WMA approves Modern Physicians Pledge

Health Care, Medicine Comments Off

WMA approves Modern Physicians Pledge

Dr KK Aggarwal

A modern successor to the Hippocratic Oath for physicians around the world has been approved by the World Medical Association.

Physician leaders, meeting at the WMA’s annual General Assembly in Chicago approved revisions to the Declaration of Geneva, which was adopted by the Association in 1948.

The revised Declaration, to be called a pledge, refocuses the text to reflect changes over the decades in the relationship between physicians and their patients and between physicians themselves. As a result, the new pledge makes specific reference for the first time to respecting the autonomy of the patient, which is not included in the current text. It also includes a new obligation for respect between teachers, colleagues and students.

The present Declaration says students must respect their teachers, but there is no reciprocity. There is a new obligation on physicians to share medical knowledge for the benefit of their patients and the advancement of healthcare.

Also added is a requirement for physicians to attend to their own health, well-being and abilities in order to provide care of the highest standard.

The current Declaration of Geneva is used across the world by physicians. In many countries it is actually part of the medical professional code and in some it is legally binding. However, in other countries it is either not used at all or is adapted in some way.

The WMA is now expecting that the revised pledge, agreed following a two-year revision process, including a period for public consultation, will become a global ethical code for all physicians.

WMA President Dr. Yoshitake Yokokura said: ‘The new wording respects the unique character and significance of this Declaration, but focuses more on important ethical principles not in the current version and not expressed explicitly.

‘The life of physicians today is completely different to what it was in 1948 when the original Declaration of Geneva was adopted. Since then, the Declaration has become a core document of medical ethics and a modern version of the 2,500-year old Hippocratic Oath.

‘We hope that the Declaration approved today will be used by all physicians around the world to strengthen the profession’s determination to maintain the highest standard of health care for patients’

(Source: WMA News Release, October 14, 2017)

India still lags behind in child nutrition with a child-wasting prevalence of 21%

Health Care, Heart Care Foundation of India Comments Off

A healthy diet including all food groups is key to preventing this condition

New Delhi, 15 October 2017: Twenty-one percent of children under 5 years of age in India suffer from wasting, according to a report. India has not seen any significant strides in checking the prevalence of this indicator since the last 25 years. Djibouti, Sri Lanka, and South Sudan are the only remaining countries in the Global Hunger Index (GHI) 2017 with a child-wasting prevalence over 20%. Child wasting is one of the four indicators in the GHI.

Statistics indicate that the prevalence of child wasting in India has increased from 17.1% in 1998-2002 to 21% in 2012-16. This is way above the global prevalence. Wasting or thinness in a child is the result of acute and inadequate nutrition along with frequent infections leading to rapid weight loss or failure to gain weight normally.

Speaking about this, Padma Shri Awardee Dr K K Aggarwal, National President Indian Medical Association (IMA) and President Heart Care Foundation of India (HCFI) and Dr RN Tandon – Honorary Secretary General IMA in a joint statement, said, “Wasting is also called as acute malnutrition and as low weight-for-height. A healthy child is normally expected to gain 2 to 3 kg of body weight every year. Wasting occurs when the weight-for-height measurement in a child is less than two standard deviations from the globally accepted reference cut-off point. Severe wasting happens when a child’s weight-for-height measurement is less than three standard deviations from the globally accepted norm. Wasting and stunting are often two separate forms of malnutrition requiring different interventions for prevention and/or treatment. However, they are closely related and often occur together in the same populations and often in the same children.”

Some signs and symptoms of malnutrition include loss of fat, breathing difficulties, abnormally low body temperature, weakened immunity, higher susceptibility to feeling cold, longer healing time for wounds, reduced muscle mass, tiredness and fatigue, and irritability.

Adding further, Dr Aggarwal, said, “Children with severe malnutrition experience slow behavioral and intellectual development, leading to intellectual disabilities later in life. Even when they are treated, under nutrition can have long-term effects in children including impairments in mental function and digestive problems, which can last for their whole life.”

Prevention of malnutrition entails eating a healthy balanced diet. There are four major food groups that should form a part of a child’s diet plan. These include:
• Bread, rice, potatoes, and other starchy foods. This forms the largest portion of the diet and provides calories for energy and carbohydrates that are converted to sugars which provide energy.
• Milk and dairy foods – Vital sources of fats and simple sugars like lactose as well as minerals like Calcium
• Fruit and vegetables – Vital sources of vitamins and minerals as well as fiber and roughage for better digestive health
• Meat, poultry, fish, eggs, beans and other non-dairy sources of protein – These form the building blocks of the body and help in numerous body and enzyme functions.
• Other factors to be considered include adequate nutrition of the mother during pregnancy and promoting the practice of exclusive breastfeeding.