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Living
together in society
--
Dr R Neerunjun Gopee
At
the initiative of its Public Relations Office, the
University of Mauritius held a seminar on20 December 2005 on
the theme “Living Together in Society: Philosophy and
Values.” I had the honour to be invited to speak on “The Values Dimension of
Medical Practice.”
A
couple of months ago I received the visit of a friend of
mine, a retired primary school teacher who had been in the
profession for nearly 40 years. Inevitably, we reflected
upon the ills, conflicts, antagonisms and misunderstandings
that were responsible for the deteriorating social
atmosphere. We remembered our younger days when we had
unconditional respect for our teachers and elders, and when
politeness, hard work, discipline, trust, honesty and an
implicit solidarity amongst neighbours formed the firm
bedrock of a society which survived on limited means and
resources.
What
a pity that some perverted minds thought it fit to deride
the “carnet
la boutique”
– but a lot of us know that the carnet
was
a lifeline, a document of trust against which rations were
issued and paid for, credit being accorded wherever this was
required and possible. It formed the bond between the
trusted owner of the “la boutique du coin” and
his clients, most of whom could never pay cash for their
rations, and had to wait till the end of the month when they
got their wages to be able to pay – without interest.
At
one point during the course of our conversation my friends
pontaneously said, “We can live very happily in this
country if only we know how to live together.” If only…
This is the down-to-earth observation of a mature
educationist who has helped to form and raise several
generations of Mauritian citizens. That a seminar has had to
be held on living together is no doubt a testimony to how
far we have drifted from this social ideal although, when we
look around and see what is happening elsewhere where social
explosions have taken and keep taking place with inordinate
violence accompanied by loss of lives and much destruction
of property, we can fairly say that we are not doing too
badly here.
However,
there is always the possibility that some misguided hotheads
might incite others to light a spark that could turn into a
conflagration, and at times some of the near-hysterical
reactions we come across about topics that need more serene
consideration e.g. education can raise temperatures to
ignition point. And thus the initiative of the PRO of the
UOM is to be saluted as a good first step in the direction
of more objective reflections on the state of our society
and its future orientations. It is only through such
dialogues that we can define more clearly the type of
society we want to create and leave for our future
generations, since at present we seem to be hopelessly
adrift.
Values,
of course, form the basis for a moral contract amongst
individuals. We know that values can never be absolute but
they must be universal, that is form part of a universal
moral order which is based on common sense and does not have
to be learned. For example, “not causing harm” is a
universal value – because nobody, not even an animal,
wants to be harmed – but it is not absolute: at times a
parent has to spank a child so as to correct him or a
surgeon has to use a knife to incise an abscess or perform
an operation. In both these examples the act performed may
appear to be harmful but since the intention is right the
act conforms to the universal moral order and is therefore
acceptable.
The
special set of values that guides the individual’s choice
of action is known as ethics, and the medical profession was
perhaps the first to swear by a code of ethics widely known
as the Hippocratic oath. It has been superseded by a more
appropriate version in modern times, but it still enshrines
the basic values on which medical practice is founded.
Fundamentally, doctors have duties towards their patients,
towards their colleagues and towards society respectively.
This was the three-pronged approach that was used while
preparing the code of practice when the Medical Council of
Mauritius was first established, and although we referenced
widely and thoroughly the models existing in several
countries, in the main we based ourselves on the General
Medical Council of the UK.
As
far as we know it is the oldest medical council to have been
established in “modern times”, having been enacted in
1858 if my memory serves me right. From time to time it
becomes necessary to recast (“repackage”) what we have
gotten used to so as to suit it to changed and changing
contexts, and such an exercise was carried out by a working
party set up by the Royal College of Physicians of the UK to
look afresh at medical professionalism in view of the
“endemic demoralization of doctors” subjected to all
kinds of pressures from government and civil society while
in the performance of their duties. Their findings were
published in ‘The Lancet’, the prestigious medical
journal from the UK, and at the seminar Ihighlighted some of
them.
Thus,
medical professionalism signifies a set of values,
behaviours and relationships that underpins the trust the
public has in doctors and medicine is a vocation in which a
doctor's knowledge, clinical skills, and judgment are put in
the service of protecting and restoring human well-being.
This purpose is realised through a partnership between
patient and doctor, one based on mutual respect, individual
responsibility, and appropriate accountability. In their
day-to-day practice, doctors are committed to: integrity,
compassion, altruism, continuous improvement, excellence,
working in partnership with members of the wider healthcare
team. These values, which underpin the science and practice
of medicine, form the basis for a moral contract between the
medical profession and society. Each party has a duty to
work to strengthen the system of healthcare on which our
collective human dignity depends.
It
can be seen that these values – compassion, integrity,
altruism, etc., – do indeed conform with the universal
moral order, and by and large it can be said that the large
majority of doctors abide by these values and are dedicated
to promote the well-being of their patients. It is also a
service to patients that modern societies have legislated to
protect and compensate them whenever they feel medical
practice has fallen short of doing the best by them,
something which the medical profession itself has considered
to be just and right. It is also a matter of comfort to the
medical profession that those who are called upon to
adjudicate in such unfortunate matters perform with the
utmost rigour and according to equally substantial
principles and values, a far cry from the baying-for-blood
type of reactions that matters of a medical nature
inevitably give rise to in the sensation-mongering media.
At
the end of the seminar, a lady came up to me and said,
“Thank you, Doctor. You have restored my confidence in the
medical profession. I never knew that medical practice was
based on such sound values.”
I
understand that the UOM intends to pursue further this
series on living together and values, and I do hope that
this will indeed happen, without too much delay.
RN
Gopee
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