CLINICAL DETACHMENT? Consensus vs cleanup of system | Photo Credit: shapecharge

The recent controversy surrounding a Hyderabad-based paediatrician who challenged the marketing of certain electrolyte drinks as ‘oral rehydration solution’ (ORS) raises concerns that extend beyond a single product. At its core lies an uncomfortable question: Who in our professional community will speak up when something is clearly wrong?

Her efforts led to judicial intervention, and the Food Safety and Standards Authority of India (FSSAI) issued a similar directive banning the mislabelling of the product. These events, however, highlight the ease with which scientific standards can be blurred in the marketplace.

The response from the medical community has been mixed. Many clinicians supported the paediatrician. The Indian Academy of Pediatrics (IAP) issued a detailed standard operating procedure outlining the correct composition and use of ORS. However, it stopped short of confronting the manufacturers involved. Moreover, it has not openly supported the paediatrician, who was served a legal notice by some of the manufacturers and has since resigned from the IAP in protest.

Worrying deflection

Institutional caution is often framed as pragmatism. But when caution repeatedly takes the form of silence, it risks being seen as complicity. Professional bodies exist not only to guide practice but also uphold standards — especially when those standards are challenged.

Equally troubling has been the reaction from sections of the fraternity. Some have questioned the motives of the paediatrician, suggesting her stance is driven by a desire for visibility or personal gain. Such insinuations distract from the real issue. It is far easier to question the intent than engage with the issue raised.

The larger problem is not difficult to recognise. Most professionals remain focused on clinical work and are understandably disengaged from institutional matters. Others, navigating leadership pathways, often operate within networks that favour consensus over confrontation. As a result, the system tends to reward accommodation rather than dissent.

And yet, progress in medicine has rarely resulted from unquestioned consensus. It has relied on individuals willing to challenge prevailing practices, often at personal and professional cost. Speaking up in such situations is rarely comfortable, and seldom without consequence.

Vital check

The issue at hand is not about just one product or company. ORS remains one of the most effective and widely endorsed interventions in public health. Its strength lies in its simplicity and the precision of its formulation. Any dilution or misrepresentation of ORS, whether through marketing or labelling, undermines decades of progress in reducing child mortality.

This is why individuals who raise such concerns are essential to the system. They act as a necessary check when institutions hesitate, and as a reminder that standards in medicine are not negotiable.

Professional bodies will continue to evolve, and leadership will change. But the willingness to question, to challenge, and uphold what is right — even when inconvenient — remains the true test of professional integrity. When speaking up becomes the exception rather than the norm, the consequences extend far beyond any single controversy.

(The writer is past national convener, IAP Committee on Immunization)

More Like This

Published on May 4, 2026