Put patients’ lives first

In yesterday’s Newsday, we reported that Justice Carol Gobin had ordered the SWRHA to pay compensation to the woman, who is now 32, having waited seven years for this decision. Her baby was killed because the hospital ordered her to take a Caesarean operation three months early. That error in turn occurred because the nurse who had recorded her ultrasound put the wrong date on the files, saying the foetus was 27 weeks instead of 19.

The doctor’s response, when the woman told him that her baby wasn’t due for another two to three months, is instructive. According to her testimony, the doctor said, "Are you the doctor here or me?" The day before the surgery was scheduled, the woman again asked if a C-section was necessary and was assured that it was.

It is clear that the doctor in question is incompetent. But it is also clear that, had he or she not been so arrogant, they would have paid attention to what the patient was saying and not relied exclusively on the ultrasound dates to decide to do surgery. After all, a medical operation of any sort should never be undertaken lightly. Yet the doctors did no further checks to see how far advanced the woman’s pregnancy really was. As a result, they only realised their error during the operation, and were unable to save the baby.

We wonder if the Medical Board will be taking any action against the doctor or doctors involved. We also wonder if the Medical Professionals Association of Trinidad and Tobago (MPATT) will have any comment to make on this matter. Since the association was formed, it has been perceived by the public as a body concerned exclusively with seeking the interests of doctors, even when such interests conflict with the general good. In that regard, MPATT acts very much an old-fashioned trade union and, despite its title, improving the professionalism of doctors seems to form no part of its agenda.

Dr Anand Chatoorgoon, a consultant anaesthetist at the San Fernando General Hospital, raised a related matter last Thursday when testifying before the Commission of Inquiry into the Public Health Sector. Criticising "errant and recalcitrant doctors who, time and time again, have unconscionably and uncaringly downed their stethoscopes and blatantly and flagrantly refused to provide a service to the poor and needy people who come to the San Fernando General Hospital," Dr Chatoorgoon made a strong call for such doctors to face disciplinary sanctions.

However, such sanctions, even if they exist in law, may not be in the sphere of practical politics. But it is certainly unconscionable that these doctors (who Dr Chatoorgoon did say were in a minority) should put patients’ lives at risk in order to get pay increases.

Indeed, can MPATT state categorically that their last industrial action did not result in needless deaths at the nation’s hospitals?

What MPATT and the Health Ministry have to do, and do before the next round of wage negotiations begins, is to agree to certain ground rules — one of which must include not putting patients’ lives at risk. This will benefit the doctors as well, because the esteem with which the ordinary citizen views health personnel — from doctors to nurses to pharmacists — is surely at an all-time low. But perhaps if doctors begin to see themselves as professionals, rather than public service employees, then that esteem will rise and, more importantly, mistakes that lead to babies’ deaths will be avoided.