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SORRY- BUT WE ARE NOT SORRY,WE ARE DOCTORS
So what else is new??In Chandigarh the farcical inquiry conducted by the PGI blames overcrowding as the cause for Anupama's death and in Jalandar, in a shocking incident , a newborn girl child dies at a government hospital after doctors removed her from the incubator because her parents could not pay Rs 200 . And ofcourse , in a Chennai hospital rats nibble the face of an infant. . Who is to blame?? ''No se culpe a nadie''--No one is to blame !! In both the cases , inquries will be done by those who themselves are to be blamed , sympathetic noises will be made by concerned ministers , and some junior non-medical staff will be temporarily suspended till the Nation is once again traumatised by seeing ward boys performing surgical procedures.Should not the doctors and health officials be held accountable and taken to task ? Should not the Hammurabian Code be invoked ? Should not the victim now demand an eye for an eye , a limb for a limb and his kin, a life for a life??
Failure to act in accordance with the standards of reasonably competent medical men forms the basis for gauging medical negligence. And if gross negligence and ''chalta hai'' attitude is apparent to the public ,should we the people not assert our right for judicial retribution? Should not the principle of ''Nemo iudex in causa sua''( No one is a judge in his own case) be invoked so that doctors know that they are professionally accountable and that the patient has to be compensated for the loss of injury suffered by him if the doctor is found negligent .
In the present day and age, the public enjoys a state of heightened awareness and expects the best possible service from the medical profession. A doctor should be able to justify every single decision taken by him and every act of commission or omission attributed to him in terms of admission, consultations, diagnosis, treatment, rehabilitation of a patient etc. Thus, medical professionals should be accountable or liable for their professional acts; hence the term professional accountability.It is un-nerving to know that The Indian Medical Association had campaigned unsuccessfully against the inclusion of medical services under the Consumer Protection Act. In stark contrast are the examples of Spain where a patients' association is planning to publish on its website a list of doctors who have been found guilty of negligence and the United States where a bill would give the public access to a database for each doctor providing information on malpractice suits and various other offences .
Much more needs to be done in the realm of health care , medical ethics and accountability as far as doctors are concerned .In-spite of all amenities at the disposal of health authorities, its a matter of concern that resources do not reach the supposedly needy & ailing. Max Weber, an acclaimed sociologist during the early twentieth century, stated that the primary purpose of law is to regulate the flow of human interaction by way of recognising accountability. Thus, one of the accepted purposes of law and codified rules is to support social order there-by banishing private retribution, deterring similar lapses and punishing offenders.There are no codified rules and regulations for doctors and pharmaceutical companies in India and there-in lies the bane of all that is wrong in this profession.
The Code of Hammurabi is considered one of the first known attempts to establish a written code of conduct.King Hammurabi of Babylon incorporated these managed care precepts in the Codex Hammurabi, a huge stone erected about 1700 B.C. Hammurabi believed that the gods had appointed him to bring justice and order to his people. The punishments for disobeying the laws were swift and harsh, further encouraging compliance. The Code established rules regarding theft, sexual relationships, interpersonal violence, and other issues. It was intended to replace blood feuds with a system sanctioned by the state.The edicts in Hammurabi's Codex left no margin for error: Health care providers had to be flawless or lucky.Penalties included burning, drowning, hanging, impalement on a stake, bodily mutilation and monetary fines.
If a physician operated on a man for a severe wound with a bronze lancet and caused the man's death, or opened an abscess in the eye of a man with a bronze lancet and destroyed the man's eye--they shall cut off his fingers.If a physician operated on the slave of a freeman for a severe wound with a bronze lancet and cause his death, he shall restore a slave of equal value. If he open an abscess in his eye with a bronze lancet, and destroyed his eye, he shall pay silver to the extent of one-half his price.If the physician erred through omission or commission, his fingers or hands were cut off, immediately stopping his practice. This severe punishment for negligence supposedly weeded out physicians incapable of delivering adequate care. In addition, it prevented these physicians from practicing in a different locality.
Absolutely relevant to mention here are two best sellers , one by Noah Gordon (The Death Committee) and one by Arthur Hailey(The Final Diagnosis) . In the book by Noah Gordon the author describes how at a local County General Hospital, three brilliant young men are bought together by their dedication to life and medicine. But they work in the shadow of the Death Committee, a hospital tribunal where doctors judge one another and decide who is to blame when a death could have been prevented. The young doctors must face the crucial dramas and triumphs of hospital life. The book written by Arthur Hailey is about the mammoth complexity of running a great hospital... where one faulty diagnosis precipitates appalling tragedy.It is the story of a young pathologist's struggle to restore the standards of a hospital controlled by a once-brilliant doctor. The new chief of surgery rallies some of the surgeons already on staff who were sympathetic to raising the hospital’s standards. Between them they tightened surgical rules and formed a strong operating-room committee to enforce them. Less competent doctors were were given the choice of resigning quietly or being ousted officially.But how many of our doctors are willing to come under the public scrutiny for their negligence , incompetency and lack of professional knowledge?
The case of Bolam Vs. Friern Hospital Management Committee 1957, forms the basis for establishing medical negligence. “The doctor is required to exercise the ordinary skill of a competent doctor in his field. He must exercise this skill in accordance with a reasonable body of medical opinion skilled in the area of medicine.” This applies to a medical practitioner when he shows gross negligence in his treatment, leading to injury or even death. He should not be held liable criminally for the patient’s death unless his callousness shows such dis-regard for the life and safety of the patient as to amount to a crime.The High Court decision in Dr. Suresh Gupta Vs. Government (of Delhi) adjudicated that legal decision is almost firmly established that where a patient dies due to negligent medical treatment by doctors, they can be made liable in civil law by praying compensation and damages in law of Torts and if the degree of negligence is so gross and his act was reckless as to endanger the life of the patient, he would also be made criminally liable for an offence under the IPC.
The medical profession has ceased to be noble profession .It is time the medical fraternity and the India Medical Association does an introspection and a reality check. The ultimate burden of unnecessary procedures, tests, investigations , costly medication is borne by the aam aadmi.The rot begins with the doctors referring patients forcuts and kickbacks to a consultants who insist that they get further investigations carried out at specified diagnostics centres, pathological laboratories, x-ray clinics--and the lesser said about hygiene and medi-care in Govt Hospitals , the better. Florence Nightingale where art thou???
D S Sarao
1553 Sector 18D
Chandigarh-160018 strong text
