Indian journal of medical ethics最新文献

The rise of e-commerce has significantly broadened the marketplace, introducing greater convenience and accessibility to the desired products at the doorsteps of consumers. In recent years, even pharmacies have embraced the online platform. E-commerce plays a crucial role in providing technologically advanced healthcare services to all. While e-pharmacies provide numerous benefits, there are also inherent risks that can impact the health and well-being of patients. Since no legislation in India specifically deals with the e-pharmacy sector, they are governed by the existing legislation that regulates the pharmaceutical industry. This paper seeks to analyse challenges in regulating the e-pharmacy sector and to critically evaluate the applicability and effectiveness of the existing legislations in ensuring the safety and integrity of online pharmaceutical transactions in India.

Medical education in India appears to be failing on multiple counts. Much has been written on this subject, including in this journal [1, 2]. Yet, little seems to have changed and in fact, disturbing new trends have arisen. An article in The India Forum by historian and medical commentator, Kiran Kumbhar, points out glaring errors of assumption and planning by the Government of India (GOI) and its Ministry of Health [3]. This has led to the mushrooming of privately-owned medical colleges without adequate infrastructure and faculty, leading to low quality medical education; in time this will result in low quality healthcare services. For some years now, authorities have cited a World Health Organization (WHO) requirement of "one doctor for 1000 patients" for an effective health policy; Kumbhar points out that such a WHO metric does not, in fact, exist! [3] Ostensibly, under pressure to achieve this unsubstantiated target, the government has encouraged privatisation of medical education, focused primarily on achieving the desired numbers of doctors. Recently, the Government even claimed success in achieving this magical ratio, using doubtful data and statistical calisthenics [3], even while the health metrics of the country continue to be woefully low, and millions do not have any access to affordable medical care.

High diffusion of the use of baclofen in patients with alcohol use disorders (AUD) in India has raised concerns from Braillon and Naudet. They say the practice is based on poor evidence and ignores possible harms to patients. This article critiques their arguments and makes a reasoned, ethical, and evidence-informed case for baclofen as a treatment option for AUD, albeit a second-line one, especially because of issues with acceptability and cost of other approved pharmacotherapies.

We at Equitable Healthcare Access Consortium (EHAC), a consortium of healthcare organisations and individual practitioners committed to ethical and equitable healthcare in India, wish to express deep concern over the recent First Information Report (FIR) filed by the Central Bureau of Investigation (CBI) [1] and subsequent report that appeared in The Lancet [2]. The FIR implicates officials from the Ministry of Health and Family Welfare, external assessors of the National Medical Commission (NMC), doctors affiliated with private medical colleges, and various intermediaries and administrators.

New medical graduates and pre-clinical doctors face a dilemma when confronted with in-flight medical emergencies. Intervening could raise ethical, legal, and practical concerns, while staying quiet may violate the moral obligation to provide care. This reflective essay discusses the challenges, including lack of standard protocols, racism, and sexism experienced by doctors in-flight. It also highlights the importance of reciprocity and proposes solutions like standardising medical kits. In conclusion, pre-clinical doctors can play a crucial role in in-flight emergencies, and should respond confidently to an emergency call. A nuanced discussion is necessary to determine their role.

The Supreme Court of India had, in a public interest litigation based on an article by journalist Sukanya Shantha in The Wire, sharply criticised existing prison manuals for several clauses reinforcing the age-old injustices of caste-based discrimination and segregation. The Court found ample evidence of this discrimination, both in prison manuals and in the administration of Indian prisons, and instructed the authorities to ensure corrections within three months. While the Court's verdict is commendable and much needed, these violations only reflect the discrimination prevalent in the larger society, in spite of the Constitutional guarantee of equality before the law. This commentary argues that such discriminatory practices should not only be banned in prisons but actively prohibited and jointly addressed in society at large by the Courts, the Legislature, the Executive, as well as the media.

Background: Global healthcare research suffers from inequalities, favouring high-income countries, which hampers fair healthcare access. Low and lower-middle-income nations face limited participation and editorial bias, posing concerns for research integrity. Potential reasons for this pattern might be the overrepresentation of researchers from the Global North on editorial boards, disparities in the quality of scientific research, lack of support for local research initiatives, and challenges posed by language barriers. The aim of this study was to assess data transparency and representation patterns of low- and lower-middle-income nations on Editorial Boards of prominent Internal Medicine journals.

Methods: The top 50 journals in the "Internal medicine including allied super specialities" subject category were selected based on SCImago journal ranking, journal impact factor, literature research and journal citation report. We examined the editorial boards of these journals using the World Bank Income Criteria.

Results: Out of 2406 editorial board members of leading journals, only 5(0.21%) were from low-income countries (LICs), while lower-middle-income countries (LMICs) and upper-middle- income countries (UMICs) constituted 64(2.67%) and 176(7.31%), respectively. High-income countries (HICs) dominated editorial boards, with 2161(89.8%) representation.

Conclusion: Editorial boards of top Internal Medicine and allied super-specialty journals lack adequate representation from low and lower-middle-income countries. This deficiency has significant implications, affecting knowledge production, policy development, and the overall progress of science and research on a global scale. Urgent measures are required to establish a fair and inclusive scholarly publishing system that caters to researchers from all regions.

Background: As patient populations become more diverse, cultural and gender competency are increasingly important for clinicians to learn and practice. Cultural and gender competency in the doctor-patient interaction may reduce healthcare inequities perpetuated by structural and personal racism and sexism. Here, we assessed whether a medical humanities elective involving observation of fine art for premedical (post-baccalaureate) and first- and second-year preclinical medical students could enhance their cultural and gender awareness.

Methods: Over three cohort years of the elective, we assessed students' written responses to artworks for culture and gender references. We also surveyed students when they were in clinical rotations or practice regarding the perceived impact of the elective on their clinical skills.

Results: Medical and premedical students recognise, note, and interpret a variety of details regarding the culture and gender of people depicted in the artworks. Of the 93 student responses to the art pieces that we analysed (three years of the elective; five to six sessions per year; 2-8 students per session), 66% (62) of their responses noted culture and 73% (68) noted gender details. In the retrospective survey, most students agreed or strongly agreed that the art observation elective improved their awareness of their patients' cultures and gender and their empathy towards their patients.

Conclusions: This study suggests that electives involving art observation may enhance medical and premedical students' cultural and gender awareness and competency in the doctor-patient relationship. In the long term, increased cultural and gender competency by clinicians could mitigate ongoing healthcare inequities due to structural and personal biases.

This response to the critique of my reflection engages with concerns raised by professors at the Braun School of Public Health, HUJI. While acknowledging their disappointment, I reaffirm my central argument that Israeli academia, despite individual gestures, collectively failed to create an institutional culture enabling fearless engagement with Gaza's humanitarian catastrophe. Workshops and academic forums inadequately addressed the crisis, depicting selective empathy and technocratic detachment. Universities bear ethical responsibility during atrocities, their silence, intentional or systemic, risks complicity in injustice.

This narrative explores the journey of young paediatric surgeons through the metaphor of a cracked bucket that inadvertently waters flowers along its path. The story illuminates how perceived imperfections and vulnerabilities in medical practice often create spaces for deeper healing beyond technical excellence. By embracing both surgical precision and human compassion, trainees discover that their limitations can become strengths, fostering holistic care that addresses not just the physical ailment, but the emotional needs of patients and families.