I agree with CH Ong ('Doctors abusing antibiotics should face the rap') that Dr Cheah TE's stance is indefensible

It is a duty of a doctor to act in the best medical interest of the patient. If it were not in the patient's interest to take antibiotics, Dr Cheah should not accede to his request for antibiotics irrespective that he was a paying customer. Such a request based on ignorance or prejudice should not be entertained. The difference between a doctor and a lay patient is that the former knows better and that is why the patient relies on his advice and prescription as well as non-prescription (in the case of antibiotics).

To say that the patient was a paying customer is no excuse because it ignores bio-ethical principles of beneficence (acting to benefit patients) and non-maleficence (acting not to bring harm to patients) in favour of business beneficence to the doctor and the clinic.

Many a public grouse against some doctors is the same their inability to distinguish medical ethics from business imperatives.

Besides prescription of redundant antibiotics or other drugs, some other examples from my personal knowledge and experience are:

• Reaffirming moms' and dads' prejudices of not eating certain food that has got no effect on the medical condition but just so to retain their confidence to come back again;
• Prescribing surgery to earn the higher fee when second and third opinions confirm a less drastic course of action is available;
• Engaging in multilevel selling of vitamins and other health products to supplement income and taking advantage in the process the leverage of medical qualifications over other sales agent;
• A surgeon's taking advantage of a daughter's gratitude in his successful removal of her mother's tumor by asking her to go out and making amorous advances on her;
• A hospital refusing to release a deceased body and holding it as if it were a bank's collateral until all hospital costs are raised and settled by the grieving next of kin.

The lists can go on. I am not suggesting that all doctors are like that but many others do blur the line between medical ethics and business imperatives.

It is a privilege to practise the medical profession, and those true to their principles are not afraid of being sued. The public and patients too have their legal rights.

So what if doctors are not sole prescribers of antibiotics as pharmacists or medical assistants prescribe them as well? Doctors should take the lead since they are at the apex of the healthy pyramid.

Before Dr Cheah criticised the health minister, he should ask himself whether, if he had known that there was "no need for antibiotics" to the irate father he cited, he ought to have relented to the "paying customer's" insistence of antibiotics for the use on his child?

I pity that child. When I was a child, tetracycline antibiotics were administered by doctors whenever I suffered from common flu and viral infections against which it is doubtful whether such antibiotics was helpful.

Today my dentists advise that my teeth is permanently yellow because of the tetracycline localised in my teeth - and God knows - my bones, liver and spleen as well.

At least doctors of more than three decades ago had the excuse that they did not know as much about down sides of antibiotics then as they do now.

Dr Cheah raised the legitimate question of how was the public to discern when the antibiotic had been appropriately prescribed.

The public, like the father in the case cited could not discern. That is why they will have to rely on doctors to discern for them rather than give in to their own prejudices and ignorance on account that they are paying customer.