At world level an increasing number of eminent doctors have been expressing anguish since the advent of COVID-19 that that they are under increasing pressure to work only in the narrow confines of what is imposed from above, and when they they try to act on the basis of the best of their judgment then they face undue opposition and harassment. This resentment has been building up over the months, and the result can now be seen in the form of an initiative by Concerned Physicians and Medical Scientists to release the Physicians Declaration (PD) at global level, invlving many eminent doctors from all over the world, which till September 27 had already been signed by 5200 doctors and medical scientists, and their number is increasing. This is a very important statement on what a significant number of doctors and medical scientists have been feeling in recent times of COVID-19 and deserves wide attention.
This statement starts with the following words — We the physicians of the world, united and loyal to the Hippocratic Oath, recognizing the profession of medicine as we know it is at a crossroad, are compelled to declare … Hence at the very outset it is declared tht the profession of medicine is at a croosroad and this is a time of very special concern for the medical profession. Further this sttement asserts, using strong language, that there is “now an unprecedented assault on our ability to care for our patients.”
Further elaborating what exactly has gone wrong the PD says– public policy makers have chosen to force a “one size fits all” treatment strategy, resulting in needless illness and death, rather than upholding fundamental concepts of the individualized, personalized approach to patient care which is proven to be safe and more effective. Physicians and other health care providers working on the front lines, utilizing their knowledge of epidemiology, pathophysiology and pharmacology, are often first to identify new, potentially life saving treatments. However what has changed now is that “ physicians are increasingly being discouraged from engaging in open professional discourse and the exchange of ideas about new and emerging diseases, not only endangering the essence of the medical profession, but more importantly, more tragically, the lives of our patients.”
Describing the extremely worrying present situation the PD says— thousands of physicians are being prevented from providing treatment to their patients, as a result of barriers, rendering the vast majority of healthcare providers helpless to protect their patients in the face of disease. This has resulted in a large number of avoidable deaths, due to failure-to-treat. The PD statement asserts strongly, “This is not medicine. This is not care. These policies may actually constitute crimes against humanity.”
To counter these worryng trends the doctors and medical scientists initiating and endorsing this statement have resolved that the physician-patient relationship must be restored. The very heart of medicine is this relationship, which allows physicians to best understand their patients and their illnesses, to formulate treatments that give the best chance for success, while the patient is an active participant in their care. Hence physicians, and all health care providers, must be free to practice the art and science of medicine without fear of retribution, censorship, slander, or disciplinary action, including possible loss of licensure and hospital privileges, loss of insurance contracts and interference from government entities and organizations – which further prevent them from caring for patients in need. More than ever, the right and ability to exchange objective scientific findings, which further understanding of disease, must be protected.
This declaration has resolved further that that physicians must defend their right to prescribe treatment, observing the tenet FIRST, DO NO HARM. Physicians shall not be restricted from prescribing safe and effective treatments. These restrictions continue to cause unnecessary sickness and death. The rights of patients, after being fully informed about the risks and benefits of each option, must be restored to receive those treatments.
Further this declaration has resolved that we invite the scientists of the world, who are skilled in biomedical research and uphold the highest ethical and moral standards, to insist on their ability to conduct and publish objective, empirical research without fear of reprisal upon their careers, reputations and livelihoods.
Further this declaration has resolved to invite patients, who believe in the importance of the physician-patient relationship and the ability to be active participants in their care, to demand access to science-based medical care.
It is clear that such a declaration requiring a lot of mobilisation effort and using strong language could have been made only after a lot of thinking , reflection and discussion on the part of many eminent doctors and scientists who played a leading role in this effort. Hence it deserves a lot of attention and debate.
Bharat Dogra is Honorary Convener, Campaign to Protect Earth Now. His recent books include Planet in Peril and Protecting Earth for Children.