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  • The Delhi government’s Health Department will re-examine the draft policy framed by a committee to regularize the functioning of private hospitals in the capital, to understand the ‘rationale’ behind some of the suggestions.
  • The draft advisory was prepared on the basis of recommendations by a nine-member expert panel, headed by Director-General of Health Services Kirti Bhushan.
  • The panel was formed on December 13 last year, after a family alleged medical negligence a private hospital for wrongly declaring a baby dead.
  • The Indian Express quoting sources said, senior officials in the department are not satisfied with the draft policy and want the committee to work again on the entire report.
  • On May 28, the Delhi government had proposed regulations restricting private hospitals and nursing homes from marking up prices of medicines and consumables over 50 percent of their procurement price.
  • The draft was placed in the public domain for 30 days and suggestions were invited. The draft advisory suggested that private hospitals can charge patients the maximum retail price for medicines under the National List of Essential Medicines, 2015, as their prices have already been capped.
  • The draft was ideally to be submitted by the end of June. It is already delayed by four months now.

Background:

  • Health is a state subject in India which means the central government has very less control. The Clinical establishment act which suggested good measures was not enacted in some states.
  • There are many reasons to regulate private health care.
  • Basically, private establishments are profit oriented and hence have very little to do with ethics.
  • India being a cheap destination for medical tourism but have many vacancies for specialised treatments.
  • Need to regulate medical education as people pour in lot of money and want to take it out after working leading to lot of problems.

Medical Negligence.

  • Private hospitals fixing targets.
  • How will the policy work?
  • If we have a policy like this then we can think on a long term standard operating protocol for private sector.
  • Can be built to a National Framework if works.
  • Besides, Policy does not have redressal system.

Ethics in Medical sector:

  • Doctors may deal with a great variety of perplexing ethical problems even in a small medical practice. Here are some common problems identified in a 2016 Medscape survey, where at least some physicians held different opinions:
  • Withholding treatment to meet an organization’s budget, or because of insurance policies
  • Accepting money from pharmaceutical or device manufacturers
  • Upcoding to get treatment covered
  • Getting romantically involved with a patient or family member
  • Covering up a mistake
  • Reporting an impaired colleague
  • Cherry-picking patients
  • Prescribing a placebo
  • Practicing defensive medicine to avoid malpractice lawsuits
  • Dropping insurers and
  • Breaching patient confidentiality owing to a health risk.
  • Professional standards are a way to provide some guidance on ethical problems, but they cannot address every issue, and they may not address troubling nuances, such as reconciling two conflicting values.

Key Values for Deciding Ethical Issues:

  • Many professional ethicists recommend using four basic values, or principles, to decide ethical issues:
  • Autonomy: Patients basically have the right to determine their own healthcare.
  • Justice: Distributing the benefits and burdens of care across society.
  • Beneficence: Doing good for the patient.
  • Normal feasance: Making sure you are not harming the patient.
  • However, ethical values are not limited to just these four principles. There are other important values to consider, such as truth-telling, transparency, showing respect for patients and families, and showing respect for patients’ own values.
  • In addition, medical ethics is not just a thought process. It also involves people skills, such as gathering the facts needed to make a decision and presenting your decision in a way that wins over the confidence of all parties.

 

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