Dr KK Aggarwal
Padma Shri and Dr B C Roy National Awardee
President, Heart Care Foundation of India
The era of Ram and Krishna represents two different perceptions of life. While Rama taught us the message of truthfulness,Krishna told when not to speak the truth and when speaking a lie is justifiable. Medical profession today cannot survive on the principles of Rama. According to principles of Krishna truth which if spoken may cause harm to someone and if not spoken does not end in any harm may not be spoken. Similarly, a lie which without harming the community may help a particular person or situation may be spoken. In medical profession doctors come across situations on a daily basis where speaking the truth may be harmful to the patient. Quite often false hopes are given and patients of terminal cancer are not told about their exact nature of illness and the prognosis. There is no way a doctor is going to tell the patient that you are going to die in the next 24 hours even if it is medically true.
Nacebo effect on the other hand means that if the patient is told that your illness is not going to cure even if medicines are given they may not act as the patient’s body produces negative chemicals which neutralizes the effect of even effective medicines.
Indian doctors were known for their social medicine which involve proper assessing of patients’ and their families’ financial status before deciding the treatment. There is no point giving options to a family to spend 10-15 lakhs of rupees for getting an ICD device implanted in the heart, which may increase life span only by one or two years or only give good quality of life for a few years. But to a family who cannot afford this amount of money and may have to sell their house or spend all the money saved for the marriage of their daughters.
But in today’s Consumer Act era not informing the family may even amount to negligence.