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VietNamNews

Ethical doctors are the corner-stone of all good healthcare

Update: November, 01/2013 - 09:01

Last week, Viet Nam News asked readers their thoughts on whether doctors in the country must pass a mandatory ethics test before being allowed to practise.

This comes after a series of incidents incensed those working in this honourable profession in this country.

Here are some responses.

Andrew Burden, Canadian, Ha Noi

It's joked that lawyers jail their clients and doctors bury their mistakes. Without professional ethics and a culture of transparency, this is true. Trust, but verify.

Prior to this doctor's horrible conduct [the doctor who allegedly dumped the body of his patient into a river after a failed breast surgery] there was a blood test controversy in Viet Nam where results were intentionally falsified on a large scale. Thankfully a whistleblower came forward. We need more brave souls, anonymous if necessary.

In Canada and the West, doctors are considered and treated like gods. Engineers and lawyers are important, but anyone that can stop the bleeding and re-start the heart deserves respect. Provided they live with and embody the Hippocratic Oath; "first, do no harm."

There's nothing more sinister than a rogue doctor that puts profit first and lies, cheats and harms their patient. This particular patient is another victim of fashion culture. A middle-aged female looking to get bigger breasts dies for vanity.

On the surface, it sounds like the beginning of a bad play or made for TV movie. In fact, it is the sharp end of the breakdown of society. When you are vulnerable and sick, you should be able to trust your doctor.

Also in the West, we are taught and told to "get a second opinion." As I age, I know more and while I still trust police and doctors, it's only when I am looking at them - in daylight. Make sure you make out your will and get a good lawyer. As we also say in Canada, "good luck with that."

John Kellas, Australian, Da Nang

The Government and the population must have confidence in the medical and hospital system. Many countries have compulsory registration of medical professionals and regular audits of hospital and medical facilities.

Without such checks, how can the community have confidence that they are being treated by professionally qualified people and in safe and hygienic facilities?

This means that there is a need for recognition of qualifications and training are preferably with continue quality improvement.

Codes of ethics should be formalised and agreed to, but these do not guarantee the standards are maintained without auditing.

While living here, I have had a personal experience of questionable blood test results.

On follow up, I found that the clinic I attended had changed its protocols to ensure that results were independently audited and verifiable.

International standards can be readily met by Vietnamese hospitals and medical services with international help, but as mentioned, quality needs to be maintained, upgraded and regularly audited.

If the community has faith in the medical system, there is great potential for ‘medical tourism'. Many westerners travel to Asia for dental or cosmetic surgery, as it can be performed by skilled staff, which Viet Nam has, for less cost.

Viet Nam has a good reputation for dental surgery, and can potentially increase the level of medical tourism. There are numerous ‘western' hospital located in Viet Nam which can contribute facilities, skills and training to the medical profession.

The downside can be unethical practitioners who take the money and run and leave the patient in a worse condition than when they arrived for treatment.

Viet Nam needs to maintain high standards of medical practice and remove unskilled or unethical practitioners to give confidence to the Vietnamese and to anyone considering travelling to Viet Nam for medical of dental surgery.

Do Thuy Linh, Vietnamese, Ha Noi

I don't think our healthcare system – which is plagued with so many problems that you can't really name them all here – is at the level of applying a medical ethics test yet. It's too ideal.

As a member of the public, I don't trust most of our doctors unless they are referred by people whom we know. Trust is critically important in medical treatment.

Even before these incidents brought medical ethics to the attention of the nation, we already had many problems. Doctors get away with medical errors; hospitals only pay dozens of million dongs to family members of victims who suffer from medical negligence.

These cases are exposed in newspapers, but what happened and what can be done afterwards is another matter. The poor suffer the most.

Unless we have a major medical overhaul that can be applied comprehensively at all levels, nothing can be changed. Starting with medical universities, we have to adopt super-strict guidelines for accepting medical students and requirements for resident doctors, which might require them to practise for years under strict supervision before allowing them to be licensed.

A code of medical ethics can be developed at each hospital and each medical school. But the question is also how to enforce them, which is a problem in many sectors of Viet Nam.

When doctors are found to be negligent, what kind of punishment should they receive for their level of medical error? Do we have the resources to examine each case?

Last of all, I believe medical ethics should be in the heart of each young doctor. They have to realise how important their job is. If not, it's very difficult to give them a medical ethics test.

Giang Nguyen, Vietnamese, Singapore

It's heartbreaking knowing about these stories of unethical medical practice in Viet Nam. But it's not surprising given the little attention we pay to medical ethics and supervising their licenses.

The medical profession has always been held in the highest esteem by the public, but never before has it seemed to be deteriorating.

Without good moral doctors, society can't function and our lives can't be stabilised. I think requiring a medical ethics test would work, but what can we include in that test? Can we include every possible case that would happen? How can we test morality?

We can learn from the establishment of the Singapore Medical Council, operated under the Ministry of Health, to regulate all registered medical practitioners across the country and whether they follow medical ethics.

If possible, this council can also have the right to take action, withdraw the rights of doctors to practise and launch investigations into medical errors. The public demands a clear-cut answer after each incident of unethical medical practice. There's no question about it. — VNS

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