I would like to reiterate why we are painstakingly reviewing selected contents of this bill. Among other things, We hope it should sensitize all health workers in Nigeria to be familiar with its contents seeing how it concerns their profession; We hope to stimulate enough public debate that might ensure that subsequent reviews/amendments to the bill will drive some of the much needed change we need in the sector; We Hope reading this makes every health professional more conscientious in carrying out their duties.

Part III, no 23.

Every health care provider shall give a user relevant information pertaining to his state of health and necessary treatment relating thereto including:-

 (a) the user's health status except in circumstances where there is substantial evidence that the disclosure of the users health status would be contrary to the best interests of the user;

 

(b) the range of diagnostic procedures and treatment options generally available to the user;

 

(c) the benefits, risks, costs and consequences generally associated with each option; and

 

(d) the user's right to refuse health services and explain the implications, risks, obligations of such refusal.

 

(2) The health care provider concerned shall, where possible, inform the user in a language that the user understands and in a manner which takes into account the user's level of literacy.

 

In discussing these statements, I would be playing both prosecutor and devil's advocate concurrently and alternately. Consider this a subtle disclaimer that my intention is to neither vilify nor absolve any cadre of health worker

The opening word of this subsection is 'Every'

Hmm...I'm not sure if that will be practical. So are we to believe that the lab scientist who gives the patient's relative the lab results should quip in when asked that the electrolyte derangement means the patient's kidneys are not functioning properly. What if the patient's hydration status makes the result equivocal? But how will this health worker know this if he has not examined the patient personally?

 

I believe this remains the purview of the managing physician and to a lesser extent the nurses on duty.

It therefore behooves on every nurse who will be catering for the patient- and I say this because of personal experiences in the past- to ensure that they have a working knowledge of the patient's clinical condition and current management goals. When this knowledge is not readily available if the patient or relative asks, I believe the prudent nurse will politely decline giving any preemptive information but contact the managing doctor to discuss with the patient or authorized caretaker (after permission has been sought from the patient, if lucid, to divulge the information).

Now to "we" doctors:  From interactions with some patients over my little years of practice, I get the feeling we have been found wanting in this regard. It appears we are not doing enough to carry patient and caretakers along in their health care plan from diagnosis to management options, goals of management, and prognosis or possible outcomes.

 

The second part of this article quickly goes on to prevent the use of a popular challenge (or is it excuse) when it comes to communicating these things to the patient. I'm afraid language and literacy levels are not satisfactory excuses. We might have the scientific answers, but ultimately it is the patient's body and he/she must know what you are doing to it.

Albert Einstein is quoted to have said that if you cannot explain something to a 5 year old then you really don't understand it yourself!

 

My pen stops here for now. Kindly drop comments below. Have a great week ahead!

BY: seyi adebola