Doctors-Patients relationship

Dr. Arun Mitra
In the past few years there has been increase in incidents of violence against the doctors, some of them of very serious nature in which doctors have been seriously injured. Unfortunately most of the times it is the young doctors, who are at regular duty, working tirelessly day and night in the hospitals, without food, rest or break have been targeted by the mobs. This not only shakes the confidence of a budding doctor but also affects his/her attitude towards the patients. A doctor cannot perform in the atmosphere of fear.
True, that a doctor is duty bound to cure, but the end result can never be guaranteed. It depends on the nature of disease and several other factors. Mishaps occur in the best hands and in the best conditions. Negligence cannot be condoned, but to err is human. Many a time faults occur unknowingly. This however does not mean that medical professionals are not accountable. There are laws to deal with such situations. Violence under any circumstances cannot be excused and emotions cannot be allowed to turn into violent behaviour.
In addition to medical skill, trust is the most important thing in medical practice. It is this trust which has become weak and has adversely affected harmonious relationship between the doctor and the patient which is of utmost importance to build a healthy society. Degeneration in the value system as a whole in the society has affected medical profession as well. In the changed socio-economic relations, medical professionals too have become amenable to machinations by the vested business. The cuts and commissions for referrals by a few have lowered the image of a doctor who hitherto has been considered as next to god. Under the circumstances, the family like relationship between patient and doctor has undergone sea change. Entry of corporate sector in healthcare has turned it into business where profit is the only motive. This is against the very principles of healthcare. Medicine is not a profession but a passion. A world of compassion and empathy is a big healing factor. In the corporate culture compassion has no meaning; it is only making profit. The medical education system too is not left out.
This has necessitated the need to define the rights and responsibilities of both patients and the doctors at global level. The National Human Rights Commission of India has come out with a 17 point charter of rights of the patients. These include, right to information, right to records & reports, right to emergency medical care, right to informed consent, right to confidentiality human dignity & privacy, right to second opinion, right to transparency in rates & care according to prescribed rates wherever relevant, right to non-discrimination, right to safety and quality care according to standards, right to choose alternative treatment options if available, right to choose source for obtaining medicines, right to proper referral and transfer which is free from perverse commercial influence, right to protection for patients involved in clinical trials, right to protection of participants involved in bio medical & health research, right to take the charge of patient or receive body of deceased from hospital, right to patient education and right to be heard and seek redressal.
As per Supreme Court, all hospitals both in the government and in the private sector are duty bound to provide basic Emergency Medical Care, and injured persons have a right to get Emergency Medical Care. Such care must be initiated without demanding payment / advance and basic care should be provided to the patient irrespective of paying capacity. It is the duty of the hospital management to ensure provision of such emergency care through its doctors and staff, rendered promptly without compromising on the quality and safety of the patients.
The charter has also specified duties of the patients which include that the patient should respect the dignity of the doctors and other hospital staff as human beings and as professionals, whatever the grievance may be. Patient or caregivers should not resort to violence in any form and damage/destroy any property of the hospital or the service provider. Patient must provide all the related information and query to the doctors without conceding any relevant information; patient should cooperate with the doctor during examination; patient should follow all the instructions regarding appointment time and cooperate with the hospital staff and fellow patients; patient should take responsibility for their actions based on choices made regarding treatment options.
The universal declaration of human rights 1948 emphasized the fundamental dignity and equality of all human beings. Based on this concept, the notion of patient rights has been developed across the globe in the last few decades. In India there are various legal provisions related to patient’s rights like the Constitution of India Article 21, Indian Medical Council Professional Conduct and Etiquettes and Ethics – 2002, Drugs and Cosmetics act. Inspired by the international charts the national human rights commission has drawn all relevant provisions in a comprehensive manner thereby making them publicly known in a coherent manner.
It is important that these are imbibed into both doctors and patients to understand responsibilities towards each other. Contempt against the other cannot sustain and will be disastrous for health of the society. (IPA)


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