If health workers forsake their patients, who can then defend them? 

Dear Editor,
The big ethical question is; is it ethical for medical doctors and nurses to protest and strike just like everyone else as is the case here at some hospitals throughout Guyana which implied withdrawing treatment and healthcare to the patients entrusted to them? One would argue that such action undermined the right of patients to healthcare and the profession’s duty to protect life and health. If we indeed agree that it is ethical for doctors and nurses to strike, then we ought to ask ourselves how should the strike be conducted? If we are against medical strike, then which other viable options do health workers with grievances against the employer have other than strike.
According to the World Medical Association declaration of Helsinki, it is the duty of the physician (health worker) to promote and safeguard the health of the people. The health of the patient will be the first consideration of the physician (health worker). The main aim of medical practice is to save life, preserve, promote and manage health. It is generally understood that health workers should always desist from harming their patients and their actions should always be in the best interest of the patient. On the other hand, health workers that are employed on agreed remuneration packages have the right to be paid and they have the right to express dissatisfaction and protect themselves from unfair treatment and exploitation
However, their own rights are limited by their responsibility to save lives and promote health as laid down by the medical profession’s code of conduct. It is suggested that there is a need to do a thorough risk-benefit assessment, before health personnel decide to embark on protest and strike. Is the protest and/or strike in the best interest of the healthcare delivery system since our country and the world is going through a pandemic? Just because a thing is legal is not necessarily that it is ethical in all circumstances. When two rights are in competition or conflict, as in this case, the right to be adequately remunerated and right for the healthcare, the impasse could be solved by resorting to what we call re-evaluation of moral values. Not all-moral values have the same weight and scope; there is a hierarchy of ethical norms and principles. Although moral values are hierarchical in nature, they are intermingled. For example, the right to life does not have the same weight as the right to privacy. Therefore, the right to healthcare (and implicitly life) on the part of the patient may be considered overriding the right to better remuneration of healthcare workers. This is not a universal perception among health workers and it is a matter of controversy in many circumstances. In the context of a protest or a strike, one should ensure not undertake anything that could result in causing harm directly or indirectly to the patient. Any struggle undertaken by medical personnel that violates the patient’s right to health is unethical. The struggle should be centred at improving overall working conditions and the environment in the hospital. The problem with this understanding is that it is almost impossible to stage a strike which is not painful and does not hurt the patient as such would in essence defeat the whole effect of the strike. One could rightly argue that the only ones who could better defend the plight of the patient are the health workers. If health workers forsake their patients, who can then defend them? Therefore, if the health workers want to improve their working conditions, let them also fight for the living and care conditions of their patients. For the working condition of a health worker is the living condition of the patient, both are two sides of one coin. A health worker and a patient are not the same and yet they cannot be separated; one cannot be without the other. Therefore, our Government cannot improve the living conditions of patients without improving the working conditions of the health personnel, something President Irfaan Ali thought about when he provided $150 million in the 2020 emergency budget for three months, something our health workers must be aware of. The budget is only for three months. The duty and responsibility to protect life are among the first in the hierarchy of values. To violate this internationally recognised regulation in industrial practice, when Guyana and our nation is facing the worst pandemic, amounts to a cruel, inhumane and unusual abdication of responsibility and will be viewed by many as conduct unbecoming whereby our citizen may die as a result of these selfish actions. Our Government and regulatory services say that it is unethical for medical personnel to strike because medical service is in the category of special services but recognised that health personnel and health workers need to express their grievances when they discover that their professional services and goodwill are being abused in the name of professional ethics. President Irfaan Ali and his Government acknowledge that all health workers are crucial in our society and will ensure that the Government gives to them what is due to them.  The GPSU has chosen to mislead the health workers in committing violations of the law. One must recognise that the GPSU has failed, neglected and/or refused to disclose to the health workers the true, legal and acceptable industrial course of action in these matters.

Sincerely,
David Adams