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Friday, August 15, 2008

India, Iran and Medical Ethics

It was for a second opinion that pregnant Niketa and husband Haresh Mehta landed up at gynaecologist Nikhil Datar's clinic in suburban Mumbai last month. They didn't want to continue with the pregnancy after discovering that the foetus had a heart problem, but Indian laws don't allow abortion beyond 20 weeks. Their gynaecologist felt that Dr Datar, who also has a degree in law, would be able to guide them better. What followed had the nation transfixed for over a week.

Medical dilemmas have a way of gripping attention. The entire world watched for five days as 41-year-old Terri Schiavo lay dying after the US courts permitted her husband to perform euthanasia using starvation and dehydration. The plight of Baby Manjhi, the daughter of a Japanese couple born to an Indian surrogate mother, is also being observed across the globe.

It is not just the smell of antiseptic that is common to all medical corridors. Dilemmas over medical ethics, too, are all familiar here. Ask Dr Samiran Nundy, Delhi-based transplant surgeon who drafted India's first law on transplant of organs in the early nineties, and he recalls how during his days in the AIIMS there always was a shortage of respirators as compared to the number of patients needing the contraption. "How can you decide which patient needs the respirator more than the other? It is such a dilemma," he says.

The questions are many. Should a husband tell his wife about his HIV infection before marriage? Should a doctor first operate on a patient who has Rs 18 lakh for a liver transplant or hanker after another liver failure patient who has no money? Should India, like Iran, legalize sale of kidneys in order to put the illegal kidney bazaar out of business? The answers are, however, far from easy.

Read it all here.

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