Why are Doctors Protesting against the Rajasthan Right to Health Bill? (Part 2)

Why are Doctors Protesting against the Rajasthan Right to Health Bill?
(Part 2)

CONTENTION NUMBER 2:
What is meant by Emergency services exactly?

[1] The bill states that medical care for emergencies like accidents, snake bites and others as determined by the state health authorities will have to be provided without insisting on payment of fees.

[2] The emergency conditions included under this have been left open ended, to be yet determined by the health authorities.

[3] This vague definition could lead to a lot of confusion and misuse as the term ‘emergency’ in itself can be interpreted in multiple ways.

[4] While having high fever and chills may be considered an emergency to patients, but if the vitals are stable, that would not be considered a medical emergency.

[5] If the ministry of health does come up with a certain of number of situations to be considered as emergency, even then determining the applicability of the rule could be subjective. For example, the current definition the rule includes accidents. But accidents can vary from simple wounds requiring a dressing to brain or spinal injury requiring emergency surgery.

[6] It would be next to impossible to come with exact scenarios where the clause will apply. Even with the best efforts of the ministry and medical advisors, if a definition like ‘life threatening emergencies’ were to be laid down, even then the clinical determination of threat to life would be complex. It could be hard to say at what point a limb threatening injury or an obstetric emergency should be considered as life threatening.

[7] The next issue would be determining what treatment would constitute ‘emergency treatment’ and what would constitutive ‘definitive treatment’. Whether merely stabilising the vitals would be sufficient or would even emergency surgery required to be done under this clause.

[8] When there is going to be ambiguity on these, there is going to be a serious risk that medical treatment decisions would be influenced by applicability of this clause.

[9] This would unintentionally encourage medical professions to document conditions as not being medical emergencies even if they are. While that would not be ethical, and most doctors would not do that, we would be creating a situation where doctor’s own interests are against that of getting the best result for the patient.

[10] All these ambiguities would eventually end up with a plethora of claims and counter-claims by patients and doctors, thereby taking up several man hours of doctors, administrators and committee members.

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