Doctors, Law and Society

The doctor-patient relationship needs to be saved from mounting mistrust and doubt as evident in the growing litigation over the ‘perceived’ medical negligence By Dr Satya Prakash

I have seen those days when a doctor was respected and regarded as next to God. The patient and the relatives had full faith and confidence in the treating doctor and would accept the outcome of the treatment in good faith. Now, the scenario has changed. Patients and their relatives generally tend to consider the doctor responsible for the poor or bad outcome of treatment and doctors too cannot avoid thinking their patients as potential litigants. The doctor-patient relationship has been further spoilt by bringing doctors under the ambit of CPA (Consumer Protection Act) which was initially meant for consumer affairs.

We must not forget that outcome of the treatment not coming up to the expectation of the patient and his relatives does not constitute negligence. Opinion on a patient may differ and sometime may differ very widely. The patient comes to the doctor/hospital for treatment in good faith. He/she pays for the services rendered to him. If the patient gets well, all is well. If the disease doesn’t get cured, the patient feels that the doctor probably has failed in his duty. Unfortunately, if the patient dies in spite of the best efforts by the doctor, the relatives try to find faults with the doctor. They even accuse that the doctor has killed the patient by negligence and try to file a case in some consumer court.

Patients and their relatives generally tend to consider the doctor responsible for the poor or bad outcome of treatment and doctors too cannot avoid thinking their patients as potential litigants. The doctorpatient relationship has been further spoilt by bringing doctors under the ambit of CPA (Consumer Protection Act) which was initially meant for consumer affairs.

With this psyche, one can’t expect patient doctor relation to grow on faith, trust and respect. In all such situations, with a “Sword of Damocles” always hanging on his head, how any doctor can would dare to take up a seriously ill patient with poor prognosis. At times, the media, unfortunately, out of smartness to be the first to report the incident, gives it a sensational twist and publishes it without verifying the truth about the incident.

Many a time, even if the patient gets well, relatives make a fuss & find faults so that they may not have to pay the due bills. Whereas if a seriously ill patient admitted and treated, dies, relatives do not want to pay at all and the doctor ends up spending from his own pocket. Every profession is a noble profession, whereas medical profession is the noblest out of all. Every section of the society owes a responsibility to help the needy and under-privileged. One fails to understand why all the philanthropy and free service is expected from doctors alone. Why are only doctors expected to render services free of cost whereas they have to pay more for everything like municipal taxes, license fee, disposal of medical wastage, and double the sector rates of the land allotted for nursing homes? Just because they are doctors, they don’t get any concession in bank loans and any other privileges. If a person dies in front of a hotel due to hunger after refusal of a free meal or a patient dies because a medical store refuses to give free medicines, will the owner of hotel or medical store be prosecuted? If not, why should a doctor be blamed? The government and the society have given a status of “business” to doctors in matters related to consumer court. Moreover, one can’t expect any person at midnight to supply ration or a suit length or even “Kafan” for the dead. It is only the doctor who can be awakened at all odd hours by the patient during the night. A doctor puts the maximum length of time to get his degrees, settles late in life, puts in maximum hours of work even at the cost of his comfort, health and social life. Then why should such a hue and cry be made on demand of reasonable fee for his services by a doctor?

Following are certain problems to which there are no easy answers in law:

1. A patient in emergency is not accompanied by attendant or relations.
2. if a patient’s attendant shows inability to purchase life saving drugs or pay for any emergency surgical procedure or blood transfusion
3. If after treatment, a patient’s relatives refuse to pay the bills.

If the apex court can order that a nursing home is under obligation to give first aid to an emergency case (which could amount to give life saving costly drugs, emergency operation, blood transfusion etc.) it should also give a ruling that the state would pay if the patient does not or cannot pay.

Increase in CPA cases is partly because some unscrupulous people file cases in the hope to extract money from the doctor, and secondly the plaintiff wants to avoid paying any court fee. Such people should be punished and fined with penalty by the law and the compensation money be paid to the doctor concerned. The law should be amended so that doctor may not think of quitting his/her profession, and rather survive with dignity, grace and excellence.

Why are only doctors expected to render services free of cost whereas they have to pay more for everything like municipal taxes, license fee, disposal of medical wastage, and double the sector rates of the land allotted for nursing homes? Just because they are doctors, they don’t get any concession in bank loans and any other privileges.

Lately, the compulsion from health ministry has come for medical graduates to serve in rural areas for two years, or lose their degree. Will it not be the violation of the fundamental rights of a citizen to force and compel him to work at a place and under situation much against his will under threat of snatching his hard earned degree, without providing him extra incentives, protection to himself and his family, provision of proper education to his children in the village? Applied as such, it would amount to penalizing a person for being a DOCTOR.

The recent U.P. Medical Protection Act, 2013 provides that any violence against the doctor or his attendants or damage to clinic, nursing home or hospital property is non-bailable criminal offence, punishable with 2-3 years’ imprisonment with Rs. 50,000 fine and penalty of double amount for damaged property. This must be strictly implemented and such a law must prevail all over the country with utmost sincerity and honesty to protect this noble profession. Let us pray to God to lead us to right path and truly justify the words of Hippocrates- “Wherever the art of medicine is lived, there lives the humanity”.