Strengthening Healthcare Ethics: A multi-disciplinary engagement with diverse constituencies related to health and healthcare

Themes | Subthemes | Tags: Trainings in bioethics, Public engagement, capacity building in bioethics
Duration: Aug 2018 – July 2019
Team:  Sunita Sheel (Lead) (Jan 2015 onwards), Navneet Wadkar (July 2018 – Aug 2019), Nikita Surani (Nov 2018 – Nov 2019)
Support team: Mahendra Shinde (Dec 2018 onwards), Vijay Sawant (June 2019 onwards), Shahnawaz Islam (March 2019 onwards)
Funding support | Amount in INR:  Tata Trusts, Mumbai | INR 83.00 lakhs                                                                                                    Slide deck
Product/s: Select list of products include

• Developed curricula in three sub-fields of bioethics for short duration intensive training programs
• Organized three short duration intensive training program in collaboration with other institutions
• Hosted four round table meetings
• Hosted five grand rounds as part of public engagement
• Organized an essay competition titled, ‘Maiden Bioethics Essay Competition for ‘IJME Young Bioethicist and Change-makers Award’

Overview:  Tragic episodes such as sterilisation camps going wrong, unwarranted hysterectomies on vulnerable women from tribal/nomadic communities and the recent deaths of dozens of children for completely avoidable reasons in Gorakhpur are all testimony to the poor state of our public healthcare system and the lack of political will to overhaul it. Similarly, the profit driven private healthcare services have problems of their own, such as lack of regulation, prevalence of ‘cut practice’, and indulgence in overuse of diagnostic tests. Overall, in India, reliable access to quality care which is affordable and sufficiently sensitive continues to be constrained. The healthcare system in India is characterised by information asymmetry between providers and users, dominance of an unregulated market, and gross governance deficit. These have created an iniquitous system adversely impacting people’s access to health care services.

The need of the hour has been to work towards achieving the goal of universal and humane healthcare for the people of India. This calls for several kinds of interventions. Among others, the constituencies that are critical to determining the character of the healthcare system and thereby people’s access to quality health care are healthcare professionals, healthcare teachers, researchers, administrators and policy makers.

There is a need for health professionals to collaborate with other professionals from the social sciences, humanities and law, as well as concerned citizens, to reform the health system so as to function in the best interests of citizens.  Towards furthering such an alignment, this initiative was to develop a multi-disciplinary approach of engagement with multiple constituencies relating to the health care system to create a movement grounded in the discipline of bioethics.  Bioethics-based engagement would provide a balance to and complement the larger “right to health” initiatives in the country to impact the health care system both at micro and macro levels.

• Goals & objectives

The overall goal was to work towards systematically creating a critical mass of individuals from undergraduate students to policy makers, who could serve as change agents to develop and sustain ethical practices as a norm and contribute to creating in-built spaces for conversations around making health systems responsive to and respectful to users.  We had a four-fold objective of strengthening networks of associations in the field of healthcare by: institutionalizing bioethics teaching in collaboration with an academic entities; systematic engagement with various concerned multi-disciplinary constituencies to deliberate on existing and emerging bioethics issues in changing contexts;  establishing a first-of-its-kind e-repository in bioethics with a focus on India and South Asia; and strengthening the digital platform of Indian Journal of Medical Ethics, for discussion and debates in healthcare and bioethics.

• Audience of engagement

The target constituencies include but were not limited to health care professionals, health administrators, health policy makers, health researchers, students from diverse streams linked toto health concerns, and those working in different disciplines both at theoretical and application levels, to enhance people’s access to quality health care. The interventions would allow us to serve the pan-Indian (training and education, grand rounds and public engagement) and global constituencies (e-repository in bioethics and health; and IJME digital platform).

This project enabled FMES to set up its programmatic platform namely, Health, Ethics and Law Institute for Training, Research and Advocacy (HEaL Institute).  It helped strengthen its own existing platforms and further expand its networks, and its engagement with constituencies from across the disciplines by institutionalizing bioethics education.

• Collaborative aspects

The initiative is collaborative in nature, although the grant was hosted and utilized by Forum for Medical Ethics Society alone. The collaborative partners included academic institutes, other health care institutions, and information technology partner.