Beyond the Scalpel

Exploring Integrity and Ethics at India's Fifth National Bioethics Conference

A comprehensive look at how healthcare professionals gathered to address integrity, corruption, and ethical challenges in modern medicine

The Conference That Asked Medicine's Toughest Questions

Imagine a medical world where trust is the default, where every patient interaction embodies integrity, and where healthcare systems prioritize ethical practice as much as medical outcomes. This vision brought together hundreds of dedicated professionals in Bangalore, India, for the Fifth National Bioethics Conference (NBC) in December 2014. At a time when public perception of corruption in healthcare was growing, this conference dared to ask: Can bioethics evolve from an academic discipline into a powerful movement that transforms medical practice? 8

The conference theme—"Integrity in medical care, public health and health research"—was both timely and courageous.

Co-hosted by St. John's National Academy of Health Sciences, the Society for Community Health Research Awareness and Action (SOCHARA), and the Forum for Medical Ethics Society (FMES), this gathering represented a collective soul-searching for India's medical community. Rather than avoiding uncomfortable topics, participants confronted them directly, exploring how ethical practice forms the very foundation of healing and how its absence undermines public trust in medicine itself 8 .

695

Registered Participants

10

Countries Represented

14

Indian States

Where It All Began: The National Bioethics Conference Series

The National Bioethics Conference series began in 2005 as a biennial initiative to address contemporary and socially relevant issues in Indian healthcare. These conferences rotate venues across India, creating a dynamic platform for dialogue that reflects the country's diverse medical landscape. The fifth edition continued this tradition while focusing specifically on integrity—a response to what Director of St. John's, Rev Dr. Paul Parathazham, described in his inaugural address as the challenge of transforming the "ruling morality of the time" 8 .

Dr. Amar Jesani, representing the Forum for Medical Ethics Society, highlighted the ongoing challenges of maintaining ethical independence in medical publishing, noting that the Indian Journal of Medical Ethics persevered without pharmaceutical industry funding.

His observation that "being a counter-current means that we do not take funds from the pharmaceutical and health industry" underscored the conference's commitment to uncompromised ethical discourse 8 .

Conference Timeline
2005

First National Bioethics Conference launched

2007

Second conference addresses new challenges

2009

Third conference expands scope

2011

Fourth conference builds momentum

2014

Fifth conference focuses on integrity in healthcare

Host Organizations
St. John's National Academy of Health Sciences
SOCHARA

Society for Community Health Research Awareness and Action

FMES

Forum for Medical Ethics Society

A Diverse Gathering for Dialogue

The conference attracted an impressive diversity of participants, creating a rich tapestry of perspectives essential for meaningful bioethical discussion:

  • 695 registered participants from 10 countries and 14 Indian states
  • 250 students from various disciplines and systems of medicine
  • Professionals including doctors, medical students, social scientists, academics, lawyers, philosophers, journalists, theologians, community workers, researchers, and advocacy organizations 8
Participant Distribution

This diversity ensured that discussions about integrity in healthcare incorporated viewpoints from multiple stakeholders, rather than being limited to medical professionals alone. The inclusion of international perspectives from countries including Australia, Egypt, Germany, Pakistan, Singapore, Sri Lanka, Thailand, the UK, and USA added global relevance to the conversations 8 .

Laying the Groundwork: Pre-Conference Events

Curriculum Development

Workshop on bioethics for medical undergraduates organized by departments from St. John's and Christian Medical College, Vellore.

Gender & Health

Colloquium on ethical perspectives in gender and health examining critical issues including sex selection and gender ratios.

Community Health

SOCHARA Community Health Learning Programme meetings with nearly 50 community health fellows sharing experiences.

How We Think About Medical Ethics: Theoretical Frameworks

The inaugural plenary featured two thought-provoking keynote addresses that established the philosophical foundation for the conference. Professor Shiv Vishwanathan argued for medical ethics rooted in deeper philosophical, sociological and cultural understanding, critiquing some medical ethics journals as lacking sufficient philosophical grounding 8 .

Professor Vishwanathan proposed examining "the body" through multiple conceptualizations:

  • The "anatomised, medicalised, and forensic body" evident during historical events like forced sterilizations
  • The objectified body and scientified body ("the invention of the corpse")
  • The relationship between these conceptualizations and their distance from actual violence and suffering 8

This theoretical framework encouraged participants to consider how different understandings of the human body influence ethical decision-making in medicine, creating a foundation for critiquing standard approaches to bioethics that sometimes prioritize procedural questions over deeper philosophical ones.

Conceptualizations of the Body
Anatomised Body
Medicalised Body
Forensic Body
Objectified Body
Scientified Body

Integrity in Action: Examining Healthcare's Tough Challenges

Corruption in Healthcare

A central focus of the conference was addressing corruption and malpractices within India's health system. The international colloquium on "Corruption in healthcare and medicine" on the final day provided a platform for candid discussions about how these practices erode public trust and what ethical safeguards might help restore integrity to medical practice 8 .

Manifestations discussed:
  • Financial kickbacks for patient referrals
  • Unnecessary procedures and investigations
  • Pharmaceutical industry influence on prescribing practices
  • Differential treatment based on ability to pay

These conversations acknowledged the systemic nature of corruption in healthcare, moving beyond individual wrongdoing to examine how structures and incentives can compromise medical integrity.

Gender Ethics

The pre-conference colloquium on gender ethics highlighted urgent concerns that would resonate throughout the main conference. Dr. Sabu George highlighted the alarming decrease in gender ratios across India due to female foeticide, emphasizing that legislation alone is insufficient without parallel efforts toward women's empowerment 8 .

Critical issues discussed:
  • Adolescent health and information gaps
  • "Obstetric violence" - lack of respect during childbirth
  • Domestic violence and medical system failures
  • Reproductive rights violations

Dr. Evita Fernandes introduced the powerful term "obstetric violence" to describe the lack of respect and privacy women often experience during childbirth, noting that trained midwives typically demonstrate greater sensitivity to these issues 8 .

Community Health: Putting Ethics Into Practice

The SOCHARA Community Health Learning Programme meetings showcased how ethical principles translate into practical community health work. The attendance of approximately 50 alumni from across India demonstrated the program's national reach and enduring impact 8 .

A particularly noteworthy presentation highlighted how most alumni were implementing their training in real-world settings, maintaining strong connections with the communities they served. The discussion about forming formal associations and discussion groups reflected a commitment to sustaining ethical practice through ongoing collaboration and support.

50

Community Health Alumni

By the Numbers: Data From the Conference

Participant Demographics at the Fifth National Bioethics Conference
Category Number Additional Details
Total Registered Participants 695 Plus additional non-registered session attendees
Student Participants 250 Included postgraduates from various disciplines
Countries Represented 10 Australia, Egypt, Germany, India, Pakistan, Singapore, Sri Lanka, Thailand, UK, USA
Indian States Represented 14 Included both northern and southern states
Total Participants Across All Events 750+ Due to open sessions for non-registered attendees 8
Key Gender Ethics Topics Discussed
Gender Ethics Topic Key Issues Identified
Sex Selection & Gender Ratio Decreasing female population
Adolescent Health Rebellion, sexuality information gaps
Maternal Health "Obstetric violence," lack of respect & privacy
Domestic Violence Burns cases, low FIR registration
Women in Health Workforce Majority without adequate voice

8

Examples of Healthcare Corruption Discussed
Type of Corruption Manifestation
Financial Impropriety Kickbacks for referrals
Unnecessary Procedures Tests & surgeries without medical justification
Pharmaceutical Influence Gifts affecting prescribing
Differential Treatment Varying care based on payment ability

8

Gender Ethics Focus Areas

The Ethicist's Toolkit: Key Concepts for Practice

Bioethics represents a branch of ethical inquiry that examines biological discoveries and biomedical advances, focusing on their moral implications for our individual and collective humanity 5 .

The field has expanded from its initial emphasis on medical ethics to include diverse issues like resource allocation, end-of-life decisions, reproductive technologies, genetic interventions, and emerging biotechnologies 5 .

Integrity in Healthcare

Consistency between ethical principles and practical actions

Social Justice

Fair distribution of healthcare resources

Autonomy

Respecting patients' right to make informed decisions

Beneficence

Acting in patients' best interests

Non-maleficence

Avoiding unnecessary harm in treatment

Accountability

Transparency in medical decision-making

These principles formed the conceptual framework for conference discussions, demonstrating how abstract ethical concepts apply to concrete medical situations.

A Lasting Impact: The Conference's Continuing Relevance

The Fifth National Bioethics Conference represented a significant milestone in India's ongoing conversation about medical ethics. By confronting challenging topics like corruption, gender disparities, and systemic inequities, participants demonstrated courageous commitment to transforming healthcare culture. The conference succeeded not only in discussing integrity but in embodying it through transparent dialogue and critical self-reflection 8 .

The conversations that began in Bangalore continue to resonate today, as healthcare systems worldwide grapple with emerging ethical challenges posed by artificial intelligence, genetic technologies, and persistent health inequities.

The conference's emphasis on rooting ethics in philosophical depth and community engagement provides an enduring framework for addressing these future challenges. As Professor Vishwanathan suggested during his plenary address, meaningful medical ethics requires understanding the many ways we conceptualize human bodies and experience—reminding us that ethical healthcare ultimately serves not just physical ailments but whole persons and communities 8 .

The Legacy Continues

The legacy of the Fifth National Bioethics Conference lives on in subsequent conferences and in the daily work of participants who carry its insights into clinics, classrooms, and communities across India and beyond. It stands as a powerful example of how honest conversation about difficult topics can plant seeds of transformation that eventually grow to heal not just patients, but healthcare systems themselves.

References