Is there a doctor in the house?

The recent actions of the doctors in Rajshahi tell us once again to think about the medical profession in a different way. It is really naive to think the medical profession is still a service and not a business. In fact, in Bangladesh, it is more than just business.

Medical services at the government and privately-run hospitals and clinics in the city came to a complete halt as doctors went on an indefinite strike on the morning of March 28, to protest the court order that sent a doctor, also the owner of a clinic, to jail. Seven organisations, including Bangladesh Medical association of Rajshahi Medical College Hospital (RMCH), BMA, and Swadhinata Chikitshak Parishad, announced the strike earlier on Thursday during a press briefing, demanding the release of Dr Samiul Haque Shimul, owner of Dolphin Clinic.

On Thursday Rajshahi’s chief metropolitan magistrate sent Dr Samiul Haque Shimul to jail after rejecting his bail petition in a case filed in connection with the death of a patient in his clinic. During the press briefing, doctors threatened that medical services at all the public and private hospitals and clinics in the city would remain suspended, and that doctors would abstain from their duties until Dr Shimul was released; and they did just so. The sudden strike threw thousands of patients into incalculable suffering.

The medical profession long ago turned into a profit-minded venture for most healthcare providers in Bangladesh. But the Rajshahi incident exposed another face of the people who take an oath to serve humanity. The medical profession is seen as a noble one because it helps in preserving life.

When a patient approaches a doctor he/she expects medical treatment with all the knowledge and skill that the doctor possesses to bring relief to any medical problems he/she has. A doctor owes certain duties to the patient and a breach of any of these duties gives a cause of action for negligence against the doctor.

A doctor may not be in a position to save his patient’s life at all times, but he is expected to use his special knowledge, skill, and positive manner in the most appropriate ways, keeping in mind that the patient has entrusted his life to him.

Receiving medical attention from doctors and hospitals is essentially a right for the patient. The relationship takes the shape of a contract to some extent because of informed consent, payment of fees, and performance of surgery/providing treatment, etc.

A doctor or a clinic usually works in three areas for a patient, which are: (a) Duty of care in deciding whether to undertake the case; (b) duty of care in deciding what treatment to give; and (c) duty of care in the administration of that treatment.

A breach of any of the above may give cause of action to be taken for negligence. If we explore the Rajshahi incident, we see that Dr Shimul failed in all three of the areas.

But the strike called by the doctors to free Dr Shimul, depriving patients of the right to treatment, was a serious offence on their part. We understand that the doctors sacrificed all the values that the “noble profession” possesses. If Dr Shimul is charged for active negligence, his doctor colleagues, who went for total strike to have him released, can be charged for a number of other types of negligence, such as collateral negligence, comparative negligence, concurrent negligence, continued negligence, criminal negligence, gross negligence, and hazardous negligence.

Every doctor takes on a duty to act with a reasonable degree of honesty, care, and skill. This is what is known as “implied undertaking” by a member of the medical profession that he would use a fair, reasonable and competent degree of skill. This is a sort of promise that in any situation, a doctor’s first duty is to look out for the patient, not for the community or individual interests. But what did the doctors in Rajshahi do?

Perhaps they deliberately want to forget the basic philosophy of this profession. This is one of the oldest professions in the world, and definitely the most humanitarian one. Do they really understand that there is no better service than to serve the suffering, the wounded, and the sick? Surprisingly, top leaders of the medical community remained silent when Rajshahi patients were suffering grievously.

For every profession there is a code of conduct, containing the basic ethics that underline the moral values to govern the professional practice. Code of ethics is aimed at upholding its dignity. Medical ethics underlines the values at the heart of the relationship between a doctor and the patient. But the politicisation of the profession has made the professional too ruthless and cruel these days. The doctors in Rajshahi have proven that the community has developed a tendency to forget that self-regulation, which is at the heart of their profession, is a privilege and not a right.

They are promise-bound to provide a good, competent, and accountable service to the public, not to act like militant trade union activists. They need to change their attitudes if they want genuine respect from the people. Doctors themselves have to build that trust in the public’s mind. If they continue to ignore their own profession’s uniqueness, this dignified profession will lose its true value.