Should Doctors go on strike? Ethics versus Egotism

The answer is simply yes since strike is a legitimate action to frown on unfavorable conditions. Strike action is legal and any institution that has legal rights can embark on strike when it deems fit by the abiding conditions. If doctors qualify under this democratic legitimacy, then under which conditions should doctors be on strike?

Why doctors go on strike

From our history as Ghanaians, we have seen doctors going on strike for salary increment. These urgencies may be as result of the following:

From global perspective, the medical profession is indeed one of the various professions that carry dignity and every doctor has this rooted deep in his or her mind. The cost that involves to become a medical doctor is less talked about. It really cost. For that matter many doctors don’t see it reasonable to leave on a meager salary.

Another point might be the gravity of their services to patients. Many doctors do heart transplanting, fix bones, treat cancer, kidney, liver etc. These works are very delicate and any careless attempt will end up paralyzing or resulting in the death of the patient. They are called deep in the night to respond to emergencies and many other emergency engagements.

Doctors have also argued that the risky nature of their profession demands a higher salary. Sometimes they are prone to contagious diseases like flu, HIV/AID’s, TB, and over 200 more contagious deadly diseases. For that matter a high salary must be given to encourage or motivate them.

All these points are reasonable though debatable. But often when we talk of risky professions, medical sector is the least talked about. We talk about areas like the military, veterinary, police, fire service, prisons etc. are all coupled with high risk and are sectors that need great attention.

Possible reasons against doctors strike action

Even though some international researches have proven that, doctors’ strike increases mortality rate, nevertheless, we can not overlook to project consequences that comes as a result of doctors’ strike.

1. Untimely death of patients
2. Prolongation of suffering of patients in severe cases
3.  Breach of international code of ethics that doctors themselves have sworn into
4.  Put pressure on government
5.  Sensitizes other equally rated professions to follow suite
6.  The public might see them as greedy other than selfless civil servants
7.  Not ethical in its nature since it involves humans’ life
8.  Their profession is no greater than others, etc.

The question of ethics

In most cases, doctors’ strike has attracted many protests because the public think they are risking the lives of millions and however not ethical. Can ethics be applied to doctors’ strike?

First, every doctor is already bonded by code of ethics. Each doctor before taking up the post swears to abide by a code of ethics. One of the lines in the international code of ethics for doctors reads like this, “I will maintain the utmost respect for human life from its beginning even under threat and I will not use my medical knowledge contrary to the laws of humanity;” The international code of ethics further states, “A physician shall not permit motives of profit to influence the free and independent exercise of professional judgment on behalf of patients.” To the doctor, the life of the patient comes first to all other things.

Doctors are also legally required to attend to patients and offer to them an undivided medical attention. This legality exists between the doctor and the government. Though the patient has intent of receiving an excellent care and treatment after paying his NHIS, in cases of strike, the patient has no legal right to sue the doctor in question, unless a private or personal doctor. He can only sue the NHIS or Ministry of Health.

The issues of ethics comes into play when we talk of issues of good and evil, live and death, justice and crime, etc. Since the doctors primary job is to save lives and that a lost life cannot be revived, it therefore becomes delicate for the doctor when taking any action that will obliterate these ethics. Should a patient loss his or her life as a result of doctors’ strike, who would be blamed? The doctor or the government?

The issue of egotism

When we are talking of labor strike, we must consider the consequential results also. This is what we call utilitarianism. From Wikipedia, “Utilitarianism is an ethical theory holding that the proper course of action is the one that maximizes the overall "good" of the greatest number of individuals. It is thus a form of consequentialism, meaning that the moral worth of an action is determined by its resulting outcome.” When doctors think an action is right, then it must have a national impact as well.

I am yet to offer a round of applause for doctors embarking on a strike action to improve quality health care products, laboratory equipment, enough patient wards, digital and IT infusion into the health practice, to stop nurses’ and medical personnel’s migration and others that bring a unanimous good for the majority of the people in the country. Strike actions under such circumstances are justifiable and must be given an immediate support and attention.

When these important things which I think are the pressing needs of Ghana are overlooked by doctors and rather, they are seeking to fulfill their own selfish gain, then their strike action would be considered as greed and however, unethical.

Nevertheless, in most cases, we might see the salaries of doctors not fitting them to take care of their own family and expenses. This will result in what Dr. Andrew Rowland considers as “Working without enthusiasm.”  In such cases a petition must be sent to the government and the government must charge the appropriate authorities to look into the matter. If it deems fit for salary increment, the government must do it without hesitant. And in this increment the government must be carefully of what he is giving out in order not to trigger other strike actions from other equally rated public sectors. On the contrary if the government refuses to adhere to their request upon countless request, then doctors can use strike as the last resort to communicate their worries.

In conclusion, doctors by constitution have every right to embark on a strike action but this must be as a result of an extreme maltreatment or lack of health facilities which makes rendering services difficult and which in effect will enrich the lives of all; both doctors and nationals as well. Doctors must esteem the lives of their patients and refrain from greed. Government must make every effort to enrich, not only the lives of doctors alone, but to make a reasonable salary rate for all public servants.  The last but not the least, the constitution must also make it clear under which and what conditions delicate professions like medicine, military, police etc. can embark on strike.

World Medical Association International Code of Medical Ethics

 Adopted by the 3rd General Assembly of the World Medical Association, London, England, October 1949

and amended by the 22nd World Medical Assembly Sydney, Australia, August 1968 and the 35th World Medical Assembly Venice, Italy, October 1983

DUTIES OF PHYSICIANS IN GENERAL

A PHYSICIAN SHALL always maintain the highest standards of professional conduct.

A PHYSICIAN SHALL not permit motives of profit to influence the free and independent exercise of professional judgement on behalf of patients.

A PHYSICIAN SHALL in all types of medical practice, be dedicated to providing competent medical service in full technical and moral independence, with compassion and respect for human dignity.

A PHYSICIAN SHALL deal honestly with patients and colleagues, and strive to expose those physicians deficient in character or competence, or who engage in

fraud or deception. The following practices are deemed to be unethical conduct:

a) Self advertising by physicians, unless permitted by the laws of the

country and the Code of Ethics of the National Medical Association.

b) Paying or receiving any fee or any other consideration solely to

procure the referral of a patient or for prescribing or referring a patient to

any source.

A PHYSICIAN SHALL respect the rights of patients, of colleagues, and of other health professionals and shall safeguard patient confidences.

A PHYSICIAN SHALL act only in the patient's interest when providing medical care which might have the effect of weakening the physical and mental condition of the patient.

A PHYSICIAN SHALL use great caution in divulging discoveries or new techniques or treatment through non-professional channels.

A PHYSICIAN SHALL certify only that which he has personally verified.

DUTIES OF PHYSICIANS TO THE SICK

A PHYSICIAN SHALL always bear in mind the obligation of preserving human life.

A PHYSICIAN SHALL owe his patients complete loyalty and all the resources of his science. Whenever an examination or treatment is beyond the physician's

capacity he should summon another physician who has the necessary ability.

A PHYSICIAN SHALL preserve absolute confidentiality on all he knows about his patient even after the patient has died.

A PHYSICIAN SHALL give emergency care as a humanitarian duty unless he is assured that others are willing and able to give such care.

DUTIES OF PHYSICIANS TO EACH OTHER

A PHYSICIAN SHALL behave towards his colleagues as he would have them behave towards him.

A PHYSICIAN SHALL NOT entice patients from his colleagues.

A PHYSICIAN SHALL observe the principles of the "Declaration of Geneva" approved by the World Medical Association.

DECLARATION OF GENEVA

Adopted by the 2nd General Assembly of the World Medical Association, Geneva, Switzerland, September 1948 and amended by the 22nd World Medical Assembly Sydney, Australia, August 1968 and the 35th World Medical Assembly

Venice, Italy, October 1983 and the 46th WMA General Assembly

Stockholm, Sweden, September 1994.

AT THE TIME OF BEING ADMITTED AS A

MEMBER OF THE MEDICAL PROFESSION:

I SOLEMNLY PLEDGE myself to consecrate my life to the service of

humanity;

I WILL GIVE to my teachers the respect and gratitude which is their due;

I WILL PRACTICE my profession with conscience and dignity;

THE HEALTH OF MY PATIENT will be my first consideration;

I WILL RESPECT the secrets which are confided in me, even after the

patient has died;

I WILL MAINTAIN by all the means in my power, the honor and the noble

traditions of the medical profession;

MY COLLEAGUES will be my sisters and brothers;

I WILL NOT PERMIT considerations of age, disease or disability, creed,

ethnic origin, gender, nationality, political affiliation, race, sexual

orientation, or social standing to intervene between my duty and my

patient;

I WILL MAINTAIN the utmost respect for human life from its beginning

even under threat and I will not use my medical knowledge contrary to the

laws of humanity;

I MAKE THESE PROMISES solemnly, freely and upon my honor.

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African poverty, Whose cause? Understanding the proud carelessness of African leaders

Dear Lord help me to be of help!

Poverty in Africa is real. People who have come in contact with some African communities will surely agree. I personally came across a scene in Benin which made me sick for a year. But Africa is the richest continent in the world, in respect to natural resources.

But what am I saying? Is it that Africa is so poor that these people should go through circles of poverty? No!!! Africa is not a land of poverty! It's a land of abundance. Even in my own hometown up to date, we have houses that throw food away each night. But how come the continent is so plagued with poverty? Whose cause?

Africans discover poverty at early age.

It is a big fact that the vicious poverty in Africa is alluded to leadership. If more than 46 African independent states cannot feed Somalia, then all of you reading this piece should understand. Nigeria alone can feed Somalia let alone South Africa.

Africa has always have greedy and selfish political leaders, presidents, capitalists, etc. The rich in Africa only lavish themselves in wealth. So the marginal line keeps widening between the rich and poor. African money do not care for it's people. Everyone wants to make money just for a name without any communal interest in mind.

Sometimes you walk through a community where there is an opening gutter which needs to be constructed. In the same vicinity you can get one rich business man (capitalist) who can fix this without government intervention. But this gutter will be there widening and flooding away lives each year. Proud carelessness that kills society is eaten up deep in the hearts of the privileged. And as Africans continue to have this mind, will there be progress? Absolutely no.

We have heard stories of presidents dieing or leaving office with huge amount of money in foreign banks. Recent is ex-president Laurent Gbagbo of la Cote D'Ivoire having 7billion CHF in a Swiss bank. Obasanjo of Nigeria had more than 24billion dollars in a foreign bank. Zaire former president Mobutu Sese Seko all having huge amount of money in foreign lands. Where did they get these money from? Absolutely exploitation of the country to lavish self.

Because of political ambitions, ruling governments empty national funds for next terms campaigns. Every government in Africa ascends to power to find deficit and huge amount of debt. The present also leaves with zero in coffers or topping up the deficit. While such a monkey tactic is being played, will the jungle continue to be in peace?

African leaders also lack vision. Instead of building a strong societal amenities like roads, hospitals, good drinking waters, residential estates, controlling rural-urban migration, etc. they lavish money in aircrafts, luxurious cars for ministers, spending money on travels, relying on loans, failing in primary measures that make everyone feel at home.

The Embraer 190 with other five military jets

For example Ghana's purchase of the Embraer Aircraft with a contract that will be valued at approximately $200 million, which includes also $105.3 million Brazilian-made Embraer 190 coupled with the construction of an ultra-modern hangar. Meanwhile the Volta lake which serves Ghanaians with fresh fish has been killing hundreds because of stumps in the Volta and poor boats on it. This is absolutely lack of vision.

Stumps in the largest artificial lake in the world since 1962

Instead of promoting local business enterprises to enrich the land, African leaders keep on exporting raw materials only for 10% and 13%. For instance in Ghana where one of the best cocoa's are found, the average person cannot maintain a constant Cocoa drink or chocolate in the home. These are some of the areas African leaders should turn their eyes unto.

There is no reason why Africans should rely on foreign aids. She can make it herself. It's time for bad leaders to be kicked out of government. The people must understand that, partisan or political affiliation is destroying the progress of Africa. We must vote for people with clean conscience and when they fail we must direct them to where they came from.

This is not a mere criticism. Even that, I have tried to be sincere and candid in my criticism. African leaders must build communities and refrain from unnecessary high tech developments that favor the rich and their families; not forgetting the former.

She must live! Africa must live!

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A million dollar question: Why should Africa be poor?

 A continent so blessed with abundance yet famine, hunger and thirst rip millions of lives. Many nations pride themselves in unique and excellent products like shoes, chocolate, gold watches, fabrics, metallics, etc. But where did they get it from? Africa. Why is it that they keep on coming? They can't stop coming because of the richness of the continent. But why its inhabitants are poor? Highly indebted, scattered as slaves in foreign lands and hunger and thirst kills millions? Because of lack of vision, greed, violence, negligence, egotism, pride, weak African Union, etc.

There is obviously an evil spirit that works through men, both within and without Africa to restrain her from her prosperity! If Africa should fail to mount over these challenges, then the other side of the world which has been exploiting Africa and ripping off her wealth must be prepared to face a recompense from God; either here below or His coming! The great judge and advocate of the poor.

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African unity, is it a dream or reality? A general perspective on African unity in the context of continental union

For many years Africans have lived in united shared states and communities. Africa could record countless strong ancient kingdoms and empires. Great empires like the Egyptian empire, Ethiopian Empire and many other Sahelian Kingdoms like Mali empire and the Ashante Kingdom have majored an important role in the history of the world. There is no doubt that these are evidences to suggest the ability of self governance, social and political organizations of Africans.

African unity is not a dream. It’s a reality that lives with each African. People who know Africans could easily detect how they are nit together in a common union of fraternity. They are people with same cultural formulae, one God, intelligent, strong, resilient and hospitable irrespective of their vulnerabilities.

African proverbs like, “Unity among the cattle makes the lion lie down hungry”, “The heavens will fall” is not the concern of only one ”, “Sticks in a bundle are unbreakable”, “The reason two antelopes walk together is so that one can blow the dust out of the other ones eyes” and more are all synopsis of contemporary Pan-African concept of unity.

Today, the concept of African unity is shifted from local community to a wider scope, even a continental level. Everywhere, in the community of Africans, comes the same cry, “Africa must unite!” Movements and organisations like Pan-Africanism, Organisation of African Unity (OAU) and African Union (AU) are names that evoke Africa’s interest for a united continent or people. Other regional groups however like the, Economic Community of West African States (ECOWAS), Central Economic Community of Central African States (ECCAS), Economic Community of Great Lakes countries (CEPGL), Common Market for Eastern and Southern Africa (COMESA), East African Community (EAC), Inter-Governmental Authority on Development (IGAD), Indian Ocean Commission (IOC), Southern Africa Development Community (SADC) and Southern African Customs Union (SACU), Community of Sahel-Saharan States (CEN-SAD) and many other organizational institutions are all players in this longstanding nostalgia.

Marting Luther King Jnr once said 1968, "Something is happening in our world. The masses of people are rising up. And wherever they are assembled today, whether they are in Johannesburg, South Africa; Nairobi, Kenya; Accra, Ghana; New York City; Atlanta, Georgia; Jackson, Mississippi; or Memphis,Tennessee, the cry is always the same: 'We want to be free.' "   Martin Luther King, Jr., 3rd April 1968.

Recalling his words to mind suggest how long the African continent has longed to have independent economic, social and political self governance.  The concept of this independence wasn’t championed for the absence of colonialism. However, it was embodied in the ability of personal management without foreign interference or influence, and above all, internal management of resources and development.

But today the continent Africa which Martin Luther King Jnr once described as a “Dark Continent” is still under the shadows of foreign exploitation and dictatorship. The influence of colonialism still permeates through out the land of Africa, only in an indescribable backend system. The natural resources, industries, formulation of policies and political businesses, are all cramped up in foreign influences. This is now the “silent pistol” depreciating the African continent both from unanimous power and economic breakdown.

The adage has always been the same, “Africa shall never be free unless Europe and America let them alone”. But the great question is, “Doesn’t Africa has the power to break from foreign influence?” Yes it has the power. But now everyone outside this part of the continent knows that Africa is a “toothless bull dog” a “sleeping giant” and above all a “wounded soldier”. The word is Africa is weak.

To recall our memories, on the night of 6^th March 1957 during Ghana’s independence address, Kwame Nkrumah, the first president of Ghana, Pan-African activist and father of Africa, made a startling statement which was not for the people of Ghana but as a cushion and bedrock for all African states. I quote “And as I pointed out... I made it quite clear that from now on – today – we must change our attitudes, our minds, we must realise that from now on, we are no more a colonial but a free and independent people. But also, as I pointed out, that also entails hard work. That a new African is ready to fight his own battles and show that after all, the black man is capable of managing his own affairs. We are going to demonstrate to the world, to the other nations, that we are prepared to lay our own foundation. Our own African identity….. Seeing you in this… it doesn't matter how far my eye goes, I can see that you are here in your millions and my last warning to you is that you are to stand firm behind us so that we can prove to the world that when the African is given a chance he can show the world that he is somebody! We have awakened. We shall no longer sleep anymore. Today, from now on, there is a new African in the world!”

In following of Ghana’s independence and the active work of Nkrumah and others, many African states began to gain their freedom from colonialism. The good work started was shared and talked about in foreign newspapers about the rising of the African continent. But this lasted for a short period of time, and Africa turned into war and conflicts, sicknesses and diseases, hunger and famine, poverty and creed, political instability and economic breakdowns.

What happened to Africa? When did the powerful words of Nkrumah wane so quickly from Africans? If Africa is weak today it is because she has failed to master the management of her own affaires and losing sight of a common identity that unifies and separates her from the other parts of the world.

To point out some of these failures by Africa are failure to the resolution of internal wars and tribal conflicts, provision of security, lack of a unified combatants, infiltration of rebels and finally the overthrown of Muammar Muhammad al-Gaddafi which the African Union could have done in their own way without any rain of foreign bombs on the continent.

Indeed I believe strongly that, the fall of Gaddafi should give all Africans a new perspective toward continental unity.

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