Need for Professional Accountability

Being at the doorstep of the 21st century it is imperative to take stock of prevailing psychiatric practices so that the profession is adequately prepared to face the challanges ahead. Psychiatry has advanced rapidly during the last few decades and today our armamentarium includes an array of effective pharmacological and psychological methods to modify behaviour. Since more powerful the tool greater is the caution, any misuse or inappropriate use of these techniques is likely to be fraught with marked danger. Medical men have somehow spurned all efforts at accountability because they feel that such attempts would amount to unnecessary interference in the noble task of healing. Nevertheless, if we fail to develop proper professional guidelines it may not be far when this unbriddled freedom may be completely curbed. From the earliest days medical profession has adhered to certain ethical guidelines because it was considered essential that the conduct of the physician should be unquestionable. Customa-ai v administration of Hippocratic oath to the graduates of modern medicine in most of the civilised world has met this need. The oath has been a guiding principle. The medical practice has however lately become complex and with the advancement in biotechnology and certain modern methods of treatment like organ transplant the old ethical codes appeared to be less adequate and so revised codes were developed by various nations. Indian Medical Council provides certain rules of conduct to the registered medical practitioners in this country. However, with the development of specialities, specific problems do emerge which need specific professional solution. Indian psychiatric society has recently adopted a code of conduct for psychiatrists and it is hoped that it should overcome various ethical dilemmas. But, the need of professional accountability may require special attention. For instance, in a recent enquiry which looked into the functioning of Shahadra Mental Hospital, the committee observed that ECT was being used excessively and without proper safeguards. Similarly, there are some psychiatrists who use large number of drug combinations for which no •-< ientific base exists. In the absence of proper guidelines for treatment such kind of professional lapses may not be quite infrequent and eventually psychiatrists would lind it difficult to defend themselves for such practices. There is undoubtedly a need to develop therapeutic guidelines which would not only protect the interests of patients and public but would also protect interests of the profession. As compared to other medical specialities, …