Wednesday 19 July 2017

Unconditional beneficence and absolute non maleficence: The hallmarks of a doctor

Unconditional beneficence and absolute non maleficence: The hallmarks of a doctor “Doctors are next to God”, “Doctors heal, God treats”. These are some oft-repeated well-known phrases. And, much has been written about how doctors have been accorded a ‘God-like’ status in society, which places them “on a pedestal” at a level higher than other profession, though this image of a doctor seems to have slowly eroded over the years. God is omniscient, omnipotent and omnipresent. We seek His refuge in our hard times all the time and have absolute trust in him because he is all-knowing, all-powerful and present everywhere. God is the person in whom one has blind belief and faith. He is there for all of us. Doctors are professionally trained to take care of the sick, look after the health of their patients and also of the community. During illness or in a life-threatening situation, doctors remain the last hope for families and patients put the same belief and faith in doctors to help them as they do in God. Non-maleficence (do no harm) and beneficence (do good) are the two of the four major principles of medical ethics, the other two being respect for autonomy and justice. These are the guiding values of medical practice. Doctors act in the best interests of the patients for their well-being and prevent harm to the patients i.e. treat the patient in a way that does not harm the patient. But, patients are more than just their disease. Doctors should have unconditional compassion and empathy towards their patients to give the best possible care to them, without being judgemental or biased or prejudiced. These are factors that influence patients’ perception of their doctor, sometimes even more than the actual science of medicine. Therefore, I add two adjectives “unconditional” and “absolute” to the two guiding bioethics principles i.e. “unconditional beneficence” and “absolute non maleficence”… just as God loves us all unconditionally and anybody can seek Him. A doctor who has these two qualities perhaps can be said to be God-like. Almost a century ago, in 1927, Dr FW Peabody wrote in an article in JAMA “One of the essential qualities of the clinician is interest in humanity, for the secret of the care of the patient is in caring for the patient”. This is as relevant today as it was then. Dr KK Aggarwal National President IMA & HCFI

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