Caraka Shapath..

[thebigthinkg]

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There is a controversy going on around whatever is termed 'Caraka shapath' and doctors taking oath on it instead of the traditional Hippocratic oath. I saw a Caraka Shapath in Hindi where students take oath in Hindi saying they will never treat a 'stri' without a husband or male companion. It's simply foolish.

The Original Hippocratic oath has several parts including where practitioner says they won't do abortions. But that's not what is being taken now. It's all customized and modified for modern times and that's what is being taken as Hippocratic oath. In fact many institutes across the world have their own oaths.

Whatever is termed 'Caraka shapath' are verses 13 and 14 from Chapter 8 Roga-bhiSag-jItIya sthAna of vimAna sthAna of Caraka Samhita. In fact these verses are what the Guru is supposed to tell the student medical practitioners, when they approach a Guru to learn medicine.

The Guru tells the students in the presence of Agni, brAhmanas and other practitioners these verses. It's more a lecture to students and the students at the end say 'tathA' (agree to that). It's not a 'Shapath' that students take.

Should always speak truth, not eat mAmsa, serve only intelligence/knowledge (no superstitions), follow guru's instructions except in case it is against Government rules or suicidal, serve the guru like a son and servant (keep interacting and learning personally from that interaction), be modest, humble, alert, focus on work, not find fault with others.

Should prioritize go (cattle, animals), brAhmanas (knowledge providers) of all those with prAnA, Strive for the health of all creatures in general, not mean to patients who cannot pay, should not drink alcohol or associated with other sinners, patient friendly (soft spoken, thankful, blissful, comforting), continuously improve the tools (technology upgradation).

Should NOT treat who are disliked by Government (read kings), who dislike kings (rebels), disliked by good people, those who are excessively diseased, wicked, those with troublesome conduct or very close to death.

Should not treat any woman without husband or other male companions and not accept food from any woman without their husband's permission.

Should maintain utmost patient confidentiality and secrecy. Should never leak it to anyone. Should retain modest living at all times.

Should not point out defects of others, while improvising oneself. For true wise, whole world is a teacher. In this way everyone blesses.

Students should agree to all these saying 'tatha' (astu).

The above is the crux of the true Caraka Shapath (whatever termed so). Even the above, is not perfect literal translation, but is the crux. So there is no Shapath at all in Ayurvedic culture. It is agreeing to Guru's wishes before the start of the teaching. Whoever agrees, Guru teaches. If students are found violating above, they are kicked out.

Some part of the above does not hold good for us, for the current times, in a democratic society. We can't say those disliked by Government or whoever dislikes ruling party will not get treatment. We can't say, women will not get treatment without a male companion. We can't say prioritize cows/cattle/animals and brahmans/knowledge providers. Well we can't even say practitioners should avoid alcohol and never take meat. These are mostly related to social or cultural ideas at a given time.

But there are a lot of very good elements about being patient friendly, humble, sweet-talking, continuously upgrading knowledge/tools, retaining modest living ways, consider treatment by intelligence and knowledge, treating all patients rich or poor the same etc etc.. These are mostly related to medicinal or domain ideas that are relevant for all times. There are much more, not covered fully.

So we should craft a Caraka Shapath that is more appropriate for modern times and cultures that is focused on improvising medicinal knowledge and patient treatment and use it for our students. Remember even original Hippocratic oath is not fit for modern times. It's customized for current times. So there is nothing wrong to customize caraka's teachings for current times. But it should be really done by the medical community after a thorough discussion on values they want to imbibe/carry forward and what they want to leave out. Politicians should stand out of it.

And this need not be a 'Oath' . It could be students just saying tatha-astu.

Personally, one primary objection to the NMC oath (as circulated in the media) is that students say "They will not attend to patients of other gender without their relatives or attendants" - This is such a retrograde thought not fit for our times. There are so many single men and women in our times, orphans, people who need emergency help. Allopathy (chemical intervention) is great for emergency situations and allopathic doctors who would deal with emergencies MUST not take such an oath, if they really mean it. Otherwise they will be just lying.

 

[renuka]

There is a controversy going on around whatever is termed 'Caraka shapath' and doctors taking oath on it instead of the traditional Hippocratic oath. I saw a Caraka Shapath in Hindi where students take oath in Hindi saying they will never treat a 'stri' without a husband or male companion. It's simply foolish.

The Original Hippocratic oath has several parts including where practitioner says they won't do abortions. But that's not what is being taken now. It's all customized and modified for modern times and that's what is being taken as Hippocratic oath. In fact many institutes across the world have their own oaths.

Whatever is termed 'Caraka shapath' are verses 13 and 14 from Chapter 8 Roga-bhiSag-jItIya sthAna of vimAna sthAna of Caraka Samhita. In fact these verses are what the Guru is supposed to tell the student medical practitioners, when they approach a Guru to learn medicine.

The Guru tells the students in the presence of Agni, brAhmanas and other practitioners these verses. It's more a lecture to students and the students at the end say 'tathA' (agree to that). It's not a 'Shapath' that students take.

Should always speak truth, not eat mAmsa, serve only intelligence/knowledge (no superstitions), follow guru's instructions except in case it is against Government rules or suicidal, serve the guru like a son and servant (keep interacting and learning personally from that interaction), be modest, humble, alert, focus on work, not find fault with others.

Should prioritize go (cattle, animals), brAhmanas (knowledge providers) of all those with prAnA, Strive for the health of all creatures in general, not mean to patients who cannot pay, should not drink alcohol or associated with other sinners, patient friendly (soft spoken, thankful, blissful, comforting), continuously improve the tools (technology upgradation).

Should NOT treat who are disliked by Government (read kings), who dislike kings (rebels), disliked by good people, those who are excessively diseased, wicked, those with troublesome conduct or very close to death.

Should not treat any woman without husband or other male companions and not accept food from any woman without their husband's permission.

Should maintain utmost patient confidentiality and secrecy. Should never leak it to anyone. Should retain modest living at all times.

Should not point out defects of others, while improvising oneself. For true wise, whole world is a teacher. In this way everyone blesses.

Students should agree to all these saying 'tatha' (astu).

The above is the crux of the true Caraka Shapath (whatever termed so). Even the above, is not perfect literal translation, but is the crux. So there is no Shapath at all in Ayurvedic culture. It is agreeing to Guru's wishes before the start of the teaching. Whoever agrees, Guru teaches. If students are found violating above, they are kicked out.

Some part of the above does not hold good for us, for the current times, in a democratic society. We can't say those disliked by Government or whoever dislikes ruling party will not get treatment. We can't say, women will not get treatment without a male companion. We can't say prioritize cows/cattle/animals and brahmans/knowledge providers. Well we can't even say practitioners should avoid alcohol and never take meat. These are mostly related to social or cultural ideas at a given time.

But there are a lot of very good elements about being patient friendly, humble, sweet-talking, continuously upgrading knowledge/tools, retaining modest living ways, consider treatment by intelligence and knowledge, treating all patients rich or poor the same etc etc.. These are mostly related to medicinal or domain ideas that are relevant for all times. There are much more, not covered fully.

So we should craft a Caraka Shapath that is more appropriate for modern times and cultures that is focused on improvising medicinal knowledge and patient treatment and use it for our students. Remember even original Hippocratic oath is not fit for modern times. It's customized for current times. So there is nothing wrong to customize caraka's teachings for current times. But it should be really done by the medical community after a thorough discussion on values they want to imbibe/carry forward and what they want to leave out. Politicians should stand out of it.

And this need not be a 'Oath' . It could be students just saying tatha-astu.

Personally, one primary objection to the NMC oath (as circulated in the media) is that students say "They will not attend to patients of other gender without their relatives or attendants" - This is such a retrograde thought not fit for our times. There are so many single men and women in our times, orphans, people who need emergency help. Allopathy (chemical intervention) is great for emergency situations and allopathic doctors who would deal with emergencies MUST not take such an oath, if they really mean it. Otherwise they will be just lying.

Why are you surprised?
Its just being legalistic.
A male doctor is not allowed to examine a female patient without a female nurse to chaperone.
Its for the safety of the doctor mainly to make sure he is not accused of misconduct and to some extent also protect the female patient.

These days even female doctors do not examine a male patient alone unless a nurse is present.

Its just safety.

So may be traditional practitioners in the past should have employed a female nurse to solve all the problems with examining female patients.

Btw the oath medical doctors have been taking for a long is Declaration of Geneva...no more Hippocratic oath.

 

[thebigthinkg]

Why are you surprised?
Its just being legalistic.
A male doctor is not allowed to examine a female patient without a female nurse to chaperone.
Its for the safety of the doctor mainly to make sure he is not accused of misconduct and to some extent also protect the female patient.

These days even female doctors do not examine a male patient alone unless a nurse is present.

Its just safety.

So may be traditional practitioners in the past should have employed a female nurse to solve all the problems with examining female patients.

Btw the oath medical doctors have been taking for a long is Declaration of Geneva...no more Hippocratic oath.

I go to female docs all the time alone. My wife or daughter goes to male docs all the time alone. Not seen such a practice anywhere in our areas. Cultures should not get time warped in my view.

More importantly, we have so many singles, old people living alone and I shudder to think of emergency situations in which docs refuse treatment due to gender because of their oath.

 

[prasad1]

Why are you surprised?
Its just being legalistic.
A male doctor is not allowed to examine a female patient without a female nurse to chaperone.
Its for the safety of the doctor mainly to make sure he is not accused of misconduct and to some extent also protect the female patient.

These days even female doctors do not examine a male patient alone unless a nurse is present.

Its just safety.

So may be traditional practitioners in the past should have employed a female nurse to solve all the problems with examining female patients.

Btw the oath medical doctors have been taking for a long is Declaration of Geneva...no more Hippocratic oath.

That is Islamic practice.


What if a female patient has no male family member to accompany them? In many practices, there is only one doctor (male or female), and they treat all patients.
In a civilized world and for productivity only one person can be spared at any given time.
Associations including Indian Medical Association {IMA} have expressed strong disapproval against this proposal. They observed that Charaka Shapath will not be suitable for modern medicine practitioners.

The IMA said that a person who is not believing in God would face the issue to take ‘Charak Shapath’.

Some doctors in Kolkata have also shown their dismay over the move.

“We really do not know what is written in Charak Shapath or if the essence of the oath is the same. But why waste time in replacing an existing oath that has been there for years? Instead, we should be concentrating on other aspects to improve the medical education system," Prabhas Prasun Giri, associate professor at ICH told the Times of India.

Punyabrata Gun, convenor, West Bengal Doctors’ Forum, said, "This clearly seems like a ploy to bring in the Hindutva concept into modern medicine institutes. We do not even know if Charaka had drafted such an oath."

Shashi Tharoor of the Congress also asked why the Charak Shapath couldn't supplement rather than replace the Hippocratic Oath taken by doctors around the world.

"Many doctors are expressing concern. I am all in favour of introducing Indian elements into Indian education, but not at the expense of universal values and standards. Why can’t the Charaka Shapath supplement, rather than supplant, the Hippocratic Oath that doctors worldwide take?," tweeted Tharoor.

 

[renuka]

I go to female docs all the time alone. My wife or daughter goes to male docs all the time alone. Not seen such a practice anywhere in our areas. Cultures should not get time warped in my view.

More importantly, we have so many singles, old people living alone and I shudder to think of emergency situations in which docs refuse treatment due to gender because of their oath.

But in the doctors room the male doc wont examine your wife without a nurse.
That is medical ethics.
Its a serious medicolegal offence if the male doc would examine her without a nurse.

I dont think you understood what I wrote.
A single woman can go to see a male doc but in the doc's room the doc has to have a nurse with him to examine her.

Once I needed an injection and I went alone to see a male doc and he called his nurse to chaperone him to administer the injection on my arm.

 

[renuka]

That is Islamic practice.


What if a female patient has no male family member to accompany them? In many practices, there is only one doctor (male or female), and they treat all patients.
In a civilized world and for productivity only one person can be spared at any given time.
Associations including Indian Medical Association {IMA} have expressed strong disapproval against this proposal. They observed that Charaka Shapath will not be suitable for modern medicine practitioners.

The IMA said that a person who is not believing in God would face the issue to take ‘Charak Shapath’.

Some doctors in Kolkata have also shown their dismay over the move.

“We really do not know what is written in Charak Shapath or if the essence of the oath is the same. But why waste time in replacing an existing oath that has been there for years? Instead, we should be concentrating on other aspects to improve the medical education system," Prabhas Prasun Giri, associate professor at ICH told the Times of India.

Punyabrata Gun, convenor, West Bengal Doctors’ Forum, said, "This clearly seems like a ploy to bring in the Hindutva concept into modern medicine institutes. We do not even know if Charaka had drafted such an oath."

Shashi Tharoor of the Congress also asked why the Charak Shapath couldn't supplement rather than replace the Hippocratic Oath taken by doctors around the world.

"Many doctors are expressing concern. I am all in favour of introducing Indian elements into Indian education, but not at the expense of universal values and standards. Why can’t the Charaka Shapath supplement, rather than supplant, the Hippocratic Oath that doctors worldwide take?," tweeted Tharoor.

It is nothing to do with any religion.
Its standard medical ethics.

Out here its also non ethical for a doctor to marry his patient.
If a doctor proposes marriage to his patient and the patient finds that uncomfortable she has a strong case to report him to medical board of ethics.
But I have noted that in India some docs have married patients.

Btw again I think you are not understanding what I wrote.

Just say I go to see a male doc alone..for eg when I needed my Covid vaccine.
To administer the vaccine, he called his nurse to chaperone him.

If I had gone with my husband or any family member he had the option not to call the nurse.

But usually all male docs call the nurse to chaperone because in case there is any complain of sexual misconduct, even if he is innocent but didnt have a nurse beside him , he will have a tough time proving he is innocent.

Even dentists here do not examine female patients alone unless nurse is present.

 

[renuka]

I go to female docs all the time alone. My wife or daughter goes to male docs all the time alone. Not seen such a practice anywhere in our areas. Cultures should not get time warped in my view.

More importantly, we have so many singles, old people living alone and I shudder to think of emergency situations in which docs refuse treatment due to gender because of their oath.

When doing home visits, docs here take their nurses along.

So if an elderly person living alone gets treatment.
Here the government emergency services provide ambulance with both male and female paramedics together during emergencies for any home visit.

Even private ambulances have both males and females on duty.

Private docs functioning alone always take their nurse along for emergencies at home.

 

[renuka]

Dear Prasad ji,

Chaperone is not based on Islamic principles.

Read this.

The Case for Medical Chaperones

It's time for more discussion about how best to incorporate chaperones in primary care.

www.aafp.org

 

[renuka]

Safeguarding, chaperones, and sexual allegations - The BMJ

In February 2020, the general practitioner Manesh Shah, received three life sentences for sexually assaulting his patients. The assaults involved carrying out “invasive examinations for his own gratification.” [1] Shah also [...]More...

blogs.bmj.com

 

[prasad1]

Family physicians are routinely entrusted by their patients to perform the most sensitive physical exams. Unfortunately, every year there are news stories and litigation alleging cases of physician misconduct during patient encounters. The “Me Too” movement has recently empowered more individuals to speak up about improper sexual behavior within and beyond medicine. In this environment, patients may be increasingly wary of their own health care providers. Physicians, too, understand that they can become targets to unethical or unwell patients who may allege misconduct that never happened but is difficult to disprove without witnesses.

ARE CHAPERONES THE SOLUTION?
How often do inappropriate examinations occur, and does the use of chaperones reduce cases of inappropriate conduct? Unfortunately, current statistics available through the National Practitioner Data Bank (NPDB) do not provide details on these types of cases. One estimate indicated that almost 11 percent of provider misconduct reports were sexual in nature. The most rigorous published studies conclude that we lack sufficient information on malpractice to accurately establish the rates and types of physician misconduct.

There also have been no studies examining whether the presence of medical chaperones decreases the risk of physician misconduct. Some studies have investigated whether medical chaperones affect patient satisfaction, and the results generally indicated that patients found it respectful to be offered a chaperone and, depending on the country, often expected one.

Finally, it is important to note that many victims do not report sexual violations by their physician, with one study estimating that fewer than 1 in 10 victims choose to report it.

The lack of hard evidence notwithstanding, if we agree that chaperoned exams have value, difficult implementation questions arise, including these: Must chaperone expectations apply to physicians of both genders? How does the sexual orientation of the patient and physician factor into the chaperone selection? What happens if the patient declines the offer of a chaperone, but the physician feels he or she must bring one in any way? How does the presence of a third person in the exam room affect the physician-patient relationship? Will we come to a point when physicians can no longer examine any patient alone? Where do the resources come from? Where is the line to be drawn?

Although a number of associations and government bodies have attempted to centralize recommendations on this topic, these guidelines are often ambiguous and conflicting. The AMA Code of Ethics recommends, in part, notifying patients about chaperone guidelines and always honoring a patient's request to have a chaperone.3 The American College of Obstetricians and Gynecologists recommends, in part, accommodating patient requests for a chaperone, regardless of the physician's gender. The American Academy of Pediatrics (AAP) explicitly recommends having a chaperone attend genital, rectal, and breast exams of adolescent patients but also recommends using shared decision making if the patient is old enough. The exam of an infant, toddler, or child should always be performed in the presence of a parent or guardian, according to the AAP policy. The American College of Physicians Ethics Manual says, in part, that “in general, the more intimate the examination, the more the physician is encouraged to offer the presence of a chaperone.” The American Academy of Family Physicians has not published recommendations on the use of chaperones.

Several states have implemented legal mandates that range from requiring that physicians offer a chaperone for intimate examinations (Ohio) to defining an examination of the genitals or breasts by a physician of the opposite gender without a chaperone as professional misconduct (Georgia). In Canada, associations in the individual provinces have made their own recommendations.16 In the United Kingdom, the General Medical Council requires that a physician offer a chaperone for an intimate examination whenever possible.


--------------------------------------------------------------------------
Personally, I [Dr. Pimienta] find the notion of a chaperoned exam troubling because I feel it implies that the physician has ulterior and possibly harmful motives that require third-party supervision. However, in light of the recent string of high-profile physician misconduct cases, I recognize the importance of chaperones. I hope that one day in my career, we physicians will be able to win back the trust of the public and remedy the malpractice of the small minority of our profession.

The Case for Medical Chaperones

It's time for more discussion about how best to incorporate chaperones in primary care.

www.aafp.org

 

[prasad1]

By mandating chaperoned exams, the medical system bleeds the patient. Ultimately patient has to pay the cost.

So let us say the Doctor charges $200.00 to see a patient. If you need a Chaperon the patient has to pay $50.00, let us see how many people opt for this service?

 

[renuka]

By mandating chaperoned exams, the medical system bleeds the patient. Ultimately patient has to pay the cost.

So let us say the Doctor charges $200.00 to see a patient. If you need a Chaperon the patient has to pay $50.00, let us see how many people opt for this service?

Out here, no added charges for chaperone.

When I was studying in India, we were taught ethics while examining a patient.
We were told that for a male doctor he needs to have a nurse as a chaperone when examining a female patient.

Its just that simple.

Out here where I stay, a female doc can examine any gender without a chaperone but its still recommended to have a nurse in cases where there are non sexual misconduct medico legal issues.
Also when examining male patients that requires the patient to undress, most female docs have a nurse with them,in set ups where there is a male nurse, a male nurse is prefered to chaperone a male patient.

Actually I am surprised that people are even surprised of medical ethics.
Thats the first thing I learnt in med school in India.

Btw some people have mild hallucination effect with certain anesthetics, so one may hallucinate a non existent sexual misconduct.
So stay safe! Have a chaperone.
Its not about how often a sexual misconduct case happens. Its about being legalistic.

 

[renuka]

Btw female patients can feel shy to be with a male doctor alone especially simple village folks feel shy and they themselves never want the nurse to leave their side.

I am sure conservative women in India too are shy to be alone with a male doc.

Out here majority of women( even the most modern) choose a female obstretrician/gynaec and breast surgeon.

For other diseases they dont mind a male doctor.

 

[prasad1]

There is a controversy going on around whatever is termed 'Caraka shapath' and doctors taking oath on it instead of the traditional Hippocratic oath. I saw a Caraka Shapath in Hindi where students take oath in Hindi saying they will never treat a 'stri' without a husband or male companion. It's simply foolish.

I agree with your view, it is foolish.

The Original Hippocratic oath has several parts including where practitioner says they won't do abortions. But that's not what is being taken now. It's all customized and modified for modern times and that's what is being taken as Hippocratic oath. In fact many institutes across the world have their own oaths.

Whatever is termed 'Caraka shapath' are verses 13 and 14 from Chapter 8 Roga-bhiSag-jItIya sthAna of vimAna sthAna of Caraka Samhita. In fact these verses are what the Guru is supposed to tell the student medical practitioners, when they approach a Guru to learn medicine.

The Guru tells the students in the presence of Agni, brAhmanas and other practitioners these verses. It's more a lecture to students and the students at the end say 'tathA' (agree to that). It's not a 'Shapath' that students take.

Should always speak truth, not eat mAmsa, serve only intelligence/knowledge (no superstitions), follow guru's instructions except in case it is against Government rules or suicidal, serve the guru like a son and servant (keep interacting and learning personally from that interaction), be modest, humble, alert, focus on work, not find fault with others.

Should prioritize go (cattle, animals), brAhmanas (knowledge providers) of all those with prAnA, Strive for the health of all creatures in general, not mean to patients who cannot pay, should not drink alcohol or associated with other sinners, patient friendly (soft spoken, thankful, blissful, comforting), continuously improve the tools (technology upgradation).

Should NOT treat who are disliked by Government (read kings), who dislike kings (rebels), disliked by good people, those who are excessively diseased, wicked, those with troublesome conduct or very close to death.

Should not treat any woman without husband or other male companions and not accept food from any woman without their husband's permission.

Should maintain utmost patient confidentiality and secrecy. Should never leak it to anyone. Should retain modest living at all times.

Should not point out defects of others, while improvising oneself. For true wise, whole world is a teacher. In this way everyone blesses.

Students should agree to all these saying 'tatha' (astu).

It is absolute surrender to Guru

The above is the crux of the true Caraka Shapath (whatever termed so). Even the above, is not perfect literal translation, but is the crux. So there is no Shapath at all in Ayurvedic culture. It is agreeing to Guru's wishes before the start of the teaching. Whoever agrees, Guru teaches. If students are found violating above, they are kicked out.

Some part of the above does not hold good for us, for the current times, in a democratic society. We can't say those disliked by Government or whoever dislikes ruling party will not get treatment. We can't say, women will not get treatment without a male companion. We can't say prioritize cows/cattle/animals and brahmans/knowledge providers. Well we can't even say practitioners should avoid alcohol and never take meat. These are mostly related to social or cultural ideas at a given time.

That is what the present administration wants. The citizen should be like sheep and follow the lead of the shepard.

But there are a lot of very good elements about being patient friendly, humble, sweet-talking, continuously upgrading knowledge/tools, retaining modest living ways, consider treatment by intelligence and knowledge, treating all patients rich or poor the same etc etc.. These are mostly related to medicinal or domain ideas that are relevant for all times. There are much more, not covered fully.

So we should craft a Caraka Shapath that is more appropriate for modern times and cultures that is focused on improvising medicinal knowledge and patient treatment and use it for our students. Remember even original Hippocratic oath is not fit for modern times. It's customized for current times. So there is nothing wrong to customize caraka's teachings for current times. But it should be really done by the medical community after a thorough discussion on values they want to imbibe/carry forward and what they want to leave out. Politicians should stand out of it.

And this need not be a 'Oath' . It could be students just saying tatha-astu.

I can live with that.

Personally, one primary objection to the NMC oath (as circulated in the media) is that students say "They will not attend to patients of other gender without their relatives or attendants" - This is such a retrograde thought not fit for our times. There are so many single men and women in our times, orphans, people who need emergency help. Allopathy (chemical intervention) is great for emergency situations and allopathic doctors who would deal with emergencies MUST not take such an oath, if they really mean it. Otherwise they will be just lying.

This is harking back to medieval periods.

 

[renuka]

Nothing is foolish.
We have to understand that not all males have self control and not all women speak the truth.
So its for the best interest of male practiotioners and for the best interest of the female patient to have a chaperone.

The Caraka Shapath surely intended to protect a female patient from a unscrupulous male practiotioner and also to protect a virtous male practiotioner from an unscrupulous female patient.

A doctor has to even ask consent to examine a patient before we touch a patient.
A patient can at any time refuse or even accuse a doctor of forcing them to be examined or even take treatment.

Thats why we have AOR forms( at your own risk forms) ready for the patient to sign if they refuse treatment.

 

[thebigthinkg]

But in the doctors room the male doc wont examine your wife without a nurse.
That is medical ethics.
Its a serious medicolegal offence if the male doc would examine her without a nurse.

I dont think you understood what I wrote.
A single woman can go to see a male doc but in the doc's room the doc has to have a nurse with him to examine her.

Once I needed an injection and I went alone to see a male doc and he called his nurse to chaperone him to administer the injection on my arm.

Well there are single doctor clinics with NO nurses, who give regular medicines as well as emergency help if required. In the clinics that we go to, often there are no 'nurses'.

I am not sure there is any 'ethical' problem in any doc treating a patient of other gender. When a man of any age is at a clinic run only by female doc and she has to perform a help, will she treat or not..?

What you are writing sounds so 1930's, like why Dr. Muthulakshmi chose medicine that time. A patient may decide to go a doc of their choice of gender. that's fine. A doc cannot take an oath saying they will not treat a person of other gender without attendants.

This oath would put docs (at times) with only 2 choices. Either doc dishonors the oath or he lets the patients die.

 

[thebigthinkg]

Nothing is foolish.
We have to understand that not all males have self control and not all women speak the truth.
So its for the best interest of male practiotioners and for the best interest of the female patient to have a chaperone.

The Caraka Shapath surely intended to protect a female patient from a unscrupulous male practiotioner and also to protect a virtous male practiotioner from an unscrupulous female patient.

A doctor has to even ask consent to examine a patient before we touch a patient.
A patient can at any time refuse or even accuse a doctor of forcing them to be examined or even take treatment.

Thats why we have AOR forms( at your own risk forms) ready for the patient to sign if they refuse treatment.

I think you are missing the point. While Ayurveda was much for wholesome long life and treating diseases over a period, Allopathic treatments excel in emergency, life-saving procedures. Nothing can beat allopathy in it.

So allopathic doctors taking oath that they will not treat people of other genders without some attendants is simply foolish only. As I said I am seeing a huge number of old men and women (whose kids are living abroad) living their life alone, who go to nearby clinics or hosps alone. Without understanding the environment and differences in societies we live, either such oaths are foolish or make you liars or killers.

 

[thebigthinkg]

I agree with your view, it is foolish.

It is absolute surrender to Guru

That is what the present administration wants. The citizen should be like sheep and follow the lead of the shepard.

I can live with that.

This is harking back to medieval periods.

We definitely can learn from the past. None can return to the past. We have to live in the present. My point was not about motives of administrations there. It was more about what we can learn from past and use it for present, as a medical community.

I can see that they are striving to get it right to modern times. But yet it does not fit. The boomer generations have to give way to young people. From saying we will not treat women without male assistants in 2019 to saying we will not treat other genders without assistants in 2022, NMC has 'progressed' in their ideas in 3 years, but definitely not enough.

 

[renuka]

I think you are missing the point. While Ayurveda was much for wholesome long life and treating diseases over a period, Allopathic treatments excel in emergency, life-saving procedures. Nothing can beat allopathy in it.

So allopathic doctors taking oath that they will not treat people of other genders without some attendants is simply foolish only. As I said I am seeing a huge number of old men and women (whose kids are living abroad) living their life alone, who go to nearby clinics or hosps alone. Without understanding the environment and differences in societies we live, either such oaths are foolish or make you liars or killers.

Wow, you still dont get it.
Let me repeat myself yet again.

A female patient who is single and staying alone goes to see a male doctor.

Patient registers herself at the clinic or hospital and is called into the consultation room.

Medical ethics is, since the doc is male and the patient is female, the doc makes his female nurse chaperone.


Thats all it is.

No doctor refuses to treat a patient who came alone.
He has a nurse with him.

No doctor male or female has no nurse with him or her in their clinic or hospital.


Its not as if a single female patient is denied any medical treatment by a male doc.
Majority of patients mostly come alone to see docs and the nurse stands by the doctor when the doc examines the female patient.

 

[renuka]

Let me give another example.
Once when I was working in a government hospital, my co-doc,a male doctor had to do an ultrasound for a pregnant female patient who had come alone.

But so happen that day the nurses at the hospital were very busy attending bus accident cases.
So the male doc could not get a nurse to stand by the female patient,..he then asked me to stand by the patient till he was done doing the ultrasound.

So I played the role of a chaperone for him.

Thats the rules for a male doc.

 

[thebigthinkg]

Let me give another example.
Once when I was working in a government hospital, my co-doc,a male doctor had to do an ultrasound for a pregnant female patient who had come alone.

But so happen that day the nurses at the hospital were very busy attending bus accident cases.
So the male doc could not get a nurse to stand by the female patient,..he then asked me to stand by the patient till he was done doing the ultrasound.

So I played the role of a chaperone for him.

Thats the rules for a male doc.

Well as I said i see so many clinics with no nurses, just a single doc. we often go to clinics like that. for eg. when my wife visits her orthoepedics doc, i don't go always with her. the doc has no nurse at all.

Not sure what times we are talking about, looking at gender. Again, think of a life-saving situation when a doc has to treat other gender and nobody else is there. you wil let them die looking for someone else..?

 

[renuka]

Well as I said i see so many clinics with no nurses, just a single doc. we often go to clinics like that. for eg. when my wife visits her orthoepedics doc, i don't go always with her. the doc has no nurse at all.

Not sure what times we are talking about, looking at gender. Again, think of a life-saving situation when a doc has to treat other gender and nobody else is there. you wil let them die looking for someone else..?

So its some clinics India which does not follow bedside manner medical ethics.

Orthopedic sans a nurse?
Why isnt he having a nurse or at least a female attendant?
Find that hard to believe.
How does he do procedures without a nurse or assistant?
Some procedures need a patient to be held down or change into a different garment for procedures..strange.

Anyway, the doc is clearly not following the rules..it might be ok for him until unless someone makes a complain about any misconduct or someone who is jealous of him makes a complain or some woman lies about him..then its risky.
Cos if there is a court case then he has no witness.

In a emergency situation for eg a road accident..a male doc can help revive a female patient or help her just like how fire and rescue personnel can help a female alone.
Just say if a male doc is leaving his clinic and his nurses have gone home and an emergency case arrives and patient is serious..then he can treat her alone cos its an acute emergency.

But in normal non emergency set up its compulsory to have a chaperone.
Rules are clear.
But in the case of the orthopedician you mentioned, out here the clinic wont be allowed to function cos when a licence is issued, nurses or female clinical assistant for a male doctor is a must.

Btw any clinic has at least a receptionist to register the patients.
Out here docs have dispensing rights and we have own pharmacy in the clinic.
So there is always a trained staff to dispense the medicine.

In India,docs do not have dispensing rights and patient buys the medicine from an outside pharmacy.

 

[thebigthinkg]

So its some clinics India which does not follow bedside manner medical ethics.

Orthopedic sans a nurse?
Why isnt he having a nurse or at least a female attendant?
Find that hard to believe.
How does he do procedures without a nurse or assistant?
Some procedures need a patient to be held down or change into a different garment for procedures..strange.

Anyway, the doc is clearly not following the rules..it might be ok for him until unless someone makes a complain about any misconduct or someone who is jealous of him makes a complain or some woman lies about him..then its risky.
Cos if there is a court case then he has no witness.

In a emergency situation for eg a road accident..a male doc can help revive a female patient or help her just like how fire and rescue personnel can help a female alone.
Just say if a male doc is leaving his clinic and his nurses have gone home and an emergency case arrives and patient is serious..then he can treat her alone cos its an acute emergency.

But in normal non emergency set up its compulsory to have a chaperone.
Rules are clear.
But in the case of the orthopedician you mentioned, out here the clinic wont be allowed to function cos when a licence is issued, nurses or female clinical assistant for a male doctor is a must.

Btw any clinic has at least a receptionist to register the patients.
Out here docs have dispensing rights and we have own pharmacy in the clinic.
So there is always a trained staff to dispense the medicine.

In India,docs do not have dispensing rights and patient buys the medicine from an outside pharmacy

If you can make an exception for emergency then, your oath is not valid..?? It's a waste of time right..?

On orthoepedics and other single doc clinics where during patient meeting doc alone (where a reception lady or gent is at the gate and not inside patient room where patient may not want to inform their problems to none except a doc), that's there across all over India.

See a doc can decide not to treat a patient without attendant for various reasons. That's not the point here. It should not be under oath, as it excludes certain possibilities altogether.

BTW, while I agree that patients can decide what kind of docs they want to visit, docs not treating other gender under oath as nauseating.

Which medical ethics or rules specify it, in India..? Can you give reference..?

 

[prasad1]

I am not against chaperoning on a Volunteer basis.
If a patient (male or female) wants a chaperon present (and is willing to pay for it) then they should be allowed.

Similarly, if a doctor is worried about getting sued, they too can opt for a chaperone.

But to mandate to take an oath is wrong and preposterous.

 

[renuka]

If you can make an exception for emergency then, your oath is not valid..?? It's a waste of time right..?

On orthoepedics and other single doc clinics where during patient meeting doc alone (where a reception lady or gent is at the gate and not inside patient room where patient may not want to inform their problems to none except a doc), that's there across all over India.

See a doc can decide not to treat a patient without attendant for various reasons. That's not the point here. It should not be under oath, as it excludes certain possibilities altogether.

BTW, while I agree that patients can decide what kind of docs they want to visit, docs not treating other gender under oath as nauseating.

Which medical ethics or rules specify it, in India..? Can you give reference..?

There is no waste of time.
The law is the law.

For eg in self defense one can fight off and even kill someone who is trying to kill us and it wont fall under murder.
It only applies in cases of self defense.
Would we want to say its a waste of time that we are allowed to kill someone under self defense but not allowed to kill someone otherwise?

Just say in case of statutory rape.
A girl's birthday is August 5th and she would turn 16 yrs of age.
Just say on August 4th she consents to sex with an adult..it is still considered rape.
But if she consented sex on August 5th, then its consensual sex.

Would you say its a waste of time?

The rules in a Democratic country will be different under Emergency Ordinance( parliament dissolved), would you say its a waste of time?


Anyway, I have already explained all ethics in my posts.

May be you should try to paste the Charak Shapath original text in Sanskrit and then all can try to understand what do the words really say.

Btw Charaka Shapath is Hindu culture.
It keeps with the idea that Hindu culture in the past had the following people to accompany her

1) if unmarried, her parents
2) if married, her husband
3) if widowed, her son/ daughter in law
4) if widowed and no kids, a relative.