Who will protect the rights of the patients?
Eleven-year-old Afreen Hoque Shristy, a student of Viqarunnisa Noon School & College, was admitted to one of the reputed hospitals in the city with Dengue fever on October 25, 2018. On October 26, she died in the hospital's intensive care unit. Her family alleged that she died due to wrong treatment but the hospital authorities denied the allegation (The Daily Star, Oct 31, 2018). According to Afreen's brother, the doctors at the intensive care unit removed her (artificial) ventilation equipment without informing the family. When her family members forcibly entered the ICU to learn about her condition, they found that there were no doctors or nurses inside the ICU.
I was taken aback to learn about the fate of the little girl who was supposed to get care and treatment from the doctors and nurses of the hospital and should have come back home healthy. Instead, she had passed away because of the alleged negligence of doctors and the hospital's staff.
Unsurprisingly, death due to "wrong treatment" or medical negligence happens all the time in this country. Many other cases of patients dying as a result of medical negligence and doctors' incompetence have been reported in the media this year alone. Last June, the death of 3-year-old Raifa in Chittagong's Max hospital, a reputed private hospital, created huge public outcry in the media and all across the country. The little girl was suffering from cold and sore throat and was unable to eat. Her parents thought that admitting her to a hospital would be best for her. But the doctors and hospital staff had proved them wrong.
Similarly atrocious was the case of an elderly man who died in front of his consulting doctor as he (the doctor) reportedly took off the patient's oxygen mask and didn't put it back despite repeated requests from the patient and other doctors who were on duty.
The cases I have mentioned here are some of the worst examples of medical negligence since in all these cases, doctors' negligence led to patients' death. Besides, medical negligence such as wrong diagnosis, doctors prescribing wrong drugs to patients, wrong doses of medicines, surgical error, unnecessary surgery, and so on, are also prevalent in both our public and private hospitals. Such cases are reported in the media frequently, although the number of cases that are reported constitute only a fraction of the total number.
However, only in very few cases do patients or their relatives seek legal redress and file lawsuits against the doctors or medical practitioners concerned. One reason for this is that we do not have any particular law to deal with cases of medical negligence or malpractice.
We do have some laws such as the Penal Code 1860, Code of Criminal Procedure 1898, Consumer Rights Protection Act, 2009 under which cases can be filed for legal remedies. In the event of death due to medical negligence, cases may be filed under the penal code, 1860, as death by negligence is a criminal offence and is punishable under section 304A of the penal code. There are also provisions for imprisonment and fine which are equally applicable to both the doctors and the complainants.
The Consumer Rights Protection Act, 2009, also protects some of the rights of the patients. Under this law, patients are consumers of health service as they receive service from doctors in exchange of a fee. In our neighbouring country India, under consumer rights protection law, cases can be filed for medical negligence and there have been instances where physicians had to compensate patients. But in Bangladesh, this law is hardly implemented in cases of medical negligence.
In addition, we also have the law of Tort which is scarcely used.
Needless to say, all these laws have limited scope to deal with the wide range of incidents and given the widespread irregularities in our healthcare sector, which is why we need a particular law that would protect patients' rights and empower them to seek legal redress.
In a research paper titled "Medical Negligence Laws and Patient Safety in Bangladesh: An analysis" published in the Journal of Alternative Perspectives in the Social Sciences in 2013, the authors proposed that a new law should be enacted to oversee the activities of medical practitioners and protect the rights of patients, which can be called Patients' Rights Protection Act. Under this Act, Medicare can be effectively and "judicially" scrutinised. It will have a provision for a complete separate medical malpractice court system or tribunal. They also proposed setting up a Medical Review Bureau which will co-exist with the courts. The bureau will be an alternative platform to the courts, where issues relating to medical malpractice and negligence can be raised and settled.
These are some proposals that the government, policymakers and other stakeholders should consider. At the same time, implementation of the existing regulations must be ensured.
According to the Medical and Dental Council Act 1980, if any allegation of medical negligence or misconduct is proven against a doctor, his registration can be cancelled or suspended. But have we ever heard of any disciplinary action being taken against any doctor because of such allegations by the council?
If only the Code of Professional Conduct, Etiquette and ethics, set by the Medical and Dental Council, is followed by our medical professionals, a lot of the problems could be solved easily. According to the code of conduct, on-duty doctors must be readily accessible to patients, listen to patients' questions about their health and answer them, make sure that patients are informed about all the aspects of the treatment including examinations and interventions. Patients should be given the chance to question or refuse any intervention or treatment and must be informed about the risks associated with any particular treatment. Do any of our doctors or hospitals follow this simple code of conduct? Moreover, being considerate to the patients' close relatives is another area where many in the medical profession have totally failed.
In Raifa's case, his father had sued the four doctors concerned for his daughter's death. But this is only an exception. The large majority of people do not have the power or knowledge to seek justice for their plight. Therefore, we hope the issue of patients' safety will be given due importance by the government, which can only be ensured through proper monitoring of our health service sector and by enacting a comprehensive law solely for the purpose of dealing with the cases of medical malpractices and negligence.
Naznin Tithi is a member of the editorial team at The Daily Star.