NATIONAL SYMPOSIUM

Certificate Course in Healthcare Ethics 2012 - 2013

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F.I.A.M.C. BIO-MEDICAL ETHICS CENTRE, GOREGAON, MUMBAI INVITES YOU TO A CERTIFICATE COURSE IN HEALTHCARE ETHICS A MUST FOR EVERY FAMILY

For Whom: The course is open to everyone from all walks of life and in particular - catechists, nurses, teachers, lecturers, religious men and women, social workers, health care workers, counselors, youth and those working with NGO’s.

Aims and objectives: To enlighten the participants on important moral issues affecting our lives from birth till death. At the end of the course, each participant will be confident to understand ethical problems and also help other people confronted with moral dilemmas to make right decisions.

Content and Format: The entire programme is in eight capsules spread over a period of nine months from July 2012 to March 2012. Each capsule involves ONLY ONE Sunday per month, from 9.00 am to 1.30 pm.

Faculty: The faculty consists of 35 reputed medical consultants, legal professionals, and ethicists who provide interactive sessions with power points and teach in a very simple way.

Inauguration: The inauguration of the course is open to the general public. So, even if one may not wish to attend the course, all are welcome for the inauguration on Saturday, 21 July 2012, 4.30 to 7.30 pm at the F.I.A.M.C. Bio-Medical Ethics Centre, Goregaon East.

For Further Information and Registration: Kindly contact F.I.A.M.C. Bio-Medical Ethics Centre, St. Pius College Complex, Aarey Road, Goregaon East, Mumbai 400063. Tel: 29270933, Monday to Friday, from 10.00 am to 4.00 pm. Alternatively, you can E-mail: fiamcmumbai@hotmail.com or call Cell: 9820332965 from 9.00 am to 9.00 pm. Course fees for the entire year is Rs 5,000 and is inclusive of meals served.

CONSENT, CONFIDENTIALITY OF MEDICAL SURGICAL

Consent is an agreement / permission given by the patient to the doctor who is doing any surgery to his or her body. This is a standard procedure in hospitals. One has the duty to one’s own body and no one can do anything without the permission of the patients consent.

Informed Consent is not only getting the patient to sign on the consent form but to take the informed consent of the patient. Consent must be given by the patient. The patient has to sign first. This is extremely important. The signature has to be taken much before the operation and not just before the operation.

The patient must be informed about the following:

i) The nature of the operation – What, Why, How, of the operation. Who is the Chief Surgeon?

ii) The risks, success and failures and complications

iii) If there is an alternative treatment.

iv) A clean picture must be given to the patient.

v) Make a disclosure of oneself and through Nurses or Paramedical staff.

vi) Operation should be taken seriously.

Confidentiality is the secrecy that the doctor has to keep about the patient’s sickness. The doctor cannot give the patient’s information unless the patient gives in writing that he / she has no objection.

When confidentiality is broken a lot of problems are created in families, in the work place or society. Breach of confidentiality can become a medico-legal issue and a source of litigation. It has brought about divorce, unemployment or discrimination.

The Doctor should inform the patient about HIV and make him understand and tell him that he should inform his close relatives. If that is not done, then the doctor has the right to inform the relatives of the patients. In certain cases where someone can be saved from some disease i.e HIV, it can be informed to the concerned party. In courts, police department, public health and authorities can be told.

Hazel Mendonca and Henrietta Monseratte (Present Participants 2011-2012)

THE PATRON AND TRUSTEES

of the

FIAMC BIO-MEDICAL ETHICS CENTRE

cordially invite you

to the

Xth F.B.M.E.C. ORATION

on

Surrogacy: Medico-Ethical and Legal Issues

in the Indian Scenario

Venue: Morelo Hall, Holy Family Hospital

Hill Road, Bandra, Mumbai 400050

on

Sunday, 20 November 2011, 5.30 pm to 8.00 pm

Dr. N. A. Antao Rev. Dr. Stephen Fernandes Senior Adv. J.F. Reis

Managing Trustee Executive Director Addl. Managing Trustee

RSVP: 29270933 / 9820332965

PROGRAMME

5.30 pm: Welcome Address : Dr. Nicholas A. Antao

5.40 pm: Introduction of the Topic : Dr. Armida Fernandez

5.50 pm: Medico- Ethical Issues in Surrogacy : Dr. Sujit Chatterjee

CEO, Dr. L H Hiranandani Hospital and

Professor of Obstetrics & Gynecology

6.20 pm: Legal Aspects of Surrogacy Senior Adv. Joaquim F. Reis

Senior Adv., Supreme Court of India

6.50 pm: Question & Answers : Rev. Dr. Stephen Fernandes

7.30 pm: Vote of Thanks : Dr. Rouen Mascarenhas

D i n n e r

Certificate Course In Healthcare Ethics 2011-2012

Click Here to download Brochure / Registration Form

FIAMC BIO-MEDICAL ETHICS CENTRE CERTIFICATE COURSE

F.I.A.M.C.
BIO - MEDICAL ETHICS CENTRE
CERTIFICATE Course
in HEALTHCARE Ethics 2010-2011
St Pius X College Complex, Aarey Road,
Goregaon East, Mumbai - 400 063 (India)
Tel.: 2874 7310
E-mail: fiamcmumbai@hotmail.com
Read More ...

ORATION INVITATION

THE PATRON AND TRUSTEES
of the
FIAMC BIO-MEDICAL ETHICS CENTRE
cordially invite you
to an
ORATION
on

Ethical Challenges affecting our Environment

Ms. Shenoa Simpson
Economic and Commercial Officer
U.S. Consulate, Mumbai
has kindly consented to be the Chief Guest
and preside over the proceedings

Venue: Morelo Hall, Holy Family Hospital
Hill Road, Bandra, Mumbai 400050
on
Sunday, 13 December 2009, 5.30 pm to 8.00 pm

Dr. N. A. Antao : Managing Trustee

Rev. Dr. Stephen Fernandes : Executive

Adv. J.F. Reis : Addl. Managing Trustee

RSVP: 28747310 / 9820332965

For More Details and Programme schedule Please Click here !

Certificate Course in Healthcare Ethics (8 weekends)

Dear Rev. Father,

We are pleased to inform you that the FIAMC Bio-Medical Ethics Centre is conducting a Certificate Course in Healthcare Ethics (8 weekends) covering the essential aspect of ethics from womb to tomb. Great care has been taken to choose the speakers who are renowned professionals in each field.

Aims & Objectives: To enlighten lay people on most healthcare issues affecting our lives (from conception to our last journey). At the end of the course, the participants will be able to discuss confidently moral issues and ethical situations with those people who are unaware, confronted and disturbed with the same.

Who can attend the course: The course is open to all persons, catechists, nurses, religious brothers and sisters, medical students, students of social sciences, social workers and all those involved in educating children and youth.

Contents & format of the course: The programme in eight capsules provides details of each capsule involving one weekend per month from Saturday 4 p.m. to 8 p.m. followed by dinner and on Sundays from 9.30 a.m. to 1 p.m. followed by lunch.

Registration: Since there are limited seats, registration will be done on a first come first serve basis. Accordingly, a registration fee of Rs.300/- will be charged. We have subsidized the cost of the Course Fees for the residential participants (at Rs.3500) and non-residential participants (at Rs. 3000/-) so as to make the course affordable.

Accommodation: Residential accommodation can be provided to those who wish to stay overnight at the FIAMC Bio-Medical Ethics Centre, Aarey Road, Goregaon East.Last date for registration: 18 July 2009.

Information regarding registration: For registration / information, contact Tel.: 28747310 from Monday to Friday between 10 a.m. to 3 p.m. or Cell No.: 9820332965 from 9.00 a.m. to 9.00 p.m.; or email: fiamcmumbai@hotmail.com OR stefano@vsnl.net

Thanking you,

Sincerely,

Fr. Stephen Fernandes

P.S. Programme attached

Click here to download the programme

Basic Course in Personal Counselling

FIAMC Bio-Medical Ethics Centre, Goregaon announces its Basic Course in Personal Counselling for the fourth year running. Conducted by the Anthony de Mello Institute, Goa, the Course will run in its tried and tested format consisting of five full weekends spread out from the first weekend of August 2008 to the first weekend in October 2009, along with Internship.The Course will be held at the Centre’s premises in Goregaon and is open to anyone who has a graduate degree in any discipline, and has a genuine interest in becoming a personal counsellor. It is especially recommended for school and college teachers, social workers, health workers, working youth and others in the helping professions.Details may be had from

FIAMC Bio-Medical Ethics Centre, Goregaon.

E-mail: fiamcmumbai@hotmail.com

Tel: 2874 7310 Cell: 98203 32965

Glimpse Into The Proceedings of The Forum on Ethical & Legal Dilemmas In Orthopaedic Practice

Presented by
BOMBAY ORTHOPAEDIC SOCIETY

in association with
F.I.A.M.C. BIO-MEDICAL ETHICS CENTRE, Goregaon, Mumbai
and
FORUM FOR MEDICAL ETHICS SOCIETY, Mumbai
Sunday, 21 September 2008

Convenor: Dr. N.A. Antao Co-Convenor: Dr. Manhar Shah
Proceedings prepared by: Dr. Stephen Fernandes

MORE

We Treat, God Cures!

by
Dr. L. J. de Souza
(Surgeon/Oncologist)

After almost 40 years of treating thousands of cancer patients, I have now removed the word “cure” from my vocabulary when talking to my patients. And believe me, I have good reasons for doing so!

Firstly, we must go down to the grass root levels and understand what the world “cure” means. Amongst the many meanings listed for “cure” in the Oxford Dictionary are “restore to health” and “eliminate disease”. My own understanding is that, to restore to health means healing has occurred, but it does not mean the disease or malady cannot recur at a subsequent date. However, if the healing is permanent, and the disease “totally eliminated”, never to come back again, we can perhaps use the word “cure”. Which man can honestly say that, especially in the treatment of cancer? I believe that only God in his Infinite Wisdom can!

The reasons that I, as only an instrument of the Master Healer, cannot use the word “cure” are as follows:

1. As per my understanding, every last cancer cell from the body must be removed before we can pronounce somebody totally “cured”. Even the wisest physician and the most sophisticated test available to us today cannot truthfully allow us to say this.

2. All our treatments, whether it is surgery, radiotherapy, chemotherapy, or any other modality, singly or in combination, treat only the effects of the cause. This is because till today we do not know the cause of a particular cancer. There are of course many theories but certainly nothing conclusive. Hence, if we do not know the cause how can we remove it totally, and if the cause persists, what guarantee is there that the cancer will not recur again? Therefore, how can we say “cured”?

3. The yardstick used to define a so called “cure” was the period the patient survived disease-free after the treatment of the cancer. Initially it was a 5 year period. Then as patients survived longer with better treatments, the period of survival went up to 10, 15 and even 20 years. But even that was not adequate, as in some cases, the cancer recurred after 25 or 30 years or even more. So again, when can we truly say a person is cured? I remember an incident in my out-patient department, when a patient came for follow-up 20 years after her treatment for breast cancer. I was elated and jubilantly invited all my students to see the case as it indicated that cancer could be cured. However, when I examined her, I had to hang my head in silence – she had developed another cancer on the other side! Oncology is therefore, the best school for humility and for down staging the ego, because you never know the end result. We are humbled every day!

4. After completion of treatment, we ask our patients to come for periodic follow-up examinations. Initially, they are at shorter intervals and after the period of survival increases, they are at longer intervals. However, they must be ongoing for the rest of the patient’s life. If we were so confident of a cure, why should we ask the patients to come for indefinite follow-ups? The reason is, we cannot because we just do not know all the answers.

And yet, you will find doctors, healers, religious and others, freely using the terms “I can cure you” or pronounce that “You are cured”. Is it ethically and morally right to say that? In fact, it is a blatant untruth, only fooling the patient into a false sense of security. I would go a step further. By using the word “cure”, you are taking the place of the Divine, because only God can know everything and thereby we are going against the first commandment which clearly states “I am the Lord, your God. You shall not have other Gods than me.”

Further, by using the word “cure” we are doing even greater harm. If a patient is pronounced “cured” by a reputed doctor or even a religious faith healer, why should he go for any further treatment or even further follow-up examinations? This false assurance of being cured has led patients to let tumors grow before their eyes because of blind faith in the falsely pronounced “cure” which brings them to us in a very late stage of the disease when we can do little or nothing for them. Such “cures” have doomed many an early case to become advanced and beyond useful treatment. Are we ethically justified in doing this? And if we do this great injustice, what will we answer the Master Healer?

However, we can never remove Hope from the patient, because man lives on Hope. Where there is Hope, there is Life, and where there Life, there is Hope. Therefore, we can never say to the patient that, “You will not be cured”. What we can truly say instead is that, with our modern treatment facilities we are able to “control” the cancer for long periods of time during which the patient leads a normal life. And, if the control is good for many years, the patient can equate it to a cure, although we can never say it. So instead of saying ”we can cure you” or “you are cured”, we can truthfully say, “we can control the disease effectively” or “you are well controlled”.

I am asked ever so often the question: “Doc, how long have I to live?” A terminally ill patient at the Shanti Avedna Sadan was given a specified period to live after his treatment for cancer by his doctor. So he carefully calculated his “due date” to meet the Master and sent cards to all his friends and relatives informing them of the same. The “due date” came and went and here he was very much alive. He had to send cards all over again to say that he was still alive and kicking! Another lady with advanced ovarian cancer was told by her doctor that she had only 6 months to live. When she came to me we treated her as best as we could and by God’s grace she responded very well and remained controlled for well over 8 years or more till I lost contact with her. And I know of many a case where the doctor has given the patient a specified time to live and the patient has well outlived that, only to bury the doctor! I have chosen not to come into this category. So when my patients ask me: “Doc, how long have I got?” I tell them, “Live fully one day at a time and the days will grow into weeks, the weeks into months and the months into years.” How many? God only knows, but who cares, because if you have lived fully one day at a time, you have fully and happily utilized whatever time has been given to you. Does anything else matter?

I am also very often asked, “Will the disease come back after completing treatment?” Again, I cannot give an answer, so I tell them my theory of “Possibility and Probability”. Technically, anything is possible and of course there is always a “Possibility” that the disease will come back. The “Probability”, or the chances that the disease will come back, depends on the various prognostic factors of a particular case. Depending on these we can tell the patient whether the prognosis is good, fair or poor. Of course we always try and give the good news to the patient, but it is a must that the bad news is always told to at least one responsible member of the family so that it does not come as a nasty surprise. However, a definite answer to the question is never possible.

And so, when you next visit your doctor, please don’t ask him: “Am I cured?”, “How long have I to live?”, “Will my cancer come back?” Ethically and morally he cannot answer the questions, simply because he honestly does not know. Always remember:

To treat is human … you and I
To cure is Divine . . . and Divine alone!

The Board of Trustees

The Board of Trustees
His Eminence, Cardinal Oswald Gracias (Patron),

Bishop Percival Fernandez (Trustee),

Dr. Nicholas Antao (Managing Trustee),

Adv. Joaquim Reis (Addl. Managing Trustee),

Dr. Rouen Mascarenhas (Secretary),

Dr. Cedric Moraes (Treasurer),

Dr. Armida Fernandez (Trustee),

Dr. Enid Prabhu (Trustee),

Dr. Giselle Paes (Trustee),

Dr.Egbert Saldanha (Trustee),

Dr. C.J. Vas (Founder Member, Emeritus).

Executive Director:
Fr. Stephen Fernandes

Aims, Genesis of FIAMC

FIAMC Bio-Medical Ethics Centre(FIAMC: Federation Internationale des Associations Medical Catholique)
The FIAMC Bio-Medical Ethics Centre [FBMEC] was established in Bombay in September 1981 to study and debate the ethical status of various actions - experimental, diagnostic or therapeutic - in the bio-medical field within the ethic of culture, religion and the modern secular state.

Our Aims:
· to provide information and data to the medical profession on matters of ethical interest.
· to facilitate discussions and help reach appropriate conclusions in areas of ethical concern.
· to interact generally with society in ethical matters involving health care and medical services.
· to assist in the development of confidence by the profession in tune with equity and ethical values despite certain problems.
· to preserve, promote and protect life while accepting the fact that death is inevitable.
An Introduction
The practice of medicine is as old as civilisation and so is corruption. During the time of the Greeks, a call to do what was good and reject all that was bad was heeded by the 5th century physician, Hippocrates. His work and dedication, with that of his disciples, resulted in the Hippocratic Oath which was adopted by physicians from that time onwards but it was amended subsequently by the Christian tradition prevailing at the time. Other cultures and religious beliefs such as those of Judaism, the Indian vedic and Chinese traditions, Islam and the later humanist influences have all left their print on the subject of medical ethics.
In the past three centuries, the Anglo-Saxon influence on medical ethics has been considerable. There was the contribution of John Gregory (1724 - 1773) and later Thomas Percival followed by the various national associations, culminating in the Codes of Practice of the many international medical associations.
It is not surprising that with such a philosophical background, the medical profession has constantly engaged itself in arguments and disputations over a variety of issues related to life and death. Science has advanced very rapidly in the past 50 years. Indeed, it has been said that there has been relatively more progress in the past half century than in all the preceding centuries. This rapid growth of science, in medicine as in technology, at an exponential rate has created its own problems, as said by a philosopher recently: "Trouble with mankind today is that wisdom has not kept pace with science." If we compare Einstein with Archimedes, who have we today to compare with Plato. (We do not even have a Plato!)
The urge to know more and more - about the sciences and arts, nature, the environment, space and the world beyond, has emboldened human mortals to rush into areas where angels fear to tread. These developments have understandably raised doubts of a moral and ethical character. Paradoxes abound and the thin line between right and wrong can at times be scarcely distinguished. There are plenty of grey areas that call for ethical questioning: in-vitro fertilization and embryo transfer, human cloning, sperm banks; experiments on living foetuses, prisoners, the disabled and terminally ill, on the ageing and dying, raise very many questions which call for debate.
It was for this reason that the FIAMC Bio-Medical Ethics Centre [FBMEC] was established in Bombay in September 1981. Its role being to debate the legitimacy of experimentation and inquiry within the ethic of culture, religion and the modern secular state.

Genesis

It would be pertinent at this stage to provide a brief account of the genesis, aims and objectives, functioning, failures and successes of the FBMEC. It was at the XIV World Congress of the International Federation of Catholic Medical Associations [FIAMC] held in Bombay in January 1978 that it was resolved to establish Bio-Ethics Centres for the association at convenient locations where the various traditions of the world would be represented. This duty fell on the shoulders of Dr. C. J. Vas who had just been elected Secretary General of the organization. After many unsuccessful attempts at starting the first such Centre in Europe, North America, and Australasia, it was decided in 1981 that it be initiated in India. Bombay was chosen for this activity with the Secretary General as the first Managing Trustee. At that time, it was the 6th Centre for medical ethics in the world and the first in Asia, Australasia and Africa.
A small group of interested individuals banded together and commenced work. A nationally prominent physician remarked: "What is ethics". He was not being facetious – but just very honest. Trustees of different faiths were appointed and these with their successors have guided the FBMEC over the years. Dr. C.J. Vas was its Founder and Managing Trustee who played a pioneering role in the FIAMC Bio-Medical Ethics Centre.Cardinal Simon Pimenta was the Founder Patron who put in a lot of efforts right from the inception of the Centre. His work was continued by His Eminence, Ivan Cardinal Dias for many years. Today, His Eminence, Oswald Cardinal Gracias, is the Patron, and has taken an active role in guiding the Centre.
All the members of the FBMEC hold the utmost respect for life as it is God given. They believe that life has to be promoted, protected and preserved. Moreover, they uphold the command to care for one’s neighbour.

MESSAGE OF HIS EMINENCE OSWALD CARDINAL GRACIAS

We are all aware of the tremendous advances being made in medical and health sciences. However, the benefit of this technology is not reaching the masses. The health situation in our country is in need of a lot of improvement. The Church affirms the intrinsic dignity and worth of every person, and in particular every sick person. On February 11, 2007, on the occasion of the sixteenth World Day of the Sick, Pope Benedict affirmed “that the Church turns her eyes to those who suffer and calls attention to the incurably ill, many of whom are dying from terminal diseases. They are found on every continent, particularly in places where poverty and hardship cause immense misery and grief…In hospitals, hospices and homes throughout the world we encounter the sufferings of our many brothers and sisters who are incurably and often terminally ill. In addition, many millions of people in our world still experience unsanitary living conditions and lack access to much-needed medical resources, often of the most basic kind. The Church wishes to support the incurably and terminally ill by calling for just social policies which can help to eliminate the causes of many diseases and by urging improved care for the dying and those for whom no medical remedy is available”.

In a particular way, we need to be concerned with the various ethical issues that seriously affect the health of our people – right from the first moment of conception until the end of life. Keeping this in mind, the F.I.A.M.C. Bio-Medical Ethics Centre has decided to start a newsletter entitled “Touching Lives”. This new initiative of the Centre would focus on healthcare issues which threaten and depersonalize human life. It would make an ethical analysis, in very simple language, of issues such as abortion, contraception, euthanasia, HIV/AIDS and child abuse and provide the teachings of the Church in these areas. In the light of public opinion being swayed by the mass media and other negative forces in society, there is an even greater need today to properly and effectively guide the consciences of people.

It is my hope that the newsletter will provide in-depth understanding and moral guidance of the ethical challenges in healthcare and thus serve those actively involved in hospital administration, medical centres, social work organizations and all health related bodies.

May Mary, Salus Infirmorum, comfort those who are ill and sustain all who have devoted their lives to healing the physical and spiritual wounds of those who suffer. May each of us truly follow the footsteps of Christ the Divine Healer and reach out to every sick and suffering person and touch their lives.

To each of you I joyfully impart my Blessing!

Oswald Cardinal Gracias
Patron, FIAMC Bio-Medical Ethics Centre, Mumbai

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