The incidence of medical negligence is not low enough to be ignored. There is a need to handle it properly and professionally
RECENTLY, newspapers reported Maryum Begum’s death who had come to Karachi for a routine gall bladder removal surgery, but met her final fate because of the carelessness of the health staff. A sponge was left in her abdomen during surgery that later on got infected and became the cause of Maryum’s unfortunate demise.
A similar incident occurred when Riaz Bibi died after a surgical sponge was left inside her during a Caesarean section. In another incident a young hemophilic patient Javaid, died after 4 weeks of coma due to the administration of wrong injection in Islamabad.
Such horrendous true medical stories are more than enough to ponder seriously the issue of medical negligence in the country. This article aims to analyze the issue of medical negligence from the perspectives of both the client as well as the service provider.
Medical negligence may be defined as the lack of application of the proper degree of medical skill and care in diagnostic and/or therapeutic techniques .
The problem of medical negligence is not restricted to the low-performing healthcare systems of the developing countries. The most sophisticated healthcare systems of the world also provide numerous examples of such negligence where one comes across more such incidents due to more effective reporting.
USA Today recently reported the case of Jesica Santillan, a 17 year old girl, admitted at Duke University Hospital for heart-lung transplant. The girl died after doctors at the hospital botched her heart-lung transplant. In a Minnesota hospital, Linda McDougal, 46, received an unnecessary bilateral mastectomy when her biopsy results were mixed up with another woman’s reports, who was mistakenly told to be cancer-free .
The cases of Jesica and Linda differ considerably with those of Maryum and Riaz Bibi. The families of the former are weighing their options of seeking legal advice and going to the courts as medical negligence laws do exist in the developed countries, while those of the latter may just have to accept it as the Will of God .
In the UK, James Green, won a lawsuit worth £2.4m as a compensation for a tragic mix-up when he was just 4 days old that resulted in him developing cerebral palsy. Similarly in the United States a $1.8 billion class action lawsuit was filed in the Washington D.C. Superior Court against Georgetown University Medical Center (GUMC), on behalf of more than 600 patients who might have been exposed to HIV or other infectious diseases while being treated by the hospital.
The spectacular cases of Green and GUMC represent high degree of empowerment of health seekers in the UK and the United States, the presence of a healthcare system that gives protection to its users, accountability of the health providers, accessibility of people to judicial system, and presence of laws governing medical negligence issues. The consumers of the health service in the developed countries are aware of their rights and educated enough to know their options.
The nexus of consumer protection agencies and litigation companies is gradually making the practice of medicine a risky business for physicians. The situation is becoming so serious in some areas that it has brought doctors out in the streets in protest. In West Virginia 50 doctors staged a walkout protesting against the sky-rocketing prices for medical negligence insurance, which doctors buy to protect themselves from costly awards in lawsuits over mistakes or negligence. The cost is passed onto patients in the form of higher bills or reduced access to needed health care .
From the providers’ perspective the spiral in negligence premiums points towards perhaps an out-of-control system for handling medical errors and mishaps. Patients have long depended on the courts to compensate them for the economic losses and pain resulting form medical mistakes. Yet mounting evidence shows that the system drives up health care costs for everyone, doesn’t protect many who suffer from negligence and has little impact on reducing the medical mistakes that cause thousands of needless deaths each year.
Medical negligence is becoming a complex issue in the West putting at stake both the clients as well as the providers of the health services. President Bush has recently attempted to tackle only the insurance problem in medical negligence by proposing limits on court awards for “pain and suffering” that are granted in addition to payments for damage from medical mistakes.
But the critics have questioned that merely limiting damage awards doesn’t correct injustices suffered by victims of medical negligence. Many patients harmed by medical errors don’t receive any damage awards, according to a report last year by the Institute of Medicine (IOM) in Washington. Those who do must wait an average of nearly five years before collecting any money. The IOM also concluded that the current system doesn’t encourage health care providers to “identify, compensate, and reduce errors,” a failing most reform proposals overlook, too. Instead, doctors are encouraged to deny fault or remain silent about errors to avoid suits. As a result, medical mistakes result in some 44,000 deaths a year, more than claimed by car crashes.
Reports say that although many lawyers get rich off medical negligence cases and many patients do indeed win large damage awards, there’s no connection between the fear of lawsuits and better medical care. In fact, there’s not even a connection between negligence lawsuits and actual cases of negligence. A team of researchers at the Harvard School of Public Health has shown that the vast majority of negligence cases arise from events that don’t involve any medical negligence.
The issue of medical negligence is therefore not simple to resolve. Although, the legal system in the West is accessible for the negligence sufferers, it has loopholes, which have been discreetly exploited by certain interest groups. Some people believe that in the larger context the laws related to medical negligence have done more harm to the healthcare system than doing good to the victims of negligence. It has in some way put the physicians on thedefensive. The expensive lawsuits have inhibited the abilities of the doctors at the subconscious level at least. It has, to a certain degree, even developed the culture of secrecy and anguish. Doctors think twice before disclosing any mistakes in front of either their colleagues or the patients themselves.
Nevertheless, the inherent challenges of medical negligence laws does not deter the need for them in the developing countries like Pakistan where consumer protection is at its lowest. The healthcare system remains unaccountable and unchecked. Ad hoc committees, delay in inquiries, and no substantial outcome add to the agony . The judicial system itself is exploitative and inaccessible for a common citizen in most cases. Laws relating to medical negligence are therefore imperative . The whole process of reaching justice should be accessible to healthcare users.
The incidence of medical negligence is not low enough to be ignored. There is a need to handle it properly and professionally 
