesting debate.
The discussions were centred mainly on the element of trust between the patients and the doctors. That commercial motives should dilute that trust, the speakers asserted, is certainly not acceptable to any of the stakeholders. Said Shivinder Mohan Singh, “It is a question of trust. Of trust and of perception. I don’t think there is a single person around who wants that trust to get affected or the perceptions of patients vis – a – vis doctors to change. That wouldn’t serve anybody’s interests. I see the medical ethics problem as our problem and I think that it cannot be allowed to linger on for long”.

Dr. Shashank Joshi, Vice President, Association of Physicians of India felt that the doctors are getting sandwiched between the Regulators and the Industry. He called for a healthy partnership between all the stakeholders to ensure that the regulations are effectively implemented and work to the benefit of patients.

Partnership between stakeholders and benefit of patients was certainly the overriding theme of the deliberations and discussions that went on all day. The consensus was that all the involved parties should ensure that the regulations are effectively implemented.

Said Swadeep Srivastava, Principal Consultant, HEAL, “With this seminar we are looking at coming out with a Practical Implementation Module, which we hope, will serve as a very useful aid for all the involved parties and will be seen by them as a standard reference document of sorts. We are also looking at setting up an expert committee after the conference. This committee, which will have as its members, eminent doctors, top regulators, leading lights of the pharmaceutical industry and representatives from various consumer bodies, will make specific recommendations for the practical implementation of the regulations. When this happens, it will certainly bring in a sense of fulfillment for us at HEAL foundation. The effective implementation of the regulations will go a long way in helping us realize our objective of spreading awareness and of bringing the medical profession closer to people”.

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