(The Indian Medical Association has called a nationwide protest today, Friday, 11 December, against the Centre’s controversial move to allow Ayurveda doctors to perform various surgeries. All medical services except COVID care units, ICUs and emergency services, will be affected. FIT is republishing this article in light of the current strike.)
A huge controversy has broken out after a notification by the Central Council of Indian Medicine was issued allowing training of the Ayurvedic graduates to perform various surgeries, 58 to be precise. Apparently, to lay to rest the apprehensions arising out of ‘incorrect interpretations’ of the said notification, Ministry of AYUSH in its clarification said that the said notification relates to the 'Shalya and Shalakya' streams of Post Graduate Education in Ayurveda only.
Eventual clarification by the Ministry of Ayush not withstanding, the list contains certain surgeries which are highly specialised and are taught in post-doctoral super speciality courses even to the students of Modern Medicine (allopathy).
Indian Medical Association, the national body of doctors practicing Modern Medicine in India has come out in protest in what they call is encroaching on their domain because traditionally the surgeries and the techniques supposed to be taught in these Ayurvedic colleges have been developed and evolved by the doctors practicing Modern Medicine. Who is going to teach these students the proposed curriculum, they ask.
Sure enough, there have been rebuttals issued by the Chairman of the regulatory body for Ayurveda, the Central Council of Indian Medicine.
“The notification is specific to these specified 58 surgical procedures and does not allow Shalya and Shalakya Post Graduates to take up any other types of surgery”Chairman of the regulatory body for Ayurveda
Ministry of AYUSH also insists that there is no policy change because teaching of surgery in Ayurveda colleges, always existed. With this notification it has only been brought under regulation.
Mixing of Two Distinct Medical Streams Dilutes Both
But the reality is that the procedures which have been developed very recently even in Modern Medicine find a mention in this list, for example, Endoscopic Surgeries. Moreover, anesthesia is an inseparable part of surgery. Surely, even the Ayurvedic colleges and hospitals are falling back on anaesthesiologists trained in modern medicine. Contrary to the claims made by the CCIM, of protecting the purity of their system, the mixing is already happening.
While all scientific advances are inheritance of the entire mankind, the crux of the problem is that these two systems viz. Ayurveda and Modern Medicine have completely different principles and philosophy of treatment, as also a different approach to a particular disease and cannot be based on one another.
Adopting disparate modalities, in a piecemeal fashion tantamounts to mixing the incompatible systems of medicine which helps no one.
As a result, not only there is no authenticity left of any one of these systems, it is completely diluted in the form it is being delivered.
Standards of Care and Mixopathy
The most unfortunate part is that the standards of patient care for both these systems of medicine have gone down tremendously to the detriment of patients.
It is well-known that diagnosis and therefore, the treatment in Ayurveda is based on the tridoshas and science of pulse reading (naadi vigyan) which is completely at variance with that in Modern Medicine.
Further, the basic anatomy also, as perceived in Ayurveda is different from what is accepted in the modern medicine, more so because there are some other invisible energy channels (naadis) recognised in Ayurveda and not in the modern medicine. Surgery can be done only on a solid foundation of complete understanding of the anatomy as seen. It is not a mechanical cutting and stitching. Unless one is fully conversant with the basics, complications that may follow cannot be dealt with effectively. But the malady runs deeper than what meets the eye. Ground reality is that the so called ‘mixopathy’ is rampant and being practiced with impunity. It not only unethical but falls foul of the law.
According to a Supreme Court ruling in 1996, a person who does not have knowledge of a particular ‘system of medicine’ but practices in that ‘system’ is a quack and a mere pretender to medical knowledge or skill, or to put it differently, a charlatan.
A case in point is the recent judgment by the District and Sessions Court in Pune, holding two doctors with Bachelor of Ayurvedic Medicine and Surgery (BAMS) degrees, incompetent to perform the surgery, and pronounced 10 years jail under Section 304 (committing culpable homicide not amounting to murder), after a 21-year old patient died days after cesarean and tubectomy surgeries performed on her by the doctors.
The two doctors were held guilty of conducting surgeries despite not having a recognised qualification in Gynaecology and Obstetrics. They knew they are not qualified, yet conducted the surgeries that caused the death of a woman.It has been held in several court judgments that even qualified specialists are not allowed to dabble in specialities other than their own. For example, a General Surgeon would be held guilty of medical malpractice if he attempts a highly specialised cardiac or neurosurgery without having undergone a proper training.
As a result, authenticity of both these systems has been compromised by those practicing something which they know not much about.
Whenever there is a controversy in India, politics does not remain far. According to a Marathi newspaper the Union Minister for Ayush has called doctors opposing Ayurvedic medicine as anti-national, an oft repeated phrase in recent times. The need of the hour is to rise above the petty politics and strengthen both the systems of medicine, so that the best medical care is made available to the patients as no system can claim to be complete and perfect in itself.
Dr Ashwini Setya is a Gastroenterologist and Programme Director in Delhi’s Max Super Speciality Hospital. His endeavour is to help people lead a healthy life without medication. He can be reached at ashwini.setya@gmail.com)
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