organising a half day seminar on medical humanities

[neha madhiwala]

Dear all, 

As you know, the 4th National Bioethics Conference is being held in December 6-8th in Hyderabad. Usually, about 200-300 participants from different organisations across the country participate in this conference. One of the components of the conference are 2 hour workshop sessions, which are organised on various themes. These can have the format of panel discussions, skill-building workshops and round-table meetings. I was wondering whether it would be a good idea to hold a workshop on developing curricula for medical humanities for undergraduate/post graduate medical students. The KEM study will be completed by that time and they could make a presentation on the findings, others could present their curricula and their work as well. 

Apart from enabling us all to meet face-to-face, it would allow us to interact with a wider audience (about 50-60 percent of the participants come from medical institutions (teaching and research))

That way, apart from all of us, we will be able to involve many other groups and institutions in the discussion. 

The organisers have made arrangements for cheap accommodation in the university campus and the registration fees are quite modest. If all of us can find some means of financing our own travel, I think that we should be OK. 

Would like to know what all of you think.

Information on the conference can be found on  http://nbcijme.ijme.in/ 

Neha

--
Neha Madhiwalla
Centre for Studies in Ethics and Rights
501, Dalkhania House, B Wing
Behind State Bank of India,
Nehru Road, 
Vakola Pipe Line, Santacruz (East),
Mumbai – 400 055.

[Ravi Ramakantan]

Neha , I am not sure such a meeting will serve any great purpose - esp. if it is only for half a day. Instead I would suggest that this meeting be used as a venue for a meeting of all concerned and present to plan for and organise a full 2 day MH Conference - say at KEM sometime soon. though I am open to other ideas and suggestions.

Ravi

[Padmaja Mavani]

I think,  the two events could be tabled  separately.  KEM and NBC are different fora.  Neha,  actually I thought if Nandini is also coming;  Bioethics training  and Medical Humanities could be brought together .  When sunita mailed , even i thought along the same lines as you did. But how should we structure it to  make it that short ?  Padmaja --- On Tue, 11/9/12, neha madhiwala <nmadh...@gmail.com> wrote:

[neha madhiwala]

Padmaja, 

I like your idea about combining ethics and humanities education. We could have a panel discussion format with different speakers talking about the need for such curricula, experiences of conducting such courses (methodologies/course designs/instructors) and also students' views. 

It would be good if we can have a varied panel - Nandini, someone from KEM, if Radha can come, 1/2 people involved in ethics/humanities training in different medical colleges. The KEM students could present their study findings as a backgrounder.  

If there are 4/5 presentations, that would take about an hour, leaving another hour for open discussion. 

Although this forum is not right for an academic seminar, it may be a good forum to approach the topic, get people's feedback and build some kind of a network. It would help to draw in people who are interested in this subject. 

It could be a workshop organised by the MH Cell of KEM in collaboration with the ICMR bioethics course students or whatever yu think works best.

Neha

[Ravi Ramakantan]

Let's frist define - "At the end of this session this is what we hope to achieve,.,.. "!

Hmmm. I do not at all like the idea of combing ethics and humanities.

I know, I know,..ethics is a part of humanities; but, I would like to artificially jettison the two for the purpose of this post.

I feel we have too much of 'bioethics' floating round for the last two/ three decades and it has made very little difference to the practice of medicine - except to make "cheating ethical"!!. If we get bioethics into this session,  ethics will take the lions share of discussions. I think we should say this  'activity" - whatever you want to do at this conference- is 'hardcore' MH minus bioethics . at ;least then people will know that there is something  more to MH beyond ethics. I feel properly trained as a"humane doctor" ethics will follow automatically.

BTW - I have major problem with the use of the word "bioethics" - why don't we  simply say "ethics"?? as long as we are using this in the context of medical practice - after all we are dealing with human beings, no?

My two cents worth :-)

RR 

ps: : I hope I do not get thrown out of the "union" for such sacrilegious remarks!!

[Dr. Rajkumar Anand]

Dear All,

This is a good idea. Unfortunately, I will be in Delhi at that time attending the World Breastfeeding Conference.

Cheers,

Dr. Anand


On Wed, 12 Sep 2012 13:38:56 +0530 wrote

>Padmaja, 
I like your idea about combining ethics and humanities education. We could have a panel discussion format with different speakers talking about the need for such curricula, experiences of conducting such courses (methodologies/course designs/instructors) and also students' views. 

It would be good if we can have a varied panel - Nandini, someone from KEM, if Radha can come, 1/2 people involved in ethics/humanities training in different medical colleges. The KEM students could present their study findings as a backgrounder.  


If there are 4/5 presentations, that would take about an hour, leaving another hour for open discussion. 
Although this forum is not right for an academic seminar, it may be a good forum to approach the topic, get people's feedback and build some kind of a network. It would help to draw in people who are interested in this subject. 

It could be a workshop organised by the MH Cell of KEM in collaboration with the ICMR bioethics course students or whatever yu think works best.


Neha








On 12 September 2012 13:20, Padmaja Mavani wrote:

I think,  the two events could be tabled  separately.
 KEM and NBC are different fora. 
Neha,  actually I thought if Nandini is also coming;  Bioethics training  and Medical Humanities could be brought together . When sunita mailed , even i thought along the same lines as you did.
But how should we structure it to  make it that short ?
 Padmaja

--- On Tue, 11/9/12, neha madhiwala wrote:

From: neha madhiwala
Subject: organising a half day seminar on medical humanities

To: "Ravi

Ramakantan" , padmaja...@yahoo.co.in, "Amar Jesani" , "MH KEM" , "KISTMC Medical Humanities group" , "Mumbai Medical Humanities Group"

Follow Rediff Deal ho jaye! to get exciting offers in your city everyday.

[Ravi Ramakantan]

Does Bioethics really matter - Pl. read this insightful review from The Lancet

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(12)60584-4/fulltext 

Ravi

[Amar Jesani]

This is an old book review (saw 5-6 months back) - you may get the book by ordering it from Flipkart, costs Rs. 1741 in hard cover.

Ravi, every disciplines has its own limitation. That is why fanaticism for one discipline take us nowhere. Recent converts to a disciplines are always more fanatic about it than those who have been in it for long and seen all from inside. The medicine needs humanity, and so does the humanity need medicine. The relationship of ethics to medicine, law, humanities, social sciences etc is therefore equally interdependent.

Lastly, you are not likely to have luxury of geeting full day or few days in national or international conferences for organising sessions/workshops on medical humanity. No discipline can be popularised if we do not grab opportunity to talk on it for half an hours as well as five days. We need to prepare how to do it in different situations. If organising medical humanity session in a conference of radiologists or surgeons is a good thing to do, then I am sure it is equally good thing to do it in a conference on ethics, and perhaps more because when someone attends ethics conference, he or she is mentally prepared to look beyond his or her discipline. Such individuals would be more interested in the message of MH.

Anyway, it doesn't matter whether this group organises a session or workshop of 90 minutes or half day at the conference. My message is that please do not bring such rigidities and extremism in the MH at such an early stage - they will not help in the development of discipline. Initial over-enthusiasm should be tempered by the long term sustainability of interest and gathering a caravan - for that we have to be inclusive rather than exclusive.

Amar

--
________________________________
Amar Jesani
Editor, Indian Journal of Medical Ethics (www.ijme.in)
and
Trustee, Anusandhan Trust
Sai Ashray, Aaram Society Road, Vakola
Santacruz East, Mumbai 400055, India
Tel (Office): +91-22-26661176, Mobile: +91- 9833073773
Email: <amar....@gmail.com> & <amarj...@yahoo.co.in>

Institutes of Anusandhan Trust:
(1) CEHAT (Centre for Enquiry into Health and Allied Themes); Mumbai (www.cehat.org)
(2) CSER (Centre for Studies in Ethics and Rights), Mumbai (www.cser.in)
(3) SATHI (Support for Advocacy and Training to Health Initiatives), Pune (www.sathicehat.org)

[Ravi Ramakantan]

Thank you Amar for your detailed and  experienced response. With your background in this field, it would have been a shame if you had not contributed to this discussion.

I must clarify that what I have said in my previous posts are only 'my' opinions - people who are familiar with my style of talking, know I can be "rudely outspoken" without meaning to hurt. 

The group should, by consensus, take a combined decison, and I am always happy to go with the majority decison even if it is at variance at my personal'prejudices'.

Now let me get at you with all cylinders firing:-).

First of all my interest in MH is not "new found".  In fact whilst at KEM, I used to write one-page 'essays" under the title of Chairman's Corner and the very first essay in 2002 or so was prompted my "Medical Humanities" instinct; Many others essays since have been on this note - only I did not know there was a discipline called MH at that time. I have since moved to a private hospital, where I still meet balanced and well meaning physicians and so many of them agree that we need to "teach" medical students how to treat patients "well" - as human beings.

The trouble with ethics is that, I KNOW, that it cannot be implemented in our life time.It will only get worse. Unlike being "humane" being ethical costs money to the physician. By and large, in normal practice, , a physician/hospital will lose revenue by being ethical in practice - There are 4-5 neurologists/neurosurgeons in Mumbai who do not accept kickbacks from Imaging centers. SKPs  of the world will not be born again. If not 'CUT", it will be called "referral charges" or consultation fees.. we Indians are very resourceful. This applies to "everything" ethics. Conferences, device and drug usage, unindicated treatment and in some cases even 'ethics committees'. .. everything.. absolutely everything. Residents in teaching hospitals are now learning these 'important' lessons  from their seniors at a very young age. As far as I can see, there is NO HOPE here - unless we 'teach' 'ethics' in elementary and high schools as a way of life. 

Give me ONE  example, Amar,  from your life-time where any intervention has made a large numbers of physicians more ethical - in the true spirit of the word.

MH me will not cost money.. in fact, it may increase a doctors referral base and add to 'revenue".  

I can go on and on, Amar.. but, for that you will have to stand me breakfast.. lunch.. and .... :-)

Or help us organise a two-day conference purely on MH :-)

Maybe, one day, you may suddenly get an invitation for one organised by SevenHills  and then instead of feeling proud that SevenHills is doing that, I will feel very sad that KEM did not take the lead.

Padmaja.. are you listening??

Ravi.

[Amar Jesani]

Dear Ravi,

I think my brief response Rakesh cover what I wanted to tell you. But just a bit more. While professional ethics are as old as medicine, the discipline of bioethics is less than half century old. Disciplines of Humanities, and their overlap with medicine are much older than bioethics. None of them have (neither MH not bioethics), one its own automatically made medicine and health system better. The humanisation of medicine is a project much larger than bioethics and medical humanities, and therefore both of them have to complement each other if they want to do something meaningful for the humanisation.

Much of the bioethics in India developed not as a rigid academic theoretical and philosophical system, but as experiential needs of the doctors who were feeling frustrated with the challenges faced and the way the system was forcing them to do something they did not want to do.

I would not like to get into debate here. But what kind of humanism the MH will bring if the cheating of patients (cut, referral charges) continued unabated since nothing can be done about it? There are lots of people arguing now-a-days that there can be humane methods of torture and humane way of execution to tackle terrorism, so perhaps in that vein you want everybody to embrace humane way of cheating as that would increase referral base and revenue. The corporates keep arguing that we should also not bother about ethics in clinical trials either as clinical trials bring lots of business (revenue) and patients are at least getting some treatment free. But Ravi, remember that the mission of MH is not to become handmaiden of business and provide it a humane cover to hide its ugly face, but its mission is to humanise medicine.

Anyway, I think I have said what I thought was worth looking at. And I believe that in India, it would be beneficial for the bioethics and the MH to work in harmony. Let them be distinct from each other, adopting different methods to make impact; but each will remain incomplete if it does not complement the other. 

Amar

[Ravi Ramakantan]

Thank you Amar. I agree with much of what you say about humane cheating. That is not desirable at all.

Let us put ourselves in the position of a patient. They all know that most doctors are dishonest - financially. They feel "cuts" and such are inevitable in medical practice and they are helpless. This is a given. I also feel this is so ingrained that it cannot be regulated. So we have a dishonest, often 'insensitive" doctor - that is a double whammy. I am trying to address the second issue - doctors who are more humane and caring. Most patients will agree they are "OK" with this..even if the doctors are financially dishonest.

All this may not be acceptable at all from the Ethics perspective - in fact may sound ludicrous.  I am not saying this is good, acceptable or OK,  I am saying this is inevitable and I know when I cannot fight city hall.

Ravi.

[Sunil Pandya]

Pardon my attempt at contributing my five-paisa worth of observations in your discussion.

All of you - Amar, Ravi and the others - are working for means to offer better and honest services to patients - especially the poor patients.

There are a multitude of wrongs that these patients are being subjected to, unethical medical practices and inhumanity being two glaring examples.

We need to try and influence changes for the better on all fronts.

Whether or not we will succeed is irrelevant. Having done our best to improve practices and attitudes, we shall sleep the more soundly. (We cannot do better than our best.)

Please continued your efforts, redoubling them if needed.

The cause is worthy of your attempts.

Sunil

On Thu, Sep 20, 2012 at 5:07 AM, Ravi Ramakantan <ramakan...@gmail.com> wrote:

Thank you Amar. I agree with much of what you say about humane cheating. That is not desirable at all.

Let us put ourselves in the position of a patient. They all know that most doctors are dishonest - financially. They feel "cuts" and such are inevitable in medical practice and they are helpless. This is a given. I also feel this is so ingrained that it cannot be regulated. So we have a dishonest, often 'insensitive" doctor - that is a double whammy. I am trying to address the second issue - doctors who are more humane and caring. Most patients will agree they are "OK" with this..even if the doctors are financially dishonest.

All this may not be acceptable at all from the Ethics perspective - in fact may sound ludicrous.  I am not saying this is good, acceptable or OK,  I am saying this is inevitable and I know when I cannot fight city hall.

--

PANDYA

[Ravi Ramakantan]

Thank you , Sir. My ravings and rantings have 'provoked' you enough to make your maiden post on the group.

Let's hope Neha and others are able to make a start in Hyderabad.

Ravi.