The case of Dr Hazida Bawa is of importance worldwide in many ways, an opportunity for learning some hard and truthful lessons, as it touched upon various crucial aspects involved in medical treatment, especially in difficult situations. Every one has sympathy for the deceased, but to blame a human factor, doctors should not be presented as sacrificial lambs.
The current verdict is nearer to reality and away from a feeling of revenge and harsher penalties. It gives a hope that now there will be acknowledgement of the difficult circumstances and limitations of medical system in health care environment. To make doctor scapegoat for the system limitations, poor prognosis or severe disease may be satisfying for some but not sensible. In this case doctors lodged their protest, collected money for lawsuit and the decision was re-looked legally. But every doctor may not be lucky enough and may have to suffer in silence.
Real failure in this case will be ignoring the factors that actually cause huge suffering for doctors-
- Presumptive failure by retrospective analysis: Retrospective analysis of any treatment will always show few things at hindsight that could have been done and would have proved life saving. One may presume that omission or commission of certain actions during treatment would have saved the life, but one can’t be sure whether these additional presumed treatment would really have benefited the patient. Therefore a perception-reality gap is created and with negative perception towards doctors, it is interpreted as a failure of doctor merely on presumptive basis and hence declared as negligence. The doctors who deal with life and death know that it is not correct interpretation, and no one can ever be sure of what the real outcome would be. They just do what they think will be most effective for the patient, and it may not eventually turn out to be the best ever.
- Variable interpretation: Same evidence, incidence and circumstances are interpreted and judged differently by people and even courts. Some will say it is negligence and other will say it is not. Some will bay for doctor’s blood and other will not. This variation in perception is not only in minds of lay men but also in the learned courts, who decide differently. At the time of death of patient, a constant and universal last link is only the doctor, that is visible. He is an unfortunate victim, a human factor and blamed for the harm done because of variable thought process.
- Medical knowledge vs wisdom: People who do not treat patients, may be very wise and may acquire medical knowledge by various sources. But medical wisdom comes only after years of medical practice, by observing varied situations and spectrum of diseases. An understanding of what can happen in given circumstances comes only by treating such emergencies. For non doctors, it is very difficult to comprehend the medical complexities and real time scenarios. Even doctors, who do not treat regularly emergency patients, can attribute the harm as doctor’s mistake.
- Feeling of revenge: in case of an adverse event, negative thoughts prevail all over. In present scenario with legal powers with the sufferer and common sentiments against doctors, it is easier to identify and blame some human factors. Adverse outcome is frequently covered by media to create a sensation among masses. Real circumstances can only be felt by doctors but that remains unheard. Harm to patient, media cry and negative sentiments against the service providers creates a sense of revenge in mind of people.
- Doctor’s negligence vs system inadequacy; This visibility of doctor at the time of declaration of death or while treating the patient on his bedside, makes him vulnerable to all kinds of accusations. By application of an average wisdom, all deaths can be easily attributed or linked to fault of the doctor. Subtle presentations of severe disease, rapid deterioration, multi organ complexities, under staffing and sub optimal systems, inadequate equipment and other innumerable shortcomings of the whole system may not be visible or not given consideration in the haze, as compared to publicity and attention given to only doctor’s faults.
A nice summary.