Denying
Emergency Medical Aid is an offence
Vanam
Jwala Narasimha Rao
The
Pioneer (22-06-2020)
There were upsetting and perturbing reports in a section of
media, facts of which are subject to verification, that, a middle-aged woman
died in Hyderabad, subsequent to denial of emergency medical aid to her in
couple of government and private hospitals despite repeated pleas by her
husband. Possibilities of such incidents, however, are not uncommon.
The reports indicate that the woman had fever and breathing
problems few days ago, and her husband took her to Sunshine Hospital-a private entity,
where she was denied admission initially. When her husband protested, they
treated her for a while and abruptly discharged suggesting that she be taken to
a different hospital without giving any reason. Husband then took her to
several hospitals, Apollo, Fever, Care, Virinchi, King Koti Government Hospital,
Osmania General Hospital etc. She however was denied admission and treatment
everywhere. Finally, he took her to the Gandhi Hospital where she was admitted
and later died. Had her husband preferred to take her to the Gandhi Hospital
first then the situation might have been different. This sort of a situation,
if it is true and goes unchecked, has several serious ramifications. Unless these
are addressed the society will be at a loss.
Unless there is a stringent law that makes denial of
emergency medical aid and treatment to patients approaching a doctor or a
hospital-be it private or government-as a heinous crime, there is no safety for
patients. It is high time that a law is enacted all over the country. Only when
deterrent punishment is incorporated in the Act incidents like this will not
happen.
Even after 70 years of independence, medical and health facilities
in rural areas are inadequate despite several measures taken by successive
governments. There are plenty of reasons for this which needs a debate and
thorough discussion. In towns and cities, though corporate level medical
facilities are plentily available and are easily accessible to the rich, for middle
class and lower middle class it is still a luxury. If this is the situation
under normal circumstances, during unexpected emergency situation like the case
that happened in Hyderabad couple of days ago to whom the patient look at for
remedy?
With the spread of Coronavirus, the situation is too unsafe and
alarming for the middle-and lower-income groups. In case of an emergency arising
out of coronavirus or otherwise, where will these middle class and low-income
groups go for treatment? In rural areas the doctor-patient-hospital ration is
poor and in urban areas it is beyond their financial capacity.
Whatever may be the reasons, denial to admit and give
treatment to patients is going on in the private hospitals unabated. It is high
time that the Centre and State Governments enact stringent laws to check this
unethical practice. 14 years ago, in August 2006, the then Law Commission of India
in its 201st Report, titled Emergency Medical Care, drafted a Bill
and was sent to all the state governments for their perusal, approval and
adoption with state specific measures. But till date no state government seems
to have really bothered to offer its comments nor work out on making an Act.
The three-member Commission headed by Justice Mamidanna
Jagannadha Rao. A Telugu person, drafted a Bill pertaining to private
hospitals and practitioners and the treatment of accident victims and emergency
patients. According to the Bill, hospitals cannot refuse care to an emergency
victim even on the ground that it was a medico-legal case. At the very least,
they must provide emergency treatment and transport, with medical support, to
another hospital, seeking the help of the police if an ambulance is not
available. Doctors or hospital administrators who refuse emergency treatment
face six months’ imprisonment and a fine of Rs 10,000 mentioned the report.
The Commission also suggested that the Government should
reimburse the medical treatment expenses including the ambulance charges to the
hospital or the doctor concerned. It also suggested that a special scheme
should be prepared by the governments in this regard. The Commission also
mentioned about the important dictum in the medical parlance called the Golden
Hour. It means that the first hour after a traumatic injury, or
other emergency, when timely treatment is most likely to be successful. On the whole, irrespective of legal concerns, doctors should not
refuse emergency treatment, at least on moral grounds was the essence.
Long time ago, under united Andhra Pradesh Government, there
was a sudden spurt in stray dogs biting the children in Hyderabad. It led to
several infants’ deaths. In one case, the hospital not only demanded money for
treatment but also asked for money to provide a cloth to cover the body! Since
it was reported prominently in the newspapers, it became a talk of the town then
and the matter on hospitals refusing to give treatment is still a topic of
discussion now.
Several verdicts by the Supreme Court, Consumer Forums have
clearly stated that doctors cannot shy away from their professional obligation on
the pretext of some reason or other. The Supreme Court also observed that since
ours is a welfare state, it is all the more the responsibility of the
government to provide all services to the people.
Though according to Fundamental Rights as enshrined in the
Constitution, protection of life of citizen lies with the government, but yet
many people have lost and are losing lives due to non-availability of medical
treatment on time. The situation of treatment refusal prevailed all over the
world. In the US, in 1986 a law was enacted by which refusal to treat was a
criminal offence.
Amidst complaints that a large number of
private hospitals across India are either refusing critical patients or have
been shut, the Centre asked states to ensure that hospitals keep functioning
for every patient needing hospital care.
In a letter written to state Chief Secretaries,
Union Health Secretary Preeti Sudan said the government had received reports
that many private hospitals are hesitating to provide critical services such as
dialysis, blood transfusion, chemotherapy and institutional deliveries even to
their regular patients either due to fear of contracting COVID-19 or because
they are not functioning.
“It is also noticed that at many places,
hospitals and clinics are insisting on COVID-19 tests before providing
services,” Sudan’s letter said. The letter said it must be ensured that all the
health facilities, especially those in the private sector, remain functional
and provide critical services to needy patients.
Moreover, patients have some basic rights
such as, Right
to Appropriate Medical Care and Humane Treatment, Right to Informed Consent, Right
to Privacy and Confidentiality, Right to Information, The Right to Choose
Health Care Provider and Facility, Right to Self-Determination and Right to Medical
Records. After all, “Vaidyo
Narayano Harihi!” (Doctor is Lord Narayana Himself) is the saying right
from our Vedic Period. Let denial of emergency medical aid by any hospital or
doctor be made as a serious and punishable offence. END
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