Junior doctors in Patna have started an indefinite “doctors’ strike” demanding a higher scale of payment for their service. While the members of the medical profession joining a “strike” to settle their personal demand against the government and in the process, disrupting the entire hospital function putting the lives of the innocent patients in great peril is unthinkable in the developed countries, “strike” by our healers is not new in India. One shudders to imagine how doctors can easily disregard the Hippocratic Oath of serving the humanity first and simply stop working to satisfy their selfish interest putting the healthcare services in total disarray. Leaving aside this ethical question, do doctors have a legal right to go on a “strike” putting the lives of defenseless patients in serious danger? Who should be held responsible for the death of the innocent patients who died as a result of “doctors’ strike”? The government as well as the members f the medical community who have participated in this “doctors’ strike” must answer these important questions.
The picture of a “doctors’ strike” is blatantly repulsive anyway you look at it. Even when only the “junior doctors” go on a strike, patients in need of urgent medical care are denied life-saving treatment because the junior medicos form the backbone of healthcare in the hospitals. The most unfortunate aspect of the present junior “doctors’ strike” in Patna is that most of the victims would be the patients who hail from the lower socioeconomic strata of the society since they have choice to attend the pricy private hospitals. One thing is absolutely certain is that the ultimate price of any “doctors’ strike” is always paid by the defenseless patients– sometimes literally through their lives as many patients have already died because of the present strike by the junior doctors in Patna. Obviously, doctors do not have a moral right to go on a “strike” at the expense of the vulnerable patients.
Although there can be no argument that a peaceful “strike” by workers in most jobs is an important tool to fight injustice in the democratic societies. But workers who are involved with providing essential public services like healthcare cannot have a right go on a “strike” and undermine the safety for the rest of the society. The Article 21 of the Indian Constitution guarantees protection of rights to life and personal liberty for all people. The Supreme Court of India has corroborated this notion many times in the past that the rights to go on a “strike” by some in a single profession can never supersede the combined rights for life and liberty for countless others in the society. In a historic judgment in 2003 involving the striking government employees in Tamil Nadu (T.K. Rangarajan vs. State of Tamil Nadu; Civil Appeal No. 5556 of 2003), the Apex Court has ruled against the striking workers and categorically said, “Government employees cannot claim that they can take the society at ransom by going on strike.” Obviously, doctors also cannot have a right to go on a “strike” and take the helpless patients at ransom to settle their personal disputes with the government. In fact, doctors in Delhi went on a massive strike to protest against the “quota” resulting in acute disruption in essential hospital services and several patients died waiting for treatment in the Emergency ward in 2006. A public interest litigation (PIL) was filed against the striking doctors and the Medical Council of India (MCI) through a writ petition (People for Better Treatment vs. MCI & Ors; W.P. Civil No. 316/2006) seeking a complete ban on “doctors’ strike”. The Apex Court has already issued notices to the respondent medicos in this case which might have significant implications on “doctors’ strikes” in India.
But even without any repercussions from the courtroom, the “Code of Ethics and Regulations” framed under the MCI Act which is binding on all practicing physicians in India also has strong prohibition against any doctors’ strike. The Section 2.1.1 of the MCI “Codes” has categorically stated that doctors cannot refuse treatment to a patient who is in need of emergency medical care. While a doctor may be able to wriggle out of a situation for his refusal to treat someone suffering from an insubstantial medical condition, he cannot deny therapy under any ground to a critically ill patient. Obviously, the death of several patients following the “doctors’ strike” in Patna is in clear breach of the MCI Rules. The striking doctors should face disciplinary action from the medical council for violation of the MCI code of ethics. They are also liable for cancellation of their medical licenses for professional misconduct under the MCI Act. In fact, if charges are pressed against the striking medicos for violation of the MCI Act, it would be extremely difficult to defend that a patient was not in need of urgent medical care when he/she actually succumbs without receiving any treatment. Ironically, not many in the medical fraternity are even aware about the intricate MCI rules and regulations and that they must follow the stipulations as framed under the MCI Act. The junior doctors would be well advised to stay away from “doctors’ strike” as it can lead them to more serious problems. Unfortunately, unlike in the Western countries, the medical council in India primarily functions to shield their errant medical colleagues without caring for the lives of the ordinary people. This is why doctors in India frequently resort to “doctors’ strike” without much fear to settle their score with the government. If previous history provides any indication for the future, it can be safely predicted that the striking doctors in Patna would face no disciplinary action from the medical council no matter how many patients eventually die.
It must also be said that the gripes made by the junior doctors in Bihar demanding a higher salary may also deserve some consideration. It is reported that the junior doctors in Bihar are paid much less than their counterparts in other states. If this is true, they obviously have every reason to be unhappy and to blame the health department. But junior doctors should not resort to a “doctors’ strike” and deny therapy to the ailing citizens even to settle their legitimate demands from the government. Whether or not their strike is able to cause any anxiety for the debauched political leaders sitting in the health department, it can certainly devastate many innocent families who cannot afford to take their loved one to the expensive private medical clinics and would have no choice but to see them dying without any treatment. The Hippocratic Oath preaches that any financial reward should only be a subordinate consideration for everybody in the noble profession of medicine. The modern day doctors in India should not become totally oblivious of the oath from the father of modern medicine and they should at least ponder once about the pain of the innocent patient left untreated at the hospital doorstep before taking decision to abandon their hospital duty and join a “doctors’ strike”. Public trust in our healers has been plummeting in the recent years for more reasons than one. Further erosion of the doctor-patient relationship is likely to occur from frequent “doctors’ strikes” in India which only upset the essential hospital services that are already substandard and bring added miseries for the poor patients in India. The trade-union mindset of our medical leaders has no place in modern day medical science.
It is easy to be philosophical and perceive doctor's strike as repulsive. Doctor's belong to the same society and have similar problems and needs as others. They spend more years in training in comparison to other professions and have a life long learning culture. This does need to be recognised and rewarded. The decision to strike is not taken lightly by the medical profession and it is always a last resort. It is easy to blame the doctors rather than dig deeper in understanding their needs and support them early so that such strikes could be averted.
It is a fundamental right of doctors in Government Hospitals in Bihar to strike. In fact, it is their birthright. Strike is their routine affair. Only those days on which these doctors are actually present on the premise of Government Hospitals are extraordinary and these rare days should be viewed or discussed as exception to their strike duty.
These doctors are highly educated goons. I am not very convinced about what they were taught in their classes, but I am very sure of what they learned in their tutorials. All they grasped was to make or churn more and more money from hapless patients. They never read “Code of Ethics and Regulations” from Medical Council of India. They don’t give a damn about the plight of the patients. They are alien to the word “service”. They do not care if the patient survives or expires. It does not ring a bell in their ears that over fifty lives have been untimely lost because of their last five days of strike. It does not bother them at all. They have absolutely no morality.
They want their salaries to be raised. They want their LTC to be increased. They want their DA to be extended. They want their paid vacation days to be more. They want their ranks to be topped. They want their work hours to be decreased. And, they won’t return to work until all these conditions are fully met. For strike is their birthright.
Most senior and junior doctors of Government Hospitals across India also have a private practice. Even if they do not own a clinic, they work at a private hospital. Even though it is illegal under Government of Bihar and Government of India directives, it is hardly enforced. The striking doctors want their private practice/business to flourish, not the Government Hospital. As long as they are in strike mode, it serves them doubly. First, they get more hours to run their private practice/business and secondly, the poor hapless patients of the Government Hospitals will be forced to see a private medical practitioner. The fact that patients are vulnerable only makes their strike a more profitable business.
May better sense prevail on these striking doctors!