The medico-political climate of near total mistrust:
There is a huge dichotomy between “the internal view” (as Amartya Sen calls it) of the healthcare system and the external view of the man on the street about what the purpose of healthcare is. Is it to consider health as a commodity, generating as much profit out of healthcare as possible, concentrating on prolongation of the heart-beat and not caring about the suffering associated with health issues? Surprisingly, many health professionals and many laymen believe so. The man on the street is totally confused and suspicious.
And everyone looks for easy solutions.
It is time we choose to look at the problem in all its complexity, identify solutions even if difficult and to address them. The solutions include:
- A discussion involving medical ethicists, health care managers, and social activists about the duty of the medical profession being not only to cure diseases but also to treat serious health-related suffering (SHS).
- A clear enunciation by statutory bodies like Medical Council of India and Indian Council of Medical Research that the duty of the medical profession is not only to cure; but rather, as the 14th century aphorism taught us, “to cure sometimes, relieve often and comfort always”.
- Rational re-drafting and enactment of the end of life care law that has been pending with the Government of India since mid-2016.
- Inclusion of palliative care as an essential part of health care and education as envisaged in the new health care policy of India and in the world health assembly resolution of 2104.
True; it will take time and effort, but if we do not start the process now, the current abysmal situation can deteriorate even further.