| 28 March 2004 | Sunday | 06 Safar 1425 |
American veto
Whither medical ethics?
There have been conflicting reports all week about the Wana operation. It is still not clear whether it has ended or simply been scaled down. Figures have been published about the number of people killed or arrested. Initial reports had suggested that the operation was primarily directed against a "high-profile" Al Qaeda leader holed up in the region along with several hundred foreign fighters. There have been casualties on both sides, and a number of people are said to have been arrested.
The bodies of eight soldiers who were missing and reportedly held hostage have been found, the men having apparently been shot from close range. This is murder, plain and simple, and an atrocity that cannot be overlooked. If it is the work of foreign nationals sheltering in the region, then it makes the task of hunting them down and those hiding them even more urgent. It was to seek out such elements that the operation was launched in the first place.
If these events provide a justification for the military operation, there are other questions that also need to be examined. The term 'tribal areas' is itself an anachronism in this day and age; the kind of autonomy they enjoy in both administrative and legal matters is a throwback to colonial times - a situation that obviously calls for a thorough review. The state of Pakistan has a right to establish its writ in the area and expect the laws that govern the country to be equally applicable there.
The Federally Administered Tribal Areas have long been notorious for serving as a hideout for fugitives and smugglers; now Taliban and Al Qaeda men have apparently found sanctuary there. The region's people and tribal leaders thus do not hold a very high moral ground from where to seek to dictate terms.
However, there is a clear political failure involved in letting things reach the present pass. The political agencies in various parts of Fata should have known what was going on in their area and warned the federal government of the threat posed to Pakistan's security by the presence of foreign fighters or militants or 'terrorists'.
If they shut their eyes and looked the other way, then we are now being made to pay a heavy price for this negligence (as indeed for our previous support of the Taliban). Even otherwise, instead of seeking to politically reform the system, the practice has always been to manipulate it by distributing largesse and favours. The wayward pro-establishment role played by legislators elected from the tribal areas has been a sordid aspect of our political life throughout the past five decades.
Beyond the exercise of military force, a new approach is called for - based on political, social and economic reforms meant to truly integrate Fata into the national mainstream. Once the dust settles down on the present tragic episode - efforts were said to be continuing to seek mediation by tribal jirgas - the government should consider a progressive dispensation for the region that promises visible and rapid social and economic uplift.
In this task, the government would be greatly helped if it sought the cooperation of political parties. At the moment it is caught in the curious position of seeing its only political ally at daggers drawn with it over the Fata operation and irresponsibly turning what is essentially a political issue into a religious one.
The Musharraf regime needs broader domestic backing; how it can get it should be obvious to those in government.Meanwhile, a fuller accounting of the Wana operation must be made in parliament so that consensus can counter further extremism and alienation that reliance on armed might alone is likely to generate.
American veto
The American veto of the Security Council resolution condemning Israel's murder of Sheikh Ahmed Yassin was no surprise. The US has never hesitated to use its veto to bail out Israel whenever the Security Council united to condemn one of its crimes. Three abstentions still meant that a majority of 11 was in favour of the resolution that justly condemned Israel for its murder of the 66-year-old blind leader and founder of Hamas. However, Mr John D. Negroponte rose to Israel's defence and killed the resolution.
Explaining the reason for the veto, America's UN envoy said the resolution was "silent about the terrorist atrocities" by Hamas. In other words, he was equating the Palestinian people's liberation struggle with Israel's state terrorism. Sheikh Yassin's murder has been condemned by the entire world, including some of America's European allies. However, the US reaction to the crime was only to ask both sides to exercise restraint.
One should now expect more murders, because Israel has gone public with its diabolical designs to assassinate more Palestinian freedom fighters, including, perhaps, President Yasser Arafat. This is Israel's response to the US-led roadmap for peace. The Israeli prime minister is also building a fence designed to annex more Palestinian land. A more sinister plan is to resettle Jews from Gaza on larger West Bank settlements.
What has disappointed Mr Sharon is that, in spite of Israel's overwhelming military superiority and Washington's categorical support to it, the Palestinians have refused to surrender. They have continued to fight and make Mr Sharon feel frustrated. This explains his frequent resort to terror in spite of the failure of this mode of action to subdue the Palestinians struggling for their national liberation.
Whither medical ethics?
Should doctors willingly accept gifts from pharmaceutical companies? Should they travel to medical conferences on tickets provided by these firms and should they accept free samples of medicines to prescribe for their patients? Such questions pose a moral dilemma for doctors everywhere. These were touched upon by speakers at the Pakistan International Medical Association's biennial convention held recently in Karachi.
Doctors were advised not to accept gifts and freebies from pharmaceutical companies because that was contrary to universally acknowledged ethical principles governing the medical profession. But how does any society guarantee that its medical practitioners will stay above personal avarice and inducement and refuse to become an instrument in the sales promotion drives of pharmaceutical companies?
The issue is an important one, especially because of the fact that the aim of a pharmaceutical company in such cases is to ensure that as many doctors as possible prescribe its medicines. With an alliance of interests of this kind, the quality of medicines being prescribed and their efficacy in particular cases become secondary and the patients are the main suffers.
Doctors occupy a particularly important position in any society because the treatment of the sick is in their hands. If they do not do justice to their profession and let themselves be swayed by considerations other than the care and well-being of their patients, they are likely to go down in the esteem of the people as healers and preventers of diseases.
In Pakistan, the absence of a regulatory system to keep a check on the practices of doctors, and the fact that most people who seek medical advice or treatment are often not fully aware of their rights as patients mean that instances of deviation from the norms might never be detected.
The Pakistan Medical Association should emphasize to its members the importance of ethics and should come down hard on doctors who violate their Hippocratic Oath, part of which says: "I will prescribe regimen for the good of my patients according to my ability and my judgment and never do harm to anyone."