Appraisal of the Duty of Care in the Medical Profession in Nigeria.

Appraisal of the Duty of Care in the Medical Profession in Nigeria.

By Obamwonyi Osahenokemen Beauty, LLB

Abstract

The term duty of care represents a core principle in both medical ethics and legal practices, mandating that healthcare professionals maintain the highest levels of patient care and welfare. This article appraises the duty of care that medical practitioners have in Nigeria, investigating the legal, ethical, and professional responsibilities inherent in the healthcare field. It looks into the extent of duty of care, the legal infrastructure governing medical practice in Nigeria, and the consequences of medical negligence. The study utilizes a doctrinal approach that primarily relies on research conducted in libraries.The analysis focuses on significant legislation, such as the Nigerian Constitution, the Medical and Dental Practitioners Act, and the National Health Act, illuminating their contributions to defining medical responsibilities. It also reviews judicial precedents where Nigerian courts have ruled on medical malpractice issues, assessing how legal interpretations affect the application of duty of care. In addition, the research evaluates the obstacles to meeting medical standards, such as insufficient healthcare infrastructure, a lack of ongoing medical education, and patients’ understanding of their rights.It discusses the function of regulatory organizations, like the Medical and Dental Council of Nigeria (MDCN), in upholding professional ethics and enforcing ethical standards among healthcare providers. Findings indicate various systemic weaknesses that have led to an insufficient application of essential medical laws. The article posits that violations of duty of care within the medical field have resulted in misdiagnoses and inappropriate treatments, often leading to serious complications or death of patients, a situation that is quite prevalent in Nigeria. By identifying deficiencies in the current framework and proposing potential reforms, this research adds to the ongoing discussion regarding medical accountability and patient safety in Nigeria. It presents suggestions for enhancing legal frameworks, bostering healthcare policies, and increasing the ethical obligations of medical professionals. Ultimately, this article seeks to foster a more accountable and effective healthcare system, guaranteeing that medical practitioners adhere to their duty of care with utmost diligence.

2.0.     INTRODUCTION:

Duty of care can only come into existence when a relationship has been established with another. In this case, it is a doctor – patient relationship. In the sense that for there to be a duty of care in the Medical Profession a relationship must be built up between a doctor and a patient. When there is a breach of this duty by the medical practitioner, it means there is an injury which the patients might have sustained at the hand of the medical practitioner who should have taken reasonable care and not inflicted pain on the person in their care.[1]

Today, many Nigerians have been affected in one way or the other and legal steps have not been taken to correct the wrongs thereby causing the wrongdoer to go scot free unlike some countries like America where the wrongdoer will be punished for their acts of negligence. This is the reason that the notion of duty of care should be over emphasized among the medical practitioners. The negative impact of the breach of duty most times has made many Nigerian patients to be depressed for the rest of their lives. As a result of this, this work seeks to bring an end to this behaviour because so many people have found themselves in these unwarranted situations just as a result of the breach of duty from the medical practitioners.

The liability of a medical practitioner covers both criminal and civil liability which comes to play as the burden of proof. Both the criminal and penal codes[2] which apply in the Southern and Northern States of Nigeria respectively in relation to the culpability of offenders contain elaborate provisions under which cases of Medical Negligence can be prosecuted. However, it is obvious that the medical practitioners owe their patients a duty of care; it is therefore expected of them to exercise that standard of care in the course of their due. If a patient suffers injury or damages as a result of failure of the medical practitioner to discharge his or her duty of care, the medical practitioner will be held liable for negligence. And the patient may institute an action against him or her. All medical practitioners are bound in performance of their duty to exercise all such care diligently and skill as is reasonably necessary for each particular circumstance.

This article explains the nature of professional responsibility, the consequences of breach of duty of care and the remedies available to the victims of the breach. It also includes the duties conferred on the patient and also the defenses available for the breach of duty.

Negligence as a tort is a breach of legal duty to take proper care which the outcome may lead to damage or injury to the patient.

Winfield stated that negligence as a tort is the breach of a legal duty to care which results in damages, undesired by the defendant to the plaintiff. It was early recognised that negligence would afford no remedy in law in the absence of a duty to the plaintiff. It is worthy to note that the development of the law of negligence has been built on this foundation, namely, identification of circumstances which give rise to a duty of care. The existence of a duty of care is by reference to the nature of activity being undertaken. In 1932, the House of Lord handed down the decision in the locus classicus case Donoghue V Stevenson[3] which established the Duty of Care.The judgement was in favour of Mrs Donoghue, who had found a decomposing snail in a bottle of ginger beer purchased by her friend. The court held that the manufacturer,

David Stevenson owed a duty of care to Mrs Donoghue despite the absence of a direct contractual relationship between them. This decision expanded the concept of negligence beyond contractual relationships, establishing that manufacturers have a responsibility to ensure the safety of their products for end consumers.

In law, negligence is the omission of doing something a reasonable man would understand in the same circumstances or doing something that a prudent or reasonable man would not[4]. As noted by the Declaration of Geneva: the health of my patient will be my first consideration International Code of Medical Ethics states: A physician shall owe his or her patients complete loyalty and all the scientific resources available to him or her. In the Supreme Court of Nigeria, In the case of Anya v Imo Concorde Hotel ltd  the court held that, The most fundamental ingredient of the tort of negligence is the breach of  the Duty of care which must be actionable in law and not a moral liability….

Therefore, a registered practitioner who fails to exercise the skill or act with the degree of care expected of his experience and status in the process of attending to a patient may be liable for professional negligence[5]. In the case of Abatan v Awudu[6] the court held that the relationship between a doctor and his patient is one of trust and confidence; a relationship where one has the power and duty to treat and restore the other to mental and physical wellbeing.

In UBT v Ozoemena[7] the Supreme Court defined it as: Lack of proper care and attention; careless behaviour or conduct, a state of mind which is opposed to attention, the breach of a duty of care imposed by common law and the statute resulting in damage to the complaint.

Therefore, where a doctor fails to attend and give prompt medical attention to a patient, leave behind in a patient abdomen an items after surgery, fails to completely access the patient, prescription of improper injection, incorrect diagnosis and so many other malpractices gives rise to medical negligence. Section 303 if the Nigerian Criminal Code Act, provides that any person who undertakes any lawful act except in a case of necessity, that may be dangerous to human life, has a duty to use such reasonable care and posses reasonable skill for doing such act. Also such person will be held responsible for any consequences resulting to the health and life of that person by reason of any omission to perform or observe that duty.

Ese Malami on law of tort[8], explains that several duties arises on the part of a medical practitioner towards his patient in a medical practitioner – patient relationship. He enumerated the duties which include; the Duty to provide adequate counselling, duty to warn the patient on any risk embedded in the treatment, duty to carry out proper diagnosis and duty to give proper treatment.

Bayero-Jimoh et al in the article Physician and Wrong Diagnosis of Patient: An assessment of Legal Duty and Liability in Nigeria opined that the inability of patients to realise the legal consequences and remedies available to him in the event if damage or injury caused through negligence of physician could be traced to religion and cultural belief of accepting fate. Medical practitioner can only treat and care, only God cures.

3.0.     CONCEPTUAL CLARIFICATIONS

3.1. DUTY OF CARE.

By definition, Duty of Care is a legal obligation imposed on an organisation, requiring adherence to a standard of reasonable care while preventing any acts that could foreseeably harm others. Much more than providing necessary employee benefits and insurance, Duty of care in the context of the modern workplace encompasses the protection of an employees health, safety, security and wellbeing. Whether on a remote site, at the office, on business travel, on an international assignment or working from home, the Duty of Care obligations remain and the absence of reasonable measures to prevent incidents may undermine an employees health and security and compromise the organisations performance.

Duty of care can only exist when a relationship has been established with another. A patient’s relationship with their doctor is unique. The majority of anaesthetists work in hospitals and typically do not have patients admitted to them directly. A duty of care relationship is established when a patient is admitted to the hospital, and this relationship extends beyond the admitting team to any clinician who interacts with the patient. Therefore, medical law scholars have maintained that every patient we encounter in our work environment is entitled to a duty of care from both the doctors the patient sees and the staff members who work for the Trust to provide patient care.

It is worthy to note that the development of the law of negligence has been built on this foundation, namely, identification of circumstances which give rise to a duty of care.The existence of a duty of care is by reference to the nature of activity being undertaken. In 1932, the House of Lord handed down the decision in the locus classicus case Donoghue V Stevenson which established the Duty of Care. The judgement was in favour of Mrs Donoghue, who had found a decomposing snail in a bottle of ginger beer purchased by her friend. The court held that the manufacturer, David Stevenson owed a duty of care to Mrs Donoghue despite the absence of a direct contractual relationship between them. This decision expanded the concept of negligence beyond contractual relationship, establishing that manufacturers have a responsibility to ensure the safety of their products for end consumers.

3.2. BREACH OF DUTY.

The term “breach” refers to the actual misbehaviour. Showing that the defendant owes the claimant a duty is insufficient; the claimant must demonstrate that the defendant has violated that duty by neglecting to exercise the necessary reasonable care. A level of appropriate behaviour that will impose excessive risks of harm to other people and their property is assumed to exist in order for the element of breach to occur. Depending on the degree of relationship between two people, such as between a restaurant owner and his patrons, a lawyer and their client, a doctor and their patient, etc., different standards of care are required for each other’s protection

A breach of duty occurs when the defendant’s actions fall short of the required level of care. A medical professional violates their duty to the patient when they fail to provide the necessary standard of care. The standards for medical professionals are established and updated by the Medical and Dental Council of Nigeria (MDCN). For instance, professional negligence is defined under Rule 28 of the Rules of Professional Conduct for Medical and Dental Practitioners, also known as the Code of Medical Ethics in Nigeria (2004). These acts include:

1. Failing to provide a patient in need of immediate attention while you have the opportunity.
2. Displaying incompetence in patient assessment.
3. Making a misdiagnosis when clinical signs were evident enough that any reasonably a skilled practitioner should have recognized them.
4. Failing to inform or providing incorrect advice about the risks of a treatment or operation, especially if it might cause serious side effects like deformity or organ loss.
5. Proceeding with a surgical procedure or treatment without obtaining necessary patient consent (informed or otherwise).

Thus, a doctor who negligently performs an operation in violation of these standards, resulting in injury or death, may be sued (Cook et al., 2003). For the same wrongdoing, Careless healthcare providers may face both civil and criminal prosecutions. The provider is accountable for unjustified duty breaches.

3.3. STANDARD OF CARE.

Although the term standard of care is nuanced by the changing approaches to its meaning[9], it can be defined medically and legally. Medically, standard of care is a diagnostic and treatment approach that a clinician should follow for a given type of patient, ailment or clinical setting[10]. In law, standard of care can be described as that degree of prudence anticipated of an ordinary reasonable individual who is under a duty of care. It refers to the level of caution expected of those whose actions inevitably put other people at danger of harm. It is argued that the standard of care needs vary depending on the situation. Generally speaking, what is needed is “reasonable”concern for other people’s safety. In practice, the standard of care varies according to the proficiency required of the individual. For example, if a person claims to have a particular skill, such as being a cardiac surgeon, then he must demonstrate the special skill and facilities required during a cardiac surgery. If a person presents himself as having the skill of an ordinary medical doctor, then all that will be expected of him is what an average doctor under similar circumstances will do.

Medical professionals have been shown to be required to treat patients with caution, but there must be a standard by which their actions are measured. It is important to understand that the required standard of care varies depending on time, place, and resource availability (Ojerinde et al., 2014). For instance, in an emergency, the expected standard of care may be lower than in normal circumstances because the provider may not have the necessary equipment. However, this does not absolve a practitioner of liability if they intentionally treat patients in environments with substandard care. A healthcare provider is expected to meet the standards of a typical, reasonable practitioner with the defendant’s degree of experience. The mere occurrence of an unfavourable event does not indicate carelessness on the part of the practitioner, provided that they adhered to recognised treatment guidelines. Similarly, in urban areas where significant technological advancements have taken place, the level of care that one anticipates from rural healthcare professionals may fall short of expectations. The decision in Warnock v. Kraft made it apparent that doctors in smaller communities with limited resources shouldn’t be held to the same standards as those in larger ones. Therefore, a doctor’s obligation is founded on both “skill”and “knowledge”in addition to the notion of “duty”to patients (Ezeome, 2011).

3.4. NEGLIGENCE.

Negligence is defined in law as the failure to do something that a prudent man would not do[11] or the failure to do something that a reasonable man would understand under the same circumstances.

Negligence is a legal concept that refers to a failure to exercise reasonable care, resulting in harm or damage to another person. It arises when someone acts carelessly or fails to act in a way that a reasonably prudent person would in similar circumstances.

Negligence occurs when there is a breach of duty or a standard of care that a practitioner in the said profession would reasonably and ordinarily expect.

To prove negligence is a legal case, three key elements must be present. Which include; duty of care, breach of duty, damages. A plaintiff, in a claim for breach of care, must prove that the defendant owed him that duty, that the defendant breached that duty, and finally, that he or she suffered damage because of the breach. The burden of proving negligence always lies on the plaintiff. However, there are many circumstances where, although the plaintiff can prove that an accident happened, he is unable to show how it happened. In such situations of the plaintiff inability to show how it happened, he may not be able to avail himself of the claim. However, the plaintiff can take refuge under the doctrine known as Res Ipsa Loquitur which means the facts speak for itself. In other words, the negligence is clear and where it is pleaded or applied, the burden of proof shifts to the defendant to disprove negligence as alleged by the plaintiff.

DEFENCES TO NEGLIGENCE:

There are two major defenses to negligence actions. They are,

a. Contributory negligence:

Contributory negligence is defined in law as actions that fail to uphold the standard of caution that one should observe for one’s own well-being and that lead to one’s own harm or loss. In defence of a negligence charge, the plaintiff’s contributory negligence is commonly invoked. The doctrine’s historical roots stem from a mistrust of jurors, who have typically shown greater sensitivity to plaintiffs in personal injury cases. The practice of not assigning blame to parties in lawsuits that is, assigning each party a portion of the blame. also supported the theory.

In most cases, contributory negligence occurs when a plaintiff accuses a defendant of negligence. The plaintiff may then be accused of contributory negligence by the defendant. Even if the defendant was negligent, the plaintiff cannot obtain any damages under common law if the defendant establishes this accusation by a preponderance of the evidence because contributory negligence eliminates the causal link between the plaintiff’s harm or loss and the defendant’s conduct. In certain U.S. states and English law since the Law Reform (Contributory Negligence) Act (1945), recovery may still be permitted if it can be demonstrated that the plaintiff was a contributing factor in the injury; however, an equitable reduction of damages is provided.

b. Vetenti non fit injuria/ Assumption of risk

Volenti non fit injuria (Latin: “to a willing person, injury is not done”), is a common law doctrine and Roman legal maxim that states that if someone voluntarily puts themselves in a situation where harm could occur, knowing that some degree of harm might result, they cannot sue the other party in tort or delict. Only the risk that a reasonable person would believe they have assumed by their actions is covered by volenti; therefore, a boxer agrees to be struck and to any injuries that may result from being struck, but not to his opponent punching him or hitting him with an iron bar outside of the bounds of boxing. Volenti is also known as a “voluntary assumption of risk ”

The plaintiff “consenting to run a risk” is another way to characterise volenti. Volenti differs from legal permission in this situation in that the latter can stop certain torts from ever happening in the first place. Giving permission for a medical operation, for instance, keeps the procedure from being a trespass to the individual, and giving permission for someone to visit one’s property keeps the individual from being a trespasser.
3.5. MEDICAL NEGLIGENCE

Medical negligence refers to a situation where a healthcare professional, such as a doctor, nurse, or hospital, fails to provide an acceptable standard of care, resulting in harm or injury to a patient. It occurs when a medical provider breaches their duty of care by making an error, omission, or failing to act in a way that a competent professional would under similar circumstances.

Medical negligence connotes a medical professional’s inability to meet the acceptable standard of care practiced by colleagues of similar professional calling[12].

When a registered medical practitioner fails to use the skill or act with the level of care expected of his experience and status while providing care to a patient, such as when he fails to provide emergency care to a patient when he was in a position to do so, he is liable for professional negligence. He is also liable for medical negligence when he obviously displays incompetence in the assessment of the patient, such as making the incorrect diagnosis when the clinical features were so obvious that no reasonably skilled practitioner could have failed to notice them. A negligence case is not always founded on medical carelessness because it does not always lead to harm. A negligence action won’t be successful if a medical professional violates the proper medical standard yet the patient remains unharmed. It must be demonstrated that the patient was harmed as a result of the carelessness.

4.0.    CHALLENGES IN ENFORCING THE DUTY OF CARE IN NIGERIA

4.1.  Inadequate Healthcare Infrastructure:

Nigerias healthcare infrastructure is severely lacking and unequally allocated between urban and rural regions. Numerous health facilities are in disrepair, missing essential amenities such as clean water, reliable electricity, and sanitary conditions. Diagnostic equipment, surgical instruments, and even basic supplies like gloves and syringes are frequently in short supply.[13]

Tertiary health institutions, intended to function as centers of excellence, experience overcrowding and scarce resources. Patients are often found lying on the floor due to a lack of available beds, and vital medications are either out of stock or sold at prohibitive prices. These infrastructural shortcomings significantly impair the ability of medical professionals to provide effective care, thus violating their duty of care.

In addition, the insufficient investment in healthcare infrastructure forces health workers to frequently improvise, raising the chances of medical errors. This issue is particularly critical in emergency situations, where time and equipment can determine life or death.[14]

Case Study: Lagos University Teaching Hospital (LUTH)

In 2017, reports surfaced regarding overcrowding and insufficient basic amenities at LUTH. Patients were reported to be resting on benches and floors because of bed shortages, and the hospital faced inconsistent electricity supply. This scenario underscored the alarming condition of tertiary healthcare facilities in Nigeria and the systemic obstacles to enforcing duty of care responsibilities.

4.2. Shortage of Medical Personnel:

Nigeria is experiencing a severe shortage of healthcare workers, including doctors, nurses, midwives, and laboratory technicians. This lack is intensified by the emigration of skilled professionals to developed nations, a trend commonly known as brain drain. According to the Nigerian Medical Association, over 75,000 Nigerian doctors practice overseas, while only about 35,000 remain in the country to cater to a population of more than 200 million.[15]

The result of this shortage is a dangerously high doctor-to-patient ratio, which often results in overworked and fatigued staff unable to uphold the necessary standard of care. Burnout among healthcare workers diminishes the quality of patient interactions, hampers clinical judgment, and raises the risk of negligence.[16]

Rural areas are especially underserved, as most professionals opt to work in urban locations that offer better facilities and living conditions. This geographical imbalanced distribution leads to systemic neglect of many segments of the population, further violating the principles of equity and access that are central to the duty of care.

Case Study: Brain Drain and Healthcare Workforce Crisis

A 2020 report by the African Health Journal revealed that Nigerian physicians relocating to the UK and Canada pointed to inadequate working conditions and limited opportunities for career advancement as key reasons[17]. In a specific case, the sole medical officer at a rural health facility in Benue State resigned because of insufficient pay and lack of equipment, leaving the community without a qualified physician.

4.3.  Legal and Regulatory Weaknesses:

The Nigerian legal system allows for professional accountability through legislation and regulatory entities such as the Medical and Dental Council of Nigeria (MDCN). However, enforcement continues to pose a considerable challenge. Disciplinary actions are frequently lengthy and unclear, and there is a widespread reluctance to hold wrongdoing practitioners responsible.[18]

Patients pursuing justice for medical negligence encounter several obstacles. Legal fees are exceedingly high, and the court system is often sluggish in delivering justice. Additionally, there is a scarcity of legal professionals and judges with expertise in medical law, which inhibits the successful adjudication of cases.[19]

There is also a lack of public awareness regarding the legal options available. Many patients do not realize that they can hold healthcare providers accountable for inadequate care, and even when they do, the complexities of the process and associated costs frequently deter them from pursuing legal action.[20] These elements collectively weaken the regulatory systems established to uphold the duty of care.

Case Study: Medical Negligence – The Ugonna Ndubuisi Case

In 2019, a young boy named Ugonna Ndubuisi passed away in a Lagos hospital after receiving an incorrect dosage of medication. Despite clear evidence of negligence, the hospital administration refuted liability, and legal actions were delayed for over three years. The case illustrates the challenges in achieving justice for medical negligence in Nigeria.

4.4. Corruption and Mismanagement:

Corruption remains a widespread concern in Nigeria, and the healthcare sector is no exception. Money intended for enhancing healthcare services is frequently misappropriated or poorly managed, resulting in deteriorating infrastructure, a shortage of necessary medications, and insufficient staff.[21]

Corruption also directly influences interactions with patients. In numerous public hospitals, patients must pay unofficial fees to receive quick attention or guarantee a hospital bed. Healthcare providers may focus on patients who are able to offer bribes, thus neglecting those who are in greater need but have fewer means.

The poor management of health sector budgets leads to medication shortages and inadequate upkeep of facilities. This disconnect between allocated funds and true service delivery diminishes public trust in the health system and violates the trust fundamental to the duty of care.[22]

Case Study: National Health Insurance Scheme (NHIS) Scandal

In 2018, a significant scandal surfaced involving the NHIS when its Executive Secretary faced accusations of fraudulent procurement activities and unauthorized expenditures. The mishandling of resources intended to ensure affordable healthcare coverage impacted thousands of enrollees, eroding faith in public health institutions and highlighting the overlap of corruption and healthcare provision.

4.5  Lack of Continuous Medical Education:

Medical science is a continually advancing discipline, necessitating that practitioners consistently refresh their knowledge and skills. However, in Nigeria, access to Continuing Medical Education (CME) is quite limited. Numerous healthcare professionals, particularly those in rural or low-funded regions, lack avenues for professional growth.[23]

In the absence of CME, healthcare professionals might depend on outdated information and methods, which can jeopardize patient safety. The scarcity of training in new technologies and treatment protocols makes it challenging for practitioners to provide modern, evidence-based care. In these settings, medical mistakes become more common, and the level of care declines.

Moreover, the institutional backing for CME is inadequate. Most hospitals do not set aside funds or time for staff education, and participation in professional conferences or workshops usually comes at the individuals cost. This discourages participation and continues a cycle of professional stagnation.[24]

Case Study: Failure to Recognize Ebola Symptoms

During the 2014 Ebola outbreak in Nigeria, the early misdiagnosis of the index patient, Patrick Sawyer, revealed deficiencies in training and preparedness. While the country ultimately contained the outbreak, the delay in symptom recognition emphasized the urgent necessity for updated training among frontline healthcare workers.

5.0.     RECOMMENDATIONS

1. Medical practitioners should be thoroughly informed about the nature of their tasks and the implications of these duties at all stages of their careers, as well as keep up with the latest trends in their field.
2. The Nigerian Medical and Dental Council should clearly define the proper hospital setting, equipment, and facilities. The government should quickly close hospitals that don’t fit these requirements, whether they are privately run or publicly owned, and should also regularly check them to make sure they’re complying.
3. The Medical professionals should always adhere to the requirements of medical practice and uphold a widely recognised professional standard of practice in order to fully comply with the Geneva Declaration.
4. The patient should be urged to seek compensation. There would be fewer cases of carelessness if doctors were held more accountable for their actions. The High Court and Medical and Dental Council of Nigeria (MDCN) have the mandate to discipline erring practitioners.
5. There should be public education and enlightenment of citizens so that they would be bold enough to challenge the infringement of their rights provided in Chapter ll of the CFRN 1999 ( as amended).
6. Laws governing medical negligence should be strictly enforced by the Nigerian government, and those who violate them should face appropriate penalties. As a result, there would be fewer medical malpractice cases nationwide.

6.0.     CONTRIBUTIONS TO KNOWLEDGE

The article contributed to knowledge as follows:

1. It revealed how legal positivism and deontological ethics intersect as frameworks for understanding healthcare practitioners’ responsibilities, offering a unique multidisciplinary viewpoint that is sometimes absent from Nigerian medical jurisprudence.
2. It highlighted the shortcomings in the existing legal system and enforcement practices that hinder efficient accountability and patient safety.
3. It offered doable suggestions for institutional capacity building, ethical awareness, and legislative reform that could influence governmental decisions and medical education programmes.

7.0.     SUGGESTED AREAS FOR FURTHER STUDIES

To improve understanding and increase the effectiveness of the duty of care in Nigeria’s healthcare system, the article identifies several areas that need more investigation:

1. Empirical Assessment of Duty of Care Implementation:

Care providers in both urban and rural medical settings need to have their awareness, understanding, and practical application of the duty of care examined. This also includes examining patient outcomes and experiences in relation to possible medical malpractice.

1. Alternative Dispute Resolution in Medical Negligence:

It is necessary to look into whether ADR methods like arbitration and mediation can be used to resolve medical malpractice cases. This strategy might offer quick and easy access to justice in a system where court cases are usually drawn out and expensive.

¡¡¡.  Regulation of Alternative and Traditional Medicine:

The ethical and legal obligations of practitioners of alternative and traditional medicine should be the focus of future studies. This is necessary because they are widely used in Nigeria and there is no clear regulatory structure in place to monitor their activities.

8.0.     CONCLUSION.

In conclusion, the duty of care is still a cornerstone of medical ethics and professional behavior, obligating healthcare professionals to provide patients with competent, compassionate, and legally acceptable treatment. In Nigeria, this responsibility is recognized both through common law doctrines and through professional conduct codes. Nonetheless, a variety of systemic, legal, and institutional obstacles hinder the execution and enforcement of this obligation.

The present state of medical practice in Nigeria shows discrepancies in the duty of care observance, which are sometimes worsened by outdated regulations, ineffective regulatory supervision, inadequate infrastructure, and training gaps. Furthermore, accountability is further weakened by the limited patient knowledge of their rights and the absence of accessible legal remedies. These problems have led to an increase in medical negligence cases and a decay in public confidence in the healthcare system.

Thus, a comprehensive assessment of the duty of care in Nigeria must go beyond pinpointing deficiencies to offering practical remedies. To establish standards and guarantee that violations are clearly defined and properly punished, legal reform is crucial. Equally important are enhancing healthcare infrastructure, bolstering regulatory agencies, and encouraging ongoing professional growth. Additionally, establishing a culture of ethics and accountability in healthcare organizations can aid in closing the gap between theory and practice.

In the end, the state, medical schools, regulatory bodies, and society as a whole share the responsibility of ensuring that duty of care is upheld in Nigeria, not just individual practitioners. A thorough and cooperative strategy is needed, one that prioritizes patients’ dignity and safety, maintains healthcare professionals’ professional integrity, and develops a health system that is both resilient and responsive. The Nigerian medical community can only then truly represent the trust and responsibility entrusted to it by the society it serves.

BIBLIOGRAPHY

1. Adebayo “Healthcare Worker Burnout in Nigeria,” African Medical Journal, Vol. 14, Issue 3, (2020)1.
2. Ugochukwu “Legal Challenges in Medical Negligence Litigation in Nigeria,” Nigerian Bar Review, (2019)7.
3. Uche “Barriers to Continuing Medical Education in Nigeria Public Hospitals,“Nigeria Medical Journal, (2019)6.
4. African Health Journal, “Nigeria’s Brain Drain: Causes and Consequences,” (2020)42.
5. BudgIT, “Tracking Health Budget Implementation in Nigeria,” (2022)1
6. J. Uko, Human Right Law, Right To Health In Africa And Aspects Of Tortous Liability And Medical Negligence (living Pub., 2007) 85.
7. Ese Malami, Law of Tort (Princeton Publishing Co., 2008).p 357-360
8. Nwankwo “Access to Medical Justice in Nigeria: Barriers and Solutions,” Health Law, (2020)15.
9. Medical and Dental Council of Nigeria (MDCN), Annual Report, (2020)12
10. Michellle Heller, Clinical Medical Assisting: A Professional Field Smart Approach to the workplace (2nd edn, Boston, Massachusetts: Centage Learning, 2016) 24
11. Nigerian Medical Association (NMA), “Press Briefing on Health Workforce Migration,” (2021)17.
12. NMA Journal, “CME Access and Gaps in Nigeria,” Vol. 23, (2021)2.
13. Adepoju “Nigeria’s healthcare system is in crisis,” The Lancet, Vol. 391, (2018)15.
14. Moffet and G. Moore ‘The Standard of Care: Legal History and Definition: The Bad and Good News”.(2019) 18
15. Resolution of Law Firm; “Nigeria Liability and proof of Medical Negligence in Nigeria (Monday 11, November 2020).
16. Transparency International, “Corruption in Nigeria’s Health Sector,” (2021)40.
17. World Health Organization (WHO), Nigeria Health System Review, (2018)7.
18. Yakubu John. Ademola, Medical Law in Nigeria,(Demyaxs Press Ltd) 2002.
19. Zontong, Kigaig Mandy An Analysis of the proof of Medical Negligence under Nigerian Law

ENDNOTES

[1]Zontong, Kigaig Mandy An Analysis of the proof of Medical Negligence under Nigerian Law

[2] Yakubu John. Ademola, Medical Law in Nigeria,(Demyaxs Press Ltd) 2002.

[3] Donoghue V Stevenson(1932) AC 562

[4] Diamond Bank Ltd v P.I.C Ltd (2009) 18NWLR

[5] Resolution of Law Firm; “Nigeria Liability and proof of Medical Negligence in Nigeria (Monday 11, November 2020).

[6] Abatan v Awudu(2003)10NWLR (pt 829) 451

[7] UBT v Ozoemena(2007) 3NWLR (pt 1022)

[8] Ese Malami, Law of Tort (Princeton Publishing Co., 2008).p 357-360

[9]  P. Moffet and G. Moore ‘The Standard of Care: Legal History and Definition: The Bad and Good News”.(2019) 18

[10] Michellle Heller, Clinical Medical Assisting: A Professional Field Smart Approach to the workplace (2nd edn, Boston, Massachusetts: Centage Learning, 2016) 24.

[11] ibid

[12] E. J. Uko, Human Right Law, Right To Health In Africa And Aspects Of Tortous Liability And Medical Negligence (living Pub., 2007) 85.

[13]  ^{World Health Organization (WHO), Nigeria Health System Review, (2018)7.}

[14]    ^{P. Adepoju “Nigeria’s healthcare system is in crisis,” The Lancet, Vol. 391, (2018)15.}

[15]   ^{Nigerian Medical Association (NMA), “Press Briefing on Health Workforce Migration,” (2021)17.}

[16]  A. Adebayo “Healthcare Worker Burnout in Nigeria,” African Medical Journal, Vol. 14, Issue 3, (2020)1.

[17]  ^{African Health Journal, “Nigeria’s Brain Drain: Causes and Consequences,” (2020)42.}

[18]  ^{Medical and Dental Council of Nigeria (MDCN), Annual Report, (2020)12.}

[19] A. Ugochukwu “Legal Challenges in Medical Negligence Litigation in Nigeria,” Nigerian Bar Review, (2019)7.

[20]  ^{I. Nwankwo “Access to Medical Justice in Nigeria: Barriers and Solutions,” Health Law, (2020)15.}

[21]   ^{Transparency International, “Corruption in Nigeria’s Health Sector,” (2021)40.}

[22]  ^{BudgIT, “Tracking Health Budget Implementation in Nigeria,” (2022)1.}

[23]    NMA Journal, “CME Access and Gaps in Nigeria,” Vol. 23, (2021)2.

[24]   A. Uche “Barriers to Continuing Medical Education in Nigeria Public Hospitals,“Nigeria Medical Journal, (2019)6.

ABOUT THE AUTHOR

Obamwonyi Osahenokemen Beauty is a law graduate from Western Delta University, Oghara, Delta State. She has a keen interest in Medical Law, Alternative Dispute Resolution ADR, Corporate Law, Property Law, Human Rights Law, Sport Law. Beauty is often praised for her academic excellence and level of dedication towards achieving a set goals as well as her ability to learn, analyze and provide solutions to legal issues. She can be reached via 08169259743 or [email protected]

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