yoga by arthurwyndham

VIEWS: 742 PAGES: 57

									   ETHICS IN RESEARCH AND PRACTICE,
         A YOGA PERSPECTIVE

          Dr H R Nagendra. VC, SVYASA, Bangalore




SWAMI VIVEKANANDA YOGA ANUSANDHA SAMSTHANA
DEEMED TO BE UNIVERSITY, BANGALORE.
                Topics
• ETHICS IN TODAYS HEALTH CARE
  SCENARIO.
• ETHICAL GUIDELINES AND ETHICAL
  MISCONDUCT
• ETHICS IN RESEARCH AND
  PRACTICE
• Ethical perspectives according to yoga
   PARADOX OF OUR TIMES
• Materialistic happiness
• WEALTH, HEALTH
  AND POWER!

• Today we have bigger
  homes, smaller
  families, more
  conveniences …. But
  less time.
 HEALTH CARE SCENARIO

• WE HAVE MORE EXPERTS…. BUT
  MORE PROBLEMS

• WE HAVE MORE MEDICINES … BUT
  LESS WELLNESS
 MEDICAL RESEARCH TODAY
• Is all about finding newer drugs and
  cures……but
• very little about testing hypotheses or
  contributing knowledge
• practice and research today are dictated by
  medical economics……..Competition to
  survive, Capturing a share of market,
  Increasing stocks and equities .
           “MAKE MONEY!!!!”
 NOT SURPRISING THEREFORE
• Majority of the research in developed
  countries are funded by pharmaceutical
  companies.
• More grants being given to CONTRACT
  RESEARCH ORGANISATIONS than
  ACADEMIC INSTITUTIONS.
• SELF INTERESTS AND FINANCIAL
  TARGETS FIRST …….Knowledge and
  Societal good SECONDARY.
Product Innovation-Developed
          Countries
          Clinical Trials today
• Majority to facilitate the approval of a device or
  drug
• Testing a novel scientific hypothesis is miniscule.
• Trials more sophisticated today
• Margins of untreated disease harder to reach
• Increase in size of trials
• Consequent increase in cost of developing new
  drugs……….$$ 500 million!!!!!
• ON THE FLIP SIDE- 19 million Diabetics in world
  today…
• OHA market more than $$5 billion!!!!!/YEAR
   Competing for revenues from
          clinical trials
• In year 2000, CRO received 60% of research
  grants from pharma companies, and only 40% for
  academic trialists.
• Competition to enroll subjects for these trials
• Sponsors call the shots … terms not in interests of
  investigators, or participants or advancement of
  science generally
• Investigators may have no input in trial design, no
  access to raw data and limited participation in data
  interpretation….
 CLINICAL RESEARCH TODAY

• Results may get buried if unfavourable to
  sponsorer.

• JAMA 2000;284:21932202 ,HIV-1
  immunogen study.
     Conflict of interest-
Economic analysis of anti cancer
            drugs
• Unfavorable conclusions if sponsor

• Drug manufacturer      1/20 = 5%
• Non profit             9/24 = 38%



• JAMA 1999,282:1453
           Conflict of interest-
           Systematic review
•   25% receive research funds from industry
•   43% receive research related gifts
•   33% have personal financial ties
•   “ Strong and consistent evidence that
    industry sponsored research tends to draw
    pro industry conclusions” ( OR 3.60, 95%
    CI 2.63 –4.91)
            » JAMA 2003;289: 454-465
        Conflict of interest-Research
Possible consequences of conflicts of interest

• HARM SUBJECTS
• BIAS STUDIES
• WEAKEN EVIDENCE BASE FOR
  CLINICAL CARE
• UNDERMINE TRUST IN RESEARCH
      CLINICAL PRACTICE –
     TODAY…Are we forgetting
       knowledge and ethics?
• Less reliance on clinical knowledge, More on
  investigative reports….
• Unwanted Diagnostic tests….
• Health Care marketing…… Unholy nexus
  between primary care physicians, hospitals and
  diagnostics centers…….
• Transition of economy into a capitalistic one ….
  There for health care economics too.
  Conflict of interest-Physicians
• Patients suffer physical harm if physician
  bases his clinical decision (to favor self or a
  third party).
• Integrity of medical judgment may be
  violated even though Pt suffers no harm.
• Violate standards of good practice----
  adverse clinical outcomes.
• Erosion of public and patient trust.
    CAUSES FOR EROSION OF
     ETHICAL STANDARDS
• Capitalistic economies,
• Population burden, unemployment, higher
  cost of living,
• Competition, survival of fittest,
• Pursuit of materialistic pleasures.
   Ethical guidelines in India.

• Indian writing in Medical ethics
  mainly dwell on the situation and
  not on the ethical issues.
• We need to explore Indian
  Philosophy to support medical
  ethics.
    Ethical guidelines in India.
• Our thinking should move from a law
  based ethic to a patient and community
  based ethic.
• Ethical values should be based on
  morality.
• Yoga philosophy and practice are
  necessary in sensitizing the individuals
  to imbibe ethical principles in life.
 Change in our Mindset and outlook
              to Life
• Develop Compassion to other beings.
• Perform Selfless service.
• Develop Contentment
• Let go of materialistic happiness and desires.
• Contribute to society and community.
• Develop inner happiness.
 Spiritual Upliftment of Individuals

• This need not be religiosity, rituals,
  worship etc
• This is developing universal love,
  compassion, seeing other as
  extension of self and developing
  selflessness and bliss.
• HOW?? Knowledge !
 Spiritual Upliftment of Individuals
• Understanding that materialistic happiness
  is transitory. Understanding that this soul is
  imperishable I need to take many more
  births to understand self . Use this life in
  search of inner happiness and self
  realisation by sadhana or practice.

• Such spiritual upliftment of individuals will
  lead to transition in the society as a whole.
There was a rich merchant who had
 He loved the 4th wife the most.


He adorned her with rich robes and
    treated her to delicacies.


He took great care of her and gave
    her nothing but the best.
He also loved the 3rd wife very much.

 He's very proud of her and always
   wanted to show her off to his
              friends.
 However, the merchant is always in
 great fear that she might run away
        with some other men.
      He loved his 2nd wife too,.
   She is a very considerate person,
    always patient and in fact is the
        merchant's confidante.
  Whenever the merchant faced some
 problems, he always turned to his 2nd
wife and she would always help him out
  and tide him through difficult times.
Now, the merchant's 1st wife is a very
  loyal partner and has made great
contributions in maintaining his wealth
and business as well as taking care of
            the household.

However, the merchant did not love the
 first wife and although she loved him
  deeply, he hardly took notice of her.
 One day, the merchant fell ill. Before
long, he knew that he was going to die
 soon. He thought of his luxurious life
 and told himself, “Now I have 4 wives
 with me. But when I die, I’ll be alone.
           How lonely I’ll be!
 Thus, he asked the 4th wife, "I loved
you most, endowed you with the finest
clothing and showered great care over
you. Now that I'm dying, will you follow
me and keep me company?" "No way!"
  replied the 4th wife and she walked
    away without another word. The
answer cut like a sharp knife right into
         the merchant's heart.
The sad merchant then asked the 3rd
wife, "I have loved you so much for all
  my life. Now that I'm dying, will you
 follow me and keep me company?"
 "No!" replied the 3rd wife. "Life is so
good over here! I'm going to remarry
when you die!" The merchant's heart
          sank and turned cold.
 He then asked the 2nd wife, "I always
    turned to you for help and you've
always helped me out. Now I need your
 help again. When I die, will you follow
me and keep me company?" "I'm sorry,
 I can't help you out this time!" replied
 the 2nd wife. "At the very most, I can
   only send you to your grave." The
answer came like a bolt of thunder and
      the merchant was devastated.
Then a voice called out : "I'll leave with
you. I'll follow you no matter where you
go." The merchant looked up and there
 was his 1st wife. She was so skinny,
     almost like she suffered from
   malnutrition. Greatly grieved, the
 merchant said, "I should have taken
 much better care of you while I could
                   have !"
Actually we
 all have 4
wives in our
   lives,..
No matter how much time and effort we
lavish in making it look good, it ‘ll leave
us when we die
When we die they all will go to others
No matter how close they had been
there for us when we’re alive, the
farthest they can stay by us is up to
the grave.
   Often neglected in our pursuit of
material wealth and sensual pleasure.
    It is actually the only thing that
 follows us wherever we go. Perhaps
   it's a good idea to cultivate and
strengthen it now rather than to wait
until we're on our deathbed to lament.
Taittirèya Upanishad has presented this systematically.
         Man has 5 major sheaths of existence.
VIJNANAMAYA                          MANOMAYA
KOSA                                 KOSA

                                        PRANAMAYA
                                        KOSA


                                          ANNAMAYA
ANANDAMAYA                                KOSA
KOSA

            FIVE LAYERED EXISTENCE
               OF HUMAN BEINGS
ANANDAMAYA KOSHA
    TRANSCENDENCE
    UNITY CONSCIOUSNESS
    TOTAL BLISS
    TOTAL KNOWLEDGE
    TOTAL POWER
    TOTAL FREEDOM

We are all brothers and sisters
   Brothers and sisters of America
VIJNANAMAYA KOSHA
DIFFERENTIATIONS   START
KNOWLEDGE IS COMPLETE
ALL ACTIONS ARE GOVERNED
BY THIS TOTAL KNOWLEDGE
NO STRESS OR TENSION

GREAT YOGA MASTERS
Shankaracharya, Sant Jnanadev,
MANOMAYA KOSHA
   MANOMAYA KOSHA



MENTAL RESTLESSNESS
Emergence of likes and dislikes…Emotions
Likes and Dislikes dominate the scene
Emergence of Duryodhana
          STARTING OF ADHI
             The seed of Stress
ADHI -        ADHI -
               EXCESS
MENTAL
RESTLESS-      SPEED
NESS
                no
begins in       control




MANOMAYA    STRESS
            SYMPTOMS
KOSA
ÁDHI - THE SEED OF DISEASE
DISTURBED PRÁNA BALANCE
                             WRONG DIRECTION
                             WRONG DIRECTION
                             WRONG QUANTITIES
                             WRONG QUANTITIES
                             CONSTRICTIONS
                             CONSTRICTIONS
                             BLOCKS
                             BLOCKS




                             HAPHAZARD BREATHING
    ÁDHIJA VYÁDHI
  SETTLES DOWN IN
ANNAMAYA KOSA AS
   ORGAN DAMAGE


             TY
           DI AN
         RE RG
     HE O       AN
        AK ORG
    WE ED
        UR
    INJ
YOGA =ASANA, Misconception
        PURE CONSCIOUSNESS
        FREEDOM MOKSHA              BRAHMAN
                                    ATMAN
                                    DIVINITY
   YOGA IS A                        REALITY
  CONSCIOUS
 PROCESS FOR                DIVINE BEING
ACCELERATING
                       SUPER MAN
 THIS GROWTH
Sw VIVEKANANDA      GREAT MAN
                  NORMAL MAN

               ANIMAL MAN


        YUJYATE ANENA ITI YOGAH
                      HOW?
      By sensitizing ourselves through Yoga


• By a systematic process of culturing and
  calming the mind …… Yoga.

• Raja Yoga….. harnessing will power and
  Psyche control.

• Bhakti Yoga- Universal love, compassion,
  devotion to GOD- Emotional culturing.
                      HOW?
      By sensitizing ourselves through Yoga
• JnanaYoga- Using reason and intellect,
  understanding Scriptures.
• Karma Yoga- Surrendering fruits of
  action, Selfless service, non attachment to
  desires, consequences etc.

• Synthesis of all these is Integral Yoga
                 Goal of Yoga
• “Yoga is meant to lift the aspirant from lower levels of
  renunciation, where objects are renounced, to loftier
  heights where desires are dead, and where the yogi dwells
  in a calm and ceaseless contemplation, while his mind and
  body are actively employed in discharging the duties that
  fall to his lot in life”
• This is a state of selfless action with detachment,
  devotion and direction.
                                               Proper breathing
Proper Diet                                      Pranayama




                                               Adequate relaxation
   Asana


              Positive thinking & meditation
MEDITATION- A TRAINING IN
AWARENESS.
                             DEEP
                             SLEEP




            DEEP REST
            ALERTFUL SLEEP     Meditation
               Ethical Principles
• Researcher
                        • Researcher
                        • Advancement of
                          knowledge and societal
                          good.
                        • Benefit both Participant
                          and society.
                        • Adopt Selfless service.
                        • No Conflict of interest.
                        • Minimise harm, maximise
                          benefits.
                Ethical principles.
•   Sponsorer
                       •   Sponsorer
                       •   Advancement of knowledge and
                           societal good.
                       •   Self interests directed towards
                           subjects welfare and not financial
                           benefits.
                       •   When interests of society are
                           guarded and societal good is
                           accomplished financial benefits also
                           accrue.
                       •   Failures are stepping stones to
                           success… learn from mistakes and
                           improvise.
We have conquered outer space but not
inner space, we have split the atom but not
our prejudice.




                           THANKYOU

								
To top