LIST OF PANELS

Society grants doctors, status, respect, autonomy in practice, the privilege of self-regulation, and financial rewards on the expectation that doctors would be competent, benevolent, altruistic, and moral. Societies require that this important social contract between the medical profession and the society it serves functions well. The evolution of this contract due to the changing organization of the heath system and various countervailing forces are well established in the context of Western countries, most notably, in the ‘end of the golden age of doctoring’ thesis. Evidence over the last few decades suggest that in many parts of the world, including in India, this social contract is under significant stress. The growing distrust of doctors and the rise in violent attacks on doctors across India, reflects this emerging reality. In our research we have analysed how changes within society and in the organization of the health system in India are leading to an erosion of trust and to disruptions in this important social contract (Kane & Calnan, 2016; Calnan & Kane, 2018; Samant et al., 2024; Dutta et al., 2025; Samant et al., 2025).

We contend that the stability of this contract is of critical importance for all societies and thus a public policy priority. Understanding the nature of this social contract and the points of contention is the first step in ensuring the stability and sustainability of a well-functioning health system. While there have been legal interventions to protect doctors’ rights and safety, repairing the disrupted social contract will require initiatives, at policy and ground level alike that deeply examine and respond to the disruptions in a sensitive and sustained manner.

In this panel, our objective is to critically discuss the nature of and the disruptions in the social contract between the medical profession and society in India. Specifically, we expect the presentations and the discussions to shed light on different aspects of the phenomenon - the drivers of this evolving crisis, its multifaceted consequences, and crucially, potential policy and practice-based approaches to restore and strengthen this critical social contract. By incorporating the discussions from the panel, we intend to refine a participatory, critical self-reflection focused intervention with doctors that we have developed as a part of our research – in doing so, our panel also links to the practice and teaching tracks of the conference.

For the panel, our aim is to critically discuss, reflect upon, and find solutions to address the deteriorating state of the social contract between the medical profession and society in India.

We invite researchers, social thinkers, practitioners, and policy makers to submit empirical or theoretical papers that engage with different facets of this critical social relationship. Papers could engage with the following questions: In what ways are structural changes in society and economy reconfiguring this social contract? What historical, current, and emerging institutional logics and arrangements of the Indian health system underpin the disruptions to the social contract? What might some practical and feasible policy solutions be to restore and strengthen this critical societal relationship?

During the panel, we will share some of our ongoing research (Kane & Calnan, 2016; Calnan & Kane, 2018; Samant et al., 2025 Dutta et al., 2025) which engages with these questions – we seek papers that critique, engage with, and/or extend this work. Our research till date has explored the social contract from the perspectives of doctors, predominantly from the private sector. We seek submissions that engage with the phenomenon from the perspectives of other stakeholders and in other institutional settings.

Proposed Papers:

1. Kane, S., Samant, M. Making sense of the deteriorations in the social contract between the medical profession and society in India.

2. Santosh, S., Samant, M., Dutta, S., Calnan, M., & Kane, S. Forthcoming. Juggling Professional Identities: Doctors Navigating Care, Commerce, and Credibility in India.

References
Calnan, M., Kane, S. 2018. Trust and regulation of health systems: Insights from India. In: Professional Health Regulation in the Public Interest: International Perspectives. Editors: Chamberlain JM, Saks M, Dent M. The Policy Press, University of Bristol. DOI: https://doi.org/10.2307/j.ctv1xxs5q.19

Cruess, S.R., Cruess, R.L., 2004. Professionalism and medicine’s social contract with society. AMA J. Ethics 6 (4), 185–188.

Dutta, S., Samant, M., Santosh, S., Calnan, M., & Kane, S. Shattered assumptions: Unravelling of the social contract between the medical profession and society in India. SSM Health Syst. 2025 Jun;4:100070. DOI: https://doi.org/10.1016/j.ssmhs.2025.100070

Kane, S., Calnan, M., 2016. Erosion of trust in the medical profession in India: time for doctors to act. Int. J. Health Policy Manag. 6 (1), 5–8.

Nagpal, N., 2017. Incidents of violence against doctors in India: can these be prevented? Natl. Med. J. India 30 (2), 97.

Samant, M., Calnan, M., Kane, S., 2024. A critical analysis of newspaper accounts of violence against doctors in India. Soc. Sci. Med. 340, 116497. DOI: https://doi.org/10.1016/j.socscimed.2023.116497

Samant, M., Santosh, S., Dutta, S., Joshi, M., Calnan, M., & Kane, S. (2025). Understanding disruption in the social contract between the medical profession and society in India: a tale of mismatched expectations? Health Policy and Planning, czaf077. DOI: https://doi.org/10.1093/heapol/czaf077