MCI's code of ethics gives docs way to accept freebies

The recently notified 'new' ethical guidelines of the Medical Council of India (MCI) are being touted as a bid to punish doctors accepting freebies from pharma companies. However, these guidelines, doctors fighting corruption in the profession point out, will legitimise doctors' associations taking money from the pharma industry.

While the guidelines elaborate the quantum of punishment for doctors on the basis of the value of favours or freebies received from pharma companies, they also include an amendment that ensures that doctors' associations are beyond the MCI's jurisdiction.

Under the Societies Registration Act, it takes just seven people to form an association. In effect, what is barred for an individual doctor can be done as soon as seven or more of them get together to form a society or association.

The guidelines are actually five years old, but were notified in the official gazette on February 1. Without them being notified by the government, they could not come into effect. As a result, the council could not allow associations to go scot free claiming that it has no jurisdiction over them.

These guidelines were framed by the MCI in March 2010, when Dr Ketan Desai, twice removed from the president's post on charges of corruption though not convicted, was heading the council. The new guidelines were meant to amend the Indian Medical Council (Professional conduct, Etiquette and Ethics) Regulations, 2002. The first amendment was to delete the words "and professional association of doctors" from section 6.8 of the Code of Medical Ethics Regulation 2002. Earlier, this section read: "code of conduct for doctors and professional association of doctors in their relationship with pharmaceutical and allied health sector industry". In the amended version, the words "professional association" have been deleted.

This was within months of the new code of ethics barring doctors and professional association of doctors from taking gifts and sponsorships from pharmaceutical and health sector industry being published in the gazette on December 14, 2009. According to the minutes of the central working committee meeting of the Indian Medical Association in June 2010 Dr Desai when asked about clause 6.8 regarding organisations had "promised that this would be rectified". That promise has now been fulfilled.

"This is a national shame. You are allowing a gang to do the corruption but not one person. It is plain and simple legalising of corruption. This gives legal sanction to pharma companies to bribe doctors and the poor will suffer as companies will go on paying doctors and the money will come from the pockets of the common man," said Dr G S Grewal, president of the Punjab Medical Council.

"This sudden hurry to notify the five-year-old guidelines is because it was recently reported in the media that the council cannot exonerate the IMA and other doctors' associations for taking money as the amendments were not notified.

Once notified, these so-called ethical guidelines may help to legitimise pharma bribes for doctors' associations," explained Dr KV Babu, who had complained against the IMA taking money from Pepsi and Dabur to endorse their products.

The absurdity of making something illegal for individual doctors but legit for their associations was pointed out in a submission made by the MCI in the Delhi High Court in 2011. It said, "what is not allowed to be done directly, cannot be permitted to be done indirectly" and that it was unsustainable to argue that what an individual doctor cannot do can be done by doctors forming an association.

This submission was in a case involving the IMA taking money from private companies and was made during the tenure of the Board of Governors (BoG), who ran MCI after it was disbanded in 2010. Yet, the reconstituted medical council that replaced the government-appointed BoG in 2013 reverted to the stance that it had no jurisdiction over doctors' associations.