Medical professionals and torture; defensive responses

By Kishali Pinto Jayawardena

The Sri Lanka Medical Council has apparently taken remarkably ill advised umbrage in regard to a previous column of mine titled "Collusion of medical professionals in torture' published on July 29, 2007. My observation that the Medical Council's Professional Conduct Committee's (PCC) recent disciplinary sanctions imposed upon a member of the medical profession for collusion in torture was not strict enough has been considered to be unjustified as the PCC "consists of very senior and eminent members of the profession who are called upon to decide on the punishment, taking all matters into consideration."

I am constrained to call this an ill advised response for three reasons. Firstly, as may be recalled, the column in question focused on the general problem of medical professionals being implicated in torture practices with the police, which has surfaced increasingly repetitively not only in complaints submitted by victims but also in judgments of the Supreme Court, which is a fact that will be adverted to later. The column's specific focus was a July 26 order of the PCC which imposed a three years suspension on a medical professional, Dr W.R. Piyasoma for engaging in conduct that was (and I quote from the order itself) "disgraceful and dishonourable as a medical practitioner." The PCC further found Dr Piyasoma "guilty of infamous conduct in a professional respect." In this context, the column only posed a mild query to the PCC as to why such a comparatively light sentence of a three year suspension was imposed on conduct, if it was as 'infamous' as the PCC itself had found it to be.

Relevantly, the Committee itself had been 'convinced' that the erring medical professional's name should be erased from the medical register permanently but imposed only a three year suspension due the fact that this was a first time offence and also, considering the age of the offender. However, in the light of such severe strictures, it was reasonable to question as to why a harsher punishment had not been imposed. Secondly, as may be specifically brought to the attention of the Council, such an observation is not an error in commentary but rather a statement of opinion and absolutely justifiable at that, given the PCC's own findings.

Thirdly, the Registrar of the Council, Dr N.J. Nonis appears to be labouring under a palpably unfortunate misapprehension that the 'eminence' (perceived or actual, as the case may be) and 'seniority' of the members of the PCC should by itself preclude any criticism being levelled at it. This is, of course, a ludicrous position but quite indicative of the umbrage that 'senior and eminent' members of the medical profession are apt to feel when they feel that they are under criticism in any way.

The contrary should, of course, be the case. We have seen instances where equally 'senior and eminent' medical professionals have been reprimanded by the courts for breach of standards, including a most recent example in Shiranthi Perera v University of Colombo and others, (CA(Writ) NO 2246/2004. C.A. minutes 22.11.2005. per Justice K Sripavan with Justice Basnayake agreeing), where the Court of Appeal issued writ of certiorari quashing a marking scheme formulated by 'eminent and senior' medical authorities on the basis that the requisite procedure prescribed by the Universities Act and the PGIM Ordinance had not been adhered to. The problematic manner in which the relevant marking scheme had been decided upon was clearly disclosed during the court proceedings. This is just one illustration substantiating the self evident fact that 'senior' and 'eminent' medical professionals are not exempt from reasonable scrutiny in any way. To consider this not to be the case is indeed, professional arrogance of the highest degree.

The reply of the Medical Council also refers to several other cases of collusion by medical professionals that have been referred to in my column and makes the already commonly known observation that the Council cannot act on its own but has to respond to complaints made in the form of affidavits. Curiously if not extremely defensively, the Council also admits to 'delay in conducting disciplinary inquiries' and states that action has been taken to amend the regulations under which the Council conducts its inquiries. However, though the draft regulations were forwarded to the Minister for necessary legislative approval, this has yet not been done.

I say that this part of the response is curious if not defensive as my column, at no point, castigated the Council for delays in its proceedings even though, in common parlance, the cap has been voluntarily fitted on its own head by the Council. This however, is well and good as the response raises some interesting questions for discussion. While in no manner is the Council asked to act on hearsay reports or press reports of complaints, the question arises as to why notice may not be taken at least, of specific judgments of the Supreme Court where the affidavits of victims have disclosed clear collusion of medical practitioners in practices of torture and whose complaints have been accepted as valid by the Court itself? If the Council wishes, a comprehensive list of such judgments could be forwarded for its perusal.

It is logical after all, that if the Council could present amendments relating to minimizing of the delays faced in its own proceedings, it could also contemplate amendments in relation to the currently restrictive manner in which such complaints may be considered. This is, of course, if the Council has a genuine desire to address the problem instead of merely indulging in isolated and 'soft' orders against its members for grievous breach of medical standards.

Yet, I remain to be convinced of the genuineness on the part of the Council in that regard. This again, may I hasten to add, (in the event of a further, possibly even more irate letter from the Registrar of the Medical Council), is a matter of opinion which I am fully entitled to hold in my own right. Indisputably however, the bona fides of the Medical Council may be better demonstrated by its comprehensive addressing of an acknowledged problem in the medical profession rather than engaging in unnecessary responses to relatively mild queries raised in regard to perceived laxity in punishments.