Editorials

World Medical Association’s tainted president, Ketan Desai

BMJ 2016; 355 doi: https://doi.org/10.1136/bmj.i5867 (Published 10 November 2016) Cite this as: BMJ 2016;355:i5867
  1. Sunil Pandya, neurosurgeon1,
  2. Sanjay Nagral, gastrointestinal surgeon1,
  3. Samiran Nundy, gastrointestinal surgeon2
  1. 1Jaslok Hospital, Mumbai, India
  2. 2Sir Ganga Ram Hospital, New Delhi, India
  1. Correspondence to: S Nundy snundy{at}hotmail.com

New appointment raises questions from India’s medical profession

In the not too distant past, Indian doctors suspected the ethical principles of the country’s medical council, but they always respected those of the World Medical Association (WMA). After all, the WMA, formed on 18 September 1947—barely a month after India gained independence—represented 27 national medical associations, all of which were of solid repute.

Unfortunately, the WMA’s standing has fallen under a cloud with the recent inauguration of Ketan Desai, an Indian urologist, as its president on 21 October 2016.1 The organisation that produced the Declarations of Helsinki and Tokyo now has at its helm an individual who stands accused of involvement in a conspiracy in 2010, whereby he allegedly accepted a bribe of Rs20m ($450 000; £320 000 at the time).2 Desai denies the accusation. This put an end to Desai’s nomination as president of the WMA in 2010, when his planned inauguration was suspended.

An investigation of Indian court records by Reuters news agency and interviews with people involved in the cases showed that criminal allegations are still pending against Desai in New Delhi.1 2

The question is why the WMA should accept someone with a serious criminal case pending against him. Arthur Kaplan, director of the division of medical ethics at New York University Langone Medical Center, urged the WMA to look for another leader: “The whole force of the WMA is its moral authority. You can’t have a compromised leader, you just can’t . . . If you push against torture, if you try to defend doctors in jeopardy from totalitarian regimes, if you try to speak up about getting more care for the poor, people will just point towards your president and say: ‘Why should we care? You have a leader who is morally suspect.’”2

In 2013, the WMA voted to lift the suspension of Desai’s inauguration—at the request of the Indian Medical Association (IMA), where Desai was president from 2001-02.2 K K Aggarwal, the IMA’s secretary general and an official adviser on the medical ethics committee of the WMA, has gone on record to say that “there are no corruption charges against [Desai] as of now.”2 Queries to the WMA have elicited a similar response. “To our knowledge, all charges against him have been dismissed,” a WMA spokesperson told Calcutta’s Telegraph newspaper.3

However, Desai attended a New Delhi courthouse on 4 November 2016 to attend a hearing in a case where he faces a criminal case for corruption. The proceedings were adjourned till February.4

Under such circumstances, it is difficult for us to comprehend why the WMA has chosen to proceed with its appointment of Ketan Desai. Furthermore, we remain puzzled on three counts: Firstly, the WMA seemingly did not find it necessary to approach the courts where cases have been filed against Desai but instead relied on information supplied by Aggarwal. Had it done so, it would have discovered the case for corruption against Desai. Secondly, according to the WMA’s charter, “The WMA serves as a clearing house for ethics information resources for its members and cooperates with academic institutions and global organisations concerned with ethical matters.”5 So why did the WMA not consult institutions working on medical ethics in India on this matter? The association had four years to have made such inquiries but does not seem to have done so. Thirdly, to our knowledge the constituent bodies of the WMA, including the British, American, Canadian, and Australian medical associations, have made no inquiries of their own. These agencies have ample resources in India to seek out facts.

We believe that organisations such as the WMA, while acting democratically in choosing their leaders, should set the bar very high on ethical standards. In this case, by electing as its leader a man facing serious criminal proceedings the WMA has arguably lowered it. Under normal circumstances, if an Indian colleague was elected to a prestigious international body we would have felt a sense of pride. But we speak for many of our compatriots, especially those who are bravely fighting corrupt practices in Indian healthcare, when we say that instead of feeling proud we feel disappointed and seek answers.

Footnotes

  • Competing interests: We have read and understood BMJ policy on declaration of interests and have no relevant interests to declare. The views expressed here are personal and do not reflect those of the authors’ hospitals.

  • Provenance and peer review: Commissioned; not externally peer reviewed.

References

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