Sunday Times 2
Knowledge without wisdom – or compassion
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I was disillusioned to learn from a couple of my friends, both respected GPs in private practice, that earlier this month some medical students from the Colombo University were going round to visit family doctors in their private dispensaries and asking them to close their clinics for the day (to strike work, in other words) in support of the current strike these undergraduates were staging.And what were these students, our nation’s doctors of the future, striking about?
They were demanding that the government, in addition to giving in to the other demands made by the Government Medical Officers’ Association (the powerful GMOA), shut down the private medical college called SAITM.
Now unlike these medical students who are less than a quarter century old, I can remember those terrible “JVP Days” we lived through in the late eighties – when the JVP, desiring to paralyse the machinery of government, sent messages through its members to various government departments asking employees not to go to work – and succeeded in effectively shutting down at various times government departments, shops, petrol stations, hospitals etc. I recall the father of a friend of mine who, having undergone surgery the day before, died in hospital on the day the doctors “kept away from work”. Whether he would have died in any event I am not sure, but his family always believed that had the doctors been working as usual on that day, their father would not have died.
So I could not help musing that what these young medical students – emboldened and influenced by their seniors, the office bearers of the GMOA – were trying to accomplish was very similar to what the JVP did in the old days: they were asking doctors to not treat patients in order to force the government to give in to their demands.
This strike by the GMOA and the medical students’ unions is serious because it appears their actions show blatant contempt of the Court of Appeal, the second most senior court in our legal system. On 31 January, the Court of Appeal ordered the Sri Lanka Medical Council to register as doctors those students who had passed the final exams of the SAITM’s medical course. Normally in this country, if a party takes recourse to the law and is not satisfied with the decision of the Court of Appeal, that party can appeal this verdict to the nation’s senior-most court, Supreme Court. Perhaps the GMOA office bearers wanted to follow the example set by some of our politicians who show little respect for the law and adopt extra-judicial measures (like death fasts and hospitalisation for unprovable “ailments”) to circumvent decisions of judges. Instead of appealing the Court of Appeal’s decision in the Supreme Court as could have been done, the GMOA decided to take the law into its own hands and took to the streets in protest, showing not only contempt of the Court of Appeal but also a callous disregard for the fate of those patients who would suffer by their “withdrawing health services”.
Now I am sure that these medical students who are “abstaining from attending lectures” in collaboration with the GMOA “abstaining from treating patients” are the most intelligent of our country’s youth. After all, they have all done well and achieved high “Z-scores” at their A Levels (whatever that proves) and have gained admission to the state’s prestigious medical schools. That is why a huge amount of taxpayers’ money is spent to educate them and ensure they get a medical degree. I am sure they are clever, with brains that can learn and memorise such important things as the order of ossification of the carpal bones and the names of the five branches of the VIIth nerve in the face. I am sure that in time to come they will be well trained in pathology, pharmacology and the clinical sciences so they can treat the less fortunate of our citizens when they fall ill.
But despite all their knowledge of matters medical, are these students endowed with wisdom? Is it wise to stay away from one’s studies for more than three months expecting that the government will come to them on bended knee with cap in hand and plead with them “Please go back to your books and study, we don’t want you to not study, we will do whatever you want” and accede to their demands? A government that is run by members of parliament more than half of whom have not even passed their A Levels will not be impressed by such short sighted logic.
As one sensible and principled family doctor told the students who came and asked him to close his dispensary for the day and deny his patients medical care, “I do not mix up other people’s politics with my professional duty. Should medical students go around requesting practising doctors to actively harm their patients?”
Taking up arms against an evil enemy is one thing. A trade union is well within its rights to carry out industrial action (or industrial in-action) when the rights of its members are infringed upon. But it is difficult for simple citizens like us to understand exactly what rights of these students or our government doctors are affected by the issue of the private medical college!
Furthermore, trying to fight a government by refusing to treat patients (who have nothing to do with the decisions made by the government) smacks not only of a lack of wisdom as to how political animals operate, but also indicates a pitiable lack of ethics and compassion.
It is well known that the Hippocratic Oath is no longer administered to graduating medical students – nor taken by newly graduated doctors – in Sri Lanka’s medical schools. It may have been in the distant past, but from the time I myself was in university in the fifties, none of my contemporaries in the medical school had to take this oath before becoming doctors. If they joined the medical college without having been taught ethics and proper values at school and at home, they were expected to imbibe these from the examples of their teachers.
I have not heard of our GMOA or students protesting at all about medical graduates from overseas medical schools being allowed to practise in this country after passing the ERPM (Act 16) exam. Many Sri Lankan students – including the children of presidents and health ministers and members of parliament – have got medical degrees from universities in places like Granada, Georgia, Bulgaria, Malaysia, Georgia and India, where tuition and other fees had to be paid for in foreign exchange. Some of these doctors are now serving patients with great acceptance in this country – while others are domiciled overseas, their talents and skills lost to Sri Lanka.
I have not heard the GMOA striking or protesting about improperly regulated homeopathic and ayurvedic practitioners who boldly use the prefix ‘Dr.’ on their nameplates and are permitted to treat patients in our country.
If the SLMC can undertake to regulate a private medical school in our own country which charges rupee fees from capable and intelligent Sri Lankan students, and trains them to pass the EPRM (Act 16) exam, why should we protest? The more properly qualified doctors we have in Sri Lanka, the better the lot of our people.
The GMOA’s media spokesman claims that their actions are intended to “safeguard both standards and patient rights”.
How can putting patients’ lives at risk protect their rights?
Maybe Citizen Silva is not as smart as the GMOA spokesman. Even though I am not a doctor, I find something not right with his logic.
What a pity he and his ilk did not learn wisdom, ethics and compassion along with the knowledge they acquired (at the taxpayer’s expense) in our nation’s medical schools.