Surgeons and ethics : A time to introspect

Abstract

Ethics is a set of behaviour expected from a group of people. A person from a cluster is expected to behave accordingly even when single. This group behaviour is an interesting behaviour which is seen in animals too, which is known as herd behaviour. Such kind of behaviour is seen prominently in the insect kingdom. This phenomenon is probably a remnant of our wild past.  When Surgeons are taken as a herd or community it is seen that the group need to work under contradiction at time. “Primum none necere” is an ethical constant for the group. It literally means “Primarily do no harm”. It is confusing at times. Sometimes harming one may be the only way one can save one. For example, a tracheostomy for ventilation in a medical cause. Donor Hepatectomy in Live related case is another. Choosing a new mesh for hernia for the first time ever. When you come across reports that the Mesh you favoured is being withdrawn from the market for the complication rates, it causes acute anxiety. This acute anxiety, amongst the ethical persons of the community, causes a dilemma. Doubts occur, whether the ethical behaviour is violated by them. To keep the surgeons in a set of behavioural boundary, some guidelines were brought in as legal bindings in the early nineteenth century. Initially these were unorganized and later from the mid nineteenth century in codified manner. First it was established in the US of A and few years later in the UK.In India the ancient Medical healthcare system considered Surgery as the most important subject. The Education system was under the control of the sages and ethics was a strong component of the students. But as the whole world embraced the modern medical education system brought in by the West, the set of behaviours changed. It brought many positive effects but along with it the unfair competition for the economics. As a result it created ethical conundrum in the minds of the ethical surgeons.