Dr Chakra Raj Pandey
Our attention has been drawn to some provisions related to doctors and health practitioners in the new General Criminal Code that came into effect from first Bhadra, 2075 (August 17, 2018).
Clause 230 (1) and (2) is full of flaws. It seems that people who do not know anything about medical science have proposed the clause. In fact, it can take many individuals lives. There is nothing small or big in medicine. One tablet can cause anaphylaxis or one surgical incision can cut nerve or artery or even cause septicemia.
Medical error has been defined as an unintended act or one that does not achieve its intended outcome, the failure of a planned action to be completed as intended (an error of execution), the use of a wrong plan to achieve an aim (an error of planning), or a deviation from the process of care that may or may not cause harm to the patient. Heart ailments cause 611 thousand, cancer 585 thousand and medical errors 251 thousand deaths, according to statistics from US Hospitals for 2013.
Looking at clause 230 (3) and (4), any of us can be in prison from three years to whole life.
Hippocratic Oath prohibits all of us from treating any patient with wrong intention. If we do so, we are not physicians. In that situation, our license has to be confiscated by the council or other regulatory bodies.
Hippocratic Oath today binds the American Medical Association’s Code of Medical Ethics (1996) and has remained a benchmark for ideal conduct of the physicians in the Western Civilization. In reality, oath-taking in recent decades has risen with almost 100 percent of US medical schools administering the oath today from just 24% in 1928.
Clause 231 (2) a and b treat malicious treatment by physicians like murders. They state that no physician will treat maliciously, and the physician’s license will be confiscated if there is any concern and complaint about malicious treatment. I have never heard and read about any physician treating maliciously in my life. How can a patient go to a physician who is treating maliciously?
Clause 232 talks about medical negligence. Is it medical error or is it a different thing? If we talk about medical error as medical negligence, there will be no space left in the country’s prisons and there will be no doctors left in the hospitals.
Nobody has discussed, what happens if doctors or nurses die while treating patients with hepatitis, swine flu, AIDS and other ailments or doctors develop bone marrow cancer due to over exposure to radiation or oncologists die due to chemotherapy preparations or pathologists die due to liver pathology secondary to formaldehyde solution.
We have not discussed doctors and nurses having mental and physical breakdown due to long hours of stressful work.
So, this law has been put forward without enough homework and no stakeholder was invited in the discussion process. It is still not too late to correct it. I am sure with the able leadership of Prime Minister KP Sharma Oli, this problem can be corrected once and for all.
The discussion, in my view, has to be focused on how to produce able doctors, how to provide life-long education, how to participate in maintenance of certification, how to do clinical and basic science research, how to make better hospitals where doctors can perform best surgeries, treat patients in the best possible way, and how to build safe institution.
It seems our focus has deviated from the main goal. Let physicians and allied specialties come together to show the correct path and solidarity.
We also love our patients and country as much as other people do. Let us not corner the practitioners of this noble profession. We may have weaknesses, like any other human being, but these all are correctable. No doctors should be in the prison to correct medical errors.
(The author is Medical Director at Grande International Hospital)