Those guilty of medical malpractice need to be held accountable

Dear Editor,

I would like to express my outrage at the recent string of maternal deaths in Region Six and other parts of the country. The Ministry of Health is tasked with the responsibility of ensuring that every Guyanese citizen who seeks medical services provided by both public and private institutions receives the best care possible. When these institutions fall below that standard and patients suffer as a result of medical malpractice then persons who are guilty need to be held accountable.

My interaction with mothers who would have utilized public institutions for the delivery of their babies have revealed that some of the nurses that are placed in the maternity wards operate at  standards  far below those expected of persons who operate in such professional capacity. The callous remarks that are directed towards mothers experiencing intense labour pains, eg, “Go and sleep; you too disgusting,” has now become part of the culture of communication in maternity wards. It is not uncommon for some nurses to disregard the doctor’s instructions and do what they think should be done, much to the detriment of the expectant mothers and their families.

It is now well established in criminal law that medical personnel who are guilty of causing death by criminal negligence can be prosecuted on a charge of negligent manslaughter. In the leading case of Adomako (1994) 2 WLR 288 it was established that once a high degree of negligence is displayed by the medical care provider then a conviction will be secured. It is my hope that following the investigations carried out into all the medical deaths in Region Six and other regions, if anyone is found guilty of negligent professional conduct they would be placed before the courts.

The civil justice system also makes provision for the relatives of victims to take legal action against medical institutions and practitioners for medical malpractice. The basic test is whether the defendant conformed to the standard of the ‘reasonable professional.’ It is expected by members of the public who seek medical attention, that medical personnel would display the degree of skill expected from a person in his /her position. In Wilsher v Essex Area Health Authority (1987) QB 730, the Court of Appeal held that doctors were negligent and by a majority, that they must be judged by reference to their position and post in the hospital. It was irrelevant that they were inexperienced, or doing a job that should be done by a specialist, or just grossly overworked.

It must be noted that errors of judgment are often the essence professional negligence, but an error itself is not negligence. The issue in all the cases is whether the error in question, evidenced a failure in professional competence. The House of Lords in Whitehouse v Jordon (1981) WLR 246 condemned the virtual immunity offered to general practitioners for errors of clinical judgment. It was further elaborated that the test of negligence is the standard of the ordinary skilled man exercising or professing to have that special skill. If a surgeon fails to measure up to that standard in any respect he or she would be considered negligent.

It is obvious that any medical professional who would have uttered callous remarks to a mother in serious pain and about to give birth would have fallen way below the medical standard.

Your editorial on October 21 which advocated the need for change in maternal care procedures would have concisely captured what needs to be done to restore confidence in our public health care institutions.

Yours faithfully,
Michael Baird (Jr)