“I swear by Apollo, the healer, Asclepius, Hygieia, and Panacea, and I take to witness all the gods, all the goddesses, to keep according to my ability and my judgment, the following Oath and agreement: ... If I keep this oath faithfully, may I enjoy my life and practice my art, respected by all men and in all times; but if I swerve from it or violate it, may the reverse be my lot.”
Thus begins and ends the ancient Hippocratic Oath (English translation) widely believed to have been written by Hippocrates, the father of western medicine, in Ionic Greek (late 5th century BC), and traditionally taken by doctors swearing to ethically practice medicine. There are slightly varied modern versions of the oath that serve as a rite of passage for practitioners of modern medicine. In Nigeria, practitioners of modern medicine swear to uphold the Hippocratic Oath as contained in the Physicians' Oath (i.e. the Declaration of Geneva) which is the modern Hippocratic Oath. The body of this modern oath is as follows:
“At the time of being admitted as a member of the medical profession:
- I solemnly pledge myself to consecrate my life to the service of humanity;
- I will give to my teachers the respect and gratitude which is their due;
- I will practise my profession with conscience and dignity; the health of my patient will be my first consideration;
- I will maintain by all the means in my power, the honour and the noble traditions of the medical profession; my colleagues will be my brothers;
- I will not permit considerations of religion, nationality, race, party politics or social standing to intervene between my duty and my patient;
- I will maintain the utmost respect for human life from the time of conception, even under threat, I will not use my medical knowledge contrary to the laws of humanity;
- I make these promises solemnly, freely and upon my honour.”
The death of Bayo Ohu, hastened, after devastating gunshot wounds, by the refusal of a Nigerian hospital to treat him, and numerous similar cases involving known and unknown Nigerians, call to mind the sad abyss that our national life has sloped into. Bayo, no doubt, has enjoyed tremendous posthumous popularity but that is now fading faster than it began and we will move on without him, or, we have moved on. The police will investigate the gruesome murder and we will, as always, hang on to the remotest possibility of success; another hospital will deny a gunshot victim the opportunity to live and if that person is a journalist or any person of consequence, we will again be entertained with the fascination of violent crime reports and lamentations of how such a person might have been saved had the hospital agreed to treat him, or her. Before Bayo Ohu, there were many sad, sombre tales of hospitals refusing treatment to gunshot victims on the excuse of Police Report; many unknown Nigerians, helpless, bled to death as a result and there is no suggestion that this folly-cycle is over.
My friend, Tutu, narrated how his cousin who was trailed home by robbers on her way from the bureau-de-change where she had gone to change foreign currency lost her life from gunshot wounds after she was refused treatment by four different hospitals including the particular hospital where she had been delivered of her baby. According to Tutu, it made no sense to the doctors and other hospital personnel that the woman was already registered with the hospital which enabled her benefit the maternity service from the hospital; the Police Report ranked above the life of the helpless woman. Cruelty! The fact that this matter recurs unaddressed is more worrisome. The police does not make laws anywhere in the world, and they do not make laws in Nigeria. Ostensibly, this cruel practice of denying treatment to victims of gunshot wounds may have stemmed from the bandwagon syndrome that pervades our polity. There were reports in the past of policemen having harassed doctors and other hospital personnel for treating such victims, including volunteers who brought the wounded to the hospital but this might have simply been unscrupulous policemen (which are in the overwhelming majority in the Force), as is often the case, arrogating to themselves powers beyond them and their employers. Subsequently, such tales of harassments spread and professionals who ordinarily should possess greater levels of intelligence succumbed to a most unlawful hoax that would time and time again claim more innocent lives than the lives of real or suspected criminals. It is shameful and most condemnable that doctors all over the country would compromise the survival of patients for fear of police arrests or harassment. Where is the courage that ennobles the profession? Has anyone bothered to trace the exact origin of this order by the police, or for that matter, cited any official document barring hospitals from saving the life of gunshot victims. It is time for review, in theory and in reality.
I am one of the many Nigerians who have experienced and therefore understand the recklessness and overreaching inanities of the Nigerian Police. In truth, I have more than once dragged the Force and the AGF to court to challenge their unlawful acts. Therefore, I ordinarily should not make any defence for the Police. This is no defence. We are in the very urgent necessity of pointing our reproachful fingers in all the right directions. Today, after more than two weeks of careful reflection, the balance of blame sincerely appears to me to tilt towards the medical practitioners, especially the representative and disciplinary body, the Nigerian Medical Association (NMA). I am particularly unhappy and deeply saddened to realize this.
On account, the police, though it has now denied such, issued a directive in the past barring emergency medical attention for gunshot victims without prior police permission, wrongly claiming legitimacy from the Robbery and Firearms (Special Provisions) Decree No. 21 of 1984 which was amended in 1986 with the addition of a new provision in Section 4 (2) which provides that “It shall be the duty of any person, hospital or clinic that admits, treat or administers any drugs to any person suspected of having bullets to immediately report the matter to the police”. The Decree did not envisage and did not provide for the hospitals to report to the police or obtain a Police Report before treatment. I hold that the Police basked in this unlawful directive only because this nation acquiesced, and did not challenge them. Actually, it may seem that the Nigerian Police never firmly claimed to have made any such order barring hospitals from treating gunshot victims unless a Police Report is produced. I have scoured various sources but cannot find any lawful or valid reference to such order by the police authority. Following the death of Bayo Ohu, incumbent Inspector General of Police, Ogbonnaya Onovo categorically denies that the police ever banned the treatment of gunshot and accident victims without police report. According to the Inspector General of Police: “At no time did the Police restrain medical doctors from attending to the needs of the victims.” Now, to the shame of practitioners of this still noble profession, Onovo says, “The Police cannot be promoting right to life and at the same time be denying treatment to those whose lives are threatened by accidental injury or gunshot wounds. Doctors and other medical personnel have a primary duty to save lives”. If this last statement from Onovo had not been tagged, one might have readily accredited it to the Nigerian Medical Association. As a security expert, I find nothing untoward in the simple requirement the Inspector General of Police included which is “All that the Nigeria Police Force asks of them is to first do their duties, and immediately thereafter inform the nearest Police station/formation of the presence of such wounded persons, as the Police may find reason to inquire into the circumstances surrounding the injuries or gunshot”. Absolute good sense! I now believe that no matter how belated, Mr. Onovo has discharged an overbearing responsibility of dispelling this terrible myth. It now behoves the Nigerian Medical Association, belated nevertheless, to take a stand, challenge whatever is not clear, advise its members appropriately, discipline erring ones and uphold the integrity of this profession. Our lives, our survival as citizens of Nigeria depend on such important endeavour.
But how did we ever contrive to rank the necessity of capturing wounded criminals over that of saving human life, be it that of the innocent citizen or the criminal. No one is really a criminal until convicted by a court of competent jurisdiction. This is what we know, it is part of our education, our civilisation, it is sufficiently clear in our fundamental law, the 1999 Constitution of the Federal Republic of Nigeria and clearly so in all others before it. That as a people, we were goaded by a baseless fable to condone the loss of salvageable lives summarizes the classic Nigerian complacency. Everything thrown our way, debasing and exploitative, deadly and detrimental, hardly beneficial is accepted and entrenched as a norm, so much so that every attempt to restore the proper form turns herculean and often unfeasible. These problems are fundamental. It reflects the root-deep rot in our value system. Honour is now a thing of little consequence, indeed, a thing of shame, sometimes attracting communal indignity. Our education and its true worth are in serious doubt; the decline is sordidly steep but I am writing about the non-treatment of gunshot and accident victims. It would perhaps be more fathomable, and somewhat less offensive to commonsense if barbers were complying, in fear, with, say, a police order not to shave people with dreadlocks than it is to comprehend medical doctors, and nurses complying, without proper verification and contest, with a myth not to save lives. Saving lives is their primary calling, the raison d’être of their noble profession; the failure to save lives and give succour would divest the medical profession of its charm, goodwill and nobility. It is to be expected, normally, that were there to exist any law that bars doctors from saving lives, that the practitioners, individually and collectively, would fiercely challenge such laws. Perhaps, doctors should know that in cases where overzealous policemen harass them while carrying out their lawful duties, they could petition the Inspector General of Police or seek compensation and restraint in the law courts. This is trite! I am sad, very sad. I know a lot of people who are.
The logic of delaying treatment of gunshot and accident wounds until a Police Report is obtained, in order to catch criminals, ought to fail on its own, with commonsense, the Police, the medical practitioners, the President of this country and in any court. Robbers and other criminals would logically sustain gunshot wounds under pursuit or repulsion by the police, vigilante group or courageous citizens who are able to do so. It follows that if the police for instance are in pursuit of, or, are engaged in an exchange of gunfire with suspected criminals in which the criminal escapes, it is necessarily part of a thorough security job to scan the neighbourhood, nearby vegetation and hospitals within a logical area for possible patients with gunshot or crime related wounds. The scanty number of hospitals in even the most densely populated cities ordinarily allows for a practical search. However, if numbers are an issue at all, communication technology simplifies this task today. Logic apart, it will always be more sensible for criminals to escape than for innocent citizens to die in the phantom pursuit of criminals. In fact, a criminal or a suspected criminal should not die, should not be watched to die by anyone save in the lawful execution of a death sentence passed on such a person by law. The appropriateness of capital punishment is a different matter.
It is desirable that suspected criminals do not escape once immobilized, as this will help reduce crime but hospitals do not possess the skill or knowledge to decipher criminals. They have the skills and duty to save all lives. However, hospitals can contribute to our collective security by informing the police of gunshot wounds as soon as possible, as the Inspector General of Police has requested. Anything else from that point is the job of the police – to verify the identity of the victim, watch over or ultimately arrest such a victim upon regaining stability as certified by the hospitals. Nothing should be done at any time to endanger the life of anybody. My friend, Tutu (aforementioned) has suggested in despair, and sadly so, that the hospitals handcuff victims of gunshot wounds while treating them. No, Tutu, I disagree utterly. I understand your despondency in this matter, having lost a dear one, but NO! A handcuffed criminal can be rescued by his gang if need be and the hospitals would be helpless. There are better ways!
Senator Osita Izunaso’s commendable bill is an example. I became aware of its contents while writing this. The bill seeks to empower medical practitioners to treat gunshots and accident victims first and then intimate the police of the presence of such victims. According to Senator Izunaso, “This bill also seeks to prevent the police from removing any victim of gunshot from any hospital without certifying the person fit by a health practitioner or hounding health practitioners who treat gunshot victims”. Section 3(i) of the bill provides: "No person with gunshot wound shall be refused immediate and adequate treatment by any hospital in Nigeria whether or not initial monetary deposit is paid”. Further, the bill has penal sections with varying degrees of jail terms for offenders. I might have disagreed with the specificity of the time for reporting to the police and the mechanism for such but I wish the bill well and an expeditious consideration into law. We can fine-tune subsequently. Commendable, Senator Izunaso, very noble cause!
The clarification by Mr. Onovo is somewhat tardy but it suffices. We should not wait for more. In the past, about 1997, the police announced through Mr. Young Arebamen, its spokesman at the time, that it had withdrawn any such directive requiring hospitals to deny treatment to victims of accident and gunshot wounds without a Police Report. Twelve years later, medical practitioners and the Nigerian public are in need of further clarification by the Inspector General of Police and a legislative bill to etch the obvious to understand that there is no special permit required by doctors to save any life anywhere in our civilisation. Alright! Mr. Onovo has clarified; we are waiting on the Nigerian Medical Association and the medical practitioners. We cannot by any means restore the lives lost, but we can save a lot more tomorrow than we lost yesterday.
I suggest that Nigerians, who wish to contribute to the success of this goal, print a copy of the Inspector General of Police’s clarification, make copies and distribute to hospitals, doctors, nurses and citizens alike. Nigerians, discuss issues like this wherever and whenever you can with medical practitioners, the police, and with everyone; we have to keep talking while we have no genuine political voice. Let us act for change, now!
