The ethical concerns of medical practice fall largely under the quartet: autonomy, beneficence, non-malfeasance, and fairness or justice. Driven to the brink by the Nazi experiments on specious pleas of medical research, the MCI regulations contain a fairly large set of codes that have adopted universal standards and are best explained through case laws not merely of India but also of foreign countries. Confidentiality is a key precept of medical practice but it is more observed in the breach in the Indian cultural set up, where a patient adopts a ‘doctor-knows-all’ attitude, and where eliciting patient history in privacy is hardly ever observed in government hospitals. Conflict of interest by a doctor prescribing drugs that are meant to be purchased from pharmacies in which the doctor has a proprietary interest is a serious issue of public debate outside India but is seldom perceived as important in India. Human rights violations seen through the context of patient autonomy is again a major casualty in Indian clinical practice.
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