The price of ‘Medical Negligence’

A very good interpersonal relationship between the doctor and patient  must be established as it is one of the key elements that would help in  avoiding matters that rise due to medical negligence. “The changing  doctor patient relationship and commercialisation of modern medical  practices has affected the practice of medicine

octors are the final resort of many as they are the saviours who offer a ray of hope to the poor souls who look upon them with the pure intention of receiving cure for all their medical maladies. Unfortunately, what is witnessed today with regard to the conduct of medical practice is sad because medical professionals who act with responsibly are getting fewer than before. Medical negligence is considered as a professional negligence caused due to an act or omission of proper medical care by a medical practitioner. Most often medical carelessness occurs when the treatment provided falls below the standard of practice established in the field of medicine.  The standards and regulations pertaining to medical negligence differ by the jurisdictions within countries. Medical professionals have the right to receive professional liability insurance to evade the possible risk and costs of facing lawsuits pertaining to medical negligence.

The Colombo Law Society organised a seminar under the theme, “Medical Negligence.” The seminar was hosted recently with a targeted group that consisted mainly of doctors and lawyers. The panelists of the discussion were President’s Counsel Mr. Romesh De Silva as the lead presenter, Dr. Wijayadasa Rajapaksa, Mr. Geoffrey Alagaratnam, Dr. Anuruddha Padeniya and Prof. Ananda Samarasekara.  President’s Counsel Mr. Romesh De Silva stressed on the significance of litigation against medical negligence. 

Mr. Silva highlighted on the key elements that caused the lawsuit against doctors. “There are three reasons for the litigation of doctors. The arrogance of the doctor is the first cause. Therefore, litigation is exercised against the doctor where medical negligence takes place  to teach the doctor a good lesson. It must be understood that negligence means the failure to act in a reasonable and competent manner. Medical negligence occurs only when there is a breach of medical care and the duty of care most often remain with the doctor,” Mr. Silva added. Medical carelessness is more evident in private hospitals than in government hospitals. Mr. de Silva said that there should be a good bond between the doctor and the patient. 

There is inefficiency, lack of discipline and poor governance in this service sector. ‘How could we talk about human resource development when we lack a good human resource structure for the medical sector

“The changing doctor patient relationship and commercialisation of modern medical practices has affected the practice of medicine. Liability for medical negligence could be civil, criminal, professional or administrative. The liability of medical negligence is mainly under the civil law where the plaintiff will ask for compensation and it is considered as criminal when the doctor has been grossly negligent,” said Prof. Samarasekara. Moreover, he stressed on the fact that the standard of care depended on the experience, knowledge and facilities available. 

Examples of medical negligence highlighted by Prof. Samarasekara encompassed the failure to diagnose or misdiagnose an ailment, misreading or ignoring laboratory results, unnecessary surgery, premature discharge, improper medication or dosage, failure to order proper testing and most significantly the inability to recognise the symptoms of a sickness.Prof. Samarasekara also stated that the incapability to exercise proper skill and care and the lack of adequate medical knowledge resulted  in such clinical carelessness. 

 Dr. Padeniya said that as a government servant, doctors have state obligations. There is inefficiency, lack of discipline and poor governance in this service sector. ‘How could we talk about human resource development when we lack a good human resource structure for the medical sector,’’ said Dr. Padeniya. He said the health sector needed to be guided properly and a medical inquiry must be conducted which was fair  by the patient, doctor and people. Although this is a good solution to avoid the possibility of medical malpractice this is a course of action that is not practised anywhere properly. Dr. Padeniya stated that the poor availability of resources in hospitals, lack of discipline and human resource structure, deficiency of medical professionals with knowledge and dexterity and the lack of apt clinical governance were some of the major causes for medical negligence.

Legal action must not be exercised only against the doctors who perform medical malpractice. The paramedics play an equally responsible role in executing their duty of care. Mr. Rajapaksa said that those who were held accountable for the duty of care need to carry out their service with a true sense of responsibility because they were dealing with the lives of the civilians. “When doctors prescribe a medicine do they give their patients the best?” he questioned.  He shared these views parallel to an incident that took place in India where a child was pronounced dead after the nurse had administered an injection which was an overdose. The doctor and the nurse were held responsible for the death of the child due to medical negligence.”Thousands of lives have been lost due to the irresponsible conduct of pharmacies and paramedics. We must not isolate the topic of medical negligence by focusing only on the malpractices carried out by the doctors because these aspects of health care also must be taken into consideration,” Mr. Rajapaksa said. According to a recent research  conducted by him the Ministry of Health was annually destroying drugs that are valued at Rs. 1,250 million. 

When doctors prescribe a medicine do they give their patients the best?” he questioned.  He shared these views parallel to an incident that took place in India where a child was pronounced dead after the nurse had administered an injection which was an overdose

There should be well established governance with regard to the role played by the responsible bodies of the medical sector. “What we need more is a proactive role of the state with relevance to the medical malpractice that is evident in most cases,” added Mr. Alagaratnam. The unfavourable consequences that are encountered at the expense of medical negligence are evident under various circumstances. It is high time that the relevant authorities that govern the medical sector understand the gravity of the problem and take the measures that are necessary to bring the issues of medical negligence under control.   
 

Pix by Waruna Wanniarachchi