Friday, 29 July 2011

A Call For Social Consciousness & Awareness

"... we must also take a position on issues like the Lynas project, torture of prisoners and detainees and other current socio-political issues. As responsible physicians, we cannot just hide under the “tempurung” of our white coats and stethoscopes."

Doctors’ Concern About Social Justice & Democracy

Dr Mary Cardosa President, MMA 2011-12.

The events of the past few weeks should have set us all thinking about what it means to be not just doctors in Malaysia but also as citizens. In particular, the arrest of Jeyakumar Michael Devaraj under the Emergency

Ordinance, with the charge of “waging war against the King”, has been particularly disturbing to many of us personally. Kumar, a Life member of the MMA, has participated in many of our AGMs and is well known for bringing up resolutions urging the Association to look into working for the health of poor communities (e.g. estate workers) and questioning policies that favour the rich and disadvantage the poor (e.g. privatisation of health services). Since his arrest, many doctors have spoken/written about the Kumar they know personally, telling stories of his peaceful, simple and humble nature, and the philosophy that he has always followed — service to the people, especially the less privileged of society. He has made many personal sacrifices, living a very simple life and driving that beat up blue Volkswagen beetle for many years.

I have known Kumar since the 1970s in Penang, and I too have many stories about the great work he has done over the years, as a student and as a doctor. Organising free tuition classes for children from squatter communities, documenting carefully the occupational hazards and high accident rate (many fatal) of the logging industry in Sarawak, working to stop the demolishing of the houses of poor city council workers are just a few examples that I have personally witnessed.

How could such a person be a threat to the King?

He has done more good and made more sacrifices than a hundred of us put together. I join the many people who have written letters and petitions calling for the release of Dr Michael Jeyakumar Devaraj and the other five members of PSM who have been detained under the Emergency Ordinance on 2 July 2011.

Doctors’ responsibility to society

Although the MMA is here to listen to you and to try to address some of your issues, as the largest doctors’

organisation in the country, we also have a responsibility to address issues that affect health. As

doctors, we are well respected, we have status in society and we are often in a position of influence; as such, we have a responsibility not just to ourselves but to others, especially those who are less fortunate than us.

JK Rowling, in her speech to the graduating class of Harvard University in 2008, said

“If you choose to use your status and influence to raise your voice on behalf of those who have no voice; if you choose to identify not only with the powerful, but with the powerless; if you retain the ability to imagine yourself into the lives of those who do not have your advantages, then it will not only be your proud families who celebrate your existence, but thousands and millions of people whose reality you have helped change. We do not need magic to change the world, we carry all the power we need inside ourselves already: we have the power to imagine better.”

As doctors, therefore, we need to think about how we can use that privilege to make this a better world for all. At the very least, we need to address issues that will affect the health of our people. At a broader level, we should also be concerned about larger issues of social justice and democracy. So while the MMA should, and will, always address issues where doctors’ welfare and the practice of medicine is affected, we must also take a position on issues like the Lynas project, torture of prisoners and detainees and other current socio-political issues. As responsible physicians, we cannot just hide under the “tempurung” of our white coats and stethoscopes.

MMA Press Statement: Dr. Jeyakumar’s hunger strike

MMA Press Statement: Dr. Jeyakumar’s hunger strike

posted in - Nation, - Palmdoc |

Press release
29th July 2011

The Malaysian Medical Association (MMA) is very concerned to hear that Dr Jeyakumar Devaraj, a Life Member of the MMA who has been detained under the Emergency Ordinance since July 2nd 2011, has gone on a hunger strike, as announced by his wife R. Mohanarani yesterday, “to seek justice, and he will continue his strike until all six of them are released or brought to trial..”

We urge the authorities to release Dr Jeyakumar and the 5 others from PSM as the police said they had been detained “for being key movers of the July 9 Bersih 2.0 rally”, which is now over. If they are not released immediately, they should be charged and tried in open court.

While we are concerned about the possible detrimental effects of this hunger strike on Jeyakumar’s health – more so as he has been brought to the hospital for heart problems twice since his initial arrest almost a month ago – we must also respect Jeyakumar’s right to this non-violent form of protest.
In this regard, the MMA calls upon the authorities to respect international human rights law and not to resort to force-feeding as a means of ending Dr Jeyakumar’s protest. The World Medical Association (WMA) – the body that establishes ethical guidance for doctors around the world – states that force-feeding by any means is considered as unethical and cruel, inhuman and degrading treatment.

We also wish to remind all doctors that we are ethically bound to respect the right of a competent person to refuse food intake as a form of protest.
The WMA Declaration of Tokyo (1985) states that
“Where a prisoner refuses nourishment and is considered by the physician as capable of forming an unimpaired and rational judgment concerning the consequences of such a voluntary refusal of nourishment, he or she shall not be fed artificially. The decision as to the capacity of the prisoner to form such a judgment should be confirmed by at least one other independent physician. The consequences of the refusal of nourishment shall be explained by the physician to the prisoner.”

The WMA has reiterated the same in the Declaration of Malta on Hunger Strikers, adopted by the 43rd World Medical Assembly in 1991 and revised by the 57th WMA General Assembly in 2006, the full text of which is available at

The principles outlined in the Declaration of Malta include the duty of physicians
- To act ethically and to prevent coercion or maltreatment of detainees;
- To respect the detainee’s autonomy (“Forced feeding contrary to an informed and voluntary refusal is unjustifiable”);
- To uphold the principles of “benefience” (doing good – respecting the individual’s wishes and promoting his welfare), complemented by “non-maleficence” (doing no harm – minimizing damage to health and not forcing treatment or coercing him to stop fasting); and
- To ensure that their primary obligation is to the individual patient – “remaining objective in their assessments and not allowing third parties to influence their medical judgement, including not allowing themselves to be pressured to breach ethical principles, such as intervening medically for non-clinical reasons.”

The WMA Declaration of Malta also recommends that a physician be involved in the management of the person undertaking the hunger strike as early as possible, making an assessment of the person’s competency, informing him of the consequences of his action, and performing a thorough medical examination at the start of the fast, noting the person’s values and wishes regarding medical treatment in the event of a prolonged fast. A physician should also be allowed to communicate with the hunger striker in privacy and “ascertain on a daily basis whether individuals wish to continue a hunger strike and what they want to be done when they are no longer able to communicate meaningfully.”

In accordance with the principles of the Declaration of Malta, the MMA urges the authorities to appoint one of our MMA members as the physician involved in the management of Dr Jeyakumar during his fast, so that we can be assured of his health and welfare and can communicate this with his family and friends on a regular basis, and can intervene medically if and when appropriate, while respecting Dr Jeyakumar’s autonomy and right to carry out this form of non-violent protest.