Can Doctors Insist On Payment When Death Knocks At The Door Of The Patients?

Recovery of fee can wait, but not the treatment for trying to save the life, says Dr Suganthi Iyer

The case involves the unfortunate death of a young boy, Sumanta Mukherjee, a student of Electrical Engineering, who was injured in an accident at about 8.00 am in which a bus dashed with the motor cycle driven by the deceased. The death of Sumanta changed the lives of his parents in an irreversible manner; his mother is under constant psychiatric treatment, while his father who is a doctor doing research in medicine has abandoned his research, in which he was actively involved before the death of Sumanta, dealing an immense blow to his profession.

Sumanta, who was conscious after the accident, was taken to Kolkata’s Ruby Hospital, which was about one km from the site of accident. At the time of reaching the Hospital, deceased was conscious and showed the mediclaim certificate and promised them that the charges for the treatment would be paid. Acting on the promise, the Hospital started treatment in its emergency room. However, the Hospital began to insist upon the immediate payment to Rs 15,000, even threatening to discontinue it if the amount was not immediately deposited. Other persons present assured them that the payment would be made as soon as they were able to get in touch with the parents of Sumanta. The crowd present there also offered to pay Rs 2000. The mediclaim certificate issued by the Insurance Company was also showed again and again to the Hospital, which however remained adamant about the immediate deposit of Rs 15,000, thus showing gross deficiency in service in utter violation of medical ethics. They discontinued the treatment after continuing it for around 45 minutes. The crowd was then forced to take late Sumanta to National Calcutta Medical College and Hospital which is about seven to eight kms from the Ruby General Hospital. Sumanta, however, died on the way and was declared brought dead at the said hospital at 9.10 am.

The complainant, i.e the father, filed a petition against the Hospital claiming compensation of Rs 1,34,60,000 for the damages caused to the complainants due to deficiency in service on behalf of the Hospital.

In the wake of facts, the preliminary contention raised was, whether the father of the deceased or the deceased can be regarded as a ‘consumer’? ‘Consumer’ means any person who hires or avails of any services for a consideration which has been paid or promised or partly paid and partly promised, or under any system of deferred payment and includes any beneficiary of such services other than the person who hires or avails of the services for consideration paid or promised, or partly paid and partly promised, or under any system of deferred payment, when such services are availed of which the approval of the first mentioned person, but does not include a person who avails of such services for any commercial purpose.

As per Indian Medical Association vs V P Shantha & Others, the expenses incurred for providing free service to the poor are met out of the income from the service rendered to the paying patients. Hence, service rendered by such doctors and hospitals undoubtedly falls within the ambit of Section 2 (1) (0) of the Act.

Keeping the aforesaid principles and the facts of the present case in mind, admittedly, apart from registration fee, hospital charges, diagnostic charges, etc. from some patients and to some patients free of charge treatment is given. Free services would also be ‘services’ and the recipient would be a consumer under the Act. “Emergency of critically ill” persons, are the beneficiaries of the service which is hired or availed by the paying class.

Parmanand Katara Vs Union of India and Others, AIR 1989 SC 2039, states wherein as per the Article 32, the Court pertinently observed that preservation of human life is of paramount importance. That is on account of the fact that once life is lost, the status quo ante cannot be restored as resurrection is beyond the capacity of man. Therefore, injured citizen brought for medical treatment should be instantaneously given medical aid to preserve life.

Obligations To The Sick

Though a physician is not bound to treat each and every one asking his services, except in emergencies for the sake of humanity and the noble traditions of the profession, he should not only be ever ready to respond to the calls of the sick and the injured, but should be mindful of the high character of his mission and the responsibility he incurs in the discharge of this ministrations. He should never forget that the health and the lives of those entrusted to his care depend on his skill and attention.

Patient Must Not Be Neglected

A physician is free to choose whom he will serve. He should, however, respond to any request for his assistance in an emergency. Once having undertaken a case, the physician should not neglect the patient, nor should he withdraw from the case.

Sumanta’s Case

Deficiency in service on the part of the Hospital is apparent in Sumanta’s Case. The Hospital admitted that it has charitable beds in Mother Teresa Charitable Ward and that it does benevolent activities to the community at large. There was no necessity of withdrawing the medical aid, which was started by doctors. It cannot be disputed that there was emergency. It was for the doctors to try to save the life of a young boy. Instantaneous medical help might have preserved Sumanta’s life.

In a critical case, where the close relative of the patient is not available, it becomes the duty of such physician or surgeon to be mindful of the high character of his mission and the responsibility in the discharge of his duties.

In such cases, the life is in the hands of the doctor. Also waiting for consent of the patient or a passer-by, who brought the patient in the hospital is nothing but absurd and is apparent failure of duty on the part of the doctors who were discharging their duties at the said time. In such cases, consent is not inevitable.

In the present case, the withdrawal of the treatment started cannot be justified on any ground. The treatment was discontinued, as they were not in a position to deposit Rs 15,000.

Once treatment is started, it means the complainant has hired the services. It is not merely the alleged harm but also the quality of conduct committed by the Hospital upon which attention is required to be founded in a case of proven negligence.

From the aforesaid set of circumstances, it can be held that doctors on duty failed to do what a prudent and reasonable doctor was expected to do in such situations.

Hence, Rs 10 lakh was awarded to the relative for deficiency of service.

The writer is Assistant Medical Director, P D Hinduja Hospital, Mumbai. Email:drsiyerin@yahoo.co.in