DOCTORS’ STRIKE: ARE THEY LOYAL TO THE HIPPOCRATIC OATH?

The health service began as a vocation like the priesthood. Top priority was given to the welfare and well being of patients. Medical doctors when they pass out still take the Hippocratic Oath which says in part : “I swear to fulfill, to the best of my ability and judgment, this covenant: I will respect the hard-won scientific gains of those physicians in whose steps I walk, and gladly share such knowledge as is mine with those who are to follow. I will apply, for the benefit of the sick, all measures which are required, avoiding those twin traps of over-treatment and therapeutic nihilism. I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon’s knife or the chemist’s drug.”

These immortal words come to mind as we reflect on the consequences of another strike launched yesterday by the Government Medical Officer’s Association (GMOA) which often boast of being one of the biggest and most powerful trade unions in Asia. Those who suffered most because of this strike were tens of thousands of poor patients who came to public hospitals as early as 5.00 am but were turned away without treatment.

Over the past few decades, especially after 1977 when Sri Lanka swallowed wholesale the globalized capitalist market economic system, the health service priorities have changed. No longer is the highest priority given to the well-being of patients. Instead we see more and more private hospitals being set up with the wealthiest business people investing money in them because private hospitals have become one of the biggest profit making businesses. With the change of priorities the medical doctors’ vocation, with some exceptions of course, became a profession and is now a profit making business. So the patients’ well-being has been degraded to priority number 03 if not lower.

GMOA leaders say their strike was launched on various demands ranging from their income tax payments being raised from 12% to 24% and the admission of their children to prestigious national schools, to issues connected with the free trade agreement between Sri Lanka and Singapore. But government leaders have pointed out that the income tax increase will apply only to medical doctors earning more than Rs. 350,000 a month while for others it will remain at 12%. Government leaders also accused GMOA leaders, mainly its President Dr. Anuruddha Padeniya, of indulging in party politics.

Social analysts are also raising major questions on the regular strikes in the health service and other essential services. They are asking whether the government should consider a ban on strikes in essential services, because essentially those who suffer most are millions of poor, innocent and helpless people. They say that just as strikes are not allowed in the security forces, the government should consider a ban on strikes in essential services such as health, transport, postal and telecommunications.

Instead, there is a better and more effective way of conflict resolution through dialogue. For this both parties need to have the dialogue with an open mind, with awareness that their view or understanding of the situation is always relative and never absolute. This paradigm shift is essential. Then the two or more parties could come to some accommodation on the hallowed middle path. This is known as synergy, where one plus one will make not two but three. That means something new or a reasonable solution on the middle path.

For decades, patients’ rights groups had campaigned for a national medicinal drugs policy based on the principles of Professor Senaka Bibile, widely acclaimed as a prophet of modern medicine. Transnational drug giants or mafias had campaigned against the Bibile policy which was essentially intended to provide quality drugs to the people at affordable prices. Transnational drug mafias are reported to have given billions to politicians to prevent the implementation of the Bibile policies. The new government however implemented the Bibile policies, but much more needs to be done to restore the priority given to patients in the health service and dialogue is the best way of resolving conflicts which arise in this vision and mission.