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                  China Daily

                  HongKong> Opinion> Content
                  Thursday, February 13, 2020, 10:36
                  Doctors must never withhold treatment
                  By Ronald Ng
                  Thursday, February 13, 2020, 10:36 By Ronald Ng

                  The decision by many doctors in Hong Kong to go on strike as a means to pressure the government into closing the Hong Kong-mainland border came as a shock to many people in general, and to old-school doctors in particular. As a practicing physician and graduate of the Medical School of the University of Hong Kong, I am dismayed at the course of action being taken. Although graduates of the Hong Kong medical school do not literally have to take the Hippocratic oath, and in reality, that oath is a bit out of date, there are certain principles of medical ethics that have been truly sacred since time immemorial, namely:

                  First, autonomy of the patients — they have the right to determine their own healthcare.

                  Second, justice — distributing the benefits and burdens of care across society; respecting the confidentiality of patients’ data; proper conduct with all patients.

                  Third, beneficence — doing good for the patient.

                  And fourth, non-malfeasance — making sure no harm is done to the patient.

                  Even during war between nations, the Geneva Convention mandates that wounded enemies are to be given medical treatment. Physicians are to follow the principle of medical neutrality.

                  Virtually, all systems of medical ethics would maintain that the patients’ well-being is their main concern. Whatever the political motivation, withdrawing medical care from patients is unacceptable under any circumstances

                  In other words, it is very clear that the medical ethics that doctors are required to uphold are that at no time should they withhold their therapeutic skills from the sick under any circumstances. To have a strike and thereby willfully withhold treatment of the sick is, therefore, both unthinkable and in gross violation of all medical ethics. Going on strike clearly violates the accepted principles of beneficence and non-malfeasance as mentioned above.

                  Let us now dissect the reason for the strike. Ostensibly, it is to force the government to block all entry points from the Chinese mainland to limit the spread of the new coronavirus and to prevent Hong Kong medical facilities from being overwhelmed by the potential number of cases that the medical system would have to deal with if all border checkpoints were not shut down. They claimed that the latter situation could come about due to the spreading of the virus, with many people from the mainland with the virus coming into Hong Kong, and in particular the fear that some infected mainland residents might come to Hong Kong for treatment.

                  Zhong Nanshan, the man who discovered the SARS virus, published a model of how widespread the coronavirus could become. His model suggests that ultimately, some 60,000 people could be infected. Professor Jon Read, an epidemiologist at the University of Lancaster, has a model that predicts that ultimately, about 240,000 people will be infected. Both models tracked the actual number of people infected up to the beginning of February. Regardless of which model, if either, ultimately turns out to be correct, they show that the idea of limiting contact with people who have been on the mainland in general, and in the city of Wuhan and Hubei province in particular, do have some merit. In fact, some governments around the world, including Singapore’s, have imposed restrictions on travelers from the Chinese mainland entering their respective countries.

                  One cannot dismiss the possibility of the system being overwhelmed should there be a large number of people with the virus coming into Hong Kong, which might even create a local epidemic. However, is going on strike the way to go to avert such dangers?

                  Virtually, all systems of medical ethics would maintain that the patients’ well-being is their main concern. Whatever the political motivation, withdrawing medical care from patients is unacceptable under any circumstances.

                  Perhaps at this point, I might address a suggestion to the Hong Kong government. Early last year, there were two cases in Singapore in which the Singapore Medical Council decreed punishment for two doctors that was deemed to be inordinately harsh, creating a local backlash. Within 24 hours of the announcement of the punishment, thousands of signatures were gathered from local doctors calling for a review of the workings of the Medical Council. The government, realizing the seriousness of the situation, immediately sent teams of people, including senior lawyers and the minister of state for health, to meet with the doctors, visiting the hospitals, the Singapore Medical Association and the Academy of Medicine. From that feedback, a paper was produced within three months that recommended various changes in the way the Medical Council conducts its disciplinary hearings and patients’ complaints. The whole furor died down. This is a lesson in the government’s listening to the people and successfully nipping a brewing controversy in the bud. It is worth exploring if there might be an equivalent situation regarding those striking doctors and nurses. Perhaps Hong Kong officials can take a lesson from the Singapore government on how to handle doctors’ concerns.

                  The author is a hematologist in Singapore and has practiced and taught medicine in various countries and regions, including Hong Kong. The views do not necessarily reflect those of China Daily.


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