“Nothing in all the world is more dangerous than sincere ignorance and conscientious stupidity” – Martin Luther King Jnr.
Indeed ignorance is the mother of many things but good. My attention has just been drawn to the most fortunate of all incidents this year. As usual, the popular Instagram handle ‘instablog9ja’ had just posted another news yet again. It was a Facebook post by one Lawal Adedunni. From all I could gather from my findings Adedunni and Adebola had both lost a boss at the office, by name Kayode Fatoyibo. According to the post, which was made on the 18th day of May 2018, at about 7:56am, kayode (the deceased), in the company of his driver where headed somewhere, but where however attacked by armed robbers along Ikere – Ekiti Road. His driver upon noticing that there was a robbery going on in front of them, immediately reversed the car. Unknown to him, some of the robbers where hiding in a nearby bush and immediately started shooting at them. The bullet hit Mr kayode leaving him in the pool of his own blood for one hour until he died because, every private hospital the driver took him to rejected him saying they needed police report whilst the government hospitals claimed they were on strike.
While I will not digress on the issue of government hospitals being on strike or the prevailing infrastructural deficiency, I am however bitter, disturbed, and angry by the act of private owned hospitals. The idea of requesting police report or clearance before any sort of treatment may be given to a gunshot victim is erroneous in law – to the best of my knowledge. The strict adherence to this requirement has been due to the habitual nature of harassment, victimization, and witch hunting meted out by men of the Nigerian police Force to hospitals, doctors, and even good Samaritans who offer to help fellow’s citizens. Of the very many causes of death by accident in Nigeria, this is obviously one of the leading causes.
The Right to life as enshrined in S.33 of the Constitution of the Federal Republic of Nigeria 1999 (hereinafter referred to as the constitution) as well as the Right to fair hearing particularly the presumption of innocence in Ss.36, and 36(5) of the constitution respectively are too sacrosanct a provision to be forgone on the mere basis that a person with gunshot injury may probably be a criminal absconding from a crime scene -or for such other flimsy excuses that may exist. Thus the idea of denying a victim urgent medical care pending police report on the basis of such being a patriotic act of aiding law enforcement agents in their job as held by many, particularly the police, is an untenable reasoning, for not only does it amount to a deprivation of Constitutional Rights (as outlined above), but also offends all sense of natural justice and human feeling, as well as the Hippocratic oath of medical practitioners. This cannot by any stretch of imagination, be the intent of any law that may be cited by those who share this belief – For if same were to be, such laws would by virtue of their inconsistency with the provisions of Ss. 33, 36, and 36(5) of the constitution be rendered Null, void, and of no effect whatsoever – however, Would it not be the intendment of any of such laws (the Criminal Procedure Act, the Administration of Criminal Justice Act, etc ) that medical care be given first to such a person so as to enable him stand trial for his crime, supposing such a person had committed a crime.
It is unfortunate that this belief has continually been shared by many including the police and medical practitioners who in this case are supposed to be very much aware of the various legislative enactment prohibiting such attempts to delay medical attention, and in absence of any be the front liners in the quest for such. The case of Mr Kayode (the deceased) and many others would have been different if the hospitals and the general public were aware of the various provisions of the law on the issue.
The legal issue raised by the unfortunate scenario above and many like this would be “whether or not the hospitals, their staff and indeed the entire citizens of Nigeria, do not owe the deceased in this case, the duty to provide them assistance (medical or otherwise), and where such obligation exist, whether neglecting to perform such obligation would not amount to a crime.
The comments of many Nigerians on this issue usual is the cry of a failed government without considering the role of medical personnel who were the first point of contact in situations such as this. If it is clear that there is indeed an obligation on the part of doctors, security agents/agencies and every citizen to render every possible form of assistance to any person with gunshot wound/wounds and further ensure that such person gets needed medical attention at the earliest possible time, should it not be correct to also say that we have all failed individually and collectively?
The National Health Act 2014 (the Act) which is an Act regulating the practise of medical practitioners in Nigeria, amongst other things states in its long title: “…provide a framework for the regulation, development and management of a health system and sets standards for rendering health services in Nigeria.”
- 10 of the Act provides as follows;
“10. HEALTH CARE PERSONNEL
(1) A health care provider, health worker or health establishment shall not refuse a person emergency medical treatment for any reason.
(2) A person who contravenes this section commits an offence and is liable on conviction to a fine of N100, 000.00 or to imprisonment for a period not exceeding six months or to both.”
The Act went further in the interpretation section to define the word Health care provider, Health worker, and Health Establishment as;
“Health care personnel means health care providers and health workers
Health Care Provider means a person providing health services under this Act or any other law.
Health Establishment means the whole or part of a public or private institution, facility, building or place, whether for profit or not, that is operated or designed to provide inpatient or outpatient treatment, diagnostic or therapeutic interventions, nursing, rehabilitative, palliative or other health service under section 12 of this Act.”
Thus by virtue of the provisions of S.10 (1) and (2) above, it is an offence on the part of any Doctor, Nurse, Pharmacist, ‘chemist’ or such other persons rendering health services who may by the provisions of the Act be considered as health care provider, or health worker, to refuse a person emergency health treatment, ‘for any reason’.
It would be safe to hold the view that the word for any reason as used in the Act includes requirement of police report/clearance. Hence S. 10 of the Act criminalises the refusal to provide emergency medical treatment to any person (which may include an accident victim and others), and in this case a gunshot victim who obviously in all circumstances would be in need of urgent medical attention.
Furthermore, in a bid to solve the problem posed by the police report requirement, the National Assembly enacted the Compulsory Treatment and Care of Victims of Gunshots Act 2017 which is to “make provisions for the compulsory treatment and care for the victims of gunshots and for other matters connected therewith.” In the same manner as S. 10 of the National Health Act 2004, S. 1 of the Compulsory Treatment and Care of Victims of Gunshots Act 2017 places an obligation on every hospital in Nigeria -whether private or public- to accept for immediate and adequate treatment gunshot victims with or without police clearance/report. Unlike the provision of the National heath Act, which is implied, the provision of S. 1 of the Compulsory Treatment and Care of Victims of Gunshots Act 2017 is express.
3(i) of the act also expands the obligation of the hospital by providing that the hospital shall not deprive a gunshot victim of immediate and adequate treatment whether or not initial deposit is paid. Going further, S. 2 of the Act provides that;
“Every person including Security agents shall render every possible assistance to any person with gunshot wounds and ensure that the person is taken to the nearest hospital for immediate treatment.”
By the rules of interpretation of statutes the implication of the word “shall” in S.2 above is that it is a mandatory obligation placed on every person resident in Nigeria inclusive of doctors, nurses, Security agents, etc. to render help/assistance to a gunshot victim and ensure that such person is taken to the nearest hospital. S. 11 of the Act criminalizes failure to comply with this obligation. Where death occurred due failure to comply with S.2, those responsible may be prosecuted for Manslaughter pursuant to S. 311, 317 and 325 of the Criminal Code Act, and If found guilty, imprisoned for life.
11 of the Act provides:
“Any person who is guilty of an offence under this Act especially, when the offence does not lead to death of victim but led to substantial physical, mental, emotional and psychological damage, shall be liable on conviction to imprisonment for a term of not more than 15 years and not less than 5 years without option of fine”
“311. Acceleration of death
A person who does any act or makes any omission which hastens the death of another person who, when the act is done or the omission is made, is labouring under some disorder or disease arising from another cause, is deemed to have killed that other person.”
Alternatively, S. 13 of the Compulsory Treatment and Care of Victims of Gunshots Act 2017, person or authorities including police officers or other security agents and hospital staff who are implicated in the unnecessary death of any person with bullet wounds, commits an offence and upon conviction may be liable to 5 years imprisonment, a fine of N50, 000.00 or both.
In the case of hospitals S. 15 of the Act provides that where a corporate body (whether private or public) is found guilty of an offence under the Act, the head of such body shall be prosecuted in accordance with the provision of 11 and 13 of the Act.
In a bid to stop the incessant harassment and victimization meted out by security agents on well-meaning Nigerians and residents, who offer humanitarian help to persons with gunshot injury, S. 10 of the Act provides that: “Every volunteer or helper of a victim shall be treated with respect and shall not be subjected to unnecessary and embarrassing interrogation in their genuine attempt to save life”. It would appear that S.10 above was an attempt to imitate similar legislations in other jurisdictions which protect volunteers. These legislations so referred to are known as Good Samaritan laws. All 50 states of the United States of America, are examples of jurisdictions with such laws.
It is obvious that by virtue of the arguments above, the hospitals as well as the heads of such Hospital where Mr Kayode was rushed to within the period of one (1) hour before his death when he was said to have been gasping for breathe, owed Mr Kayode an obligation in law, and having failed to fulfil their respective obligations, are thus exposed to criminal liability under the various provisions of the law outlined above. Indeed The hospitals in this case perfectly fit into Martin Luther King Jnr saying “Nothing in all the world is more dangerous than sincere ignorance and conscientious stupidity” As their ignorance in this case has just bought them a pot of criminal charges. Would ignorance of the law avail them?
It is surprising that despite the innovative and robust provisions of the Compulsory Treatment and Care of Victims of Gunshots Act 2017 are unknown to majority of Nigerians. One would at this point ordinarily ask what then is the function of the National Orientation Agency? If it cannot create awareness to this effect. Similarly, the Nigeria Medical Association (NMA) has failed if of all things to do, it has failed to address its membership on the provisions of the Act, and their obligations therein.
In an attempt to avoid a repetition of this sad occurrence experienced by Mr Kayode and his loved ones; Firstly, professional bodies (and in this case the NMA) are at all-time advised to provide continuous enlightenment and training to its members.
Secondly the National Orientation Agency and other government parastatals such as the National Human Rights Commission, are advised and called upon to keep up with their responsibilities as well as create adequate sensitization of the matters of this nature.
Thirdly, the importance of legal advisers in every organisation cannot be overemphasised, this havoc would have simply been avoided if the private hospitals had a law firm/legal Practitioner on retainer, who would definitely have informed them of the provision of the Act and their obligations thereunder, and in the event that the hospitals are unable to foot the bills, they may collectively through the NMA have such legal practitioner/law firm on retainer on behalf of their members. Lastly and most importantly, Nigerians are advised to get involved in governance. For while it is the duty of the government to make the laws, the burden lies on the citizens, and other concerned professionals to get enlightened about the existence of such laws, as a simple awareness on the part of the staff of the hospital, the driver, or any person available around there, would probably have saved the life of the deceased and many others.