Sensationalization of a tragedy and criminalization of a doctor
“Hospital declares live baby dead” screamed headlines. Two doctors have had their services terminated by the hospital trying to pin the blame on a scapegoat after the media trial. What was ignored in the media circus was that the so called baby by definition was not a baby. Yes it was a product of conception but one which was delivered due to premature labour at 22 weeks of gestation. Maybe technology could have been used to save one baby but the cost of about 2-3 months of advanced neonatal ICU care as would be needed with a less than 10 % chance of survival if at all would have crossed the 50 lacs estimate given without any significant chances of survival. This is also not taking into consideration that such a premature fetus even if taken to viability in intensive care would probably suffer from neurological damage needing lifelong help.
Even brain dead patients are known to occasionally show movements and spinal reflexes. This would not justify their prolonged ventilatory support and corresponding medical bills if brainstem reflexes are absent. But then there is hardly any need for our super intelligent media to stop and ask intelligent questions. The grey zone is exceedingly difficult one for the doctors. If they aggressively choose to treat such foetuses they would be accused of being greedy. If they discard them despite minimal signs of life then they have declared a living being dead. By this definition the GOI limit for permissible time till which abortion can be conducted which is now proposed to be 24 weeks would make all doctors who conduct these abortions into murderers. Even when abortion is conducted at less than 20 weeks the fetus shows some movements and gasps. Should then these products not be discarded but aggressively treated ?
We are a resource poor country. Dedicating humungous efforts and resources to a single fetus whose survival is bleak due to extreme prematurity would deprive others of the same resources where they may give better results. Callous though it seems that a life is being discarded, these are among the many facts of life and ethical dilemmas which doctors face day in and day out. The same may be presented in screaming headlines as callous and indifferent attitude of doctors but the same press would next day be baying for blood of the doctor who presents bill for keeping such foetuses on ventilators only to declare them dead after few days.
Other interesting aspect is the FIR has been registered under Section 308 IPC within 24 hrs. Obviously no medical boards opinion was taken in this high profile media circus to determine the negligence before filing the FIR. Jacob Mathew Judgment of Supreme Court and guidelines issued in it to police may as well have been non existent. The doctors have been summarily terminated from service. New guidelines should be issued immediately where all products of abortion which show any sign of life should be kept in neonatal ICUs and treated aggressively.
It is the undue adverse publicity to an incident like this which will result in doctors becoming overcautious even when declaring someone dead. The cost of the EEG, ECG, Brain scan and other tests on all dead bodies would then be objected to and violence resorted to.
Dr Neeraj Nagpal
Convenor,Medicos Legal Action Group, Managing Director MLAG Indemnity,
Ex President IMA Chandigarh
Director Hope Gastrointestinal Diagnostic Clinic,
1184, Sector 21 B Chandigarh
09316517176 , 9814013735
0172; 4633735, 2707935, 2706024, 5087794
For Contributions; "Medicos Legal Action Group" Ac No 499601010036479 IFSC code UBIN0549967 Union Bank Sector 35 C Chandigarh