Tip of the iceberg

By asking the Hyderabad-based Nizam Institute of Medical Science (NIMS) to pay a compensation of Rsone crore to software engineer Prashant Dhanaka who was left crippled for due to medical negligence during a surgery to remove a tumour in the chest in 1991 the Supreme Court has laid down a strong precedent in such cases. This should serve as a deterrent to hospitals and the medical fraternity in general to be accountable.

This is not a case in which the court wanted to be merely punitive. As a matter of fact, justices BN Agarwal, HS Bedi and GS Singhvi have noted how Dhanaka had himself argued his case without any rancour. This is to show that the purpose is not to place the medical fraternity in the dock and drag them into litigation. It is not meant to intimidate the doctors from using their knowledge in the best interests of the patient, and where human fallibility could play a role. The court has come to the considered conclusion that there was proven negligence on the part of the team of doctors and of the director of the institute during and after the surgery.

Though NIMS is a government-run institution, it is not as if private hospitals are immune to this kind of situation. There was an earlier case of a table-tennis player who had sued the private Apollo Hospital in Chennai for compensation for disabling him. These cases open up the general question of medical ethics, which is of utmost importance, something which the doctors in general and hospital managements are averse to discuss and which has remained largely uncharted territory in India. In the west medical negligence is a very serious issue and insurance companies provide protection to doctors against it. But then it makes doctors and hospitals take the matter equally seriously.

With the growing commercialisation of health care, there is a danger that hospitals may sacrifice ethical imperatives to commercial ones. There is little doubt that the quality of healthcare has improved vastly, and no evidence that doctors are negligent by design, but the patient’s rights have to be kept in mind too. Not everyone who has a rightful grievance against doctors and hospitals has the ability to fight long legal battles.

It took Dhanaka 18 years to get justice, though he is not happy with the amount. The issue at stake here is the commitment on the part of the hospitals to accept moral obligation in case something goes wrong. In the case of Dhanaka the doctors failed to take a broader picture of the complications involved in a surgery which is what the courts took into account.

The case of Dhanaka is not rare or an aberration. It is more like the tip of the iceberg. The court’s verdict should make the medical fraternity more vigilant and the
patients more aware of their rights.