Bitter pill for all: Breakdown of trust between doctors and patients is caused and aggravated by state failures

News: Recently, a Dausa gynaecologist committed tragic suicide after Rajasthan police booked her for murder over a pregnant woman dying during childbirth. Also, two district hospital doctors in Howrah were severely assaulted after a patient with severe kidney disease died. These confrontations, which are a relatively recent phenomenon, reveal a broken system.

With both doctors’ and patients’ kin demanding justice when such incidents occur, police must proceed with caution and ensure public order until medical experts deliver a conclusive opinion.

What is the situation wrt medical negligence in India?

NCRB data indicates 552 cases of medical negligence between 2018 and 2020. But given patchy healthcare coverage, actual incidence of medical negligence and deaths avertable with nearer-to-home healthcare facilities would be significantly higher.

Why do people resort to violence in such cases?

Broken-down government hospitals and huge monetary demands of private hospitals leave the average low-income Indian citizen helpless.

This may explain the periodic outbursts of violence.

To make matters worse, due process and procedure are still evolving, decades after Independence.

What is the due process in cases of medical negligence?

In 2021, National Medical Commission issued the following guidelines –

– Police, prior to making arrests, is required to send medical negligence criminal complaints to the district medical council’s medical board.

– The board must send recommendations within two weeks and an aggrieved party (doctor or prosecuting agency) can approach the state medical council’s board for another opinion, again not exceeding two weeks.

Eighteen states have a special law prescribing three years imprisonment for assaulting doctors, the amended Epidemic Diseases Act prescribes harsher punishment, but police are failing to ensure deterrence.

What is the way forward?

NMC must ensure every district has medical boards in place and local police internalise due processes.

Doctors demand that penal provisions must be written into IPC, the handy rule book in thana, to ensure implementation by police.

For patients, approaching consumer courts for civil remedies to medical negligence is futile because of horrible backlogs.

Meanwhile, NMC Act allowing appeals from doctors but not patients to the national-level Ethics and Medical Registration Board against state medical council decisions aggravates patients’ disenchantment.

For doctors’ professional wellbeing and to deter medical negligence, let’s have even-handed rules – and better public health facilities.

Source: This post is based on the article “Bitter pill for all: Breakdown of trust between doctors and patients is caused and aggravated by state failures” published in The Times of India on 14th Apr 22.