Strong opposition to exploitation in the field of medicine and unethical nexus between some doctors, drug companies and laboratories has started within the medical fraternity itself. About 100 doctors from different states met in February 2015 at the All India Institute of Medical Sciences in Delhi and discussed in detail unethical trends in the field of medicine and doctors’ role in them. Following that, a forum that opposes commercialisation of healthcare sector and adopts ethical practices in treatment – Doctors for de-commercialised, ethical and rational health care – was formed. A book – Voices of Conscience from the Medical Profession – which noted the bitter experiences of many doctors regarding unethical practices in the field of medicine was released at the conference.
Meetings of doctors in Kerala who think on similar lines were held in Thiruvananthapuram and Aluva last year by involving Dr Abhay Shukla and Dr Arun Gadre, who lead the forum. Many young doctors attended these two conferences. It was decided at these conferences to conduct awareness campaigns among doctors against kickback culture and the unethical nexus with drug companies and equipment manufacturers by upholding ethics of medical science.
Professional associations of doctors in many developed countries have adopted practices based on medical ethics. Most medical organisations have taken the stand that they will not receive any financial benefit from drug companies or equipment manufacturers that cannot be easily revealed to patients and the general public. Doctors and medical students are campaigning through many websites against the nexus between doctors and drug companies that is against medical ethics.
No Free Lunch is a forum formed by American doctors to make doctors and medical students aware that gifts received from drug companies are not free but inducements to sacrifice the interests of patients for the commercial interests of such establishments. Its website (http://nofreelunch.org) suggests many plans of action to resist the lure of drug companies. The forum organises many programmes. It gives certificates to those who sign up to the pledge that they will not receive gifts from drug companies, publishes a directory of such people, distributes pens and other items engraved with No Free Lunch to doctors in place of gifts from drug companies and organise lectures that reveal frauds committed by drug companies. Its website gives links to sources of scientific information about medicines and authentic studies on the nexus between doctors and drug companies. It contains slideshows that reveal marketing methods of drug companies. The website also gives details of organisations that give medicines at fair price to patients.
PharmFree is a campaign of the American Medical Student Association that adopts strategies and measures to counter the conflict of interest that the medical fraternity has with medical companies. PharmFree has prepared guidelines to form relationships with drug companies based on medical ethics. On the basis of this, PharmFree has published on its website a model curriculum that should be adopted. PharmFree is trying to enact laws to shield the medical fraternity from the bad influence of drug companies. It also participates in protests to end market-based drug pricing to ensure that patients get medicines at affordable prices.
Healthy Skepticism is an initiative started by doctors from 32 countries to check unscientific and misleading health campaigns. They conduct awareness campaigns mainly through their website, email discussion forums and regularly organised programmes called PharmedOut.
Pew Health Group is a charitable agency that aims to ensure safe health service and prescription of drugs by targeting medical colleges and health institutions. Pew Prescription Project is a programme it organises to encourage doctors to prescribe medicines responsibly without being influenced by drug companies. The group helps medical institutes to implement rules of conduct that helps to overcome the marketing strategies of drug companies.
Indian Journal of Medical Ethics is a quarterly published under the leadership of public health activists such as Sunil K. Pandya, Amar Jesani and Amit Sen Gupta which discusses ethics in medical science. This publication has become an all-India medium to discuss most problems related to medical ethics. Measures initiated by the medical fraternity in Kerala to protect medical ethics and oppose exploitation in the healthcare sector give a lot of relief and hope to the general public.