Medical negligence: When does it become a criminal matter?

Health is a crucial asset for human existence. The relationship between health care providers and patients is one built on trust, with an inherent expectation that medical practitioners will act in the best interest of their patients. Therefore, when a person visits the hospital for medical checkup, diagnosis, treatment, surgery and other purposes, the medical practitioner assigned to care for a patient is to act and carry out his duties as he ought to because there is a measure of care which the medical practitioner has a duty to uphold.

This duty, ethically and legally, is usually referred to as Duty of Care. And where the medical practitioner in the course of carrying out his duties, performs below the standard required of him performs below the standard required of him or omits acting accordingly, it can be said that the medical practitioner has breached the Duty of Care.

Breach of duty of care often arises in cases of harm to a patient which results in physical or psychological damage prompted by the medical practitioner’s failure to uphold the degree of care that a reasonably competent and skilled medical professional, who has a comparable background and practices in the same medical community, would have given to a patient under the same set of circumstances.

When a doctor, medical personnel, or healthcare institution engenders harm to a patient by failing to uphold the standard of care deemed necessary when supervising, diagnosing, or treating a patient, the implications of the act or omissions of negligence on the lives of the patients often ranges in severity.

However, they can have severe consequences, including the loss of limbs, worsened health conditions, development of new health complications, psychological issues are often subsequently developed. The life of the victim tends to be negatively altered due to the negligence of the medical practitioner.

However, this delicate balance can be disrupted when a patient suffers harm as a result of breach of duty of care which may in turn trigger questions of legal liability.

There are many issues that may be termed medical errors that constitute negligence are. Examples include using the incorrect type or dosage of anesthetic during surgery, ignoring certain signs during childbirth; for example, where a C-section is needed in the process of natural birth but the doctor fails to notice the signs, leaving an existing chronic condition like heart disease undiagnosed, post-surgical negligence, prescribing wrong medications to patients or retention of objects in operation site.

Basically, medical negligence occurs when a healthcare professional fails to provide the standard of care expected in their field, resulting in harm or injury to a patient. This legal concept is a fundamental part of medical malpractice claims, which allow injured patients to seek compensation for damages caused by a provider’s mistakes.

Element of duty of care

The duty of care exists because of the relationship between a doctor and patient. Once this relationship has been established by the doctor accepting the patient to be under his care, the following duties are automatically established:

Duty to exercise caution when applying the knowledge and skill expected of a reasonably competent physician, duty to possess the skills necessary for a reasonably competent health care practitioner engaged in the same specialty.

There is also the duty to possess the medical knowledge required of a reasonably competent medical practitioner engaged in the same specialty, duty to exercise the same level of care as would be expected of a practitioner in the same medical field who is reasonably competent and duty to treat a patient, as well as to inform a patient of the pros and cons of a particular treatment.

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Others include duty to duly inform a patient of everything he needs to know concerning his treatment or sickness, such as his diagnosis, seriousness of his treatment, and the risk of such treatment, duty to obtain patient’s free and informed consent. This can be achieved only by providing the necessary information to a patient and attending to the patient’s questions. The duty to get the consent of patients is a continuous process and duty to respect patient confidentiality which can also be called the duty of professional secrecy. Patient confidentiality refers to the information given out to the practitioner by the patient, as well as discoveries made by the medical practitioner in the course of treatment of the patient.

Proving medical negligence

There are particular factors that must be proved to successfully claim medical negligence; the person making allegations must establish that a doctor-patient relationship existed that necessitated a duty of care.

It must be proved that the provider breached the standard of care expected in their medical field and the breach caused harm to the patient.

Also, it must be proved that the patient suffered damages, such as medical expenses, lost wages, or pain and suffering among others.

Legal framework for medical negligence

There are ethical and legal consequences for Medical Negligence in Nigeria’s Healthcare system. And this is guided by a variety of rules which include the Constitution of Nigeria, Medical and Dental Practitioners Act, Rules of Professional Conduct, The Nigerian Criminal Code, The Nigerian Penal Code, and Evidence Act, as well as other secondary sources

The basic piece of legislation governing the medical industry in Nigeria is the Medical and Dental Practitioners Act (the Act) of 2004. It provides for the establishment of The Medical and Dental Council of Nigeria (MDCN), which manages the registration of medical and dental professionals. The MDCN codified the standards of professional conduct for medical and dental practitioners in its Code of Medical Ethics in Nigeria, 2008, in order to fulfil its statutory obligations under the Act. The authorized medical and dental practices in Nigeria are outlined in this code.

The Medical and Dental Practitioners Disciplinary Tribunal and the Medical and Dental Practitioners Investigating Panel were also established under the Act. When charges of infamous conduct in a professional capacity are made against a medical professional, the Panel is tasked with conducting preliminary inquiries into those claims.

If the Panel determines that the allegations are true, it then refers the case to the Tribunal for a trial.

Determining liability in medical negligence

The question of liability would arise when the medical professional did not carry out his responsibility as expected. The victims of medical malpractice may file a complaint under criminal law, bring a lawsuit for a civil violation, or use the Act’s complaint process.

It is said that a doctor is not guilty of negligence if he has acted in accordance with a practice accepted as proper by a responsible body of medical men skilled in that particular art. Basically, a medical practitioner is not deemed negligent if he is acting in accordance with established practice.

Medical negligence can be regarded as a crime when the negligence or misconduct of the medical practitioner amounts to grave circumstances such as the death of the victim, permanent disability, loss of a limb or limbs, etc.

The Criminal Code and the Penal Code are the two codes that regulate criminal liability in Nigeria. The Criminal Code regulates criminal conduct in the Southern Region while Penal Code regulates criminal conduct in the Northern Region.

Section 303 of the Criminal Code provides that there is a duty on persons doing a dangerous act such as administering surgical and medical treatment and their responsibility for the consequences that may result to the life or health of any person by reason of any omission to observe or perform that duty. The Section does not by itself create an offence but creates a duty where it would have been doubtful whether or not one existed in criminal law.

It establishes liability for consequences of the breach of that duty. In circumstances where it is applicable, it makes negligence the basis of criminal liability for offences against the person (excluding murder) where the need to establish intention, knowledge and such mental elements as the basis of liability would have been required.

In other circumstances, the medical professional may not be held responsible as long as he acts in good faith and uses reasonable caution in performing his obligations.

Civil liability in medical negligence

A civil action is a lawsuit filed by a private person against another private person. Usually, this action seeks monetary compensation for damages resulting in injury or loss alleged to be caused by the defendant. A defendant who loses in a civil action does not face the risk of prison or fines, like in criminal court. A person found liable in a civil action, upon a verdict in favor of the plaintiff, must pay whatever monetary damages the jury (or sometimes the judge) awards to the plaintiff.

When a medical practitioner is involved in medical malpractice that causes injury or death to the patient, the patient or family of the patient (in a case where the malpractice leads to the death of the patient), can pursue a civil claim against the medical practitioner. To be eligible for damages, the patient must prove that the doctor had a responsibility to the patient, that the required level of care given fell short of basic acceptable standards, that the harm is compensable and that the patient’s harm was brought on by the breach of the standard of care.

Medical negligence or medical malpractice?

Medical negligence and medical malpractice are closely related but have distinct legal meanings. Medical negligence refers to unintentional errors or lapses in judgment by healthcare providers while medical malpractice, on the other hand, occurs when negligence leads to harm and a patient files a legal claim.

While negligence is a mistake, malpractice involves harm where the patient must suffer injuries as a direct result of the negligence.

And while it is almost certain that medical practice will occasionally result in situations in which patients suffer harm or injury while receiving treatment from medical practitioners, it can be deduced that a doctor can be held liable only if the failure of treatment is due to his negligence.

When a medical practitioner’s criminal liability arises, the criminal code and penal code that govern criminal matters in Nigeria will be referred to, while the patient must be able to prove certain elements to be eligible for civil liability damages

Medical negligence is a serious issue that can lead to devastating consequences for patients. While not every medical error results in a lawsuit, victims who suffer harm due to a provider’s negligence may be entitled to compensation.