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Commentary  

 

Strikes and Doctors- psychosocial and ethical dilemmas  

 

Avinash De Sousa
1, 

Shivanshu Shrivastava
2 

Sushma Sonavane
3 

Nilesh Shah
4 

 

1.
 
Research Associate, 2. Research Assistant, 3. Professor and 4. Professor and Head, Department of 

Psychiatry, Lokmanya Tilak Municipal Medical College, Mumbai. Email: avinashdes888@gmail.com 

 

Abstract: This paper is a commentary on whether doctors have the right to strike work or not while 

keeping in mind, psychosocial and ethical implications of the same. Certain guidelines and criteria that 

may be applicable when examining doctors on strike are elucidated and discussed. 

 

Key words: doctors, strike, ethical, psychosocial. 

 

Introduction: Strikes involving medical doctors have been around since time immemorial. Strikes in 

India and Asia differ from the west often in the factors that lead to the strike. The following paper is a 

commentary on whether strikes by doctors are needed, if yes then are they ethical? and finally are 

there some criteria or guidelines that can be laid down regarding doctors that strike work? These 

views are generalized to doctors across various nations, though in individual cases, the nature and 

reasons as well as the need to strike work may differ. 

 

Critical Points When Examining Strikes Involving Doctors: 

 Strikes among doctors differ immensely when the strike involves senior versus junior doctors. 

The senior doctors would often go on strike when new laws that restrict their freedom and work come 

into place, in some cases a need for increased salaries and at times protesting against violence 

towards a senior colleague. Junior doctors often go on strike when they demand increase in stipends 

or violence by patients relatives towards them or if there is some government bond fulfillment or 

course fee issues that worry them
1
.
 

 

 Doctors are often regarded as selfless people working in the honourable profession. With the 

advent of private hospitals and public private collaborations, doctors are often made to sign work 

contracts and forced into bonded labour. Does this mean that we equate doctors with industrial 

labourers and other workforce or should we have separate category that we assign to them. It is a 

debate that will need considerable thought and deliberation2. 

 

 Doctors often are asked to adhere to a professional code of conduct as per the ethical 

guidelines of various medical associations and councils. Worldwide doctors adhere to the same. The 

same ethical guidelines do not specify what the doctor must do when similar moralities are not 

mailto:avinashdes888@gmail.com


Bangladesh Journal of Bioethics 2014; 5(3):23-25 

 

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adhered to patient’s relatives and kin when talking, dealing and interacting with doctors. Many times, 

doctors are manhandled, faces blackened and beaten up by relatives. Angry mobs destroy their 

clinics and nursing homes causing damage to property and life beyond reasonable doubt
3
.
 

 

 Another thought provoking area is the question whether there could be criteria that may be 

fulfilled regarding doctors going on strike and whether a strike by doctors is justified after those criteria 

are fulfilled. Interestingly it is very difficult to draft out such criteria in black and white and it is further 

interesting to note whether fulfillment of such criteria would make doctors striking as legal and 

legitimate
4
.
 

 

When Can a Doctor Go on Strike 

The following sections draws on literature related to doctor’s strikes and takes a peek into whether 

criteria can be drawn with regarding to calling a strike by doctors just and needed. 

 

 People believe that when the cause is just and backed by the right intentions, any form of 

agitation is reasonable. The same way a doctor’s strike when just and with the right intention of 

greater good of most doctors is considered fine. The strike must not be political or aimed at political 

ambitions, it should not be because of one man’s ire against the government or an act meant for the 

aggrandizement of one’s ego or a means to show one’s power
4
.
 

 

 Wage or salary disputes come under just causes as doctor’s that cannot provide for one’s self 

and their family may often demonstrate a decline in medical skills and this may affect the public health 

of a nation in general. The wages of a doctor who puts in hours of work often neglecting personal and 

family time must at least compensate partially for these sacrifices. The issue of wages is of public 

health importance as the poor wages of doctors force them to work excessively long hours, 

compromising the quality of the medical care they offer and their ability to act in the best interest of 

their patients5. Poor wages and salaries will also affect the medical teaching in a country as young 

people may not take up medicine fearing poor salaries and seeks other sources of vocation and 

employment while senior medical teachers may go abroad or to arenas where the salary justifies their 

talent and expertise
6
.
 

 

 The criterion of just cause often demands a utilitarian philosophy determinant which 

demonstrates that ultimately, the beneficial repercussions of the strike on the health system that must 

outweigh the temporary disruption and suffering caused by it. During the strike it is pivotal that doctors 

must demonstrate the right intention and they should remain benevolent to their cause while avoiding 

gall spewing acts that may compromise their just cause7. 

 

 

 While striking it is of paramount importance that medical emergency services remain 

unaffected thereby adhering to medical oath and ethical guidelines while yet continuing the fight for 

one’s rights. Just like in a war between two nations, in a doctor’s strike unnecessary civilian 



Bangladesh Journal of Bioethics 2014; 5(3):23-25 

 

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casualties must be avoided and doctors on strike should continue to provide at least such critical 

services as emergency care and intensive care
8
.
 

 

 It is very essential that doctor’s that strike be assured of success in some way as very often 

many strikes in the long run prove futile and catastrophic. For example the strike by junior doctors 

citing an increase in stipends led to the government increasing the stipend by 20% while medical 

course fees were hiked within a month of this ruling by 60%. Thus the loss financially was for the 

doctors who ended up paying more than they did prior to the strike. 

 

 Strike must often be the last resort measure and not the first. Doctors being a part of essential 

services must not strike unless all other means and negotiations and talking cures fail. A formal 

announcement of the strike, adequate warning, candle marches, silent protests and press briefings 

followed by a one day token strike must lead up to the final strike. This provides a mechanism to help 

patients prepare in advance for the unsettling effects of the strike i.e. by relocating, stocking 

medication, and booking appointments with alternative providers
8
.
 

 

Conclusions: The authors of this paper wish to state that they believe that strikes are unnecessary 

and uncalled for especially when in a profession like medicine. The aim of this paper is to provide an 

unbiased view regarding some considerations to be made when doctors have no resort but go on 

strike. As doctors, our duties towards our patients is one of the highest importance, but people must 

not forget that doctors are human beings, they have a life, a family, responsibilities and bills to pay like 

all of us. We must remember that human dignity and respect must be preserved from doctor towards 

a patient and the converse also holds true. Doctors are usually very patient and bear a lot silently with 

courage, but the old adage comes into play once in a while when things cannot be taken lying 

down….‘When the going gets tough, then the tough get going’ ! 

 

References:  

1. Ekbal B. IMA strike: need for public debate. Indian J Med Ethics 2012; 9 (4):226–8. 

2. Frizelle F. Is it ethical for doctors to strike? N Z Med J 2006;119(1236): 2037 

3. Sachdev PS. Doctors’ strike—an ethical justification. N Z Med J 1986; 99(803): 412–14. 

4. Ogunbanjo GA, van Bogaert DK. Doctors and strike action: Can this be morally justifiable? SA 

Fam Pract 2009; 51(4): 306–8. 

5. Grosskopf I, Buckman G, Garty M. Ethical dilemmas of the doctors’ strike in Israel. J Med 

Ethics 1985; 11: 70–71. 

6. Selemego M. Criteria for just strike action by medical doctors. Indian J Med Ethics 2014; 

11(1): 35-8. 

7. Dunn HP. Resident hospital doctors’ strike. N Z Med J 1992; 105: 20-1. 

8. Chima SC. Global medicine: Is it ethical or morally justifiable for doctors and other healthcare 

workers to go on strike? BMC Medical Ethics 2013;  14(Suppl 1): S5-15. 

 

  Conflict of Interest: Author declared no conflict of interest and no financial disclosures. 




