The Hindu Business Line : A call for human touch

CAN doctors insist and wait for money (fees) when death is knocking at the doors of the patient? The obvious answer is recovery of fee can wait - but not death - nor the treatment for trying to save the life.

With that depressing Q&A begins the verdict of Justice M.B. Shah in the Pravat Kumar Mukherjee vs Ruby General Hospital case that came up before the National Consumer Disputes Redressal Commission (NCDRC), New Delhi.

Dateline Kolkata, January 14, 2001, 8.10 am: Sumanta Mukherjee, aged 20, studying B.Tech. second year, was riding his motorcycle and proceeding to attend his tuition when a tramway bus hit him from behind. "Before hitting Sumanta, the bus had already hit one cyclist, Vishwajeet Sardar, and Sumanta was the second victim of the bus. Since the said cyclist was from the humble background, he was taken to National Calcutta Medical College & Hospital which is a Government Hospital."

What about Sumanta? It seems he was conscious after the accident, despite oral and nasal bleeding, and passers-by rushed him to Ruby, a hospital close to the place of the accident. Sumanta had mediclaim cover issued by New India Assurance for Rs 65,000. And one learns from the text of the Commission's order that Sumanta showed the mediclaim certificate which he was carrying in his wallet and promised that the charges for the treatment would be paid and that the hospital should start the treatment.

"Acting on the promise the respondents' hospital started the treatment in its Emergency Room by giving moist oxygen, starting suction and by administering injection deryphyllime, injection lycotin and tetanus toxoid." However, after the treatment began, the doctors presumably insisted upon the immediate payment of Rs 15,000 and threatened to discontinue treatment if the money was not deposited.

Some of the people who had brought the boy to the hospital (and who later on became prosecution witnesses) appealed that the treatment be continued, even as they tried to get in touch with the boy's parents. "The crowd present there also offered to pay Rs 2,000 and to hand over the motorcycle." Poignant, but the doctors were unmoved; "they discontinued the treatment after continuing it for around 45 minutes".

Thereafter, people from the crowd took Sumanta to National Calcutta Medical College and Hospital, which is about 7 to 8 km from Ruby. "Sumanta, however, died on the way and was declared brought dead at the said hospital at 9.10 am."

The sole question that the NCDRC had to consider was whether the doctors in Ruby were deficient in discharge of their duties in not continuing with the treatment after having started giving some treatment to Sumanta. His parents, the appellants in this case, contended that treatment was not continued because of failure on the part of the persons who brought him to the hospital to deposit Rs 15,000. This resulted in denial of treatment and consequential death of the young boy," notes the ruling.

At the Commission, Ruby's counsel argued that there is no law that makes the person injured a consumer of the hospital itself within the meaning of the Consumer Protection Act. Also, that since no consideration was fixed and no amount was received from the complainant, there was no relationship between the deceased and or the complainant with the hospital or doctors and therefore the deceased or his father was not a consumer.

But the Commission rejected that argument as lacking in substance, in the context of the law and duties of doctors: "No doubt, in a society where there is cent per cent commercialisation of each and every walk of the life this submission is cent per cent valid. But, fortunately, we have not reached the stage of 100 per cent commercialisation. We still believe in the ethics of noble profession and duties to the society."

Important cases that the NCDRC cited were of V.P. Shantha and Vasantha P. Nair. Treatment has to be on the same footing irrespective of the fact that some patients pay for the service and others avail of the same free of charge, the court had said. "In our view status of `emergency or critically ill patient' would be same as `persons belonging to poor class'. Both are not in a position to pay - may be for separate reasons," observed the Commission, and cited the Code of Medical Ethics drawn up under Section 33 of the Medical Council Act.

Finally the decision was that the Commission awarded a compensation of Rs 10 lakh to Sumanta's parents "for mental pain and agony".

Justice Shah wished that there be "a qualitative change in the attitude of the hospitals when providing service to the human beings". Human touch is necessary, he emphasised. "That is their code of conduct; that is their duty and that is what is required to be implemented. In emergency or critical cases let them discharge their duty/social obligation of rendering service without waiting for fees or for consent."

E&OE@TheHindu.co.in

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