The news making round on the death of Alhaji Muideen Obanimomo , suspected to have been as a result of the dreaded ‘Coronavirus infection’ has thrown up some medico – legal and ethical issues for consideration.
The fundamental principles of medical ethics are universal though they may be expressed in different languages and jurisdiction. It has the tone of personal benefit. This is to say that the action and inaction of the medical practitioner must produce beneficial results for the patient.
The obligation of preserving the life of the patient is one of such duties stipulated in Rule 8( b) of the Code of Medical ethics in Nigeria 2004. The action of a medical practitioner is to produce beneficial consequences to the society. The Physician’s oath sworn to by medical practitioners during induction as contained in Rule 2′ of the code states among others ” ..to consecrate my life to the service of humanity” .
The practitioner has a duty to promote the health of individuals and society and the common good of all. The Principle of Benevolence in agreement with Rule 11 ( c) ( d)( e) considers it an act of negligence when the practitioner fails to do anything that ought to reasonably have been done under the circumstances of the patient for the good of the patient.
This include failure to refer or transfer the patient in good time when such action was necessary. The principle of honesty requires that practitioners be trust worthy and that they deal honestly with patients and colleagues at all times.
Rule 9( c) requires that practitioners do not practice deceit on either patients or members of the public for official gain or any other motive. The principle of lawfulness demands that practitioners obey the laws of the land. This is provided for in Rule 9( d) of the code.
Employment laws demand that a practitioner is obliged to obey the lawful and reasonable instructions of his employer to whom he must account to. His freedom of medical discretion and clinical judgement must be subject to his employers expectations unless he can prove overriding interest of the patient as reason for his difference in the circumstance.
The worry in the public space is that the patient returned from the United Kingdom where the coronavirus infection has witnessed a wide spread and many deaths.
There is a question on the lips of many; why the remote handling and ensuing denial of public suspicion? Why was there no post mortem test to clear the air on cause of death?
A strong issue of law to consider here is the “duty of confidentiality” and ‘ privacy’. A practitioner owes his patient a duty of confidentiality regarding information gathered in the course of their relationship.
Section 37 of the 1999 constitution as amended provides for the privacy of individuals as a right.
Section 26 of the National health Act 2014, Rule 44 of code of medical ethics provides for privacy and confidentiality in the practitioner’s relationship with the patient even after the death of the patient. However, the above provisions does not portend absolute obligation.
Rule 44 of the Code of Ethics in Nigeria 2008 provides guideline on the practice of confidentiality.
Section 45 of the 1999 Constitution of the Federal Republic of Nigeria provides that a proclamation of the president in times of emergency over rules every law in place in a reasonably democratic system. Protection of public health, public interest and protection of health practitioners and workers are strong reasons to renege the duty of confidentiality.
The questions arising therefore are;
1. Should the duty of privacy and confidentiality be adhered to under the circumstance?
2. Was there a state of health emergency in Kwara state? Was there a public health interest to protect?
3. Was University of Ilorin Teaching Hospital (UITH), the employing institution of Professor Kazeem Alakija who supervised the treatment of the patient satisfied with his clinical conduct of the case.
4. Did Professor Kazeem observe the principle of lawfulness and did he act in good faith?
Patricia Adaku Udechukwu LLM, LB is a Nurse and Legal Practitioner based in Abuja.