Abstract
Background: Medical doctors’ strikes are a common global phenomenon. In the recent past, a number of strikes have been reported in various developing countries including India. The objective of this ethical overview is (a) to study and describe reasons, modalities and impacts of the doctors’ strikes in India, (b) to develop an ethical reflection on doctors’ strike and (c) to evaluate the doctors’ strikes in India using this ethical reflection. Discussion: In this literature based study, we discuss Indian doctors’ strike and its various ethical reflections and assessment. This paper is arranged in three sections in accordance with the objectives of the study. In the first section, we analyse the Indian situation with doctors’ strikes in terms of its reasons, modalities and its impacts. In second section, we elaborate a general ethical reflection on doctors’ strike explored using normative ethical framework. General ethical reflection developed based on the Hippocratic Oath and other codes, biomedical principles like beneficence, non-maleficence and autonomy, as well as ethical approaches like deontological and utilitarian reasoning, and traditional Indian philosophy. The third section focuses on the assessment and evaluation of doctors’ strikes based on ethical reflection developed in previous section. Summary: Indian doctors’ strikes are morally not acceptable and ethically not allowable based on deontological reasoning, Hippocratic tradition, different biomedical principles and ancient Indian philosophy. However, considering utilitarian reasoning, doctors’ strikes for fair wage, better hospital infrastructure and working conditions are justifiable if it causes less harm to present patients and gives more good to the future patients.
Highlights
Medical doctors’ strikes are a common global phenomenon
Strikes are usually collective actions that occur in all democratic societies
In many countries health care workers including doctors are unsatisfied with factors like payments and with non-monetary aspects such as healthcare policy issues, security and safety issues, better working conditions and hospital’s physical and administrative infrastructure [4,5,6,7,8,9,10,11,12]. Doctors argue that they are compelled to action to make their needs or demands met, and that strikes may be chosen as an ultimate choice of action. Such collective actions by practicing doctors are occurring with increasing frequency worldwide [13,14,15]
Summary
Medical doctors’ strikes are a common global phenomenon. In the recent past, a number of strikes have been reported in various developing countries including India. In many countries health care workers including doctors are unsatisfied with factors like payments and with non-monetary aspects such as healthcare policy issues, security and safety issues, better working conditions and hospital’s physical and administrative infrastructure [4,5,6,7,8,9,10,11,12] Doctors argue that they are compelled to action to make their needs or demands met, and that strikes may be chosen as an ultimate choice of action. In 2006, Frizelle pointed out that in the past two decades there has been strikes by medical doctors in many countries including Australia, Belgium, Canada, Chile, Finland, France, Germany, Ghana, India, Ireland, Israel, Italy, Korea, Malta, New Zealand, Peru, Serbia, Spain, Sri Lanka, Romania, USA, UK, Zambia and Zimbabwe [14]. Many of these strikes have been harmful to patients as strikes reduce patient’s access to care by eliminating or delaying necessary care, and may, at times interfere with the continuity of such care [16,17]
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