Vigilance is needed
CMAJ 2000;163(2):160
The commentary by Peter Craighead on the situation in South Africa1 is a good warning of the way in which members of the medical profession can be coerced into acting unethically on behalf of their government, and how professional organizations can be negligent in failing to oppose such unethical actions.
Unfortunately, the commentary did not mention the alleged unethical behaviour that occurred in Canada when physicians working with the Department of Immigration allegedly tranquilized deportees against their will to facilitate the removal process. When this situation became publicly known, no medical association in Canada publicly condemned this behaviour or protested to the Canadian government about its alleged unethical use of physicians. When pressured into responding, the Canadian Medical Association stated only that it "has gone on record on various occasions as categorically condemning the practice"2 and that these actions "may have been [only] unacceptable acts by some of its members."2
No medical association made a complaint to any of the regulatory provincial colleges to demand that the doctors involved be investigated and appropriately disciplined if found guilty. When the Medical Network of Amnesty International made a complaint to the College of Physicians and Surgeons of Ontario, the College expressed concern and sought further information from the Minister of Employment and Immigration. However, the Minister refused to reveal to the College any details about the medical treatment or the names of the physicians involved during the period before the Department instituted new guidelines on June 18, 1990. As a result, the College was blocked from carrying out any independent investigation. The alleged victims of the involuntary treatment were no longer in Canada, were not in a situation to easily make a complaint on their own and were unlikely to remember the name of the physician who treated them. If these physicians were guilty, they had, in effect, being granted impunity for their unethical actions.
Craighead is right in pointing out that all physicians should have a good grounding in medical ethics. However, abuses continue even with this knowledge. We must have the political will to actively point out and condemn unethical medical behaviour that relates to governments before it becomes part of accepted government practice and before physicians are put under further pressure to conform to the government's increasing expectations of them.
Donald E. Payne
Coordinator, Medical Network
Amnesty International, Canadian Section
Toronto, Ont.
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References
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Craighead PS. Ethics through the looking glass [commentary]. CMAJ 2000;162(8):1147-9.
Kluge E-H. Tranquilizing deportees [letter]. CMAJ 1990;143(3):170.
© 2000 Canadian Medical Association or its licensors
