Madam, as a developing country with a high inflation rate, Pakistan\\\'s economy is barely afloat. It is difficult to afford health care when most people cannot afford basic life necessities. With a nominal health budget, doctors have insufficient incomes in government services and consequently work multiple jobs and overcharge in private setups. With such a scenario, it is not uncommon for patients\\\' naivety to be taken advantage of by doctors.
This issue has long been ignored and considered petty. Patients are subjugated in various ways, the principle exploitation being financial. Such doctors have developed an indifferent attitude to the burdens faced by patients, and surpass ethical boundaries when dealing with them. The lack of accountability has worsened the situation.
Whilst working at a tertiary care hospital, I was taken aback when I met a patient who had come to the doctor to get a prior prescription altered. She had had a reaction to one of the drugs he had prescribed. The doctor charged her in full to change that one drug. It was a four digit number. Another incident I recall is when a close relative was on a ventilator and underwent cardiac arrest. When I called her consultant, he refused to provide assistance saying he was busy in another hospital with patients. My relative passed away the next day.
According to the WHO fact files, in developing countries, the probability of patients being harmed in hospitals is higher than in industrialized nations.¹ Health professionals should always remember that they do not treat diseases; they treat patients who have their preferences, morals and rights . Patients should not be charged more than they should be. Human rights and medical ethics are harmonizing, and use of the two together maximizes the protection available to the vulnerable patient.²
We, as doctors, accept that patient rights are important but little tangible action seems to be at work. There must be properly implemented laws that hold doctors accountable for unethical exploitation of patients and more importantly, awareness programmes in collaboration with NGOs should be established so that patients know their rights and to help them if they are exploited. It would greatly help the profession if doctors in service revise and upgrade their ethics. It might help to eliminate the moral stigma attached to the profession nowadays that has led to low confidence amongst patients who are victims of medical exploitation.
 
Muhammad Owais Khan, Rabeea Mirza, Mariam Rauf
Medical Student, Dow Medical College, Dow University of Health Sciences

1.WHO Fact files. (Online) (Cited 2010 Nov 10). Available from URL: http://www.who.int/features/factfiles/patient_safety/en/.
2.Peel M, Human rights and medical ethics. J R Soc Med 2005; 98: 171-3.