Healthcare ethics in PH

Caring for the health of people is a most sensitive and demanding profession because it directly affects life itself and the quality of a person’s existence. For this reason, as can be gleaned from inscriptions on ancient clay tablets, medical practice has been reserved for the most respected, credible, ethical and compassionate intellectuals in the community. Which gives us an idea of how the medical profession was looked up to since time immemorial.

The clay tablets were found by a German archaeologist among the artifacts recovered from an excavation of ruins in the Sumerian city of Babylonia. The German archaeologist discovered the ruins under the Arabian desert between the Tigris and Euphrates rivers of Mesopotamia.

In Greek mythology, Hammurabi and Asclepius, both physicians, became gods after death because they were benevolent icons of power and good behavior. But since physicians in those days came from rich, influential and powerful families, Hippocrates, a Greek philosopher and a genius with foresight, had some reservations about the profession, which he expressed during a council meeting: “Who will watch the gods in their activities?” So, he composed the Hippocratic Oath, which became the creed by which doctors have lived by through centuries and generations, and up till now.

In modern times, medical practice has become more complex, comprehensive and far-reaching but, fortunately, more precise and effective because modern technology can now clearly demonstrate the absence of disease; or can define its extent or limits whenever or wherever it is a problem. Indeed, modern technology can indicate the consequence of treatment by serial monitoring. Ergo, the diagnosis and management of illness have become more definitive because it is evidence-based. Erstwhile, the art of healthcare relied on experience and crude technology support.

In the Philippines, the quality of healthcare has been upgraded to international levels because of the 150,000 Filipino physicians spread around the world, 80,000 have opted to establish their practice at home. Many of them pursued postgraduate training overseas but they decided to return home and have diversified their fields of interest. And they have not limited themselves to private practice; they have ventured into government service and the academe as well.

Because of excellent nursing care, together with modern pharmaceutical remedies, reliable paramedical assistance and technological facilities, all of which are accessible in the country’s modern medical centers, healthcare service in the Philippines has been categorized as world-class.

Health maintenance organizations subsidize excellent healthcare and has enabled a larger number of patients with limited budgets for health to access the same. Which in effect has extended the life span of the Filipino from 40 years before World War II to 70 years at present.

Contributory to good quality healthcare and its resultant wellness is the strict ethical mode required of health providers. For physicians, the ethics of medical practice include:

1) appearance and behavior, which should be beyond reproach;

2) medical knowledge and expertise, which should be updated;

3) ability to determine, with the aid of modern technology, the state of health of the patient, the absence or presence of illness, what is necessary to restore health, what would be the outcome if treatment is administered, or the consequence if no remedy is instituted, and how much it will cost to underwrite the proposed necessary healthcare;

4) cordial relationship with their colleagues and other healthcare providers;

5) mindset and ability to work together in harmony and mutual respect in the delivery of healthcare;

6) primary concern for the welfare of the patient, with professional fees only a secondary consideration and commensurate to patient’s capacity to pay;

7) readiness to cooperate with the authorities in promoting and providing community healthcare.

The Philippine Medical Association (PMA) oversees the ethical, moral and legal responsibilities of physicians, as provided for in the Medical Act of 1959, as amended. Because physicians are also human, it is possible for them to commit errors in their practice and in their service to patients. Such incidents do happen occasionally— given the human factor of healthcare. But as part of its public service, the PMA has set up a structure through which aggrieved parties can seek redress.

Santiago A. del Rosario, MD, a former president of the Philippine Medical Association, currently chairs the association’s ethics commission.