CHALLENGES TO PUBLIC HEALTHCARE
A MORAL THEOLOGICAL REFLECTION FROM THE INDIAN CONTEXT
Keywords:
Ethics of Healthcare, Health, Healthcare, Human Life, Human Person and Rights, Public Healthcare, Public Healthcare in India, Social Justice, Option for the Poor, Healthcare Professionals, Unethical Practices in HealthcareAbstract
Health as a fundamental good is to be preserved, protected and promoted by every human individual. To take care of one’s own health and as far as possible that of the other is a moral duty of all humans. However, the health of the community is not solely dependent on individual healthcare. Here comes the importance of an efficient healthcare system in a country. Since public healthcare is a collaborative work, not only the specific healthcare professionals, but all citizens as well as social groups in the society can and have to contribute to the promotion of public healthcare in their own specific capacity and competence. India has a praiseworthy public healthcare system. However, it is not flawless. Disparities in public healthcare access, rising cost of healthcare, shortage of medical professionals, bribery, informal payment, private practice of public healthcare professionals, unethical practices in bio pharmaceutical industry, lack of newer technologies and medical facilities and issues associated with organ transplantation are some of the unethical practices in the present Indian public healthcare scenario. To remedy these, we need an ethics for healthcare based on the value of human life, the rights of the human person and social justice. Besides, understanding the nobility of the healthcare profession will help us to appreciate the service of healthcare workers.
References
Karl H. Peschke, Christian Ethics: Moral Theology in the Light of Vatican II, Bangalore: Theological Publications in India, 2016.
L.S. Chauhan, “Public Health in India: Issues and Challenges,” Indian Journal of Public Health 55, 2 (2011)
Daniele Giusti, Bart Criel and Xavier de Bethune, “Public Versus Private Health Care Delivery: Beyond the Slogans,” http://ucmb.co.ug/files/UCMBdocs/Reports/ ARTICLES/Article%20Public%20vs%20Private%20%20Giusti%20Criel%20De%20Bet hune.pdf.
George Joseph, John Desrochers and Mariamma Kalathil, Health Care in India, Bangalore: Centre For Social Action, 1985.
Sayed Amin Tabish, “Historical Development of Health Care in India,” Journal of Cardiology and Current Research 9, 3 (2017)
Somnath Roy, “Primary Health Care in India,” Health and Population 8, 3 (1985)
Ministry of Health and Family Welfare, Government of India, “Universal Immunisation Programme,” https://www.nhp.gov.in/universal-immunisationprogramme_pg
Department of Health and Family Welfare, MoHFW, Annual Report 2017-18, New Delhi: Department of Health and Family Welfare, 2018.
Ministry of Health and Family Welfare, Government of India, National Health Policy, 2017, New Delhi: Ministry of Health and Family Welfare, 2017.
https://mohfw.gov.in/ (accessed on 13 December 2018). Also cf. http://ayush.gov.in/
“Primary, Secondary and Tertiary Health Care,” http://www.arthapedia.in/ index.php%3Ftitle %3DPrimary,_Secondary_and_ Tertiary_HealthCare .
M. Chokshi, B. Patil, R. Khanna, S.B. Neogi, J. Sharma, V.K. Paul and S. Zodpey, “Health Systems in India,” https://www. ncbi.nlm. nih.gov/pmc/articles/PMC5144114/ #__sec2title.
National Coordination Committee, Jan Swasthya Abhiyan, “Health System in India: Crisis and Alternatives,” http://www.mumbaidp24seven.in/reference/ JSA_Health_system_in_India.pdf (accessed on 15 December 2018).
Mario Vaz, “Ethical Challenges in Healthcare and Medical Research in India,” in Shaji George Kochuthara, ed., Moral Theology in India Today, Bangalore: Dharmaram Publications, 2013.
Lucose Chamakala, “Bio-Medical Ethics in India: Challenges Ahead,” Asian Horizons 4, 1 (2010).
World Health Organization, “Health Equity,” https://www.who.int/topics/ health_equity/en/
Chamakala, “Public Health and Redeeming Human Dignity: Indian Christian Ethical Reflections,” Journal of Dharma 35, 4 (2010)
Alex Vadakumthala, “Healthcare in the Face of Commercialization,” in Baiju Julian and Hormis Mynatty, ed., Catholic Contributions to Bioethics: Reflections on Evangelium Vitae, Bangalore: Asian Trading Corporation, 2007.
Srinivas Goli, “Rural-Urban Divides in Health Status,” https://www.researchgate.net/profile/Srinivas_Goli/Publication/233919730_Rural -Urban_Divide_in_Health_Status/links/0912f50cf1400c2bae00000/Rural-UrbanDivide-in-Health-Status.pdf.
Manisha A. Mehrotra and Saumya Chand, “An Evaluation of Major Determinants of Health Care Facilities for Women in India,” IOSR Journal of Humanities and Social Science 2, 5 (2012)
“Improving Women’s Well-being Needs More than Access to Free Healthcare: Study,” https://www.downtoearth.org.in/news/health/improving-women-s-wellbeing-needs-more-than-access-to-free-healthcare-study-61025 (accessed on 15 December 2018).
Shazia Nigar, “India’s Dalit Women Lack Access to Healthcare and Die Young,” http://www.atimes.com/article/indias-dalit-women-lack-access-to-healthcare-anddie-young/
Saba Khan and Malik Itrat, “Current Issues in Geriatric Health Care in India—A Review,” Journal of Community Medicine and Health Care 1, 1 (2016)
Lucose Chamakala, “Health Care in India: A Few Contemporary Challenges,” in Shaji George Kochuthara, ed., Moral Theology in India Today, Bangalore: Dharmaram Publications, 2013.
Gopal K. Ingle and Anita Nath, “Geriatric Health in India: Concerns and Solutions,” Indian Journal of Community Medicine 33, 4 (2008).
National Health Accounts Technical Secretariat, National Health Accounts Estimates for India, 2017, New Delhi: National Health Systems Resource Centre, Ministry of Health and Family Welfare, Government of India, 2017.
Maitri Porecha, “Rising Healthcare Costs Push 5.5 Crore Indians Below Poverty Line,” https://www.thehindubusinessline.com/economy/rising-healthcare-costspush-55-cr-indians-below-poverty-line/article24116816.ece
Pretesh Rohan Kiran, “Challenges in Medical Education and Healthcare in India,” Health Action 28, 7 (2015)
Sanchita Sharma, “India’s Public Healthcare System in Crisis: Too Many Patients, not Enough Doctors,” https://www.hindustantimes.com/indianews/public-health-system-in-crisis-too-many-patients-not-enough-doctors/story39XAtFSWGfO0e4qRKcd8fO.html
Karthik Muralidharan, Nazmul Chaudhury and Jeffrey Hammer, “Is There a Doctor in the House? Medical Worker Absence in India,” https://econweb. ucsd.edu/~kamurali/papers/Working%20Papers/Is%20There%20a%Doctor%20in %20the%20House%20-%2012%20April.%202011.pdf
Neelmani Jayaswal, “Rural Health Systems in India: A Review,” International Journal of Social Work and Human Services Practices 3, 1 (2015)
“No Mechanism to Check Private Practice by Govt Hospital Doctors,” https://timesofindia.indiatimes.com/City/nashik/No-mechanism-to-check-privateby-govt-hospital-doctors/articleshow/52804863.cms
Neetu Chandra Sharma, “Clinical Trial Trap: No Payment for Deaths of Human Guinea Pigs,” https://www. indiatoday.in/mail-today/story/clinical-trial-trap-nopayment-for-deaths-of-human-guinea-pigs-277573-2015-12-17
“Re-imagining the Possible in the Indian Healthcare Ecosystem with Emerging Technologies,” https://www. pwc.in/assets/pdfs/publications/2018/reimaginingthe-possible-in-the-indian-healthcare-ecosystem-with-emerging-technologies.pdf
Scaria Kanniyakonil, Living Organ Donation and Transplantation: A Medical, Legal and Moral Theological Appraisal, Vadavathoor: Department of Publications of Paurastya Vidyapitham, 2005
J. Charles Davis, “Medical Ethics in India,” in Mathew Illathuparambil, ed., Indian Moral Theology: Historical Studies and Future Prospects, Bangalore: Dharmaram Publications, 2017
Richard A. McCormick, Health and Medicine in the Catholic Tradition, New York: Crossroad, 1987
Paulachan Kochappilly, Life in Christ: Eastern Perspectives on Christian Ethics, Bangalore: Dharmaram Publications, 2010
Germain Grisez, The Way of the Lord Jesus, Volume Two: Living a Christian Life, Illinois: Franciscan Press, 1993
George Lobo, Current Problems in Medical Ethics, Delhi: St Paul Publications, 1980.
Ramón Lucas Lucas, “The Anthropological Status of the Human Embryo,” in Juan de Dios Vial Correa and Elio Sgreccia, ed., The Identity and Statute of Human Embryo: Proceedings of Third Assembly of the Pontifical Academy for Life, Vatican: Libreria Editrice Vaticana, 1998.
Bernard Häring, Medical Ethics, Slough: St. Paul Publications, 1973.
James B. Nelson and Joanne Smith Rohrict, Human Medicine: Ethical Perspectives on Today’s Medical Issues, Minneapolis: Augsburg Publishing House, 1984
World Health Organization, “Constitution of World Health Organization,” http://www.who.int/governance/ eb/who_constitution_en.pdf
Constitution Assembly of India, Constitution of India, New Delhi: Constitution Assembly of India, 1946.
E. Premdas, “Right to Health and Healthcare,” Integral Liberation 12, 1 (2008)
Bernard Häring, The Law of Christ Vol 3: Special Moral Theology, Cork: The Mercier Press, 1966.
Karl H. Peschke, Christian Ethics: Moral Theology in the Light of Vatican II, Vol. II
John Karuvelil, “Justice and the Common Good in Public Health: A Contextual Reflection for India,” in Scaria Kanniyakonil, ed., New Horizons in Christian Ethics: Reflections from India, Bangalore: Asian Trading Corporation, 2014.
Philip S. Keane, Catholicism and Health-Care Justice: Problems, Potential and Solutions, New York: Paulist Press, 2002.
Dnyaneshwar P. Chouri, Right to Health and Legal Protection, New Delhi: Regal Publications, 2013.
“Explore the Ways to Improve the Health Status of the Country: PM,” http://pib.nic.in/newsite/erelcontent. aspx?relid=12227
Eileen P. Flynn, Issues in Medical Ethics, Kansas City: Sheed and Ward, 1997.
John P. Kenny, Medical Ethics, Cork: Mercier Press, 1952.
Ramesh Kumar Sangwan, Health, Human Rights and Ethics, Jaipur: Rawat Publications, 2017.