Medical negligence in Bangladesh is a pressing issue with serious consequences for patient safety and recent cases of malpractice and patient harm have highlighted the urgent need for systemic reforms.
In Bangladesh, medical negligence is a growing concern, with incidents of malpractice and patient harm on the rise. Recent cases, such as the tragic deaths of Mahbuba Akter Akhi and her infant at the Central Hospital in Dhaka, have once again brought the issue to the forefront. While only three days had passed since this tragedy, a second case of a woman dying during leg surgery at Ibn Sina Medical College Hospital in Dhaka, with her son alleging negligence in treatment for multiple leg fractures caused by a fall, was reported.
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Following the unfortunate death of Mahbuba Akter Akhi and allegations of medical negligence, the operating theatre at Central Hospital was closed by the Directorate General of Health Services (DGHS). Dr. Sangjukta Saha, Akhi’s gynecologist, is facing a lawsuit, while two other doctors have been arrested in relation to the case. Despite the closure of the operating theatre, the ICU at Central Hospital has been reopened. The second case has no reported development yet.
What makes medical negligence so common? Let’s explore its causes, consequences, the laws’ challenges and the need for systemic reforms to ensure accountability and patient safety.
What makes the growing issue of medical negligence more prominent?
According to Ain o Salish Kendra’s research, between June 1995 and September 2008, Bangladesh witnessed 504 cases of medical negligence. Moreover, no study was done from 2008 to 2020 to identify the number of medical negligence cases. Unsettling incidents have highlighted the seriousness of the issue.
Many cases of utter negligence have come forward in recent years highlighting the carelessness of the doctors and hospitals, some of which include high-profile cases too. In response to these cases, the High Court has launched an investigation into potential doctor negligence, emphasizing the significance of accountability and adherence to medical ethics. These incidents highlight the imperative need for improved healthcare practices, increased patient safety measures, and robust legal measures in Bangladesh to combat and prevent medical negligence.
The Culture of impunity:
In Bangladesh, healthcare personnel frequently operate with a sense of impunity and rarely face repercussions for medical malpractice. In its entire history, the Bangladesh Medical and Dental Council (BMDC), the governing body responsible for monitoring physicians’ conduct, has only penalized 14 doctors, with only one losing their license permanently. This lack of accountability perpetuates a culture of negligence within the healthcare system, where healthcare professionals feel unconcerned about repercussions.
The culture of impunity is caused by a number of factors, including a lack of robust investigation procedures and a lack of resources within the BMDC. In addition, the complexity of the legal framework governing medical negligence hinders the ability to hold negligent healthcare professionals accountable. This prevalent culture of impunity reduces patient trust in the healthcare system and disrupts efforts to improve patient safety.
Legal ambiguity and inadequate framework:
Legal ambiguity surrounding the offense is one of the reasons why medical negligence cases are not prosecuted effectively in Bangladesh. Different types of medical negligence fall under numerous offenses, making prosecution difficult. Patients or family members who are aggrieved can file lawsuits under various sections of the Penal Code, the Consumer Rights Protection Act, or in civil court. However, the lack of specific legislation regarding medical negligence hinders the ability to hold physicians and medical professionals accountable.
As a result of the absence of a distinct legal framework, medical malpractice victims are frequently unsure of which legal provisions to invoke. In the absence of a law specifically addressing medical negligence, there is space for interpretation and inconsistency in the handling of cases. This hinders efforts to establish an equitable and effective system for addressing medical negligence and undermines the pursuit of justice for victims.
What laws are there for medical negligence?
Section 23 of the Bangladesh Medical and Dental Council Act of 2010 empowers the Council to revoke the registration of healthcare professionals found guilty of improper conduct or violation of the act. The constitution of Bangladesh recognizes the right to health and medical care in Articles 15 and 18, and the right to life under Article 32.
The Code of Medical Ethics also states that gross negligence in the performance of duties may lead to suspension or removal from the registrar (Section 5(a)).
Under the Medical Practice and Private Clinics and Laboratories (Regulation) Ordinance of 1982, the director general of health services has the authority to inspect registered medical practitioners’ chambers, private clinics, hospitals, or pathological laboratories to ensure compliance with the ordinance (Section 11). If violations are found, recommendations can be made to bar practitioners from private practice, revoke licenses of clinics or hospitals, or close pathological laboratories.
Patients’ rights in cases of medical negligence are protected under the Consumer Rights Protection Act of 2009, which defines services, including health services, provided to consumers in exchange for payment (Section 2(22)).
However, despite these legal provisions, challenges persist in effectively implementing and enforcing the laws surrounding medical negligence.
Challenges in the current system
Bangladesh’s current system for confronting medical negligence faces numerous obstacles. First, the Bangladesh Medical and Dental Council (BMDC) suffers from a lack of public confidence, causing many individuals to instead submit complaints to the police. This diminishes the disciplinary committee’s effectiveness and perpetuates the cycle of impunity. Insufficient documentation and evidence from complainants also hinder the progression of cases. Disputes are frequently settled through mediation, further undermining transparency and accountability.
The limited access to justice for victims of medical negligence is another obstacle. Numerous individuals in Bangladesh are discouraged from seeking legal recourse by high legal fees, limited knowledge of their rights, and social stigmas. The absence of legal aid services and support exacerbates these obstacles, leaving victims without sufficient assistance to navigate the complex legal system.
Need for reforms
To effectively address the issue of medical negligence, comprehensive reforms are required. The following measures can help improve patient safety and accountability in Bangladesh:
- Strengthening regulatory bodies: The BMDC needs to be equipped with sufficient resources and authority to conduct comprehensive investigations and take appropriate action against physicians convicted of medical negligence. Establishing public confidence in the regulatory body is essential for achieving transparency and accountability.
- Implementing specific legislation: Implementing a law specifically addressing medical negligence can provide clarity and establish a framework for handling these cases. This legislation should outline the responsibilities of healthcare professionals, define the standards of care, and establish a fair procedure for investigating and prosecuting claims of medical negligence.
- Increasing legal awareness: Efforts to improve the legal literacy of the general populace can enable individuals to assert their rights in cases of medical negligence. Educational campaigns, seminars, and readily available legal aid services can play a crucial role in ensuring that victims comprehend their legal options and can effectively navigate the justice system.
- Establishing medico-legal panels: Collaborative efforts between the medical and legal sectors can expedite the resolution of cases of medical negligence. Medical-legal panels comprised of medical and legal professionals can evaluate cases, offer expert opinions, and expedite the resolution process. This multidisciplinary approach ensures that medical negligence claims are evaluated fairly.
- Improving healthcare infrastructure: It is essential to reduce instances of medical negligence by enhancing healthcare infrastructure and facilities. Investing in training and continuing education for healthcare professionals, ensuring adequate personnel levels, and enhancing the overall quality of healthcare services can contribute significantly to reducing medical errors and patient harm.
To conclude, medical negligence is a systemic issue that requires urgent attention in Bangladesh. Addressing medical negligence in Bangladesh requires strengthening regulatory bodies, enacting specific legislation, and improving healthcare infrastructure to ensure patient safety and restore public trust. Proactive measures and comprehensive reforms are essential for a safer and reliable healthcare environment.