Ethics, locum and strikes among health practitioners in Malawi

Recently we have been hearing of health personnel in most of the countries hospitals, like Zomba central hospital, Kamuzu central hospital, Neno and Thyolo district hospital going on strike on several grounds. The major reason for their withdrawal of labour was the workers demand for an increment in an allowance commonly known as locum. Locum is an allowance that  a health personnel gets after working outside his or normal working hours .The most obvious questions any person can ask is whether these strikes were justified or not depending on the nature of this proffession?

The issue of locum is on one hand an industrial relations issue because, it concerns an employer and an employee relationship. Workers fight for a better pay, the one that is equivalent to their work. On the other hand it is an ethical issue because the patients’ welfare is overridden by the professionals demand for a high pay. For the purpose of this discussion my focus shall be on bioethics.

A profession in the field of health care is different from other professionals. It is unique in that the practitioners need to take an oath before taking up various jobs in hospitals, the most famous being the Hippocratic oath that was formulated by Hippocrates.

Nurses;:On demo

Further it is unique because it deals with life. It respects the fact a person only lives once, therefore one’s life demands to be handled with care. If this profession was not as crucial, the practitioners could not have been taking any oath.

This profession is further guided by the principles of autonomy, nonmaleficence, beneficence and justice. As far as I am concerned these principles are have to do with the relationship between a patient and a practitioner and not in any way with the employer.

According to the Medical Council of Malawi, Code of Ethics and Professional conduct of July 2007 ,section 1,subsection 1.1, ‘every practitioner shall respect all aspect of human life, and shall do all that can reasonably be done to safeguard and improve the quality of human life, and shall not do anything which may cause suffering or terminate life’.

The above cited section seems to be contradictory with the current behavior of health practitioners in Malawi. These professionals seem to love money more than safeguarding and improving the quality of human lives as if they did not learn any ethics at all.

Moral reasoning is required to reach ethically sound decisions. This is not an inherent gift but a skill that must be practiced so that it becomes part of the health practitioners’ life.

My view is that a health profession is twofold. Firstly it is a vocation, before joining this profession one needs to have a strong desire to do this particular job and secondly it should be taken as a source of income.

Therefore it is morally wrong to priotize the latter because life cannot be bought no matter how much money one may have, unlike with life issues of allowances can be negotiated with the employer without putting the lives of innocent people at risk. I am aware that nurses, clinicians and other health personel are not volunteers, they too need to work in a safe environment and above all need enough money to support themselves and their families.

In conclusion, I attribute the breeding ground for strikes by health personnel to lack of ethics. My view is that schools which train them do not put emphasis on the importance of ethics because if they do it could have rare to see nurses and clinicians abandoning patients in the intensive care unit because of an allowance .

In addition, the health personnel themselves fail to understand the oath that they take when joining this profession, otherwise anyone who understands these oaths sees the respect of all human life as an unnegotiable.

The only way out of these problems, is not to train more nurses, clinicians and medical doctors, but to teach and make them understand their professional ethics, it would be useless to train more health personnel who would sacrifice the lives of innocent people for locum. Further there is need for the ministry of health to be organizing trainings in bioethics for those who are already in the profession.

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