Posted on: Tue 21-04-2020

Healthcare is a partnership between the patient and caregivers with both parties having rights and obligations. The mutual goal essentially, is the restoration of the health of the patient or alleviation of his suffering. The patient carrying out his part of the bargain enriches the quality of care and obviates frictions in the relationship.

One of the key responsibilities of the patient in the ensuing relationship is to provide complete and accurate information to the extent possible including information about self; full name, contact addresses, telephone number, particulars of next-of-kin, past illnesses, present condition, vaccinations, addictions/history of drug use, vitamins, herbal products, drug reactions, allergies, countries resident in and periods, recent travel history, drinking and smoking habits, hospitalisations, family history of illnesses and other matters relating to present health.

Patients should be truthful in communicating with health personnel. This is critical for a firm grasp and understanding of the condition of the patient. Apart from clinical presentation, reliance has to be placed on the information provided by the patient or the accompanying relation to enable health personnel make correct assessment and care management decisions. Often times, some patients conceal information or deliberately give misleading or wrong answers to questions asked by caregivers. This can result in unintended consequences and may affect the diagnosis, prognosis, quality of care and outcome.

As simple as some of the foregoing seem, they can have serious implications. For example, where a patient resides could have direct bearing on the physician’s understanding of his ailment. Also when a patient who accessed hospital care in the name of his brother died (in a situation where anonymity is not indicated), issuance of death certificate would become an issue, given that all hospital records (including that of the referring hospital retained by the brother’s corporate employer) did not bear his real name. Strictly speaking, the Death Certificate has to be issued in the name of the person who is still alive.

Concealing information from healthcare personnel could not only be detrimental to the patient, but may expose caregivers, other patients and the public to risk of harm or actual harm as was seen in the recent cases of patients that presented at the Lagos University Teaching Hospital and University of Ilorin Teaching Hospital whose travel histories were concealed, only to be discovered after their death that they had recently returned from abroad, a red flag, that could have influenced decisions about their management.

Indeed, one can safely posit that the relations of those patients deliberately withheld the information because presently, it would be almost impossible to have any case where upon presentation, a crucial part of the clerking session would not be travel history.

Even the President had emphasised the importance of not concealing travel history and the Chairman of the Presidential Task Force on Covid-19 reiterates this fact from time to time. Concealing travel history in the circumstances that we are, would be an irresponsible and dishonest conduct which unnecessarily exposes hospital staff, other patients and the public to avoidable risk of covid-19 infection.

Having regard to the serious public health jeopardy that the deliberate concealment of relevant information pertaining to covid-19 exposure poses, patients/accompanying relations should know that they may be liable to criminal prosecution e.g. for reckless act causing harm or for an act which is likely to spread the infection of a disease that is dangerous to life and to civil suit at the instance of affected health personnel.

One may take the liberty of a cue from some jurisdictions (e.g. many states in the United States) where they have specific laws on HIV transmission and exposure that criminalise a person that is HIV positive exposing another person to the risk of HIV infection through unprotected sex without disclosing his status to the partner. Indeed on this account, charges have been laid for recklessly endangering another person’s life, causing grievous harm, criminal negligence, aggravated assault etc.

In fact, studies have shown that about 75% of workplace assault occurred in healthcare settings, therefore in some other jurisdictions, assault against health workers in the course of their duties is given special status and attracts heavier punishment.

These two examples underscore the fact that special consideration should be given to protecting and re-assuring our healthcare personnel, who the whole nation, as of necessity, must now depend upon. Healthcare personnel cannot give their best when they are apprehensive or when they are not sure of their own safety in the course of their duty.

Finally, it is not debatable that failure to provide correct travel history exposes health care personnel to actual harm or risk of harm, therefore it is being suggested that covid-19 specific Laws and Regulations should make it mandatory for persons seeking medical care or persons accompanying them to make full disclosure about travels in and out of Nigeria while failure to do so or concealment or misleading information in that regard, should attract severe punishment. Such provision should also be given the necessary publicity.

Social/physical distancing stipulation, the violation of which attracts punishment is for the purpose of curtailing exposure and breaking the chain of transmission. Concealing travel history also exposes healthcare personnel to harm and is antithetical to this purpose, therefore it should attract sanctions.

Sesan Olajide                                                   

[email protected]

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