INTRODUCTION

Undoubtedly, individuals are prone to sickness and the only place where they get proper treatment is at the hospital. This makes it very important for people to know their rights and privileges and trigger them in a critical health state. Unlike other businesses where consumers negotiate on the price of services, medical care often involve reviving the normal health state of patients which makes it important to have classified ways of dealing with issues that upsurge in the process. The managerial status of a hospital or any medical centre does not prevent patients from enjoying these rights. The rights are codified into various legislative Acts because they cut across all aspects where emergency medical care might be needed. Thus, this article seeks to appraise the inalienable rights of patients under relevant laws in Nigeria.

What Relationship Exists Between A Doctor And A Patient?

The law is fairly settled on the kind of relationship that exists between a doctor and a patient. Rule 28 of the Code of Medical Ethics in Nigeria, 2004 reads:

“Medical practitioners and dental surgeons owe a duty of care to their patients in every professional relationship. The particular skill which training and eventual recognition and registration bestow on a practitioner is to be exercised in a manner expected of any practitioner or any member of the profession of his experience and status. It is required that a practitioner upgrades his skill as best as possible in the light of advancing knowledge in the profession…” 

In light of the above provision, it is settled that medical practitioners owe a duty of care to the patients. In the case of OILSERV LTD V. L. A. IBEANU & COMPANY NIGERIA LTD & ANOR, the Nigerian Court of Appeal held that:

“Duty of care means taking reasonable care to avoid acts/omissions which one can reasonably foresee would be likely to injure his neighbour” PER RHODES- VIVOUR, J.C.A.(As he then was).

In law, the term “neighbour” implies “persons who are so closely and directly affected by one’s act that one ought reasonably to have them in contemplation as being so affected when one is directing his mind to the acts or omissions which are called in question.” This is the position of law as it was restated in the case of MOBIL OIL v. BARBEDOS CARS LTD. Therefore, within professional outreach, a patient can be legally referred to as a doctor’s neighbour with whom lies a duty of care that must be properly dispensed.

In line with the provisions above, patients have rights to a reasonable amount of care within the professional clairvoyance of medical practitioners.

In furtherance, the quality of care expected to be dispensed by doctors to patients is restated in the Patient’s Bill Of Rights. (PBOR), which was developed recently solely for the protection of patients rights. Paragraph 5 of the Bill explains extensively that patients must have:

1. Access to clean, save and secure healthcare environment.

2. Access to equitable quality care and caregivers irrespective of disability.

Right To Emergency Medical Care.

Under section 10 of the National Health Act, individuals have the right to medical treatment in an emergency irrespective of their financial ability. However, free medical attention in an emergency does not give patients rights to waiver the cost of medical services rendered to them. The PBOR reinstate that patients are legally required to “Recognize that emergency treatment or prioritization do not mean a waiver of obligation to pay for services.”

Right To Refuse Medical Care.

Just like the way patients have the right to medical care, they also have the right to refuse medical care. Enshrined in section 23(d) of the National Health Act is the right of patients to refuse medical care in any situation after detailed information must have been given to the patients about their health status. The section reads thus:

“Every health care provider shall give user relevant information pertaining to his state of health and necessary treatment relating to:

(d) The user’s right to refuse health services and explain implication, risks or obligations of refusal.

This position of law was visited in the case of MEDICAL AND DENTAL PRACTITIONERS DISCIPLINARY TRIBUNAL V. DR. JOHN EMEWULU NICHOLAS OKONKWO where the supreme court determined the right of a patient to refuse life-saving medication. The court held that:

“The patient is free to decide whether or not to submit to treatment recommended by the doctor. If the doctor making a balanced judgment that advises the patient to submit to the operation, the patient is entitled to reject the advice for reasons which are rational or irrational or for no reason”. Per Ayoola J.S.C.

However, in any case, where a minor is sick, the parents or guardian assume the position to give consent in place of the child. Although the parents or guardian is ultimately saddled with the responsibility of deciding for the minor, the law is absolutely against any negative decision. For example, in the celebrated case of TEGA ESABUNOR & ANOR v. DR. TUNDE FAWEYA & ORS, the appellant therein ordered that blood transfusion should not be administered for her one-month-old child who was critically ill and was suffering from severe infection and anaemia ( lack of blood) and which subsequently transforms the child’s colour, the child was convulsing and had poor breathing. All in all, the child’s mother bluntly refused blood transfusion for her child. Out of professional curiosity, the doctor brought an action before a competent court and the blood transfusion was later administered on the child. The appellant filed an appeal to the court of appeal and subsequently to the supreme court. The supreme court held that:

“It is instructive to note that the law exists primarily to protect life and preserve the fundamental right of its citizens inclusive of infants. The law would not override the decision of a competent mature adult who refuses medical treatment that may prolong his life but would readily intervene in the case of a child who lacks the competence to make decisions for himself. See the case of Medical And Dental Practitioners Disciplinary Tribunal v. Dr. John Emewulu Nicholas Okonkwo (2001) 7 NWLR (Pt. 711) 206). Note also that the Child’s Right Act, LFN 2003 is replete with judicial powers to ascertain the survival and total well-being of the child. Section 13 of the Act provides particularly for the right to health and health services of the child. Section 13(2) of the Act provides that: “Every Government, parent, guardian, institution, service, agency, organization or body responsible for the care of a child shall endeavour to provide for the child the best attainable state of health:” Section 59(a) provides that: “Where it appears to the Court in proceedings in which a question arises as to the welfare of a child, that it may be appropriate for a care supervision order to be made with respect to that child, the Court may direct the appropriate authority to undertake an investigation of the child’s circumstances.” In the light of the above provisions, I hold the view that it could have amounted to a great injustice to the child if the Court had stood by and watched the child being denied of basic treatment to save his life on the basis of the religious conviction of his parent. He probably would not be alive today(2019). I agree with my learned brother that in a life-threatening situation, such as the 1st Appellant was in as a child, the consideration to save his life by application of blood transfusion greatly outweighs whatever religious beliefs one may hold, especially where the patient is a child.” Per OKORO, J.S.C.

Conclusion

Individuals need to know their legal rights because it is the only way a violation can be acknowledged. It is an irrational presumption that one can fight ignorantly without knowing the cause of the fight. It is therefore relevant for individuals to know their rights so they can seek redress in any pitiful case of violation.

By ADESINA SELIMLLAH ABIMBOLA

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