Medical emergencies: Examining citizens’ right to treatment

It is a common occurrence in Nigeria’s healthcare establishments for victims of emergencies to be denied treatment for inability to provide a police report or failure to be accompanied by necessary reports from other security agents.

Some of the healthcare providers flagrantly disregard the sanctity of life and often watch victims creeping to death on grounds that a police report is not provided.

Many hospitals in the country have imbibed the old tradition of usually turning down victims of emergencies on account of the failure of the people who brought them to the hospital to produce a police report without making effort to update themselves on the current laws.

The practice of rejection of emergency cases is not only limited to gunshot injuries but instances of severe accidents and even lack of money to pay to commence treatment by an emergency victim.

The healthcare providers, base their arguments for refusing emergency treatment on the suspicion that a patient might actually be an armed robber or offender shot by police and not truly a victim of a stray bullet.

Aondo

The more worrisome, according to industry watchers, is the instance where patients who are not able to pay in advance or deposit a fraction of the bill are denied treatment by healthcare providers, including in government-owned facilities.

However, the opinion or argument advanced by healthcare givers, according to experts, is weak, considering the need to preserve life. Whether the victim is a crime suspect or not, the fellow deserves to first stay alive through emergency treatment, before eventually facing the due process of the law, if that be the case.

They argued that it is imperative for healthcare providers to first save a life before investigating the cause of wounds. Commentators believe that the victims are denied emergency treatment mostly due to ignorance from both parties.

Lawyers said some victims and or their families would have won millions of naira worth of lawsuits against healthcare providers or establishments, if only they were aware of the right to emergency treatment.

They contended that if only healthcare providers knew that mere denial of emergency treatment carries a fine or imprisonment or both, they would have been more careful and most reluctant to deny patients the right to emergency treatment. It is obvious that they are majorly unaware of the law that says emergency treatment should not be denied for whatever reason.

Compulsory Treatment and Care for Victims of Gunshot Act 2017, states that any person who contravenes the law is guilty of an offence and is liable on conviction to a fine of N100,000 or imprisonment for a period not exceeding six months or both.

An Abuja-based lawyer, Akamihe Ephraim said the Act provides that every Hospital, public or private, shall offer treatment, with or without police clearance, with or without monetary deposit of persons with gunshot wounds, and criminalises contravention.

According to him, this is to prevent Nigerians from dying, especially from gunshot wounds. He explained that the law authorises medical practitioners to treat persons with gunshot wounds first before making any report to the Police. The purpose of the law is to save lives and to prevent the innocent from dying in a bid to get a Police report before treatment.

Ephraim said it is therefore improper for any law enforcement agency to insist on a doctor obtaining a Police report before treating a patient, adding that no doctor also has the right to insist on that before commencing treatment on victims of medical emergencies. According to him, anyone that does that incurs criminal liability.

He, however, explained that doctors are required to make such reports after treatment to protect themselves from being accused, as accomplices should such a patient turn out to be a criminal.

He said the penalties under the Act include that any hospital that fails to make a report, commits an offence and is liable on conviction to a fine of N100,000 and every doctor directly concerned is equally liable on conviction to a term of six months or a fine of N100,000 or both.

A person who commits an offence under this Act, which leads to or causes substantial physical, mental, emotional and psychological damage to the victim, he said, commits an offence and is liable to imprisonment for a term of not more than 15 years and not less than five years without an option of fine.

“Any person or authority including any police officer or other security agent, who stand by and fails to perform his duty under this Act, which results in the unnecessary death of any person with gunshot wounds commits an offence and is liable on conviction to a fine of N500,000 or imprisonment for a term of five years or both,” he cited.

A Lagos-based legal practitioner, Paul Mgbeoma said the section that requires police to permit before emergency treatment has been removed by the Nation Health Insurance Act (NHIA).

The lawyer explained that the right of an emergency victim to hospital facilities and treatment during an emergency has been codified by necessary laws like the NHIA, particularly in section 20.

He said the law puts obligations on health workers, health managers and establishments to treat cases of emergencies, first without conditions and that, particularly Section 20 (2) of the NHIA stipulates punishment for those who violate the law.

The lawyer, however, said while the stipulated punishment may not be sufficient, it is a good start at the moment, hoping for a better improvement.

Another lawyer, Jerry Aondo said that Section 33 of the Constitution of Nigeria 1999 (as amended) guarantees the right to life to every citizen.

Citing that section 33, the lawyer said, “every person has a right to life and no one shall be deprived intentionally of his life, save in execution of the sentence of a court in respect of a criminal offence of which he has been guilty in Nigeria.”

He stressed that life is an inalienable right given to man by God the creator himself. This right, he maintained, is available to all against all, whether it be state, corporate or private individuals.

“The right to one’s life is the most important, principally because life is everything and stands at the very root of human existence,” he emphasised.

Aondo submitted that it is therefore a violation of the Constitution to deprive any person intentionally of his life by refusing him access to treatment, which he highly deserves by the very fact that he is a citizen of Nigeria.

“Hence anybody that deprives another of such right will be in breach of the hallowed provision of Section 33 of the 1999 Constitution (as altered),” stated.

According to him, it is absurd for hospitals to demand a police report before treating victims of medical emergencies. This, he said, has caused a lot of lives to be lost almost on a daily basis as a result of a lack of access to Emergency Medical Service (EMS).

He said, both the state, institutions, as well as private individuals owe it as a duty and are under obligation to protect and observe the sanctity of the life of a citizen.

By the fundamental objectives and directives of state policy, the state government is supposed to make available a conducive atmosphere for the enjoyment of citizen’s life.

His words: “These include the provision of basic amenities as well as making appropriate legal framework to enable the enjoyment of these rights, which include guaranteeing rights to access emergency medical treatment.

“It is therefore a violation of the right of the individual to place a hindrance on his right to life by asking him to produce police approval, report or whatever before he can access treatment. These requirements are clogs in the right to access medical treatment and by extension, a clog to his right to life guaranteed by the Constitution and are therefore unconstitutional.

“National Health Act, 2014, in Section 20 (1) makes it a criminal offence for any hospital or health facility to demand a police report before attending to medical emergencies. Similarly, the Compulsory Treatment and Care for Victims of Gun Act 2017 makes it compulsory for hospitals to attend and treat accidents and Gun Victims,” the lawyer stated.

He added that it is sad to state that amidst all these legal frameworks, the Nigeria Police in clandestine and commando-style keep raiding hospitals and clinics to harass medical workers that treat emergencies like accidents and gunshot victims. He submitted that the law has made provision for an elaborate legal framework to outlaw such practice.

“It is highly recommended that all hands need to be on deck to end this ugly trend. Ministries of the health of the Federal and State Governments should collaborate to uphold the law and other far-reaching aspects of the Act, to improve healthcare delivery. Also, the Medical Association of Nigeria (NMA), Nigeria Bar Association (NBA), Medical and Dental Association and others must work together to end this ugly trend,” he charged.