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Background material by Professor Omar Hasan Kasule Sr. for Year 1 Semester 1 Med PPSD session on 20th August 2008
1.0 RESPONSIBILITIES OF A PHYSICIAN
1.1 Responsibility to the patient
The physician is bound by fidelity obligations to provide the best care for the patient following all ethico-legal guidelines. The fidelity obligation is a contract and the physician cannot get out of it except when the patient is cured, or is referred to another physician, or dies. To this obligation must be added delivery of excellent and affordable care as well as working towards ensuring universal access.
1.2 Responsibility to the community
Physician is powerful person in the general society. He can use his position to play a leading role in enjoining doing the good and forbidding doing the bad. He can play a leadership role on many major and urgent social issues. He can advocate for the poor, the weak, and the deprived.
1.3 Responsibility to medical science
The physician has a duty to undertake research in order to push forward the frontiers of knowledge. Medical practice must be based on new knowledge that is produced by constant research. Research is needed to solve practical medical problems. The physician should publish in order to disseminate knowledge. He should also teach to share his knowledge with others.
1.4 Responsibility to the environment
The physician has to play a role in maintaining a clean and healthy environment as well as preventing environmental pollution. He can directly influence proper disposal of toxic and infectious waste from hospitals.
1.5 Responsibility to posterity
The physician should not think only of current responsibility but also of posterity. He must not encourage practices like selective abortion based on gender or other characteristics because they will lead to imbalances in the human genetic pool. He must consider long term effects of exposure to new drugs, chemicals, and radiation.
1.6 Responsibility to self
Because of pressure of work and the burden of responsibilities physicians may forget to take care of their own health or to leave time for their own recreation. What is needed is to achieve balance in time allocation so that the physician does not forgo his own personal welfare.
1.7 Responsibility to family
The physician must allocate time for his family from his heavy schedule.
2.0 RIGHTS OF THE PHYSICIAN
2.1 Material comfort and financial compensation
Material motives cannot be completely ignored in the name of idealism. A minimum of comfort is necessary for the practice of virtue. The physician should be recompensed adequately for his services. Inadequate material rewards often result into frustration or even brain drain when young physicians leave their country or the medical profession to better pastures. Incentives for graduates to work in rural or depressed areas or choose unpopular but necessary specialties lies beyond the control of medical educators. The medical school can however maintain motivation for its graduates by means of continuing medical education programs.
The physician working in a materialistic society is torn between contradictory forces of greed and service. Service should have the higher priority but the material rights and privileges of the physician should not be forgotten because he also wants to live a happy life. The prophet talked a lot about payment of the physician. The physician fee should be fixed and known in advance. The prophet paid the cupper who operated on him. The physician fee must be known in advance.
2.2 Continuing medical education
The physician should be encouraged and assisted to attend medical meetings and refresher courses to keep his skills and knowledge update.
2.4 Professional freedom and professional independence
The physician as a professional should be free in the exercise of his profession and his work performance can only be reviewed by his professional peers and not managers or administrators outside the medical profession.
2.5 Refusal of medical procedures based on conscience
The physician should be free to refuse undertaking procedures such as abortion if he feels that they violate his personal values.
2.6 Torture or degrading punishment
The physician should not forced against his will to participate in cruel or degrading punishments or torture.