Sunday,2007-1-28: Concerns for the Health for All
The Mirror, Vol. 11, No. 492
The Prime Minister took the opportunity of the inauguration of the new Cambodian-Korean Friendship buildings at the National Pediatric Hospital to call for the upholding of ethical principles in the field of medical care. He referred to two incidents which allegedly had happened where at other medical institutions completely unacceptable discrimination had been practiced. Treatment for a child was refused, because the aunt of the child who brought it had voted for a political party not in favor at that hospital, and in another case, a patient was transferred to another hospital – again for allegedly having a preference for a different party from the one held in respect a the hospital he had entered first.
If such cases happen, they are in violation of fundamental principles of medical ethics. The internationally most widely known formulation of medical ethics, which has been considered as reference through many centuries in the countries of the European culture and beyond, is the Oath of Hippocrates, dating back to the physician Hippocrates in Greece, a text that is about 2400 years old.
Some elements of this commitment of a physician have been set aside, as they did not fit into later and other contexts – like to swear this promise to the gods of the Greek religion, or the promise that a physician will teach medical science only to his own sons and to the sons of his teacher, and to nobody else,because they are not bound by the same oath.
But some other elements have been kept through the ages:
“I will follow that system of regimen which, according to my ability and judgment, I consider for the benefit of my patients, and abstain from whatever is harmful and mischievous.
Into whatever houses I enter, I will go into them for the benefit of the sick, and will abstain from every act of mischief and corruption; and, further, I will abstain from the seduction of females or males.
Whatever, in connection with my professional practice or not, I see or hear, which ought not to be spoken of about, I will not divulge, reckoning that all such should be kept secret.”
These basic principles were considered fundamental through the ages: the benefit of the patient as most important; a physical will not engage in economic or sexual exploitation; and whatever information is received – “in connection with my professional practice or not” – will be kept secret.
Modern medical and social developments, and the conviction that medical practice has to be based on an ethical basis, led to new formulations. The Declaration of Geneva, adopted by the General Assembly of the World Medical Association at Geneva in 1948, has been widely used as a model for a text which young medical doctors have to solemnly declare, before they are accepted as licensed medical practitioners:
- At the time of being admitted as a member of the medical profession:
- I solemnly pledge to consecrate my life to the service of humanity;
- I will give to my teachers the respect and gratitude that is their due;
- I will practice my profession with conscience and dignity;
- The health of my patient will be my first consideration;
- I will respect the secrets that are confided in me, even after the patient has died;
- I will maintain by all the means in my power, the honor and the noble traditions of the medical profession;
- My colleagues will be my sisters and brothers;
- I will not permit considerations of age, disease or disability, creed, ethnic origin, gender, nationality, political affiliation, race, sexual orientation, social standing or any other factor to intervene between my duty and my patient;
- I will maintain the utmost respect for human life;
- I will not use my medical knowledge to violate human rights and civil liberties, even under threat;
- I make these promises solemnly, freely and upon my honor.
At the time of this writing, I do not have information what formalized, official standards of medical ethics are used in Cambodia.
But this type of a publication on the Internet, with the possibility that readers can add “Comments” at the end: observations, opinions, questions, or suggestions, – allows all readers to actively participate in and promote public discussion about common concerns.
All readers are invited to make use of this possibility. Please make frequent use of it.
The Prime Minister said:”If you were a doctor, you had to treat all patients. This is called the basis of medical ethics. One has to remember that two or three people could affect the general reputation of all medical doctors… When patients arrive, never should a doctor ask for whom the patient had voted.” It is hoped that this basic humanitarian principle will not be violated – it affects the health of a person. But its violation by some individuals affects the health of the whole society.
During this week, also another concern about discrimination was expressed. Though, as the Committee for Free and Fair Elections in Cambodia – COMFREL – reports, fortunately “no candidates or activists of any political party were murdered during this period,” however, “members and activists of other than the ruling party have fear and face many difficulties in performing their networking activities and arranging candidates for the [upcoming commune] elections.” This, too, violates basic ethical principles – in this case set by the Constitution of Cambodia, which defines the Kingdom as “a multi-party liberal democratic regime guaranteeing human rights and the respect of law.” COMFREL calls on the National Election Committee to continue “to play its role, especially to help to intervene with the media, especially television, so that all political parties can use the media to publicize their activities.” In this case, too, the activities of even only two or three people affect the general reputation of the electoral procedures.