ethics

Meanwhile, in India (an ethical issue)

Robyn, , , 4 Comments

Imagine you’re a woman. Easier for some than others, I know. You’ve got this pear-shaped organ inside you that’s capable of creating and sustaining life and delivering it to the world. It’s amazing(ly terrifying). This organ is so intimately connnected with you that every month you are forced to (reluctantly) acknowledge its existence. This organ and it’s little helpers are the very fundamentals of who you are as a woman.

Now imagine some greedy upstart of a doctor reaching inside you and ripping it out for no good reason.

That’s exactly what private medical practioners in rural India are being accused of doing. It’s a pretty strong claim. But when you have villages with 90% hysterectomy rates (and most of the women under 30), those numbers are hard to explain. It’s hardly likely that 90% of women in one village in rural India fulfil the indications for the removal of their uterus. Yet it happens. And most of the stories are along these lines:

“I went to the clinic because I had heavy bleeding during menstruation,” she says. 

“The doctor did an ultrasound and said I might develop cancer. He rushed me into having a hysterectomy that same day.”

That is a really crappy build up to taking someone’s uterus out. You need tests which can prove that yes, there is definitely something going on in your uterus (the gold standard CT scan) and yes, it may quite possibly kill you (biopsy). You need informed consent.

Medical advocates in India are understandably upset about this. But it has been happening for years. When will it stop? Who knows. Maybe when someone with enough power and motive is alerted to the situation. Maybe a charity. Maybe Obama.

But the key issue remains the state of India’s health sector, which is being financially starved by its government. Oxfam reports,

The gap left by the public health system combined with a government policy of proactively promoting the private sector has led to the proliferation of private health providers which are unregulated, unaccountable, and out of control.

Just how pervasive is this practice, and how much work will be needed to ameliorate the situation? Can the Indian government do this on their own? I’m sure there are plenty of tangled socioeconomic issues at play here. But I think it is primarily a problem of standard, and the standard for ethical medical practitioners in India is far too low.

Original Oxfam report here.

Things that make me mad – laws that convict people trying to do a good deed

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This article from our local paper and this one from the Washington Post are both about Lloyd Goldson, a gynaecologist from Kingston who was arrested a week ago for performing an abortion on a twelve year-old girl. Her mother is being charged as well for cruelty to a child. Come to think of it, I’m not sure which child she’s being charged for.

Surprisingly I’ve never ranted before about abortions (or other morally dubious medical strategies). It’s weird, because this is such a passionate topic for me. Ever since high school, the great “abortion debate” has been waged, and I’ve somehow always been the only (or one of the few) pro-choice camper(s). And I use the word ‘debate’ loosely, because I don’t think any number of convincing arguments is going to convince this government to legalize abortions any time soon. Church. State. Nuff said.

So when I heard this tidbit come over the radio this morning on my way to school, I saw red. And it wasn’t just the colour of my school bus. The people behind me were arguing that abortion was illegal, so why do doctors keep doing them anyway? And in class why do they always mention terminating pregnancies so casually, like you can’t potentially lose your license by doing it? That was their argument.

So I turned around and (innocently, innocently I tell you) asked,

“So what happen to the asshole who go breed the girl in the first place?”

Whereupon they agreed that of course he should be brought to justice as well. But inside I was still churning. They are going to arrest the mother who brought her little girl to the doctor to help her, and the doctor who was trying to do a good thing. Yet the man who either (a) raped this girl or (b) had consensual sex with a minor (and it’s still rape, guys) is walking around scot-free. I find that fundamentally wrong.

I really feel for the doctors when I hear these cases, because they are sworn to “do no harm” but yet have to navigate all kinds of moral morasses in order to preserve life. And before someone gets self-righteous and picket-y, the doctor’s patient was the girl in this case. Not her unborn foetus. Twelve year olds are simply not equipped to have children; and he had to decide if the pregnancy would do more harm than the treatment (i.e. the abortion). If he’s as good a doctor as they say, then he’d have made what he thought was the best decision given the situation. I just hope they don’t lynch him for it.