License to kill
In his famous drama “The Doctor’s Dilemma”, famed English playwright George Bernard Shaw refers to doctors as licensed murderers. A Bill being presented to the Constituent Assembly of Nepal is likely to further strengthen the doctors’ license to kill.
As reported in the media, the Bill that is likely to be introduced in the Constituent Assembly very soon will slap a penalty of up to Rs. 50,000 on those who manhandle a doctor. Also proposed in the Bill is a special security system for hospitals and doctors. For this, a separate body called ‘healthcare institutions security committee’ is proposed to be set up.
Any proposal to strengthen the security system should be welcome. But the Bill has drawn its share of critics as well who insist that it is silent about the security threat posed by negligent doctors to the general people. The Bill wrongly assumes that the threat is only to the doctors from the general people, not the other way round.
Doctors are administered, what is known as, the Hippocratic Oath before they are licensed by the government to operate as doctors. If the doctors are not governed by this oath, they are governed by a code of ethics. In Nepal there are frequent complaints that the Hippocratic Oath as well as the code of ethics of medicinal profession are frequently breached. There is no system to ensure that the doctors operate with complete honesty to this oath or code. This is a big failure of the Medical Council and the Ministry of Health.
Health services are characterized by high level of, what economists refer to as, information asymmetry. Even fairly learned persons do not have the capacity to understand the medical reports. So they don’t have any recourse to ascertain whether a particular doctor performed his duty in full compliance of the ethics prescribed for this profession. Therefore, the solution to this problem should focus on solving the problem of information asymmetry. .
As long as this sort of mistrust between doctors and patients continues, the problem will keep on cropping up no matter what sort of new laws are enacted.
One solution to the malaise is universal medical insurance system. Of course, such problems are reported also in countries that have universal medical insurance. However, the frequency of such problems cropping up is very low there as compared to Nepal. Once such system is in place, the insurance company has to pay the compensation, which can have a competent team of medical experts to verify whether the harm caused to the insured was due to the negligence of the doctor or not. While the company pays compensation to the insured soon after the harm is incurred, it can use the legal system to get itself compensated from the doctor if the harm is caused by the negligence of the doctor.
(By Arthaprakash Bidyarthi)
