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Doctors freedom in Peril

Doctors freedom in Peril

Physicians must have the professional freedom to care for their patients without interference and also enjoy right to refuse, where ever the doctor feels he cannot treat or attend for any reason. Doctor alone can decide which patient he can treat and which he is unable to treat due to lack of skill, equipment, medicines or support of staff or his own health in his set up. Under no circumstance, should he exercise his discretion in providing medical treatment unreasonably, irresponsibly or arbitrarily.   Unreasonably onerous burden of responsibility cannot and should not be placed on private doctors, simply because a law exists, especially given the lack of resources and limited infrastructure in the public hospitals. Clinical establishment Act is one such law that has been enacted by the parliament in a hurry, without discussion with all the stakeholders, and promulgated recently. This passes on the responsibility of providing emergency care from the public sector to the private sector, which by and large is neither equipped nor prepared to deal with the emergency patients. Govt has not proposed any incentives or help to private clinics to render emergency care. In fact a sense of rivalry exists between two wings and the bureaucrats give step motherly treatment to issues concerned with private doctors.

If under the weight of this law, private setups are forced to close down the patients will be deprived of the benefit, knowledge and convenience of nearby/family / senior doctors. It is a known fact that most clinics are run by single doctors (often in the golden age), without any staff or emergency care facilities, but serve useful purpose of good advice for limited hours in a friendly way. The ACT calls for registration of the clinics of all doctors, whether or not in practice, old or young, general or super-specialist, aging or ailing, functioning or bed-ridden. Many of them may be riddled with several ailments and have to take treatment round the clock and still tend to serve patients whenever possible. They cannot retire, they cannot take leave, they cannot fall sick! They cannot say no, even if they are unable to treat a particular emergency! The Act directs them to employ doctors for all kind of emergencies, round the clock, with no guarantee of income from such patients and notwithstanding the financial capacity of the clinic doctor to afford such top heavy set up. Payment issue to the doctors’ service is left as a gray area. If an unwilling, un-equipped or physically/mentally unfit doctor is forced to attend an emergency, will the courts excuse him in case the results are unfavorable?
Forcing physicians to act against their wishes, to do something they believe they are not skilled or prepared, not only harms their patients but also exposes them to the allegation of negligence and greed in the eyes of the law. This coercive violation of their freedom also harms society and the patients. There are issues of human right violations for the doctors and the patient both, when doctor is not in a position to attend and treat, but is forced by the law of the land to do so. His physical or mental inability may be exploited by unscrupulous patients.  In fact flogging a sick and aged horse may not help to win the race but may lead to loss of valuable loss of golden hour and consequent unfavorable outcome.. If a critical patient reports to a centre that is not in full preparedness to administer emergency treatment (and is only nominally designated as a clinic in the eyes of the law), the patient is sent from this clinic to another, or gets deficient treatment. How then can this patient get effective treatment given the scarcity of skill, resources and infrastructure? Not by passing a law blindly!

When can a doctor refuse to give treatment?

  1. If the doctor does not have adequate skill or means to treat the patient

  2. If referring the patient to another medical practitioner is beneficial for the patient; for example, if the doctor does not have the time or the expertise to attend to the needs of the patient

  3. If the doctor does not have the adequate facilities or equipments necessary for the treatment of the patient.

  4. If the doctor is not physically or mentally fit to work beyond limited consultation hours.

Why to snatch the freedom?

More and more laws and bye laws are being enacted to curb the freedom of the doctors without any tangible benefits to the community. In this country, everyone has right to exercise his freedom…. But why are doctors suppressed from their professional freedom? Not a day passes when media carries a caption that such and such doctor was assaulted or his property burnt down when the outcome was not as per the expectations and wishes of the patient or his kin.  How will he save his patients when Damocles sword hangs over his head always? So, the person that treats and guides everyone into a healthy living himself/herself is threatened while saving another human being.

The doctors are being blamed for mistakes that others make or due to system failure. For instance, delay of ambulance due to traffic chaos, childbirth in the waiting area due to bed shortage, failure to provide ventilator to the needy, blindness due to infected saline and deaths in a sterilization camp due to faulty medicines etc. This has led to such extreme situations wherein doctors have been severely injured or even some have died due to attacks from violent crowds. To add fuel to this, the media has not helped to save doctors’ image.


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