On non-consensual sterilization of women by Kurunegala doctor

The doctor at Kurunegala Hospital, Dr. Seigu Siyabdeen Mohammed Shafi has been accused of performing thousands of non-consensual sterilisations on women who delivered babies at Kurunegala and Dambulla hospitals. It was reported, already over six hundred complaints from victimized mothers have been received by the Health Service authorities and an official committee appointed by the Health Ministry Secretary is looking into this incident.

By Raja Wickrmamasighe

The doctor at Kurunegala Hospital, Dr. Seigu Siyabdeen Mohammed Shafi has been accused of performing thousands of non-consensual sterilisations on women who delivered babies at Kurunegala and Dambulla hospitals. It was reported, already over six hundred complaints from victimized mothers have been received by the Health Service authorities and an official committee appointed by the Health Ministry Secretary is looking into this incident.

Dr. Seigu Siyabdeen Mohamed Shafi has also been reported by Kurunegala Hospital authorities to the Health Ministry for forging documents of a newborn to give the baby to another party. And he is presently under investigation by the Police into allegedly acquiring a large number of assets through suspicious means.

Meanwhile many opinions and views are doing the rounds by both medical professionals and non-professionals in this field as usual. Some of them express the inability of performing sterilizations procedures during Caesarean sections without someone in the operating theatre noticing it and it’s nearly impossible for the others on the team not to notice. As per other accounts there is quite a number of medical and non-medical staff in attendance in the operating theatre with the doctor performing the Caesarean sections procedure. Nevertheless, large numbers of people were protesting in cities and villages in the country, many in and around Kurunegala district against this incident.

However, the present shocking experience has led me to think deeply about the problem of doctor who acts without conscience and what that could mean for patients. Every one of us has experiences with doctors and do remember the awful power of illness to take lives, as children or adults. These allegations may be fabricated and baseless as expressed by some medical professionals, or may be true as believed by some others. It could only be known after the conclusion of the ongoing investigations. Yet, it’s normal for the public to entertain doubts about the efficiency and the safety of our state hospital system and to be seriously concern of the safety of the patients.    

Although it’s one doctor is involved, the wrongdoing on the part of one doctor can undermine public confidence and the trust in the entire profession. People generally do trust their medical professionals, but there has been surprisingly little concern how patients judge whether they are in the hands of a good doctor. Generally the personal characteristics such as being a good listener and friendliness, as well as professional competence, were considered important to patients, but the appearance could be occasionally misleading. Only an impartial and thorough investigation, based on reliable evidence including scientific evidence can find the truth. 

People understand the Doctor’s job is to heal the sick and save lives, and that role evokes an image and expectation of beneficence. Doing only good; doctors, when they espouse a code of conduct descended from the Hippocratic Oath: “I will use treatment to help the sick according to my ability and judgment, but never with a view to injury and wrongdoing.” Patients also have expectations; when illness strikes, they must often put their lives, their confidence and their most vulnerable selves in the hands of the doctor they barely know. The expectation of conscience is at the core, but what if your faith in doctor having conscience was shaken?

In our country, main factors that influence students to pursue a career in medicine and become doctors can be identified as prestige and earning potential. Passion for caring and healing the sick as a factor to select medicine as a carrier is almost non-existent now. Being attracted to prestige and money does not make someone a bad doctor, but it creates a moral vulnerability. Those trappings of power are everywhere in medicine, and they create temptation. Furthermore, if a substantial proportion of doctors are receptive to those temptations, a culture could develop in which unethical behaviour is normalized.

The formal curriculums at the medical-school may emphasize the importance of compassion and empathy, but that empathy, in fact, may decline in future doctors as they are exposed to real working situation at government hospitals due to pressure of work and other de-motivating and demoralising factors prevalent in our health system and in general in the Public Service. Furthermore, Doctors-in-training and junior doctors can be exposed to negative role models. The most influential among these role models are senior doctors who demonstrate to their trainees and junior doctors what behaviour is acceptable and what traits are associated with success. 

In fact, a person completely without conscience can make sophisticated use of deception to conceal their motivations and advance their self-interest. Of course, the patients can’t have judgment on whether their doctor is a person of conscience. But we cannot leave that completely to fend for them. Patients only have the doctor’s personal demeanour in a brief encounter to go on. Underlying motivations matter too, because trust that a Doctor will put the patient’s interests first is at the heart of a healthy doctor-patient relationship.

What if a doctor was only motivated by the trappings of power and money, and a doctor was competent and effective, but had no conscience and what if a doctor was to decide a patient didn’t matter, where is the line they would not cross? That patient’s care and health would be jeopardized.

The wrongdoing on the part of one doctor can undermine the entire profession. Doctors have historically enforced their own professional standards. These are run by senior doctors and part of their role is to discipline doctors’ whose action amount to conduct unbecoming a medical doctor. In these accusations against Dr. Seigu Siyabdeen Mohamed Shafi it is in the hands of the medical professionals and the leaders in medical administration to conduct investigation and enforce discipline. 

It is the Sri Lanka Medical Council (SLMC), specifically the SLMC’s Professional Conduct Committee (PCC) that would hold a formal inquiry and if the doctor is deemed guilty, the SLMC would decide on the punishment. It could be a decision to erase the name of the guilty medical practitioner off the register for a period of time.   

The medical community, particularly the leaders, those who supervise and administer hospitals and health service system and processes and perform policing of the system should leave no room for doctors acting without conscience to flourish in our medical culture. We should be concerned about doctors who act without conscience at work; they shouldn’t have any opportunity to evade accountability. The medical administrators, medical professional bodies and the hospital administrators have a duty to protect patients and the public from a doctor who is likely to harm them. 

The Kurunegal hospital incident is an opportunity to have a frank public discussion about what people expect of their doctors and those who lead their health care institutions. The solution must include true independent investigations when doctors are suspected of workplace misconduct. Such doctors have the potential not only to damage the lives of patients, the public and the colleagues directly, but they may shape the thinking of morally vulnerable doctors and future doctors around them, that through acting without conscience is a path to success. That should worry us all. 

(The writer is a resident in Canada)