Doctors should not be sent to jail for doing their job. That was the loud and clear message from Indian Medical Association President Dr KK Aggarwal at a leadership meeting in Delhi last Sunday, intended for doctors across the country and the Government.

The immediate trigger for the IMA chief's call is the Gorakhpur tragedy that left over 70 children dead in about three days. The reasons behind the tragedy point to a combination of endemic encephalitis, administrative apathy and corruption leading to a shortage in oxygen cylinders. But among the first heads to roll was that of a doctor, who ironically was feted at one point for procuring oxygen cylinders when BRD Hospital had run out of it.

Doctors are soft targets and they get criminally prosecuted for doing their jobs when there may be an administrative failure, says Aggarwal. Citing the Gorakhpur incident where the nodal doctor was sacked, he says every doctor can then end up having a case against him or her if the hospital they work in does not have enough facilities to treat a patient. This is a misuse of the Indian Penal Code, he says, adding that criminal prosecution of doctors should be an exception rather than the rule.

Drawing a parallel between the Gorakhpur incident and the Haryana violence, both of which resulted in several deaths, he says, “the riot was an administrative failure. But people were transferred and not put behind bars.”

Systemic failure

In a letter to Uttar Pradesh Chief Minister Yogi Adityanath, the Jan Swasthya Abhiyan (JSA) makes a similar point on punishing doctors when there is in fact a huge system failure.

“We are appalled, that far from being appreciated, the one person who appears to have actually done his duty by his patients and even went beyond the call of duty to organise oxygen cylinders; Dr Kafeel Khan (head of the encephalitis ward and an assistant professor), has been victimised and made the scapegoat for this enormous administrative failure. Taking hasty and superficial action against frontline workers has been the routine practice of governments across the country whenever the current policies of systematic disinvestment in public resources erupts in a highly visible tragedy.”

The JSA called on the UP government to “reflect upon the criminally negligent systemic underpinnings of the Gorakhpur tragedy rather than vilify a doctor who has been upheld by the people who were present on those fateful days as possibly the only hero attempting to assist the poor families of dying patients in whatever manner he could. We demand that he be reinstated with respect and that an independent, time bound, enquiry be set up to detail the events leading upto these deaths so that appropriate and urgent action be taken against those truly responsible.”

Dr Aggarwal points to another serious problem where a doctor’s professional ethics could be different from the establishment’s. Referring to hospitals that are run like businesses, with their own considerations on targets and revenue, he says if there is an administrative lapse, administrative action should be taken. “Doctors are just part of the whole chain, he says.

Professional misconduct, he says, is a different issue and is effectively handled by State Medical Councils (SMC).

But can doctors sit in judgment on fellow colleagues, and will that action be fair?

When a complaint is made against a doctor, he says, it is screened by a multi-member committee (Delhi has 20 members, Mumbai 18) to assess the case. Both parties involved are heard and action is taken. There are systems to be followed to keep out corruption and there are suspensions and cancellations of doctors’ licences regularly, he says. The issue can be escalated to a higher authority if required and the Government too can strengthen SMCs if they don’t work effectively.

But if the prevailing hostility continues, Aggarwal cautions, it could lead to doctors having a contract-based relationship with their patients with terms and conditions outlined to safeguard a doctor working in good faith.

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