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August 2015, Volume 65, Issue 8

Letter to the Editor

Crossing the ethical boundaries

Syeda Dania Shujaat  ( Ziauddin University, Karachi, Pakistan. )

Madam, I would like to shed light on a highly prevalent yet unspoken issue that is observed in our country\'s medical system. During our medical school days, we were given innumerable classes on medical ethics, patient beneficence and autonomy. Unfortunately when we entered the real world of medical practice, we observed a complete paradox to the teachings.
Quite a number of senior consultants and practicing physicians cross the ethical boundaries when it comes to conducting research studies. They misuse the authority that has been bestowed upon them and use patients to their disposal. They conduct studies on them and collect data without informing the patient of their motives. Unnecessary laboratory tests are run while keeping the patient in the dark. A few doctors do inform the patient about their study when asked why they\'re being asked to fill a particular questionnaire but majority of the time, the patient\'s inquiries are rudely dismissed. Since we live in a third world country, most of our patient population predominantly consists of impoverished individuals. A few doctors have taken this to their advantage and coerce these destitute patients into joining their study by giving them food and monetary incentives. Our Illiterate population is a researcher\'s paradise as these patients are just asked to submit their thumbprints on the consent forms without additional knowledge. A few incidents have also been reported in medical institutions where students are blatantly threatened to be deemed ineligible to sit for the exams if they deny to be part of the study.
More unfortunate is to see how the residents and interns who are part of the research team keep mum about this due to ulterior motives of getting their names published and out of fear and respect of their seniors.
Although it is impossible to completely eliminate such heinous acts by the medical personnel, they can be greatly reduced if patient awareness measures are implemented by our hospitals. This can be done by putting up multilingual posters in the patients\' waiting room and inside the doctors\' office. Reading material should also be made available for patients so they know their rights to consent. Seminars should also be held for students and nurses to make them realize their responsibilities to the patients as caregivers and to report such incidents to the ethics committee of the institute without having the trepidation of the senior medical practitioners.

Journal of the Pakistan Medical Association has agreed to receive and publish manuscripts in accordance with the principles of the following committees: