Sunday, April 1, 2018

The cost of saving a life - going to jail

This morning a lady came into the hospital. She had delivered a baby 2 days ago and had been bleeding ever since. She was white like a sheet and her blood pressure was barely recordable. Her Haemoglobin was 3 gm. When I worked in Jharkhand 15 years ago, our management would have been simple. Find someone with her blood group, bleed them and transfuse. But things are different now. As in all aspects of medicine, there are strict regulations and guidelines governing blood transfusions and without a recognised blood bank, it is not allowed. A few years ago, two staff members of a rural hospital spent some months in jail for transfusing blood to save a patient without a blood bank licence. So now, even if a patient is dying, we cannot transfuse them blood to save their life without running the risk of going to jail.

A lot of things are like this in our country today. With more and more regulations being brought in by powerful lobbies and highly placed doctors from the large corporates in cities like Delhi, those of us who practice medicine in very different circumstances find ourselves battling with life and death questions like this every day. It is no wonder that doctors don't want to work in rural areas or smaller hospitals. On the one hand, since the majority of our patients are poor, we are never going to get enough money to procure all the expensive gadgets, doctors and facilities that are mandated by the law to practice even basic medicine. On the other hand, we are faced with situations like this where a simple intervention that has very little risk is guaranteed to be life-saving, but cannot be done without breaking the law.

The husband of the patient was sent to the local blood bank and came back with the news that there was no blood. But he had been told of some private clinic where blood was available. I don't know if it a profitable side business of someone from the government blood bank or it is a private clinic who have bribed the powers that be to turn a blind eye. Since bribing is not an option for us, we will always be at a disadvantage if we ever stray even a millimeter from the law. Anyway, we sent off the patient, feeling relieved that our ethical dilemma had been solved by someone else. But the big question remains - will I risk going to jail in order to save a life? I do not know the answer to that question........

1 comment:

  1. glad to see that you ar emaking a difference arpith
    all the best and look forward to seeing more from your blog viju