Mon, May 26, 2003 - Page 2 News List

SARS doctors' ethics put to the test

UNDER SCRUTINY Not only are the reputations of all medics on the line, but the nation's entire medical system is being carefully monitored for carelessness

REUTERS , TAIPEI

When Taiwan doctor Chang Yu-tai (張裕泰) was sealed inside the Taipei Municipal Hoping Hospital a month ago, he knew he was putting his life at risk to treat patients with SARS.

But the emergency ward chief and his colleagues had little inkling their reputation and medical ethics would also be put to test as the worsening viral outbreak placed Taiwan's medical system under scrutiny.

This week, health authorities fined Chang's hospital and three others NT$1.5 million each for covering up or delaying their reporting of possible SARS patients, resulting in a wider spread of the virus.

Three Hoping doctors, including Chang, were personally fined T$90,000 each. All deny the charges.

"If any government officials are doctors, I wish they would go sit in an emergency ward and see some feverish patients," said Chang, a Japan-educated endocrinologist. "Let's see if they can tell who has SARS and who just has a cold."

Whispers of hospital cover-ups started to make the rounds this month, after President Chen Shui-bian (陳水扁) ordered an investigation into why a SARS outbreak at Hoping Hospital had been allowed to continue unchecked.

As Taiwan's cases jumped 10-fold in a month to 570 by yesterday, with hospital infections accounting for 95 percent of new cases, suspicions grew that some hospitals may have delayed reporting SARS patients for fear of hurting revenues.

At the Kaohsiung Chang Gung Memorial Hospital -- one of the four penalized -- many patients fled on media reports of a SARS outbreak, causing occupancy to plunge to 300 beds from 1,600.

Taiwan requires all doctors to report suspected SARS cases within 24 hours, but medical workers say there can be many reasons why that is delayed, including the difficulty of diagnosing an illness with similar symptoms to the common flu.

"If a doctor doesn't know for sure that a patient has SARS, he might not want to report the case," said Jenny Liao (廖張京棣), president of the Taipei City Nurses Association and a Chang Gung nurse.

Carelessness, pride and profit concerns may have also encouraged doctors to classify some borderline cases as non-SARS, medical workers say, though most do not believe doctors will go so far as to wilfully violate the Hippocratic oath.

"It's impossible for a doctor to purposely cover up SARS," said Kuo San-dar (郭聖達), another doctor at Hoping's emergency room. "I can't accept a doctor will do that on purpose for any reason."

Chang and Kuo criticized the government for not investigating more thoroughly before issuing the penalties, saying the fines only pile more pressure on doctors battling to save lives.

Medical workers also fear a backlash: if all patients with fevers and coughs are treated as SARS cases, strained hospitals will be swamped with flu patients taking up quarantine beds.

"We will be very careful now. It will change the mentality and practices of many doctors when they see patients," said Wu Shu-min (吳樹民), chairman of the Foundation of Medical Professionals Alliance.

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