Instructions for healthcare providers on invasive behaviour and patients’ dignity are often ignored in Bangladesh, says an expert
The lack of a uniform law on patient safety and awareness about the right to information often prevent people from filing complaints and exercising their rights as a patient, experts have said.
They added that a law specifically enacted on patient safety may work as a middle ground for patients and doctors to resolve issues regarding medical negligence and ethics.
Dr Farid Hossain Miah, director of hospitals at the Directorate General of Health Services (DGHS), told Dhaka Tribune that patients and doctors alike would benefit if the government passes the Sasthya Surokkha (health protection) law.
“If a patient thinks that they received wrong treatment at a hospital, they should complain to the hospital director first. If the issue is not resolved, they can file a complaint to the DGHS chief. The DGHS would then form a probe team, which would report to the Health Ministry,” he said.
Also Read - The hurdles of getting a hospital bed
The Health Ministry would make a decision on the basis of the probe report, the DGHS official added.
The aforementioned law would have provisions for all issues regarding patient safety, he told Dhaka Tribune.
Acknowledging the complicated nature of the current complaint-filing process, Dr Farid said it would get easier once the Sasthya Surokkha law is passed.
Furthermore, an aggrieved patient has the option to lodge a complaint to the Bangladesh Medical and Dental Council, which in turn may initiate disciplinary proceedings if a doctor appears to have neglected or disregarded their professional duties.
Farida Akhter, executive director at Unnayan Bikalper Nitinirdharoni Gobeshona (Ubinig) and co-convener of Shasthya Andolon, said the law also protects healthcare providers as patients’ families often abuse them and vandalize hospitals.
“There is no alternative to having a separate law for patient safety. There is a draft law but it has yet to be ratified,” she told this correspondent.
Farida also said that unnecessary caesarean delivery (C-section) — a surgical procedure performed when a vaginal delivery is not possible or safe — is commonplace in Bangladesh.
Invasion of privacy
While some patients complain of receiving the wrong treatment and medical negligence, many others take issue with doctors not being transparent with patients. Doctors often do not provide an explanation of the health issue or the recovery process, on top of lecturing patients about morality.
One disgruntled patient, Tanzila Rahman Mounita, unknowingly took contraceptive pills for years for menstruation-related issues. Her gynaecologist had prescribed the pills and gave her mother unsolicited advice to marry her off as soon as possible. Tanzila was a teenager back then and had little idea about women’s health issues.
Now in her 20s, Mounita feels “violated and humiliated” whenever she thinks back to it.
“I deserved to know what my health problem was, not being told that I should get married. As a patient it is my right to know what treatment I am going to undergo,” she said.
The Bangladesh Medical and Dental Council Code of Professional Conduct, Etiquette and Ethics categorically instructs physicians not to interfere in the family affairs or private lives of patients unless there is a professional reason to do so.
It also states that: “Doctors may apply new methods of treatment in lieu of the long-time practiced ones for appropriate patients under appropriate circumstances. In this respect, innovative ideas, new appliances and medications are expected and are encouraged. Nevertheless, the doctor must be reminded that the human rights of the patient must be protected and his dignity respected.”
However, instructions for healthcare providers on invasive behaviour and patients’ dignity are often ignored in Bangladesh, Farida Akhter of Shasthya Andolon said.
“I do not know what doctors get out of knowing a woman’s marital status. A physician’s job is to ask the right questions, diagnose, explain the health issues to the patient, prescribe medicine and give appropriate advice,” she remarked.
A married woman can be sexually inactive or an unmarried woman can indulge in sexual activities, she said, adding that such questions may be medically immaterial.
“I do not think that a doctor could magically get a female patient’s medical history just by asking her about her marital status,” she said.
Directorate of National Consumer Rights Protection (DNCRP) Deputy Director Monjur Mohammad Shahriar said the agency occasionally receives complaints about wrong treatment at hospitals but it forwards them to the DGHS as they are out of its jurisdiction.
However, the DNCRP can take action against pharmacies for selling expired or counterfeit drugs if a person lodges a complaint, he informed.