Dr. Y has not yet made a decision to join the union. Some senior young doctors encouraged her to join the union,3 stressing the need for professional solidarity and the need for everyone to help prioritize their common interests. Dr. Y and others are reluctant to join the union, in part because they wonder what exactly class action might require of individual physicians and how it might affect their patients and careers. On the eve of an open strike, union representatives suggested that GPs should refuse to perform certain tasks, such as entering critical billing-related information into patients` medical records. Dr. Y believes this measure can be justified as long as patients are still receiving the care they need.4 Overall, however, she questions whether she should join the union.5 Bernstein J. Washington`s troubled medical residents need a raise. Nation. 9 October 2019. www.thenation.com/article/medical-strike-seattle/. Retrieved 9 December 2019.
Stafford N: Czech doctors get pay rises after three years of campaigning. Bmj. 2011, 342: D1371-10.1136/BMJ. D1371. Sears B: Temple Healthcare Workers strikes for dignity and patient care. 2010, Peoplesworld, [www.peoplesworld.org/temple-health-care-workers-strike-for-dignity-patient-care/] And yet, I haven`t heard any call for a strike here. Yes, it`s illegal under our seemingly outdated antitrust laws. Should they be challenged? One of the first questions to ask, whether or not a doctor can strike, is its impact on the Hippocratic Oath. Even if the law says a doctor can strike, his moral and ethical responsibility to a patient must be paramount, said David Kemp, a lawyer who writes about medical ethics. “For physicians to participate ethically in an organized work stoppage, they must first exhaust all other means of negotiation,” he says.
“I am of the view that [physicians] must also take all necessary steps to protect the well-being of patients before proceeding with any type of organized work stoppage, given the unique nature of the physician-patient relationship.” 28. In December 2021, the New York Times published an article on “Protracted doctors` strike due to understaffing triggers chaos in New Delhi hospitals”. 1 At the same time, the Omicron COVID-19 variant overwhelmed understaffed medical facilities, young doctors went on strike, as well as medical students across India. The protests were apparently sparked by delays in placing medical school graduates in positions in state health facilities. Thousands of striking doctors were arrested by the police. Recent results: Recent reports show that strikes by doctors and health workers around the world are an ongoing phenomenon occurring in both developed and developing countries. The main reasons for health workers` strikes are the failure of employer-employee negotiations on fair wages and working conditions, political issues, infrastructure deficiencies in poor countries, and health workers` concerns about personal safety in the workplace. The main effects of health worker strikes are health care disruptions, such as cancellation of ambulatory appointments, hospital admissions, and elective surgeries.
There was no clear evidence of an increase in patient mortality during strikes, except in isolated cases where emergency services were also withdrawn during strikes. With regard to workers` rights, employers` rights are governed by the right of men to provide or refuse their services. The right of workers to strike is an essential element of the principle of collective bargaining. In other words, it is an essential element not only of the union`s bargaining process, but also a necessary sanction to enforce the agreed rules. It must be recognized that physicians and HCWs have an ethical obligation to provide their patients with the best possible care. The Hippocratic Oath, which doctors must respect, carries the exhortation: “The health of my patient shall be my first consideration” [61]. Therefore, in circumstances where the patient`s health is threatened; For example, if it is not possible to provide adequate medication or adequate facilities for patient care. Physicians may feel ethically and morally obligated to intervene on behalf of their patients, and this intervention may eventually lead to a strike or suspension of services to improve conditions of patient care [7, 12, 20, 22, 27, 28]. Arguably, the resulting improvement in the overall quality of health services in the implementation of negotiated changes mitigates the direct damage caused by the strike [2]. As a result, strikes by health care workers can ultimately lead to better health care for patients and the general public. Toynbee M, Al-Diwani AA, Clacey J, Broome MR. Should young doctors go on strike? J Med Ethics.
2016;42(3):167-170. In most countries, the right to strike is part of the law. South Africa is similar, as the right to strike is enshrined in the Bill of Rights and the Constitution, perhaps as a result of the historic struggles for liberation from apartheid oppression [44]. Strikes in collective bargaining are also protected by specific provisions of the South African Industrial Relations Act (LRA) which state that workers` grievances cannot be resolved through alternative dispute resolution mechanisms [45]. In more developed countries such as the United States, collective bargaining mechanisms between health care workers such as nurses and their employers have existed since 1935 [5, 42], supported by federal legislation under the National Labor Relations Act (NRLA) [46]. § 7 of this law summarizes the protected activities of employees as follows [42]: Admittedly, we have a terribly paradoxical situation, because the growing health needs respond to insufficient resources and overburdened doctors. On the surface, any form of strike would exacerbate health problems, at least in the short term. But would it help in the long run? If not, what happens? Bhuiyan MMZU, Machowski A: Impact of the 20-day strike at Polokwane Hospital (18 August – 6 September 2010). SAMJ. 2012, 102: 755-756.
Physician assistants in the UK have been fighting for several years for a new contract with Britain`s National Health Service (NHS). In early 2016, there were four work stoppages – one-day strikes – taking place. Last fall, it was planned to tighten work stoppages with longer-term measures. But the five-day series of strikes was called off due to concerns for patient safety, according to the BBC. Is a strike necessary, as the growing demand for health care is met by insufficient resources and overburdened doctors? Ogunmade O, Akinsanmi G, Dada S: Nigeria: Lagos fires 788 doctors for strikes, recruits 373. 2012 It has been argued that denying the right to strike to a group of workers, including “essential workers,” amounts to ethically and morally indefensible slavery. Although strikes by health workers are taking place around the world, the impact appears to be more severe in developing countries facing poorer socio-economic circumstances, inherent infrastructural deficiencies and the lack of viable alternative means of obtaining health care. These communities appear to meet the criteria of vulnerability and may merit special ethical consideration when physician and health worker strikes are contemplated.
18 Larry Haiven and Judy Haiven, The Right to Strike and Emergency Service Delivery in Health Care in Canada, Canadian Centre for Policy and Alternatives, December 2002. J Natl med Assoc. 1984, 76: 1117-1121. Frizelle Q: Is it ethical for doctors to strike? N Z Med J. 2006, 119: 1236:U2037- One of the sources of friction and the most frequently cited reasons for calling strikes is the failure of employers, whether public or private, to comply with the terms of negotiated collective agreements. For example, nurses and orderlies have been striking health care workers in California, USA, citing their employer for not giving them the promised 10% pay rise, while planning to increase health care costs by 25%.