The issue of medical negligence has drawn the attention of many people lately. Advancements in the medical field have made it possible to cure many diseases deemed incurable in the past, but the cost of medical treatment has also increased drastically. This obviously causes people to have higher expectations from medical procedures and therapies. When expectations are not met, people become frustrated and accuse health care providers of medical negligence.

Not untouchable

There are two types of negligence: Civil negligence where doctors do not provide a simple degree of care and attention to the patient thereby causing damage; and criminal negligence where doctors deviate from the standard of care or perform an illegal medical procedure like criminal abortion or unlawful organ transplant. Whatever the type of negligence, there are legal measures to file a complaint against the offending doctor. Gone are the days when people regarded doctors like gods.

Medical service is also governed by the Consumer Protection Act where patients are the consumers and medical personnel are the service providers. Patients have rights to get quality medical service under this law. If patients or their relatives are dissatisfied with the medical service rendered to them, they have a right to lodge a complaint with the district compensation committee which is chaired by the chief district officer. If there is an issue of criminal negligence, the complaint can also be filed with the concerned court.

In some circumstances, when the patient develops complications or dies, the attendants accuse the doctors of failing to provide proper treatment and protest on the hospital premises instead of opting for the legal way by charging them with negligence. Health professionals are at times threatened and forced to apologise in public. Most of the time, the protestors demand compensation and other direct benefits for the relatives of the deceased. Hospitals and health professionals feel insecure, and many times, they have given in to the demands in a bid to settle things peacefully and avoid bad press. The government too is unable to provide security, and such cases have occurred time and again in different hospitals in Nepal. This has created a condition of lawlessness in the country.

Differing circumstances

When deciding whether a doctor is liable for negligence or not, the ‘standard of care’ should be analysed. This means the practice should be well accepted to implement. It should be one that an average doctor engaged in the particular field would have chosen in similar circumstances. However, even when a doctor has duly opted for the standard procedure, there are chances of the patient developing complications. All human bodies do not react in exactly the same way to a medical intervention even though it may be a scientifically proven one, and there are chances of medical misadventure.

Doctors should possess a reasonable degree of care and skill when attending to patients. The degree of care and skill should be comparable to an average doctor in a similar setting. In order to analyse these issues, expert opinions should be sought from reputable and unbiased experts from a similar field of medicine. In case of death due to alleged medical negligence, the dead body should be autopsied by experts qualified in forensic medicine. This can reveal much information about the deceased which can be helpful in determining negligence.

Councils framed to settle cases of medical negligence, especially the Consumer Protection Council and the Nepal Medical Council, should seek the opinion of experts in the concerned field. It is high time the government moved to address this sensitive and humane issue. If this trend is not ended, it is going to create a disastrous condition and lead to lack of trust in doctors. Doctors too can’t work effectively when there is no safe working environment, and they may opt to abandon critical cases for lack of protection in case complications arise and something unfortunate happens to the patient.

Subedi is an assistant professor at the Department of Forensic Medicine, Gandaki Medical College, Pokhara