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.
Dharma, artha, kama and moksha are the four basic purposes of life for which we are born. The basic purpose of life is to fulfil our desires in such a way that we end up in inner happiness. Fulfillment of desires should be done by following the principles of righteous or ethical earning. Taking more money from the rich and helping the poor is what the medical professionals are taught from day in and day out. This principle will fall more onKrishna’s principle than on Rama’s. most charges in the hospital settings are different depending upon the categories chosen by the patient. A single room patient invariably has to pay more than a patient admitted in the concessional three-bed room or general ward. Even the charges of the treatment, operation theatre, investigations and consultations may be different depending upon the categories. Placebo therapy is a well established therapy in medical science which means treating the patient without giving the actual drug to a patient.this information that the drug does not contain any ingredient is withhold from the patient in this type of therapy. As per the literature 35% of the illnesses and symptoms may resolve using a placebo and is based on the principle that the very feeling that a medicine is being given stimulates the inner body pharmacy and produces healing substances and chemicals.
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.