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A pregnant woman walks into a hospital complaining of stomach pain, and the doctors immediately conduct sonography. The doctors “manage” her sonography reports and call it an emergency, only to operate her, do unnecessary stitches and extract money. This whole drama of “sonography” and “emergency” was needless and was done only to acquire money. Scary isn’t it? 
 This is not the only instance in which doctors have manipulated the patient to make money. Likewise, hundreds and thousands of cases happen every day in <keyword id="3357789" type="UNKNOWN" weightage="20" keywordseo="indian-medical-profession">Indian medical profession</keyword>, where doctors, on whom patients blindly trust, make fool out of patients. 
 Be it in urban or rural areas, the malpractices in medical profession in India are rampant and all these have been sized down in one book-‘<keyword id="3353580" type="UNKNOWN" weightage="20" keywordseo="Dissenting-Diagnosis">Dissenting Diagnosis</keyword>, Voices of conscience from the medical profession’. 
 
Two doctors, Dr Arun Gadre and Dr Abhay Shukla, took the initiative to list down such malpractices in the profession and took interviews of 78 specialist doctors, who told them about the extent to which doctors can go to mint money. 
 
The book, which is published by Random House India, entails how a normal fever is shown as dengue or in worst case scenario, how operations are botched up. 
 
The unscrupulous practices are not only in hospitals but are seeped deep down into diagnostic centres, pharmaceutical companies, asking for cuts from doctors, giving them gifts and throwing parties in return. 
 The doctors themselves have raised questions on <keyword id="3357790" type="UNKNOWN" weightage="20" keywordseo="unethical-practices-in-medical-profession">unethical practices in medical profession</keyword> and demanded regulation of private medical hospitals. 
 
Dr Gadra and Dr Shukla told Business Insider India challenges they faced and what is the need of the hour. 
 
1. After reading this book, people may see every doctor with suspicion. How scared they should really be? 
 
The purpose of the book is obviously not to scare people, but to make them aware of the undeniable realities in the medical sector today, so that they can be alert and assertive as a patient or caregiver. Some of the stories and examples in the book may be a bit shocking, but the purpose is to wake up society, and to shake the medical profession out of denial mode. So rather than being scared, people should become aware about patient’s rights described in the book and should start dialoguing with their doctor, asking for all required information, knowingly choosing the best options, while being alert to possible malpractices. 
 
2. You both have addressed the elephant in the room. What were the challenges you faced while taking down experiences of doctors from across India? 
 
Firstly, it was not very easy to identify ethical doctors across the country, who would be willing to fearlessly speak about the real situation in medical practice and health care, who would call a spade a spade. However, initially through Arun Gadre’s personal contacts among fellow ethical doctors, and further by our contacts in the health movement, the numbers snowballed and we could reach 78 such doctors. Secondly, around half of these doctors were reluctant to have their names mentioned in a public document, although the others boldly offered to be quoted personally. Thirdly, there was some backlash from one powerful body of the ‘medical establishment’, which tried to deny the issues being raised in an earlier vernacular version of the book, and seemed to be more interested in silencing the messenger than heeding the message. 
 
3. You said the private medical sector needs to be regulated. What are the first few steps that should be taken in this direction? How the health sector should be healed? 
 
Three steps must be taken urgently. The Medical Council of India needs major reform – you may call it radical surgery - based on the report of the Parliamentary committee on MCI, and further suggestions by the recently crystallised national coalition of ethical doctors and health activists. Secondly, all states should either adopt the national clinical establishments act or preferably enact a modified and improved act at state level, and ensure prompt implementation of such acts in each state, with provisions to protect patient’s rights and accessible grievance mechanisms. Thirdly, the Health Ministry should conduct a highly visible and effective national awareness campaign through the mass media (similar to media coverage of consumer rights), making people aware about patient’s rights and the need to curb malpractices in the private medical sector. These could be important first steps in the long march to heal the private health care sector in India today. 
 
4. How does one differentiate between a doctor who is adopting malpractices and a doctor who wants your well-being? 
 
Firstly, the doctor would be willing to answer questions and have a dialogue with the patient, explaining about any doubts, logically explaining the rationale for any major procedure, and giving possible options, rather than just dictating the treatment and ordering the patient into silence. A rational doctor does not promise magical results, nor would he / she usually claim to know everything about the patient’s condition in the first encounter. A doctor who claims to know everything about your condition before even going into the details is suspicious. A rational doctor avoids creating panic and would not press for an immediate decision to conduct a major procedure, except in genuine emergencies. He / she would also welcome the patient seeking a second opinion, rather than suppressing such suggestions from the patient or relatives. 
 
5. Often, patients go for second opinion and doctors advise them to take similar tests yet again. What is your advice on this? 
 
Seeking a second opinion is the patient’s right, and should be encouraged especially in cases which are complex, where the diagnosis is unclear, or where major procedures are being recommended. The patient or relatives should encourage dialogue between the first treating doctor and the doctor providing the second opinion, so that unnecessary repeat tests can be minimised. Patients should be wary of doctors who, while providing a second opinion, start by first ordering a full battery of repeat tests, without properly examining the patient, scrutinising the existing reports, and interpreting the available evidence. 
 
6. Medical students pay a hefty amount for completing their degree and charge patients a bomb to recover the costs. Do you think having more government colleges will help the situation? 
 
In our opinion, there should be a moratorium on setting up any new private medical colleges in India for several years, until the entire regulatory system, which is currently centred on MCI, is thoroughly overhauled. Yes, government medical colleges with regulated fee structure should be set up in those regions of the country where genuinely required. However, even government medical colleges must change their emphasis to serve public health rather than the market. We need to shift away from current specialist doctor- driven care, towards a more public health and primary health care based model, so that the focus is on prevention, health promotion and basic health care which could be largely given by paramedics and family doctors. 
 
7. How bad is the situation of Indian medical profession when compared to rest of the world? 
 
India has produced many highly skilled doctors who have worked to provide good quality care to patients both within the country, and in other countries like US and UK. Yet to understand the fate of doctors in India today and compare it with other countries, we need to examine three key elements that are combined in a good doctor. The first is practical, hands-on clinical skills; the second is scientific medicine based rational practice; and the third is medical ethics and sensitivity to patients. Even today there are many ‘good doctors’ in India who combine all three in their person. But due to gross commercialisation of medical education, as well as of the health care system, all three are under massive attack now. The medical profession in India needs to extricate itself from the clutches of the mentioned ‘unholy alliances’, and must get involved in the task of reforming the health care system, pulling its chariot out of the mud. It is still not too late for Indian physicians to lead the way in healing the health care system in the country. 
 
(Image: Indiatimes)

Scary, real incidents show how unethical Indian doctors have become. But these Doctors tell you just how to figure fake from real

<ul class="summary-list"><li>Two <keyword id="12087640" type="UNKNOWN" weightage="60" keywordseo="death-row" source="Orion">death row</keyword> inmates, both of whom were Black, were executed last Thursday.</li><li>One suffered from mental illness and the other from an intellectual disability.</li></ul>On January 27, 2022, two Black men were executed: one in <keyword id="11910055" type="UNKNOWN" weightage="60" keywordseo="oklahoma" source="Orion">Oklahoma</keyword> and the other in <keyword id="11910053" type="UNKNOWN" weightage="60" keywordseo="alabama" source="Orion">Alabama</keyword>. One of them, Donald Grant, had a debilitating mental illness. The other, Matthew Reeves, had an intellectual disability.Advocates against the death penalty say that their cases are examples of capital punishments being placed on particularly vulnerable individuals. Robert Dunham, executive director of Death Penalty Information Center, a non-partisan organization with a focus on the death penalty, told Insider that Oklahoma and Alabama "are rushing to carry out executions," adding that the haste "interferes with fair litigation of issues in a person's case."In these cases, executions happened despite advocates' concerns that they were mentally unfit.<h2>Alabama executed Matthew Reeves despite his intellectual disability</h2>Reeves, 44, was convicted of killing a man that gave him and some friends a ride and robbing him of $360, <a href="https://apnews.com/article/health-alabama-executions-state-courts-477d4bac31cccb8afb2dc1a9511dad12">the Associated Press reported</a>. Reeves danced and mimicked the man at a party after the killing, according to the report.<div type="image" title="This undated file photo provided by the Alabama Department of Corrections shows death row inmate Matthew Reeves." height="660" width="660" msid="89357265" hostid="261"></div>Reeves' defense team argued that he had an intellectual disability — demonstrated by an IQ score in the 60s — and should therefore be reprieved of the death sentence, <a href="https://apnews.com/article/health-alabama-executions-state-courts-477d4bac31cccb8afb2dc1a9511dad12">according to the AP</a>. An intellectual disability presents "significant limitations both in intellectual functioning and in adaptive behavior, which covers many everyday social and practical skills," and "originates before the age of 18," according to <a href="https://www.aaidd.org/intellectual-disability/definition">The American Association for Intellectual and Developmental Disabilities</a>. Reeves and his legal team claim that he was unable to understand the form for choosing his preferred method of death — lethal injection or nitrogen hypoxia — and consequently left it blank, <a href="https://www.newsobserver.com/news/article257769568.html">The News Observer</a> reported. Alabama scheduled Reeves for execution with the lethal injection protocol because he did not select an alternative method, <a href="https://eji.org/news/matthew-reeves-execution/">according to the Equal Justice Initiative</a>. An Alabama judge issued a stay of the execution, and an appeals court upheld it on the basis that his disability had not been accommodated during the process to select an execution method, <a href="https://www.cbsnews.com/news/matthew-reeves-execution-alabama-stay-upheld-appeals-court/">CBS News reported</a>.But the state of Alabama brought the case to the US Supreme Court, which decided in a 5-4 vote that Reeves's application for a stay of execution "should be denied," <a href="https://www.supremecourt.gov/DocketPDF/21/21A372/211556/20220127124538503_Reeves%20Opposition%20to%20Scotus%20Application%20to%20Vacate%20FINAL%20DRAFT.pdf">according to court documents</a>. In a <a href="https://www.supremecourt.gov/opinions/21pdf/21a372_5436.pdf">three-page dissent</a>, the four objecting judges — Justices Amy Coney Barrett, Elena Kagan, Stephen Breyer, and Sonia Sotomayer — argued that the Court should not have allowed "Reeves's execution by lethal injection to go forward.""The State will soon be ready to execute Reeves by nitrogen hypoxia. A short delay cannot justify dismissing, as the Court does today, the strength of Reeves's suit — or the careful work of the judges primarily responsible for assessing his case," they added.The decision came an hour and a half after the scheduled execution.Reeves refused to eat the day before and of his death and was only seen drinking a Sprite, <a href="https://www.al.com/news/2022/01/matthew-reeves-execution-tonights-execution-on-hold-while-us-supreme-court-decides-fate.html">according to AL.com</a>."The majority decision of the Supreme Court to vacate a stay imposed by the lower courts enabled the execution to proceed without a full examination of the question of the effect of his mental capacity on his ability to elect an execution method," a spokesperson from the United Nation Human Rights Office told Insider.<h2>Oklahoma executed Donald Grant despite his schizophrenia diagnosis</h2>Grant, 46, was convicted of murdering two hotel workers during a robbery to get bond money for his girlfriend in 2001, <a href="https://www.oklahoman.com/story/news/2022/01/27/donald-grant-oklahoma-first-execution-2022/9235163002/" target="_blank" rel="noopener noreferrer">according to The Oklahoman</a>.He ordered sesame chicken, shrimp fried rice, and egg rolls the night before he was executed. Associated Press reporter Sean Murphy <a href="https://apnews.com/article/crime-oklahoma-oklahoma-city-robbery-mcalester-3693d1a245878cc773aa6bdbbad56ab4">attended</a> the execution. According to him, Grant's last words were: "Yo God, I got this ... No medication, I didn't take anything. Brooklyn for life."Grant was declared dead at 10:16 a.m. on Thursday, January 27, <a href="https://www.nbcnews.com/news/double-murderer-donald-grant-executed-lethal-injection-oklahoma-rcna13806">NBC News reported</a>.Grant was diagnosed with schizophrenia at least twice, was abused throughout his childhood, and was placed in special education classes while in school, <a href="https://www.huffpost.com/entry/oklahoma-execution-donald-grant_n_61f1eb4ce4b067cbfa1811d1" target="_blank" rel="noopener noreferrer">according to NPR</a>.His mother drank throughout her pregnancy with Grant, which "severely impaired his brain development and left him with lifelong disabilities," a doctor found. His father also slammed Grant's head into a metal pole multiple times a week, Grant's brother told NPR. His attorneys argued that "executing someone as mentally ill and brain-damaged as Donald Grant is out of step with evolving standards of decency," <a href="https://www.oklahoman.com/story/news/2022/01/27/donald-grant-oklahoma-first-execution-2022/9235163002/">according to The Oklahoman</a>.<h2>The death penalty is reserved for the 'most vulnerable of the vulnerable'</h2>The number of people sentenced to death each year in the United States <a href="https://documents.deathpenaltyinfo.org/pdf/FactSheet.pdf">dropped</a> from 295 in 1998 to 18 in 2021.But critics note those who have been sentenced to death are often people who experienced chronic or severe trauma, suffer from severe mental illness, or struggle with intellectual disabilities.Forty-three percent of death row inmates executed between 2000 and 2015 suffered from a diagnosed mental illness, according to a 2017 <a href="https://www.washingtonpost.com/news/monkey-cage/wp/2017/04/03/does-the-death-penalty-target-people-who-are-mentally-ill-we-checked/">investigation by The Washington Post</a>. The outlet also reported that 20% were diagnosed with a personality disorder, and 8.9% with antisocial personality disorder in particular.Nearly 40% of inmates were abused as children, The Post added."What we have seen over the years is that people who are being executed are not the worst of the worst," Dunham told Insider. "They are the most vulnerable of the vulnerable."According to <a href="https://deathpenaltyinfo.org/death-row/overview/demographics">data from the DPIC</a>, 41% of death row inmates in the US are Black, despite being 13% of the US population.Aurelie Placais, director of the World Coalition Against the Death Penalty, agreed. "All over the world, where <keyword id="12251525" type="UNKNOWN" weightage="60" keywordseo="capital-punishment" source="Orion">capital punishment</keyword> is applied, it is not used against the worst criminals, but against the poorest and the most marginalized people in society," she told Insider.

2 Black death row inmates were executed despite one having an intellectual disability and the other having a severe mental illness

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You Searched For "Dissenting Diagnosis" and got 3 results

Scary, real incidents show how unethical Indian doctors have become. But these Doctors tell you just how to figure fake from real

Akanksha Jain

2 Black death row inmates were executed despite one having an intellectual disability and the other having a severe mental illness

Taiyler Simone Mitchell

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