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Medicine and Conscience

News of violence by unhappy patients’ parties in government hospitals and sometimes in private ones too, are becoming too frequent to be comfortable. It cannot also be dismissed as part of a natural and understandable friction between patients and doctors in any hospital anywhere. Something must either be wrong with the attitude of those in the medical profession, or else with the expectations of those who come to these hospitals for treatment, or more probably with both. It is an understandable sentiment for patients and their attendants to be extra anxious about the degree and quality of attendance their wards get in the hospitals, especially from doctors and nurses. Death and injury may be a routine sight for those in this noble profession that they are somewhat desensitized to them, but not for the patients for whom, rightly or wrongly, every relative and friend hospitalized is a life and death question. Obviously, patients and their attendants cannot possibly know what the doctors and nurses know, therefore the worry levels of the medical practitioners would certainly be different from those of the relatives and friends of the patients. All the same, we do feel it is the duty of the doctors to bridge the gap by treating with understanding, if not compassion, the anxiety of the patients parties even if he or she knows it is excessive. For after all, the patients’ parties do not know this, while as professional health practitioners, they do. For this reason alone, the onus must be on the latter to comfort the former and give them the confidence they lack.

However, very often, the story is more than about just a lack of understanding but of gross neglect, especially in government hospitals and if the patients are poor and unconnected. Probably this also explains why there are more cases of clashes between patients’ parties and doctors in government hospitals, as these hospitals are where the latter go to. Those who can afford the now highly escalated cost of health services in private hospitals, avoid government health care facilities. One of the most common complaints where these unfortunate violence break out is the frustrating, and indeed condemnable, long absence of doctors, even of those who are supposed to be on duty, thereby causing complete loss of confidence and a sense of security to the patients and their attendants. This brings up the question, what exactly are the hospitals doing about ensuring round the clock availability of doctors in the hospitals? This is one side of the problem. There is another side too. Though we sympathise with patients’ parties who suffer losses of their loved ones during treatments in hospitals, they too must realise that patients do die in hospitals and that not all patients can be saved by doctors. While it is understandable for them to be outraged about neglects by health professionals employed in these hospitals, it would be wrong for them to presume every death in the hospitals is a result of neglect. They, as lay persons, also have no right to presume the quality and quantum of professional attention given to their ailing loved ones, amounts to neglect. This can be established only by expert probes.

However, not by way of witch hunting, but as a measure to improve the health services, the government must pledge to institute high level inquiries into cases where there are reasonable doubts about the quality of service accorded to the unfortunate patients who die while under treatment in hospital. Such probes must also be with a longer term goal of finding out if the working conditions in the hospitals are causing overstress to the health professionals, making them commit avoidable human errors of judgment as well as misreading of life threatening situations patients go through. We are of the opinion that improvement of the working atmosphere as well as more rational distribution of workloads can do wonders towards uplifting the standard of services in government hospitals. While patients and their attendants must exercise patience and repose faith in the assessment of doctors of the condition and gravity of the illness, and therefore the urgency of active attention their wards need, doctors and nurses must also be made to realize the full weight of the responsibility they shoulder, after all the honesty and proficiency of their professional commitment can be a matter of giving life or causing death. This also implies, deaths of patients in hospitals, established to have been caused by gross neglect, must be made liable to be legally interpreted as culpable homicides, even if they do not amount to deliberate murders.



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