Dying from denial:

'Youth dies due to medical negligence'- cried the local headlines in the newspaper this morning. In recent days, infamy has become the doctors' friend , while death is befriending the lesser mortals. And the lower in the SEC-pyramid one is, the lesser are the odds that he or she will cross the average life expectancy of an Indian. The unfortunate death of Shivaraj (Read the story here.) is just another example of how much the socio-economic system is lacking in accountability (what is that!) and social responsibility (ouch, not that nerve again!).

Either some of us keep running into the wrong set of people or it has now become a habit for doctors to act pricey-and-stately for no reason. A smaller example of this- minor in significance but chafing none the less under the circumstances- is that of a relative of ours who recently lost her mother and had to call-up as many as four doctors in vain, before my father requested our family doctor on the relative's behalf, to provide a death certificate for the departed woman. One 'nieghbourhood doctor' refused to even speak on the phone, let alone decline a visit, when called up for the request.

Such callousness as shown at Bowring should not go unpunished, for there is absolutely no reason why doctor should deny service to anyone. One can look at it in several dimensions. As pointed out in the article, there is no legal impediment to providing service. Medical negligence of the popular kind (misdiagnosis, failure to exercise diligence during procedure etc) comes later. One must first ask the question- Can a doctor be punished for providing service. Obviously no! Additionally, there ought to be no economic impediment, at least not in Shivaraj's case, as he was brought into the hospital by his father to a government hospital. In any case, the responsibility of the cost of the treatment in an emergency cannot and should not be the doctor's responsibility. The doctor is expected to skillfully do that which is technically apt in his judgment based on his training. Economic responsibility lies with the patient or his kin as the case may be. Denial of service on grounds of economic status certainly is unconstitutional. There is no evidence of procedural impediment either, because the patient in this case was not a victim of crime. Typically, one requires an FIR or some police report for an unaccompanied or unidentified patient where foul-play is suspected. Shivaraj's case is plainly that of a one-party road accident and moreover the police themselves shifted Shivaraj from one hospital to the other.

Come to think of it, basically, it makes no economic sense for a doctor to behave this way. Thousands of doctors pass out every year from greater Bangalore given the plenteous harvest of doctors from medical colleges in the region. Good doctors might be in short-supply but medical graduates are not. How can a doctor think he can grow by turning away or turning off patients in this demand-supply situation?

That the accused doctors shouted at the grieving party and refused to read the report given by NIMHANS, let alone admit the victim, itself tells that they are not fit to be doctors. Of course, suspension of the doctors has been issued and a 'departmental enquiry' ordered, but this will not help the dead man's family, for whom he might just have been the sole bread-winner. It can be fairly estimated that after having paid tons to get into the medical education-and-profession the doctors will try to buy their way out of the death on their hands. If the case goes judicial, all hope is lost for the survived, who might find themselves in a dilemma to choose between survival and legal (and moral) victory.

Treating this as a second degree murder (their action directly lead to the patient's death, did it not?), the doctors should be stripped of privileges to practice, barred from IMC and made to compensate the Shivaraj's family financially.

This may be an odd case that has made it to page-2 of a popular tabloid, hundreds more may not even be noticed. But this should be made a precedent for other doctors who consider themselves as human gods and take their roles for granted.

After that, the doctors might not live in and patients not die out of denial.