The Hindu : Karnataka / Bangalore News : Lakshmi’s surgery raises privacy issue

Online edition of India's National Newspaper
Sunday, Nov 11, 2007
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Karnataka

Karnataka - Bangalore

Lakshmi’s surgery raises privacy issue

Staff Reporter

It is a violation of MCI guidelines, says H. Sudarshan

Sudarshan says there is nothing unique about the complicated surgery
‘Any breakthrough should be published in medical journals first’

BANGALORE: Many people in India and around the world now know about two-year-old Lakshmi Tatma, the “eight-limbed girl” from a remote village in Bihar who recently underwent a 27-hour surgery in Bangalore to separate her from her parasitic twin.

As pictures of the little one with the fused body of her headless parasitic twin was splashed across the media, many prayed for her. But a few medical professionals have expressed concern over the child being made into a spectacle and have raised issues of medical ethics and patient privacy.

“Medical professionals who promote a medical procedure performed by them through a patient thus getting publicity are not doing the right thing. There are guidelines laid down by the Medical Council of India and the Karnataka Medical Council against doctors advertising their skills or unnecessarily turning media attention on themselves. In Lakshmi’s case, the medical team operating on her should have shown a little more restraint,” said H. Sudarshan, former Vigilance Director, Lokayukta, who headed the Karnataka Task Force on Health and Family Welfare, 2000.

The surgery done on Lakshmi was not unique and similar procedures have been performed, he said. “When there is a medical breakthrough or a landmark medical case that needs to be made public, it should be published in reputed medical journals and only then taken to the media,” he said.

Section 6.1 of the Indian Medical Council (Professional conduct, Etiquette and Ethics) Regulations, 2002 says: “Soliciting of patients directly or indirectly, by a physician, by a group of physicians or by institutions or organisations is unethical.

A physician shall not make use of him/her (or his/her name) as subject of any form or manner of advertising or publicity through any mode, either alone or in conjunction with others, which is of such a character as to invite attention to him or to his professional position, skill, qualification, achievements, attainments, specialities, appointments, associations, affiliations or honours and/or of such character as would ordinarily result in his self-aggrandisement.”

Informed consent by the patient, or if a minor, the patient’s family, for publicising confidential medical details either in a book, journal, or the media, is an issue that has exercised the medical community the world over. The academic literature and debate on this sensitive issue is large with detailed guidelines formulated by individual hospitals and medical associations.

In countries where patients are poor and often illiterate, and cannot afford the cost of treatment, the question of informed consent assumes additional complexity.

“While it is a good thing that the girl received free care which she could not have afforded otherwise, the vulnerability of Lakshmi’s parents is exposed.

“They may have consented to the surgery but since they come from a poor background, there is little chance they would have refused,” said Prem Pais, Dean, St. John’s Medical College.

About the issue of confidentiality, Dr. Sharan Patil, who headed the team that operated on Lakshmi, said: “It is sad that when people in India and around the world are proud of the feat achieved by us, some people are talking about it negatively.”

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