It is extremely concerning to see an ongoing sit-down strike by The Gambia Doctors’ Association despite heartfelt apology from the Minister of Health and Social Welfare, Dr Saffie Lowe-Ceesay regarding truthful statements she had made.
In press conference, Dr Lowe alleged that “When you talk about corruption in the health system we all know how it is…These young doctors that will just go and practice pharmaceutics, some of them have opened their own pharmacies with the resources that we have. I am very sure of what I am saying because I was the PS”.
The continuing sit-down strike by these young doctors is continuously resulting to inaccessible healthcare and increasingly death rate among the patients population as reported in media. This harmful action is total violation of three of the most important Principles of Biomedical Ethics . Every healthcare professional is required or obligated to show nonmaleficence (an obligation to do no harm), beneficence (action taken to benefit and promote the welfare of patients and their families) and justice (doing what is morally and legally right). These principles are currently being ignored and abandoned by The Gambia’s protesting Doctors who took the Hippocrates oath to uphold and defend these principles in every decision making. The most significant of the Hippocrates oath is that patients responsibility should always be the highest priority of any Medical Doctor because it supersede any other interest or responsibility of Doctors may pursue. It is this simple reason that early in this crisis, I called on The Gambia Doctors Association to acknowledge and accept responsibility. Any sit-down strike will have detrimental effects on the already poor healthcare system in the country by the very doctors who pledged to serve and make improvement.
The ethical Principles of Nonmaleficence, beneficence and Justice are the guidelines which serves Doctors and other healthcare professionals to make justifiable moral decisions and evaluate the morality of their actions. Since these Biomedical ethical principles are guidelines that our protesting Doctors should have followed before embarking on any actions that are detrimental to our patients wellbeing and healthcare system then the most important question any reasonable person should ask is whether it is morally justifiable for Gambia’s young doctors to continue sit-down strike despite increasingly death rate, prolong suffering, delay in treatment and poor healthcare delivery experienced as a result of their actions.
I believe that there is no justification to embark on this strike which violates every Biomedical ethical principle and medical standard of care . Thus there is no moral or ethical basis for this protest. Attaining maximum level of health is a basic right of every citizen and it is also constitutional responsibility of our government to provide optimal health services and resources to citizenry. The ongoing protest violate the constitutional rights of patients to access healthcare and be cared for.
Considering the Biomedical ethical principle of Nonmaleficence which requires Doctors and other healthcare professionals to do no harm, it has so far evidently indicates that the continuing sit down strike cause more harm to patients, their families and already deteriorating healthcare system. This is evidenced by lack of services provided by these young Doctors resulting to increasing death rate, delay in treatment, waste of state resources , continuing suffering of patients as well as overall poor health care delivery. As a result, The Gambia healthcare system is in poorer condition today than before the strike began due to limited number of Doctors available in public hospitals across the country. Nonmaleficence has significant implications in the medical practice and health care, some of these implications means that Doctors should absolutely try at all costs to avoid negligence in medical care, to avoid harm when deciding to abstain from work or withdraw from treatment team due to unprofessional conduct or actions such as sit down strike that are detrimental to welfare of patients and their families. Everyone knows that continuing protest seriously affects these implications and it has seriously questioned the morality and responsibility of these young Doctors when they decided to protest . It is justifiable to state that the unreasonable actions of Gambia’s young Doctors will continue to cause more harm to our patients and healthcare system than the resignation of health minister they have demanded as a top most priority since the beginning of this unnecessary and consequential crisis created by these young doctors. This is unnecessary and unacceptable professional misconduct. The Gambia doctors are well respected and admired by majority of citizens despite countless medical errors or problems they have made over the years resulting to devastating consequences. The protest is increasingly eradicating that respect and it is creating mistrust and lack of confidence in therapeutic relationship between the doctors, patients and general public.
As far as this protest is concerned, the ethical principle of Beneficence which guides doctors to take actions or decisions that are beneficial and promotes the welfare of patients and their families has been violated. This ongoing protest efforts by young Doctors Association hasn’t benefited the patients currently and the long term consequences will be greater since most patients condition will deteriorate as a result of lack of care, delay in treatment and continuing suffering they experienced already. This is another violation which signifies that the protest is detrimental to welfare and supreme constitutional rights and interest of patients. Doctors’ professional responsibility is to embark on actions or decisions that are beneficial to patients and general public but not to cause harm. It is also this reason that during time of civil conflict, Doctors and other healthcare professionals stay to offer help and care for wounded, sick and vulnerable people. A mere factual statement by Hon Minister has led the country’s young doctors to embark on protest. How about during the time of civil conflict, would they even stay to help general public? This bring to mind the idea of duty and justice to serve wholeheartedly.
The hallmark of medical profession is always to ensure that healthcare practitioners do the right thing putting the patients first as top most priority in every decision making process. This should also be based on individualized cultural competence care guided by compassion, moral and legal justifications. Looking at actions of The Gambia’s protesting Doctors, there is no moral or ethical justification as far as medical profession is concerned. This is because their actions has justifiable led to death and suffering of patients and their families which is violation of medical standard of care and biomedical ethic of justice. Though I recognize their constitutional rights to peaceful protest but such rights has also violated constitutional rights of patients whose care and needs should be superior responsibility for this protesting Doctors since it involve life and death situations. Thus the role of doctors is to alleviate suffering by providing therapeutic medical interventions . This has been ignored or absolutely abandoned. Instead of being patients advocate, The Gambia’s young doctors are advocating for their selfish interest and protection of professional integrity. During this crisis, the young doctors’ protest has conflicted with their medical professional role. Therefore, it can also be concluded there is a justifiable reason to state that their action cause more harm than benefits to patients and general public in both short and long terms. I believe that they are violating the rights of patients who are under their care.
Peaceful protest is a constitutional right but that right must not infringe on rights of others especially the vulnerable patients. The Gambia’s protesting doctors should quit their attention seeking action and get back to work. This crisis can only be solved through honest dialogue and accept responsibility that there are some doctors who steal drugs and engage in pharmaceutical drugstore business. Let justice guide our actions toward the common good. This is the way forward.