Threat to life, need for specialised care, reasons we refer patients — Gynaecologist

Professionally, medical practitioners are compelled by the Hippocratic Oath to treat and save the life of any patient that presents for treatment.

However, the media has been replete with stories of patients in dire condition that were turned back by physicians for several reasons.

The code of ethics of the Medical and Dental Council of Nigeria states that a physician shall always bear in mind the obligation of preserving human life. And whenever an examination or treatment is beyond the physician’s capacity, he should summon another physician who has the necessary capability.

“A physician shall give emergency care as a humanitarian duty unless he is assured that others are willing and able to give such care,” the Oath states.

It, however, notes that, “Practitioners shall have absolute discretion and authority, free from unnecessary non-medical interference, in determining when to give their services, the nature of care to be given to a patient under their care and must accept responsibility for their actions.”

Similarly, the American Medical Association’s code of ethics states that physicians have a responsibility “to place patients’ welfare above their own self-interest.”

This is even as it also recognises that doctors are individuals with the right to free choice, stating that they “should have considerable latitude to practise in accord with well-considered, deeply held beliefs that are central to their self-identities.”

While trying to find out reasons a physician might insist on not treating a patient, PUNCH HealthWise learnt that despite joining the medical profession due to a strong desire to help others, certain situations could leave doctors at a crossroads.

For Dr. Kelechi Igbokwe, an obstetrician and gynaecologist in Lagos, rejecting a patient is never an option for any physician.

He notes that what most do is to refer, rather than reject, in order to avert possible loss of lives.

“A patient can be referred from a private hospital to a general or teaching hospital for specialised care,” he adds.

He, however, laments that most people, especially in Nigeria, usually prefer to self-medicate and present very late to the hospital in a very critical state.

“Mostly at this stage, a multidisciplinary approach of management is required to help bring the patient out of the woods.

“Personally, I understand how time is critical to the recovery of a patient, especially during an emergency.

“If it is a case that clearly requires the attention of specialists, I would resuscitate and refer the patient to a teaching hospital.

“However, if the patient is unconscious, I would explain all the possible outcomes to the patient’s relatives if they are around,” he says

The physician says no doctor is superhuman, lamenting that many Nigerians however regard doctors as such.