Australasian Science: Australia's authority on science since 1938

Third World Bioethics

By Michael Cook

Poverty overcomes informed consent in India, where nearly 2900 people died in India during clinical trials of drugs between 2005 and 2012.

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Bioethics has its own flavour in a tidy, law-abiding, wealthy country like Australia. Here we assume that, once approved, regulations and laws will be obeyed – and by and large, they are. Corruption, in other words, is uncommon. Not unknown, mind you, but Australia ranks seventh out of 194 in the Transparency International corruption index. Not too bad.

This defines the focus of our bioethics. Here doctors are trained to respect patients’ autonomy.

But corruption is endemic in the developing world, so much so that a bioethicist in India (which ranks 94th) contends that “corruption is arguably the most serious ethical crisis in medicine today”. So the focus has to be protecting patients from exploitation.

In a recent issue of the Indian Journal of Medical Ethics, Dr Subrata Chattopadhyay has asserted: “Quality care cannot be provided by a healthcare delivery system in which kickbacks and bribery are a part of life”.

Unhappily, Exhibit A of this system is the former president of the Medical Council of India (MCI), Dr Ketan Desai, a urologist who should have been a model of probity. He wasn’t.

Desai was a consummate political operator. His personal website described him as “an apostle of genuine imagination, innovation and creativity which has resulted in his enviable ascending to key positions in the world of medicine”.

But...

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