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Questions that linger after the pyre has crackled off

D. Murali

A FEW days back, it was reported that the apex court has held that a doctor will not be criminally liable if a patient dies due to an error of judgment or carelessness or for want of due caution though he can be liable to pay compensation. Too disheartened to get myself to read the complete text of the judgment, I sit back to think of what happened about a fortnight ago.

That evening, when I returned home at the end of one more workday, there was this message from an old friend who'd called from Noida to tell me that his aged sister was admitted for surgery in a hospital just a furlong from where I reside, and that he was desperately trying to get an update.

Within minutes I go there, find the ward, meet the patient's daughter attending on her, visit the patient herself, tell her about her brother's fond enquiries - and she smiles to acknowledge - and I leave after learning that surgery is over for piles and removal of uterus, and the daughter tells me that there's nothing to worry.

I return to call my friend and give him the numbers: "You can speak right now, before she sleeps off," I advised.

Little things, but it gives great satisfaction to have been of use to somebody even if playing a mere postman, and so I have a good night's sleep, only to be woken up early morning by a call from my friend to say, that his sister died at 2.30 a.m. Dazed, I go to the daughter's place in Thiruvanmiyur where the body is kept, unable to reconcile to the fact that she was awake and smiling only hours ago, and that perhaps I was one of her last visitors before she took the train to a different world.

I am told that the hospital helped in getting the surgeon to come in the wee hours if only to confirm there was no hope, but he had waived his fee; they even assisted in getting ice-box, ambulance and so on.

Weeks have gone by, ashes must have blown off, and ceremonies are over. Only questions remain. Was the operation done properly? How can you prove that it was otherwise? Were two surgeries too much for the patient's age? Should one go into the cause of death? Or, are these things we'll never get to know? Is a fee waiver by the surgeon the right remedy for a goofed up surgical procedure? Has our medicare system become a black hole that sucks in money and delivers its product in body bags?

The story goes that when Kisa Gautami asked Gautama Buddha to revive her dead child, he sends her away asking her to fetch sesame seeds from a house that has seen no death. Gautami, of course, returned with an empty hand. But she had learnt that no one escapes death and that there is no return from death. Likewise, almost every family has a tale of woe about how they felt betrayed by the healthcare system, be it in the form of wrong diagnosis, delayed attention or fatal errors.

With due respect to the court, one tends to wonder how a common man would be able to prove a standard of negligence so high as could be described as gross negligence or recklessness. Because a careless act of a medical man can be termed criminal only when he or she exhibits a gross lack of competence or inaction and wanton indifference to his patient's safety and which is found to have arisen from gross ignorance or gross negligence; and that where a patient's death results merely from an error of judgment or accident, no criminal liability should be attached to it.

"Mere inadvertence or some degree of want of adequate care and caution might create civil liability but would not suffice to hold him criminally liable." Sitting outside the operation theatre, you'd never know, and even thereafter, you're not going to open the sutures to check if everything was done okay.

It's a rainy and windy day, once again, and I can see some more ashes flying off.

On the subject of last week's E&OE, it's heartening to note that the column triggered off action in the Ministry of Petroleum, so much so that a press meet has been scheduled for Tuesday to explain "the pricing structure of various petroleum products."

So, watch this space!

E&OE@thehindu.co.in

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