We are so vulnerable when there
is inequality of power. Sadly,
inequality of power is everywhere.
I saw a patient last week. He was at a loss with his blood pressure
condition. He was diagnosed with “hypertension”
and was given anti-hypertensive by an A&E doctor when he recorded elevated
blood pressure after a heated quarrel with his wife. He took the medicine and felt dizzy, with
self-checked blood pressure of 90/60mmHg. He did a follow-up appointment to GOPC and
told the doctor about his hypotensive symptoms and his blood pressure readings.
Despite the confirmation of the reading
of 90/60mmHg at GOPC, the attending doctor ignored him, told him nothing, and
prescribed the same medication for him for another 6 months.
Inequality in power is the
classical description of the doctor patient relation. The doctor is equipped with the medical
knowledge to diagnose and to treat, the skill to operate, and the license to
prescribe controlled drugs. If he so
wishes, he is in the position to fully manipulate the patient, who becomes even
more vulnerable when stroked with pain, and preoccupied by prognosis of his
illness.
Unfortunately, inequality in
power is not unique to doctors and patients. Every time my clinic needs renovation, or when
the air-conditioner fails, or when I hire a plumber, or whenever any service with
special knowledge or skills is needed, I will have a taste of such inequality
in power.
Regulation has been one of the
solutions to partially address the problem of inequality in power. The Medical Council is the regulatory body of
doctors. It fulfills its function by
setting standards, maintaining registry, handling complaints and having the
power to order disciplinary actions. On
the other hand, the Hospital Authority, as the largest employer of doctors in
Hong Kong, regulates its employees mainly through administrative actions. However, with the creation of such regulatory
bodies, there comes a new set of inequality of power between the regulatory
bodies and doctors.
Inequality of power is
everywhere. What is important is to have
checks and balances on the power, and proper routes of appeal and redress. A specialist who is removed from the
Specialist Register permanently because of a prescription error can lodge an
appeal to the Court of Appeal. A doctor
who is prevented from doing operation by his seniors can write to every
possible source and he can talk to the media every day. We ask ourselves how useful such remedies are.
And we are so vulnerable.
As citizens, the most common
inequality in power we face every day is the police. To enforce law and order, the police is
equipped with lethal weapons, and the power to arrest a citizen and to detain
him. The eternal debate, which is still
going on, is how to strike a balance between effective law enforcement and
abuse of power by police. Of course, one
of the factors for consideration is how much power the police is given by
statute. In September this year, the
Government, through the Action Committee Against Narcotics, will launch a
consultation exercise for a compulsory drug testing scheme. Be it Compulsory Drug Testing Scheme, or
Community Drug Testing Scheme, or by whatever fancy name the scheme is called,
a major and controversial component of the scheme is to greatly increase the
power of the police. It is proposed that
a police officer can, upon reasonable suspicion, require a citizen to go to the
police station to carry out further testing, which includes a urine test for
controlled drugs. The targeted citizen
can have no choice. His consent is not
needed.
The statutory position now is
that the police have no power to force anyone for any reason to submit his
urine sample for drug testing. The
reasons behind such “lack of power” or more appropriately “prohibition of such
power” are manifold. It protects the
citizen against invasive search of his body. More importantly, forcing (Yes, it is forcing.
The citizen cannot refuse, as he will be
charged for failing to submit a urine sample, the punishment of which is the
same as positive urine results.) the citizen to provide a urine sample which
can incriminate him is against human rights.
I wonder, what will be the use of
compulsory drug testing when we all realize that drug abusers are turning more
and more “hidden”? They take drugs at
home or at friends’ homes. What is the
chance of a police officer catching an abuser on the street?
I wonder, when the School-based
Drug Testing Scheme is boosted as very successful and millions of dollars are
pumped to launch more similar schemes at different schools, why is it necessary
to introduce another totally different scheme?
I wonder, how easy it would be to
trigger the subjective “reasonable suspicion”? And, don’t be as naïve as to think that you
can challenge the police officer’s findings on you.
I wonder, how can a police
officer distinguish between drug abuse and alcohol consumption? How can a police officer distinguish between
drug abuse and psychiatric illnesses? How
can a police officer distinguish between drug abuse and the side effects of
common medications?
I wonder, when I am at home, I
open the door to answer a police office claiming to look into a complaint about
noise, can he exercise his reasonable suspicion on me?
I wonder, how much should I
wonder?
Paulo Freire, the Brazilian philosopher, claimed that: "Washing one's hands of the conflict between the powerful and the powerless means to side with the powerful, not to be neutral." This new drug testing scheme will have drastic consequences on all of us. We are facing enough inequality in power. I decide to spend some time to go through the consultation document in detail and to give my comments. Do you still choose to remain neutral?
(Source: HKMA News September 2013)
