2Cents: Should doctors have the right to refuse service as a form of protest?

This is a fairly complicated issue that I came across a while back.

The buildup

Somewhere in Barisal, a couple of relatives of a patient vandalized the hospital and assaulted the staff there, broke down the OT room, and caused massive havoc. In return, the doctors closed down the hospital services and demanded that they will only work once the perpetrators are punished.

The only problem being that this was not an isolated incident, and there has been cases like these for a long while now. Bangladeshi patients tend to be super-reactive and ignorant regarding most medical emergencies (albeit the fact that one cannot say that these aren’t triggered by amazing care and service).

Here are a few examples of how often these incidents occur:

How prevalent is this violence?

A lot. Doctors in the country face everything between physical, verbal, and mental violence at the hands of the patients, who somehow are under the impression that doctors are magicians (or, in some cases, crooks – with the latter being a popular opinion these days).

So what?

What I cannot come to terms with is how the doctors in each of these cases think it is perfectly okay to punish hundreds of other patients in order to get their point across. Sure, relatives of one patient have vandalized your hospital and assaulted your colleague, and you have every right to refuse them any form of further treatment as a show of solidarity.

Create a national list of perpetrators, widely circulate it, and stop providing any form of medical facilities to the personnel involved. Make sure that these people are not provided any form of medical care at any institution around the country until they learn a lesson. That would make sense.

But in what stupid sense do you imagine that it is perfectly okay to punish a poor man who dragged himself to a government hospital with the slight ray of hope that he will be treated here with respect and dignity? What did he do to you guys?

Are protests morally sound?

Very recently, I collaborated with a grad-student of the Albany College in their Ethics course, where I actively participated in their course assignments. This was for students majoring in Pharmacy Ethics, so there was a fairly great deal of talk related to how professionals in the field of medicine should be responding to moral crisis situations.

One of the topics that came up every now and then was how Pharmacy-Ethics is not goal oriented, and rather, it is more of benefit, or end-result-oriented.

As a doctor, those students were not expected to ‘fix” 70 patients per day. Rather, they were asked to “help” 70 patients live another day.

In typical conversations, this would be marked as a consequential-ist view.

Offcourse, if you are taking a teeth off a patient, they are going to be hurt for a day or two. But if that gives them a better 7 years afterwards, it makes sense to give that pain.

So, how are protests related to that?

Wikipedia defines protests as such:

A protest (also called a remonstrance, or demonstration) is an expression of bearing witness on behalf of an express cause by words or actions with regard to particular events, policies or situations. Protests can take many different forms, from individual statements to mass demonstrations. Protesters may organize a protest as a way of publicly making their opinions heard in an attempt to influence public opinion or government policy, or they may undertake direct action in an attempt to directly enact desired changes themselves.

You see, protests are meant to make a point.

You hurt me? I want everybody to know that hurting me is not okay, and that I will not accept that.

A logical protest for that scenario would be to say that no doctor in the country will treat any of the people who were involved with that assault.

The problem with refusal to provide service to unrelated patients is that it does not make a point for anybody. It hurts innocent civilians in a quest to gain a personal satisfaction of sorts. I mean, if you refuse to help patients who had nothing to do with the original event, then it does nothing but undermining your original quest.

What happens is that instead of treating that one damaged teeth of that one patient, these protests take off one teeth from every patient that visits the hospital after the assault-incident.

The logical expression is this: if you are willing to hurt innocent patients in your quest to gain respect, or security – what is the guarantee that you are not willing to harm other patients in your quest to gain other personal gains?

Whats the solution?

Nothing. Really. I am sure that most doctors will not care about what I say – and these events will continue. But if you are a doctor and you are reading this – I hope this made you rethink your policies. People go to hospitals at times of dire need.

Someone who visits a hospital in Khagrachori or Rajshahi does not do so because they are suffering from a morning cough – they go there because it is a life-threatening issue to them. Many can’t afford to wait, and most can’t even properly afford the trip. When you become a part of the problem by refusing them service, then it does nothing but undermining your respect instead.

You don’t gain respect by hurting civilians.