The medical profession, revered globally for its life-saving impact, involves complex interactions between healthcare providers and patients, encompassing tests, operations, diagnoses, and more. Despite their expertise, medical professionals may occasionally breach their professional code of conduct, leading to negligence. This discussion explores the legal implications of such breaches, focusing on select areas of medical specialization, including surgery, obstetrics and gynecology, emergency medicine, and primary care, to examine the consequences of negligence, violation of patient rights, compensation, and professional liability.
MEDICAL PRACTICE IN NIGERIA
The predominant statute regulating medical practice in Nigeria is the Medical and Dental Practitioner Act Cap M8 Laws of the Federation 2004 which provides all the necessary framework for the establishment of the Medical and Dental Council of Nigeria for the purpose of registration of medical practitioners and dental surgeons and to provide for a disciplinary tribunal for the discipline of members. It’s important to mention that western medicine was not formally introduced into Nigeria until the 1860s when the Sacred Heart hospital was established by Roman Catholic Missionaries in Abeokuta. Basically the major purpose of medicine is the Art of Healing. It encompasses a variety of health care practices evolved to maintain and restore health by the prevention and treatment of illness.
A Medical Practitioner must take necessary steps to avoid negligence and a Breach of Duty of Care. A medical practitioner may also be liable criminally and may be asked to pay damages by way of civil remedy where it is discovered that the act or omission of the medical practitioner falls below expectation. In Denloye v Medical Practitioners Disciplinary Committee (1968) ALL N.L.R 308 "Thecourt pointed out the fact that where the nature of the act or omission of a medical practitioner amount to a crime, the regular law court must determine the criminal aspect of it before liability is determined under the Medical and Dental practitioners Act with respect to misconduct or infamous conduct.
Duty of care can only occur when a relationship has been established with someone. In this case a doctor-patient relationship. When there is a breach of this duty, it means there is an injury which a person might have sustained at the hands of another who should have taken reasonable care not to inflict pain on the person. The liability of a medical practitioner covers both criminal and civil liability which comes to play as the burden of proof. Both the criminal and the penal codes which apply in the southern & northern states of Nigeria respectively in relation to the culpability of offenders contains elaborate provisions under which cases of medical negligence can be prosecuted. However, it is obvious that the medical practitioners owe their patients a duty of care; it is therefore expected of them to exercise that standard of care in the course of their duty.
LEGAL FRAMEWORK FOR ENFORCEMENT OF MEDICAL ETHICS IN NIGERIA
The law is designed to vindicate individual rights and to ensure that certain basic rules of social conduct are observed within the society. Consequently, there is hardly any profession or discipline in the world that has no relationship with law. The medical profession is not an exception in this respect. Various laws provide the legal regime for the regulation of its practice.
To ensure ethical compliance or sanctions as the case may be the Medical and Dental Practitioners Act provides for the establishment of Medical and Dental Practitioners Disciplinary Tribunal. Section 15 gives provision for the establishment of an investigation panel called the "Panel”. Subsection 3 The Panel investigates and report cases of professional misconduct
Section 16 of the Act provides for penalties for all forms of professional misconducts. The penalties range from admonition; and suspension; to the striking out of name of erring person from the register of doctors. Section 16(6) of the Medical and Dental Practitioner Act, under reference, there is a right of appeal from the decision of the Disciplinary Tribunal to the Court of Appeal. Section 17 of the Act contains a long list of offences, for instance, it is an offence to impersonate or make false representation as to status, name and identify It is also an offence to administer supply or recommend the use of dangerous drugs within the meaning of Dangerous Drugs Act.
INFORMED CONSENT TO MEDICAL TREATMENT
This is an ethical-legal issue. It centres on both the common law and constitutional right of a patient to object to a form of treatment. Sometimes, doctors in treating certain patients tend to override their objection to certain form of treatment on the basis of medical ethics. A doctor who disregards the opinion of the patient would be liable to the tort of assault and battery as well as infringement of the fundamental right of the patient as preserved under Section 37 and 38 1999 Constitution of Nigeria.
The Supreme Court of Nigeria in Medical & Dental Practitioners Disciplinary Tribunal (MDPDT) v Okonkwo held: I am completely satisfied that under normal circumstances no medical doctor can forcibly proceed to apply treatment to a patient of full age and sane faculty without the patient's consent, particularly where the treatment is of a radical nature such as surgery or blood transfusion. So doctor must ensure that there is a valid consent and he does nothing that will amount to a trespass to the patient. Secondly, he must exercise a duty of care, advice and inform the patient of the risk involved in the contemplated treatment and the consequence of his refusal to give consent. In Okekearo v Tanko, a medical doctor amputatedthe left centre finger of a 14 year old boy without his consent. The boy's action for exemplary damages succeeded. The doctor's appeal to the Court of Appeal failed and his further appeal to the Supreme Court was dismissed.
But however, in Esabunor V Faweya The Parents were Jehovah Witnesses and their child was in need of Blood Transfusion to save his life, The parents refused this option as it’s against their religious beliefs as Jehovah witnesses but however the Doctor administered the blood transfusion without the consent of the parents which saved the child life The parents however sued the doctor for infringement on fundamental right to religion. The Court held that the child is not yet an adult but a minor and it is the duty of the court to protect the life of a child but however if the child was and Adult he can refused to take blood transfusion.
LEGAL PERSPECTIVE ON ABORTION AND EUTHANASIA
The law on abortion in Nigeria could be found under Section 228, 229, 230 and 328 of the Criminal Code Act as well as sections 232, 235 and 236 of the Penal Code all of which prohibit and criminalize abortion. Abortion according to Blacks Law Dictionary is spontaneous or artificially induced expulsion of an embryo or foetus. It is a negation of right to life. The offence of attempting to procure an abortion is a felony and is punishable with 14 years imprisonment.
The offence of killing an unborn child via abortion in Nigeria is punishable with life Imprisonment. However, Section 297 of Criminal Code of Nigeria has been reinforced by the judicial decision expressed in R v Edgal to the effect that an abortion performed to preserve the life of the pregnant woman or the unborn child is lawful. The foregoing represents Nigeria's position on abortion which has become a live topic in contemporary debates.
Euthanasia is defined by Black's Law Dictionary as the act or practice of killing orbringing about the death of a person who suffers from an incurable disease or condition especially a painful one for reasons of mercy. The Constitution of Nigeria 1999 provides in Section 33 (1) that every person has a right to life and no one shall be deprived intentionally of his life, save in execution of the sentence of court in respect of a criminal offence for which he has been found guilty in Nigeria. There is no provision of law in Nigeria that recognize any form of euthanasia (whether voluntary, involuntarily, active or passive) whatsoever. The itemized categories of euthanasia falls within the ambit of homicide which is a subject of criminal law. Euthanasia is apparently not legalized in Nigeria.
Section 306 of Criminal Code complements the constitution and provide that it is unlawful to kill any person unless such killing is authorized or justified or excused by law. Section 308 of Criminal Code states Except as hereinafter set forth, any person who causes the death of another directly or indirectly by any means whatsoever, is deemed to have killed that other person section 299 of the criminal Code, Consent by a person to the causing of his own death does not affect the criminal responsibility of any person by whom such death is caused. Section 326 of the Criminal Code also provides: Anybody who procures, counsels, or aids another in killing himself is guilty of a felony and is liable to imprisonment for life. Punishment for manslaughter is life imprisonment while that of murder is death sentence.
CONCLUSION
In conclusion, medical practitioners should be cautious in carrying out their duties, they should act in the way any reasonable person should act. They should try their possible best not to fall short of their code of conduct either by their acts or omission as regards the conduct expected among practitioners. They should not neglect or disregard professional responsibilities to patients for their care and treatment. Their behaviour should not be derogatory to the reputation of the medical profession and they should avoid abuse of their professional privileges and skills.