Ethics in the medical profession

Juliet Siena Okoroh, MS4 at UCSD SOM, PRIME-Health Equity
I will maintain the utmost respect for human life

She left, my aunt left… and I can’t believe she is gone
Joining the developing world of women who have lost their lives to pregnancy
Nothing about my training thus far, would ever bring her back
My country Nigeria, continues to rank 10th out of 196 countries in maternal mortality, spending less than $22 US dollars per person annually in healthcare.
This is saddening as I think about the 750 billion dollar annual waste industry called the United States’ health care system of which 30% is in unnecessary services.

What does it mean: to train in a system that doesn’t even protect my family from the consequences of poverty and false commitments of the country’s leadership?

What does it mean: to loose an aunt to pregnancy, an uncle to appendicitis, and three other loved ones to trauma because no one would operate or stop their bleeding?

What does it mean: to travel to a country where a body is left on the streets after an accident, like road kill with by-standers too scared to call the corrupt police?

When we ask ourselves if people need help in Africa, why is it that the first thought that comes to our minds is can we afford it?

In the United States, we are not trained to think about this question when patients come to see us, as if we are economists and not clinicians: A life is a life and everyone is entitled to enjoy the highest standard of physical and mental health: not just the absence of disease or infirmity but improvement in social wellbeing. Yet when I ask, if my aunt and uncles deserved necessary care, some health professionals say “Can we afford it” as if there is a better alternative to obstructed labor or ruptured appendicitis.

We take an oath that reads, “I will not permit considerations of age, disease or disability, creed, ethnic origin, gender, nationality, political affiliation, race, sexual orientation, social standing or any other factor to intervene between my duty and my patient. I will maintain the utmost respect for human life…” Do we value people differently? Is the experience of the poor with the healthcare system the same as the rich? Are the lives of Africans discounted to mean less as a result of us being born in a resource rich but economically disadvantaged continent due to relics of colonialism?

Martin Luther King once said, “of all the forms of inequality, injustice in health care is the most shocking and inhumane.” We have a moral obligation as physicians to desist from perpetrating the disparities that exists in our society by; treating our patients with the uttermost respect, valuing their well being and dignity, consecrating our lives to the service of humanity, and contributing to advancing the ethics of our profession.

The WHO estimates a minimum of 44 dollars per person per year is needed to provide basic life saving services. Yet my country’s government continues to invest only half of this amount. I wonder, what the world would be like if we all just traded a pair of cheap shoes to save more women like my aunt.

Struggling with abortion

Anonymous

My preceptor handed me the chart. “Positive pregnancy test” was scratched in ink on a sticky note on the front. We were at the adolescent medicine clinic at a local under-served high school. Continue reading “Struggling with abortion”