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More discussion needed on medical ethics in places of detention in India
- Anant Bhan (16 May 2007)
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May be there is some hope?
- Dr Gurinder Singh (20 December 2007)
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Anant Bhan, Independent Researcher in public health and bioethics Pune, India, Postal code: 411027
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The meeting organized by the Indian Medical Association with the World Medical Association and the International Committee of the Red Cross on medical ethics in places of detention is a welcome step for India. While the news report highlights torture during detention, lack of routine medical assessment and a continuum of care for prisoners, high infectious disease prevalence as well as pressure on prison doctors, some crucial aspects seem to have not been covered in the meeting. India still allows for capital punishment, a vestige of British colonial rule and laws drafted during that period. While the death penalty was abolished in Britain in the late 1990s, capital punishment through death by hanging is still prevalent in India. This form of death penalty by law requires that the prison doctors certify the fitness of death row convicts for execution, as well as be present during the hanging to certify death. This means that the doctor is essentially waiting to pronounce the prisoner clinically dead. This is a violation of medical ethics, where the doctor’s first duty is to protect the life of his/her patient. Also the doctor can be consulted on the length of the rope used by hanging to cause instant death under jail manuals. Plans are underfoot to change the mode of execution to lethal injection, which has greater complicity of the medical profession. These facts have been discussed in detail in earlier articles in Indian journals (1),(2). While the WMA has a clear policy stating that it is unethical for doctors to participate in the death penalty (3), I am wondering if the role of prison doctors in death penalty in India was deliberated at the Delhi meeting. Medical professionals have been called upon to assist in investigations in recent years by administering sodium pentothal, commonly called ‘truth serum’ to under trial prisoners for ‘narcoanalysis’. While statements taken through this method are not admissible in courts, Indian police officials are increasingly using it. Medical professionals need to desist in India from participating in such acts that are dubious scientifically, ethically (4) as well are a clear violation of the rights of the prisoners. Discussions on medical ethics in places of detention need to extend to the role of medical professionals and hospitals where these procedures are often carried out. References: (1) Jesani A. Medicalisation of 'legal' killing: doctors' participation in the death penalty. Indian J Med Ethics. 2004 Oct-Dec; 1(4): 104-5 (2) Bhan A. Killing for the state: death penalty and the medical profession: a call for action in India. Natl Med J India. 2005 Jul-Aug; 18(4):205-8. (3) World Medical Association Resolution on Physician Participation in Capital Punishment. Adopted 1981, amended 2000. Available online: http://www.wma.net/e/policy/c1.htm (accessed May 16, 2007) (4) Jesani A. Response: questions of science, law and ethics. Indian J Med Ethics. 2007 Jan-Mar; 4(1): 10-11. Competing interests: None declared |
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Dr Gurinder Singh, Speciality Registrar Royal Manchester Children Hospital
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Considering the fact that Indian Prison system is in appaling condition, I don't think doctors can do much to help the prisoners. Many of india's prisons date back to colonial rule, with thousands of prisoners kept in crumbling facilities largely unchanged since the beginning of the last century.There are 322,000 inmates in 1,135 prisons in India. India's prisons officially have capacity for 237,000. There is lack of proper legislation and reforms. The only major all-Indian prison reform ever implemented dates back to the Indian Jails Committee of 1919-1920. Among the worst-affected groups are women with children and the mentally ill. Female prisoners account for 3.12 percent of the total jail population and are allowed to keep their children until they reach the age of five. According to available statistics, 1,400 children younger than five are accompanying their mothers in prison. It is very difficult for Prison doctors to remain impartial and do his/her job properly with limited resources. Tuberculosis and HIV is widespread in Indian jails. In year 2003, 1462 custodial deaths were reported by Indian Home Ministry. The state of India’s penal and justice systems speaks volumes about the true nature of human rights and social equality in a country routinely held up by the Western media as the "world’s largest democracy". I think prison doctors need the support of whole community rather than there medical collegues. 1.http://news.bbc.co.uk/2/hi/south_asia/5116332.stm 2.http://www.hindu.com/op/2004/04/20/stories/2004042000251700.htm Competing interests: None declared |
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