1.1 Background to the Study
Attention over healthcare issues has been received as health and human life have great universal value. Indeed the medical profession is considered a noble profession because it helps in preserving life. In the healthcare sector of developed countries, patient rights are of major priority. Typically, patients want excellent, caring and cost effective treatment, with their confidentiality respected and their dignity preserved. It is the expectation of patients that their physicians would be competent, humane, and efficiently able to detect diagnoses and address their overall healthcare needs. Regrettably, healthcare providers are notoriously known for not always meeting these expectations Madhukar & Shobha (2009).
Before in Nigeria, there was minimal awareness amongst the populace that there were laws regulating the delivery of medical services by medical professionals. This is no longer the case as globalization has occasioned an increased awareness of the rights of patients and the duty of care imposed by the law on those in the medical field in the course of performing their duties. Over the past few years, there have been published news reports of cases of physical harm and deaths occurring as a result of the negligence of doctors, nurses, pharmacists, dentists, laboratory technologists and technicians, anesthetists, ward attendants, and hospitals Titilayo Ojo (2018). Many Nigerians have been sent to an early grave as a result of the professional ineptitude and wanton disregard for human life exhibited by some medical practitioners.
In addition, the high rate of poverty in Nigeria has prompted many to seek the services of quack doctors. The decline in the economy has also led to an increase in the distribution and sale of sub-standard and expired medication by those in the pharmaceutical field. At the same time, the desire of some doctors, physicians and hospital managements to meet up with their financial obligations have led them resort to devious and unprofessional practices and this has had the consequent effect of causing harm to unsuspecting patients. The fact that most of the medical malpractice cases go unreported and very few are recounted in the media has further aggravated the situation Olutoye Oluyinka, (2016).
On the other hand, there are those who attribute the culpability for the rise in deaths caused by medical negligence to the government by citing the deplorable state of Nigeria’s healthcare infrastructure and the government’s unwillingness to improve it. The number of harm and death occasioned by the negligence of those in the medical field of practice has led many to question the legal mechanisms that are in place for addressing this rising epidemic. This study aims to examine some issues that may instigate the filing of medical malpractice lawsuits and critically appraise the position of our laws (civil and criminal) in combating the prevalence of medical negligence. This is necessary in order to engender compensatory and punitive sanctions against medical practitioners, who as a result of negligence have caused harm to their patients. The effectiveness of these punitive and compensatory sanctions will also be examined in terms of its capacity to deter medical negligence and its overall effect on the delivery of medical services in Nigeria. Additionally, few cases of medical negligence in Nigeria will be appraised.
1.2 Statement of the Problem
Nigeria being the most populous country in Africa with an estimated population of 160 million carries 10% of the global burden of disease and is noted to have some of the worst health indicators in the world Samuel (Ujewe, 2013). Two-thirds of the Nigerian population lives in poverty (below one- dollar-per-day) (Kanu, 2017) and also lack adequate access to basic healthcare. Those who, as a result of good fortune, have had the means to access basic healthcare at one time or another have had negative experiences with the service that they received. Indeed in Nigeria, most individuals from birth till death have had a firsthand experience of the deplorable state of care afforded by our healthcare system.
Over times, publicised reports of harm incurred by patients as a result of the negligent care provided by medical practitioners have raised public concerns about the state of our nation’s healthcare system. In the past, Nigerians have always had a rather lethargic attitude towards issues of malpractice by medical practitioners often resigning it to an “act of God” or “the work of the devil”. This is no longer the case as in recent years, due to the development of the Internet age and the globalization of information dissemination; cases of wrongful deaths occasioned by medical negligence have received both domestic and global attention.
Generally, the medical profession has been self-regulatory from time immemorial and research on the worldwide history of medical practice reveals that it has been characterized by malpractice for almost as long its existence (Yohanna Dangata, 2012). Lack of official records in Nigeria that identify the number of harms and deaths that have occurred as a result of medical malpractice has fostered unaccountability and apathy within the medical field and amongst medical practitioners. This comes as no surprise as till date most hospitals in Nigeria still manually record information and data of patients, including birth and death registration. In developing countries, most hospitals (private and public) have yet to adopt the use of computerized information collection and storage, which is the practice in developed countries (World Health Organization, 2019).
The rise in publicized cases of medical negligence and increasing patient awareness of their rights and entitlements as it relates to the delivery of medical services has motivated an increase in the number of lawsuits instituted against private and public healthcare providers. Few cases have been filed against medical quacks because typically, those who patronize these individuals are those who live below the poverty line and who unfortunately are ignorant of their rights as it relates to any ensuing harm they may suffer as a result of engaging these individuals. In a small number of cases, successful lawsuits against medical practitioners have caused compensatory payments to be made to patients and families of patients. In fewer cases, sanctions have been imposed upon these medical practitioners such as suspension from medical practice or in cases of extreme malpractice; removal from the register of doctors (Osanyin La-Olu, 2016).
Despite the measured development in medical malpractice litigation in Nigeria, the disposition of the law and indeed our legal system on cases on medical negligence remains ambiguous. Notable issues such as the burden of proving malpractice claims and inadequate laws that combat the prevalence of medical negligence have been identified as major obstacles to the development of the jurisprudence in this area. Consequently this study seeks to give an appraisal on medical negligence in Nigeria by using University of Nigeria Teaching Hospital, Enugu as a case study.
1.3 Objectives of the Study
The objective of this study is to give an appraisal on medical negligence in Nigeria by using University of Nigeria Teaching Hospital, Enugu as a case study. However, the specific objectives are:
i) To understand the different forms of medical negligence among medical practitioners
ii) To examine the consequences of medical negligence by medical practitioners
iii) To study the different damages awarded to medical negligence
1.4 Research Questions
The following questions were generated during the course of this study:
i) What are the different forms of medical negligence among medical practitioners?
ii) What are the consequences of medical negligence by medical practitioners?
iii) What are the different damages awarded to medical negligence?
1.5 Significance of the Study
This study will be of great significant to the medical professionals who have defaulted in carrying out their duties to their patients. Also, it will enlighten Nigerians on their rights and the need for them to seek redress once these rights have been infringed upon.
1.6 Scope of the Study
This study focuses mainly on medical negligence in the health care system in Nigeria. An extensive writing will be made on the topic medical negligence and the consequences of this action among medical practitioners. It will however be carried out among the staff and patients at University of Nigeria Teaching Hospital, Enugu.
1.7 Limitations of the Study
The time frame was not enough for the researcher to delve into the issue as comprehensively as would have been desired. This also informed the decision to focus on one hospital so the time would be invested in identifying and evaluating all possible aspects of the subject matter so as to make the study as comprehensive as possible. The use of a case study arguably has many limitations, however it allows for a level of research that was commensurate with the nature of results expected.