Milord, please don’t try this Medicine!

MLH

An old saying “The young man knows the rules, but the old man knows the exceptions” seems to keep our judicial officers forever young. The following article is not for a comparison between doctors and legal professionals (my best friend is a lawyer, and I owe much of my reasoning and tea bills to him).

Not always while learning could we understand or agree with some decisions made by our seniors, as they either contrasted with the “textbook” instructions, or were never mentioned anywhere, it was the sheer genius and practical experience of those seniors that often saved lives. Such risks were almost always well calculated against the risk of death, and discussed with patient’s relatives whenever they had a capacity to understand (rare). We have never seen a doctor working / acting with the intention of “causing harm” to the patient.

There are often (not at all rare) situations when even two of the world’s best authorities do not agree upon some medical issue. This is beyond the “average IQ” people to comprehend, as they can only understand the most simplified. It is not because of a clash of egos, but a tie between two dead ends.

This is why medical definitions and management guidelines change very frequently. This is why every practicing doctor becomes a criminal, having ‘bypassed’ some guideline somewhere in his / her career for doing good to the patient who did not fit in the medical definition or was not mentioned in the textbooks.

It takes @ 6 years to become basic allopathic doctor, and @ 15 years to become a medical specialist. Only half of this training is in the books, remaining half is the actual experience of dealing with the thousands of complicated medical problems and learning to untangle the situation by an extremely difficult decision making. But we see some specialists do very well as compared to others, and to presume it is only because they “cut-practice” is intellectual poverty! Most doctors who do well do so because of their exceptional abilities in their field, especially in this society with such a bias against doctors as a class!

Legal training does not include medical knowledge and reasoning, it usually deals with crimes like rapes, sexual aberrances, poisonings and murders. Beyond that, a lawyer would have to make a special effort to learn from prior judgments about the precedents set mostly in the western world. To apply these to Indian medical practice is humorous. We have a legal system which has many differences from the western: be it relationships, marriages, sex, rapes, political crimes or homosexuality. In most of these the judges quote “Indian Culture and difference in society”. Separate laws and courts have evolved where industries and money was concerned. Military conducts its own trials / court martial.

But the most intellectually complicated field dealing with human life is left out to be handled by people who may be very good in law, but have little or no knowledge of the intricacies involved in handling a complicated medical case. Most of the judges and lawyers, with due respect, would lack the basic knowledge about the “unpredictability” of various medical treatments, procedures and clinical outcomes, despite best medical brains involved in their use.

Summarily, doctors are as law-dumb as those not doctors are medical-dumb. To allow anyone except medical professionals to either make laws or to try doctors in courts that have had no medical training or acumen (which, incidentally takes years of day & night training in hospitals) is like asking an MBBS doctor to analyse and decide about the decisions of a Supreme court judge. We are so mentally enslaved to the ancient British system, that we have to rise and salute the authority of every judge because they are so “highly placed” socially, legally and ethically (then what are all the criminals doing out in the society and different governments?) that a doctor who deals with human life, saves hundreds for all his life has to beg them with folded hands. Beg to understand that he / she was trying to save a human life, and they will decide the merit based upon their puny medical knowledge, which is unchallengeable!

Laws practiced today were mostly made over 100 years ago. Medical science changes daily. Only the sane and solid minds will sense the paradox here. We need separate Medical courts. Thousands dying due to incorrect political decisions and accidents do not receive even pebbles as compensation despite knocking the doors of all courts, but a single inadvertent medical mistake is punished with 12 crores compensation, a lifetime income beyond 95% doctors in our country!

Yes. Doctors should not have to stand in regular courts begging mercy for trying to do good. We must have medical courts, with special judges who have adequate (atleast MBBS level) knowledge about human body, and are also trained as well in law. Only a multidisciplinary panel of young and old doctors and legal experts can properly analyse the merits or otherwise of a medical case. Or the MCI should conduct qualifying examinations for Judges who conduct medicolegal cases, or train them with experts from various superspecialties about basic principles of a Doctor’s approach to complicated medical issues. Also about the non-medical issues that kill a patient (delay in admission, addictions, health neglect, non compliance with advised tests / treatment, neglect by family etc.) which never appear in legal discussions of negligence cases.

Come on. I have immense respect about the Judiciary and its abilities, I have immense faith in its intentions. However, being a doctor, I cannot harbor superstitions or blind faith. I DO NOT believe that the regular Judges or doctors will understand all that happens in a spaceship travelling to the Mars, only the astronauts can understand those intricacies.  I do not believe that anyone who has not composed the same music as Mozart or Tchaikovsy or AR Rehman or Ilayaraja should criticize them.

The present tradition of any court trying medical cases can only be equated to the legal system punishing an acclaimed singer for singing a wrong note! Unfortunately, as this profession concerns life, the “Wrong Note” or “Bigda Sur” can result in health complications. But then to completely avoid it, one must stop singing.

This is why most new generation Indian Doctors are leaving India. Not that there are better Judges outside, but better payments for the frustration involved!

If not anything else, my dear and most respectable Milord, Sir, please understand the dire necessity of a  “DURESS FREE DOCTOR” the society deserves.

© Dr. Rajas Deshpande
Picture courtesy medicolegal literature help http://www.invohealth.com with thanks.

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