Doctors are neither businessmen nor God

 Doctors are neither businessmen nor God

There is a legal and social debate on whether the medical profession is a service or a business.

The incident in which the consumer court accused doctors of negligence and demanded compensation has hurt the morale of doctors.

While doctors are trying to fulfill their professional religion and humanity, the judicial system needs to ensure justice.

Is the medical profession a business or a service?

This question is worth thinking about.

Some recent legal developments have brought the medical profession and healthcare to the center of a big debate. The consumer court has accused Om, Grande City, and Himal hospitals. And has ordered the doctors assigned to treat them to pay compensation on charges of negligence.

Although this order will make many Nepalis happy. But the Nepali doctors who serve the same Nepalis are not only angry, their morale has been deeply hurt. Their own Nepali doctor friends who have gone abroad are saying, ‘You said you would serve in a good country, but you are a fool.’

Doctors are writing on social media, ‘I am a doctor, not a businessman. If my treatment does not cure you and you have to pay me compensation for negligence, please do not come to me.’

This is not just an emotional expression, it is a plea for professional self-respect and justice. We spend countless years of our lives to become doctors.

We capture the enthusiasm of youth in hospitals and libraries. Even as doctors, we skip dinner and run to emergency ‘calls’. Even when a sick child is crying at home, we enter the operating room to save someone else’s life. Only we can understand this pain. Others see the car we drive and the clothes we wear, but do they see us burning in the AC room?

We are fighting death every day. When we enter the hospital gate, we do not have money, but only the morale to count the patient’s breath. We forget the sleepless nights and start a surgery even in that fatigue.

In the hope of saving someone's life, we make a sincere effort to save the breath of someone's daughter, father, wife or son. But when sometimes that effort fails, we start being judged commercially. Just as someone asks for a warranty on a broken mobile phone, similarly, we are also told, 'If you don't fix it, give compensation.'

At this time, we have to ask ourselves. Are we working in a shopping mall, not a clinic? Are patients not our responsibility, but customers? Internationally, it is said that medical services are not a business, but a service based on responsibility.

According to the famous British decision of 1957, Bolam v. Foreign Hospital Management Committee, 'If a doctor has adopted a method of treatment that a responsible and experienced community of doctors considers appropriate, then even if the treatment fails, that doctor cannot be accused of negligence.' This decision is known as the 'Bolam test' in medical law.

Even today, it is considered the basis for determining whether there is medical negligence in countries including the UK, India, and the US. That is, if the doctor has tried according to existing medical standards, then the failure of treatment is not negligence. The World Health Organization (WHO)'s 'Global Patient Safety Action Plan (2021-2030)' also talks about the 'just culture' of doctors.

Where learning is learned from failure, not blame. There has been an attempt to disrupt that cultural norm in our society. That is why we are now forced to ask ourselves. Will the religion of service now be weighed on the edge of court papers? Will the medicine of effort now become a subject of punishment?

We only fulfill our medical or human religion. That religion, which is in the essence of the 'Hippocratic Oath'. 'I will take all necessary measures for the benefit of the patient, I will not harm anyone.' But it is not that religion that is now on the court of justice, but the failure of our fate.

Not only us, everyone knows that not every patient recovers. Science has not answered every question. Treatment is an effort, not a guarantee. But when a patient does not recover, what is the charge against us? ‘Neglect!’

This is not just a legal debate, it is a matter of self-confidence. Should I now think that the patient’s family will drag me to court tomorrow every time I perform a surgery? Should I now not try to save the patient if there is no equipment, technology or state-of-the-art services? Then who will treat in rural areas? Who will work in a hospital without an ICU or NICU? And if a problem arises, will the court accuse us of negligence? We had heard that effort is our religion, humanity. But now it is being said that failure is a crime.

A district judge’s decision is overturned in the high court. There are dozens of such cases. Does society say that the district judge was guilty or negligent. Is there a law to demand compensation? A police officer keeps him in custody for 25 days and conducts an investigation. They demand punishment by showing him as guilty. But that person is found innocent by the court. Is there a system to hold the police guilty and get compensation for 25 days of physical and mental stress?

If the doctor treats, tries and the disease does not cooperate, we prove negligence. Is this social justice? But still, we do not say that doctors are allowed to make mistakes.

The basis for proving a doctor's mistake is not the death of the disease. Because death is the ultimate truth. The doctor's mistake is to prove negligence.