He’s a successful orthopaedic surgeon in Chennai, a fan of English literature and rock music – Bob Dylan and Jimi Hendrix are his favourites. Eclectic interests, but his passion is ethics – meet Dr. George Thomas. In our freewheeling conversation, he did not mince words and said it like it is.

His interest in ethics started when he was a medical student at Kilpauk Medical College in the late 1970s. When he started clinical work he realised that there was a wide gap between what was taught and what was practised – the altruism seemed to be missing. He was lucky in the sense that many of his peers thought the same way. One of them in particular, Dr. J. Amalorpavanathan (former Member Secretary, Transplant Authority of Tamil Nadu), who was a year ahead has been a great influence through the years and a comrade-in-arms. 

Dr. Thomas first read the National Medical Journal of India (NMJI) when he was working at Railway Hospital, Trichy. This was in 1989 or thereabouts; he then became a regular reader of the NMJI and was particularly impressed by Dr. Sunil K. Pandya’s writing in a section called Letters from Mumbai. It was ‘Luck by Chance’ when he went to Mumbai to learn flap covers for open bone exposures where he met a general surgeon, Dr. Muralidhar who knew Dr. Pandya. They were all involved in the ethics movement, and Dr. Thomas became a part of it as well. 

In 1993 Dr. Pandya started what was simply a newsletter entitled “Medical Ethics,” and Dr.Thomas not only subscribed, but also wrote for it. But Dr. Pandya’s vision was meant to soar to greater heights. The bulletin was transformed into a journal in an initiative that was spearheaded by Sandhya Srinivasan, Consulting Editor, and was christened Indian Journal of Medical Ethics (IJME) in 2004 when Dr. Samiran Nundy, an eminent surgical gastroenterologist was editor of the journal. Taking over the reins thereafter, Dr.Thomas was editor of IJME for six years from 2005 to 2011. It was during this time that a landmark event took place in IJME’s history – it got indexed with the National Library of Medicine (NLM)*. Call it serendipity or what you will, but this was how it came about – two researchers working in the Kennedy Institute of Ethics at Georgetown University, one of the most prestigious bioethics institutes in the world had a grant, part of which they used to get IJME indexed. They felt IJME was a good journal on ethics from the developing world and gave NLM the IJME metadata**. Unfortunately, when the grant money ran out, IJME went off the index for a while. But one can’t keep a good thing down for long, and NLM decided to do the metadata themselves. Dr. Thomas in his stint as editor widened the scope of the journal. He is of the opinion that medical ethics cannot be narrowly limited to the medical profession alone and as he succinctly puts it, “Less of philosophy and more action oriented!”

I spotted a book on Dr. Thomas’ table titled “The Righteous Mind’ by Jonathan Haidt and discovered yet another facet to Dr. Thomas – his interest in social science research and the eternally fascinating questions of what defines morality and why people behave the way they do! 

In a recent editorial ‘Medical education – the way forward’ in IJME in 2016, Dr. Thomas quoted Abraham Flexner (who had critiqued medical education in America in his Flexner Report in 1910), “Medical education is a social function, it is not a proper object for either institutional or individual exploitation.” Given the debate about the state of medical education today, I asked him if medical ethics should be taught in medical colleges. The answer was an unequivocal ‘yes’ because it was important to expose people to those ideas, he said, otherwise they simply wouldn’t know that they existed. He added that ethics is not frozen in time. 

Dr. Thomas has been writing on organ donation and transplantation in IJME since 1995 and has put forth strong arguments against the sale of organs. He admitted that it was difficult to get evidence when both parties were complicit, but he was emphatic in saying “when the legal system is violated, I will do what’s possible, rather than do nothing.” He felt that the recommendations from the recent summit on organ trafficking and transplant tourism held at the Pontifical Academy of Sciences, Vatican City were good since they exerted tremendous influence in the social sphere. With regard to deceased organ donation, he stressed the need for strong education programmes for both the doctors and the public. He said that for doctors to feel comfortable about turning off the ventilator in brain stem death required a much greater measure of trust from the public. At present the social reality is that there is cynicism about the medical profession and hospitals. For the families of deceased donors, he felt that social recognition was important. Any form of compensation, monetary or otherwise, he felt was an inducement. 

The interview ended on a positive note with Dr.Thomas, a hardcore optimist, saying that the world was getting better and better and that the way forward was to practice, talk, debate, and improve practice in the light of evidence and opinions. 

Some articles on transplantation by Dr.George Thomas published in IJME (www.ijme.in): 

1. Problems arising from kidney transplantations. 1995 July-September

2. Organs for sale, philosophy for hire. 1996 July-September 

3. The case against kidney sales. 2001 April- June

*The National Library of Medicine (NLM), on the campus of the National Institutes of Health in Bethesda, Maryland, USA is the world’s largest biomedical library, NLM maintains a vast print collection and produces electronic information resources on a wide range of topics that are searched billions of times each year by millions of people around the globe.

**Metadata is “data about the data” – information that serves to identify or describe the article, for example, authorship, article title, copyright year, and publication date, keywords and abstracts, and details of the journal. Metadata helps in facilitating online searches for scientific research.

                                                                                                                            Dr. Sumana navin