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Docs Attacked after Kid’s Death in Hospital
Published by नेपाली
25-12-2006
Docs Attacked after Kid’s Death in Hospital

Kathmandu, December 26, 2006, Relatives infuriated over the death of an eight-month-old child of Bhaktapur attacked doctors and forced the closure of the outpatient service in the Kanti Children's Hospital.

The child had died on Sunday. One of the doctors was seriously injured in the attack. Police have taken relatives of the child, Sharan Gurung, Rajesh Dahal and Madhusudhan Gurung, under control for their involvement in the attack.
Doctors and other employees of the hospital have warned that they will even bring emergency services to a halt if the assailants are not punished. Protesting the incident, doctors are working by wearing black armbands. - The Himalayantimes
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By नेपाली on 25-12-2006, 08:17 PM
Kanti OPD closed

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KATHMANDU: A meeting of the Kanti Children’s Hospital Development Committee held on Monday decided to close down the out-patient department (OPD) service of the Hospital from Tuesday. The decision was taken to protest the mistreatment of doctors by parents and relatives of eight-month-old Nischit Dulal, who died while undergoing treatment at the Hospital on Monday. The meeting also demanded that the government take action against those who manhandled the doctors. The hospital has denied any wrongdoing on the part of doctors involved in the treatment of the child. The child was brought to the Kanti hospital for treatment on Saturday. He died at 2:30 pm on Monday.
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By autowreckers on 26-12-2006, 08:12 AM
Re: Docs Attacked after Kid’s Death in Hospital

This is not good. We should not forget that we are doctors and not hooligans. whatever the circumstances patient should come first and their life should not be risked. Why should other patients suffer? Nepal Medical Council should provide strict rules and the government should provide adequate support and safetly of health personality. And above all people should stop thinking that doctors are god and can cure anything. After all all of us are human and the disciplinary action should be taken by the NMC not the people.

Join the debate.
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By Walrus on 26-12-2006, 06:28 PM
Re: Docs Attacked after Kid’s Death in Hospital

Quote:
Originally Posted by autowreckers View Post
This is not good. We should not forget that we are doctors and not hooligans. whatever the circumstances patient should come first and their life should not be risked. Why should other patients suffer? Nepal Medical Council should provide strict rules and the government should provide adequate support and safetly of health personality. And above all people should stop thinking that doctors are god and can cure anything. After all all of us are human and the disciplinary action should be taken by the NMC not the people.

Join the debate.
This comment is funny.

No body has forgotten they are doctors. And like you said, we are not Gods, we are human beings; so we have limits. Limits to tolerate what is going on.

What we do in the hospital is 'our job'. It is our profession not a social service not charity stuff for impressing Chitragupta for pass to Swarga. I don't care I land in heaven or hell after I die. All I care for is I do my job good but if I am threatened by such irresponsible behaviour of a mob, my adrenaline cannot be supressed.

We understand innocent people are suffering from this but so did innocent doctors. When did we rise above 'people' that we should care of others more than our fellow colleagues? If me and my colleagues cannot work in a secure environment then how can we guarantee a good service.

If such vandalism continues, who will go to see a sick patient? C'mon, read NMC code of conduct. I have rights to choose my patient and in such an insecure environment, who the hell will ever even take pulse of a dying patient. . .rule then will be . . if a patient is collapsing. . dont even think of feeling the pulse. Ignoring those patients will be the wisest thing. Do U think ur ethics will allow U to do that?

Those who caused trouble are infact hooligans. They have nothing to lose. It is just that they want to terrify people and if we sit silent right now our future will be questioned. It will then be better to leave Nepal and go to US. Those who can do go and those who remain are infact fools then. And let people of Nepal be treated only by fools not doctors. Should we head for that then?

I feel it is already too late to make people realise the power we have with us. It is a revolution and people have to suffer for better tomorrow.

And, it is not NMC that should be seeing all this. NMA should wake up at times like this. They are seen all over the place with smiles before the election and in these situation where do they disappear? This is not the first time this has happend. Why could they not take the stand when such incident happend on the first time?

I am working in a stressful situation then I tend to make mistakes. NMA should make sure we have a workign environment, else what are they for?

And if a doctor makes a mistake people should either shut up and say thank U else do what ever law allows them to do. If they go against law, why should doctors shut up and watch like a fool?

If U feel like doctors should be doing service for people not just their job then U have 95% of Nepal empty for U. Go to some remote village and do it. You are writing a comment here means U are in a city just talking more than what U do.

So, all doctors join hands. Lets do what we can do and do out work sincerely and if someone makes this kind of problem again, let them understand doctors are not just mute nerds
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By sarosem on 27-12-2006, 01:39 AM
Re: Docs Attacked after Kid’s Death in Hospital

it's the bad happening. regarding the bhaktapur. i am too resisdance of bhaktpur. the doctor and nurse are not so curious about the patients. i think this condition is not ony one time there had been many times and it may be problem of not only the bhaktapur its the problem of the whole nation. any where we go in goverment hospitals. There had been great negligence . i know this is bad incidient the hospital shouldnot give chance for this type of incidience .wish for not happening these sort of cases.
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By autowreckers on 27-12-2006, 10:18 AM
Re: Docs Attacked after Kid’s Death in Hospital

Well said. Imagine yourself as son bringing your father for treatment after 7 days tough journey from land of far far away with few hundreds rupees to spare only to realise that you have been denied to receive any form of help from the doctor. how would you feel.

It is totally understandable to feel disheartened and frustrated by the way things are done in health sector of nepal and that doctors are threatened but every angle by few angry bunch of people but what about others. why should they suffer? this is no way a solution. threatening behaviour is good by terrorists not respectable people like doctors. And last but not the least Is Nepal Sarkar ready to provide security to each and every doctor after this 3 days protest.

Do read these oaths from NMC website and familarise yourself with the duties of a doctor:

STATEMENT BY THE PROFESSIONS AND PHYSICIANS
A. HIPPOCRATIC OATH (425 BS)

I swear by Apollo Physician, by Aesclepius, by Health, by Heal-all and by all the gods and goddesses, making them witnesses that I will carry out, according to my ability and judgement, this oath and this indenture.

To regard my teacher in this art as equal to parents; to make him partner in my livelihood, and when he is in need of money to share mine with him; to consider his offspring equal to my brothers; to teach them this art, if they require to learn it, without fee or indenture; and to impart precept, oral instruction, and all the other learning, to my sons, to the sons of my teacher, and to pupils who have signed the indenture and sworn obedience to the physician' law, but to none other.
I will use treatment to help the sick according to my ability and judgement, but I will never use it to injure or wrong them, I will not give poison to anyone though asked to do so, nor will I suggest such a plan. Similarly I will not give a pessary to a woman to cause illegal abortion. But in purity and in holiness, I will guard my life and my art. I will not use the knife on sufferers from stone, but I will give place to such, as are craftsmen therein.

Into whatsoever houses I enter, I will do so to help the sick, keeping myself free from all intentional wrong-doing and harm, especially from fornication with woman or man, bonded or free.

Whatsoever in the course of practice I see or hear (or even outside my practice in social intercourse) that ought never to be published abroad, I will not divulge, but will consider such things to be holy secrets.

Now if I keep this oath and break it not, may I enjoy honour, in my life and art, among all men for all time; but if I transgress and forswear myself, may the opposite befall me.


B. A NEW OATH FOR PHYSICIANS

In the name of suffering humanity, with humility, compassion, and dedication to the welfare of the sick according to the best of my ability and judgment, I will keep this oath and stipulations:

I will be honor with my patients in all medical matters. When this honesty reveals bad news, I will deliver it with understanding, sympathy and tact.

I will provide my patients with acceptable alternatives for various forms of diagnosis and medical and surgical treatment, explaining the risks and benefits as best I know them.

I will allow my patients to make the ultimate decision about their own care, In circumstances where my patients are incapable of making decisions, I will accept the decision of family members or loved ones, encouraging them to decide as they believe the patient would have decided.

I will not sit in moral judgement on any patient, but will treat their illness to the best of ability whatever the circumstances.

I will be empathetic to patients with illnesses caused by substances such as alcohol or drugs, or other forms of self-abuse usually believed to be under voluntary control.
Knowing my own inadequacies and those of medicine generally, I will strive to cure when possible but to comfort always.

I shall perform medical tests only if I believe there is a reasonable chance that the results will improve the outcome.

I will not perform any tests or procedures or surgery solely to make money. I will freely refer my patients to other physicians if I am convinced that they are better able than I to provide treatment.

I will freely furnish copies of medical records to patients or their families upon request.

I will do unto patients and their families only what I would want done unto my family or me. I will not experiment on patients unless the patients give truly informed consent. I will strive to instruct patients fully so their informed consent is possible.

I will remain a student all my professional life, attempting to leam not only from formal medical sources but also from by patients as well.

I will provide care to all patients seeking it, regardless of sex, race, colour, creed, sexual preference, life-style, or economic status. In particular, I will volunteer some of my time to providing free care to the poor, the homeless, the disadvantaged, the dispossessed, and the helpless.

I will turn away no patient, even though with dreaded contagious diseases.

I will encourage my patients to seek medical opinions other than my own before agreeing to accept my opinion.

I will treat my professional colleagues with respect and honour, but I will not hesitate to testify openly about physicians and medical institutions that are guilty of malpractice, malfeasance, cupidity, or fraud.

I will defend with equal fervour colleagues who are unjustly accused of malpractice, malfeasance, cupidity, or fraud.

Abstracted from: The Lancet, London, U.K. (1995): (345), 8962, 1423



C. WORLD MEDICAL ASSOCIATION DECLARATIONS
WORLD MEDICAL ASSOCIATION DECLARATION OF GENEVA

Adopted by the 2" General Assembly of the World Medical Association, Geneva, Switzerland, September 1948, amended by the 22nd World Medical Assembly Sydney, Australia, August 1968, and the 35th World Medical Assembly, Venice, Italy, October 1983.

AT THE TIME OF BEING ADMITTED AS A MEMBER OF THE MEDICAL PROFESSION:

I SOLEMNLY PLEDGE myself to consecrate my life to the service of humanity;

I WILL GIVE to my teachers the respect and gratitude that is their due;

I WILL PRACTICE my profession with conscience and dignity;

THE HEALTH OF MY PATIENT will be my first consideration;

I WILL RESPECT the secrets, which are confined in me, even after the patient has died;

I WILL MAINTAIN by all means in my power, the honour and the noble traditions of the medical profession;

MY COLLEAGUES will be my brothers;

I WILL NOT PERMIT consideration of religion, nationality, race, party politics or social standing to intervene between my duty and my patient,

I WILL MAINTAIN the utmost respect for human life from it's beginning even under threat and I will not use my medical knowledge contrary to the laws of humanity;

I MAKE THESE PROMISES solemnly, freely and upon my honour;



WORLD MEDICAL ASSOCIATION DECLARATION
on
PHYSICIAN INDEPENDENCE AND PROFESSIONAL
FREEDOM
Adopted by the 38th World Medical Assembly
Rancho Mirage, Ca, USA, October 1986
The World Medical Association, Inc., recognizing the importance of the physician's independence and professional freedom, hereby adopts the following declaration of principles:
Physicians must recognize and support the rights of their patients, particularly as set forth in the World Medical Association Declaration of Lisbon (1981).

Physicians must have the professional freedom to care for their patients without interference. The exercise of the physician's professional judgment and discretion in making clinical and ethical decision in the care and treatment of patients must be preserved and protected.

Physicians must have the professional independence to represent and defend the health needs of patients against all who would deny or restrict needed care for those
who are sick or injured.

Within the context of their medical practice and the care of their patients, physicians should not be expected to administer governmental or social priorities in the allocation of scare health resources. To do so would be to create a conflict of interest with the physician’s obligation to his patients, and would effectively destroy the physician’s professional independence, upon which the patient relies.

While physicians must be conscious of the cost of medical treatment and actively participate in cost containment efforts within medicine, it is the physician’s primary obligation to represent the interests of the sick and injured against demands by society for cost containment that would endanger patient’s health and perhaps patient’ life.

By providing independence and professional freedom for physicians to practice medicine, a community assures the best possible health care for its citizens, which in turn contributes to a strong and secure society.

Life is short and the Art (of medicine) long, opportunity is fleeting, judgment difficult, and experience dangerous. The physician must do the right thing right time. – First aphorism of Hippocrates translated by Adams, a nineteenth century Aberdeen doctor and classical scholar.




WORLD MEDICAL ASSOCIATION DECLARATION OF MADRID ON PROFESSIONAL AUTONOMY AND SELF- REGULATION
Adopted by the 39th World Medical Assembly,
Madrid, Spain, October 1987.

The World Medical Association, Inc., having explored the importance of professional autonomy and self-regulation of the medical professional around the world, and reorganizing the problems and the current challenges to professional automony and self-regulation, hereby adopts and following declaration:

1. The central element of professional autonomy is the assurance that individual physicians have the freedom to exercise their professional judgment in the care and treatment of their patients, as set out more fully in the World Medical Association Declaration on Physician Independence and Professional Freedom, adopted in October, 1986 (see document 17.0).

2. The World Medical Association and its National Medical Associations re-affirm the importance of professional autonomy as an essential component of high quality medical care and therefore benefit due to the patient that must be preserved. The World Medical Association and its National Medical Associations therefore re-dedicate themselves to maintaining and assuring the continuation of professional autonomy in the care of patients, which is, an essential principle of ethics.

3. As a corollary to the right of professional autonomy, the medical profession has a continuing responsibility to be self-regulating. In addition to any other source of regulation that may be applied to individual physicians, the medical profession itself must be responsible for regulating the professional conduct and activities of individual physicians.

4. The World Medical Association urges its National Medical Associations to establish, maintain and actively participate in a system of self-regulation for the physicians in their respective countries. It is this dedication to effective self-regulation that will ultimately assure professional autonomy in patient care decision.

5. The equality of the care provided to patients and the competency of the physician providing that care must always be a primary concern in any system of self-regulation. Physicians have the expertise to make the necessary evaluation. These evaluations must be used for the benefit of patients to assure them continued quality care by competent physicians. Included in this area of responsibility is the need to monitor advances in scientific medicine and the use of therapeutic regimens that are safe and effective. Experimental procedures must comply with the protections required by the World Medical Association Declaration of Helsinki and other protections as may be required in each country. Discredited scientific theories must not be used on patients.

6. Cost consciousness is an essential element of self-regulation. The highest quality of care can be justified only by assurances that the cost of such care will allow access to that care for all citizens. Again, physicians are particularly qualified to make the evaluations that are necessary for cost containment decisions. National Medical Associations must, therefore, include cost containment activities in their respective system of self-regulation. Common issues in cost containment activities relate to methods of delivery of medical care, access to hospital and surgery, and the appropriate use of technology. Cost containment activities must not be used to deny patients needing access to necessary medical care. Nor should over-utilization of medical facilities be permitted to drive the cost of medical care upwards so that it will not be available to all who may need the particular care.

7. Finally, the professional activities and the conduct of physicians must always be within the bounds of the professional code of ethics or the principles of medical ethics governing physicians in each country. National Medical Associations must promote ethical conduct among physician for the benefit of their patients. Ethical violations must be promptly corrected, and the physicians guilty of ethical violations must be disciplined and rehabilitated. This is a responsibility that only National Medical Associations can undertake and perform effectively and efficiently.

8. There are, of course, many other areas of self-regulation for which National Medical Associations are urged to assist each other in coping with new and developing problems. The exchange of information and experiences between National Medical Associations is encouraged and the World Medical Association will assist in facilitating this exchange of information to improve self-regulation.

9. The World Medial Association and its National Medical Associations must also educate the public generally as to the existence of an effective and responsible system of self-regulation by the medical profession in each country. The public must come to recognize that it can rely on this system of self-regulation for an honest and objective evaluation of the issues relating to the practice of medicine and the care and treatment of patients.



Read what good medical practice means:

Patients must be able to trust doctors with their lives and health. To justify that trust you must show respect for human life and you must:

Make the care of your patient your first concern


Protect and promote the health of patients and the public


Provide a good standard of practice and care


Keep your professional knowledge and skills up to date


Recognise and work within the limits of your competence


Work with colleagues in the ways that best serve patients' interests


Treat patients as individuals and respect their dignity


Treat patients politely and considerately


Respect patients' right to confidentiality


Work in partnership with patients


Listen to patients and respond to their concerns and preferences


Give patients the information they want or need in a way they can understand


Respect patients' right to reach decisions with you about their treatment and care


Support patients in caring for themselves to improve and maintain their health


Be honest and open and act with integrity


Act without delay if you have good reason to believe that you or a colleague may be putting patients at risk


Never discriminate unfairly against patients or colleagues


Never abuse your patients' trust in you or the public's trust in the profession.


Last but not the least offender should be punished not at the expense of public lives. We should first know who was the offender either the arrogant relatives or the doctor himself because of his gross negligence led to this situation. Government, Nepal Police, NMA and NMC should work together to solve the problem as soon as possible.
Last edited by autowreckers : 27-12-2006 at 01:12 PM.
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By Walrus on 27-12-2006, 06:03 PM
Re: Docs Attacked after Kid’s Death in Hospital

It is nice to know that there are still those who find time to go thru what is written in Codes and Ethics.

And, the father and son who had come after 7 days walk. It has been long that so called 'democracy' had been 'restored' in 'our' country but what was government doing and what were people doing that

1. To recieve treatment still they have to come to KTM
2. To go somewhere they still have to 'walk' for 'days'

These 2 aspects of your story already tells us where we stand. When rest of the world is thinking how can they go to moon someday for a vacation, people in Nepal still have to choose between going to the city for treatment with the little money they have walking for days or staying home and working so that rest of the family can eat something that night.

We lag behind a lot everywhere, that is mainly because of poverty but to be a little descent and respect each other does not cost U money.

U read so much but I think U missed the duty part. It writes

--------
3.1 Obligation to the Patient
A physician is not bound to treat each and every patient asking for his services except in emergencies, but s/he should be ready to respond to the calls of the sick and injured in conformity with the high character of medical profession.
--------

So, are the doctors who are on strike not doing what they are obliged to do?

They are!!!!!!!!!!!!!!!!!!!!!!!!!!

They are still providing the emergency service and if things get ugly I think doctors can even deny that. All that people understand these days is revolution.

This father and son reach kathmandu. We should be thankful. They were not stopped anywhere because of some stupid bandh for some filthy political agenda.

And, Hippocartic oaths and all the other ethical guidelines - scan thru them and see how practical that is. Still, doctors are accepting those. But if U read it carefully, those are responsibilities of a 'doctor' to a 'patient' not everyone. So, until I establish a doc-patient relation with someone, I am not obliged to help that person - HE IS NOT MY PATIENT UNTIL I ALSO ACCEPT HIM/HER AS MY PATIENT.

So, what doctors are doing now is not recognising this father and son as their patient unless it is emergency.

What is happening in the country is a revolution. People have to suffer if they want it and it is not only doctors who chose to bring this revolution in the country.

If they can boast that they could come out in curfew and cause so much political and social stirr then why are they not accepting one more revolution.

If U go by law, even patient's and their relatives don't have any right to manhandle a doctor nor even to raise their voice. Everyday there is death in hospitals, doctors cannot stop that. But, if it is because of negligence then there is a place it should be questioned and the proper way is to approach it legally.

Ok next you will say if U go to police or somewhere and try doing this legally then it will never work out. Does that mean U should go back and beat up the doctor or vandalise the hospital, burn tires out in the street and demand for a heavy compensation?

Ask ur logic what should be done to them.

I think we should look back in our recent past. There were a few such incidences and the relatives after so much vadalism were able to fish out quite handsome amount of money too.

If we really want proper tomorrow, it is time to punish those bast"!&%! also. They rooted this evil. It is not fair that they walk out just like that with so much money. If wrong had been done by the doctor, why were they not punished by law but only paying compensation was ok? Those relatives who got the compensation should be hanged if country wants revolution. Why spare them? Whatever is happening is because of the path they made.

Few hours of chakka jam in one part of the city can cause more trouble than 3 days of strike by doctors. Doctors are selectively imposing this. Those who need urgent help are not denied and nor those already admitted denied of treatment. If country understands only language of strike then I think 3 days is not enough. And it should be extended to cover even the emergency and inpateint service. Then will only people able to respect out profession. Doctors are not demanding respect, they just want there to be a working environment and are asking people to respect this noble service we are providing.

Chakka jam for an hour can stop a student from sitting for some exam he had prepared his life for, he can miss his career just by matter of minutes. Why don't you also question them?

People of Nepal are being irresponible day by day and I think it is even worse than UP/Bihar now.
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