Detention Of Patients In Hospitals

Sonnie Ekwowusi writes that the detention of
patients by hospitals is wrong

Last week I found myself in a certain big hospital in Lagos
(name withheld) trying to assist a terminally-ill patient who had
been detained by the hospital for non-payment of hospital bills.
That was not the first time I was encountering such a patient being
maltreated by a hospital. Over the years I have been encountering
patients who had been detained by hospitals for non-payment of
bills. Increasingly hospital managers in Nigeria are detaining
their patients for their inability to pay hospital bills. As far as
the managers of these hospitals are concerned, the most effective
way of compelling poor patients to pay their hospital bills is to
detain them at the hospital immediately after treatment or midway
during treatment. Que barbaridad!

The dying patient who solicited my assistance last week
underwent a major surgery at the hospital. Prior to the surgery,
the patient, with the assistance of many charities and generous
public donors, paid the hospital in question a gargantuan sum of
N17.5 million. The sum covered all pre-surgical and surgical
expenses. But unfortunately the surgery was unsuccessful. Before he
was wheeled into the hospital operating room he wasn’t experiencing
any severe pains in his stomach. But since he underwent surgery he
had in the last one month been writhing in great pain. As at last
week, the patient could hardly eat, let alone sleep at night due to
the intense pain. Not even his wife, children, brother and friends
frequenting the hospital to accompany him could console him or
cheer him up. The pain seems unbearable. The pathetic aspect is
that the hospital is unsure of the time the patient would be
relieved from the intolerable pain. To add insult to injury, the
hospital had slammed additional N6.2 million post-surgery bills on
the patient. To avoid incurring more hospital bills and expenses,
the family and friends of the patient had applied last week to the
hospital to temporarily discharge the patient from the hospital so
that he could go home and be attending hospital from home. The
hospital turned down the application. Instead of acceding to the
application, the hospital insisted that the patient must pay at
least 50% of the N6.2 million additional post-surgery bills. Before
I left the hospital last week the patient was still being detained
despite all pleadings. I even had a meeting with the hospital
management wherein I pleaded with them to allow the dying patient
to go home. As we struggle to live with multiple perceptions of the
truth, we should aim at building one world rooted in common
humanity in which care for the sick occupies a primordial place.
The sick are always with us and we cannot afford to remain in our
respective cocoons unmindful of their plight.

Clearly the detention of the patient by the hospital is
unconstitutional and illegal. By placing the patient under a false
imprisonment for non-payment of bills, the hospital had flagrantly
violated his right to freedom of movement and right to human
dignity as enshrined in our 1999 Constitution and African Charter
on People’s and Human Rights. Secondly, by acting as the offended
party, complainant, accuser, prosecutor and the judge in their own
case, the hospital had violated the rule of natural justice
expressed in the well-known Latin maxim Nemo judex in causa
sua.

You see, two wrongs cannot make a right. If the hospital was
aggrieved that the patient had not settled his hospital bills
before applying to leave the hospital, all it could have done was
to request the patient or his relatives to enter into a written
undertaking agreeing to the mode of and precise date of settling
the bills. Subjecting the patient, who had earlier paid the
hospital a whopping sum of N17.5 million, to psychological torture
and humiliation simply because he was unable to pay his
post-surgery bills is, in my humble view, inhumane. More
importantly, recourse to force and self-help in settling disputes
is a recipe for chaos and anarchy. A hospital not governed by the
rule of law poses great danger to society. This probably explains
why the law court has been vested with the jurisdiction to
determine or settle all matters relating to the civil rights and
obligations of the citizens.

Consequently, Nigerian hospitals should stop detaining patients
for non-payment of bills. Aggrieved patients should approach the
law court to seek remedy. Nigeria and Cameroun, I gather, are
holding the world record as countries with hospitals where patients
are routinely detained for non-payment of hospital bills. Why is
Nigeria always featuring bad things? I also gather that some
Nigerian pregnant women who had been detained in some hospitals for
non-payment of hospital bills had died. Remember Mrs. Folake
Oduyoye, a pregnant lady who was detained at the Lagos University
Teaching Hospital (LUTH) for non-payment of her hospital bills
despite the entreaties of her husband that the bills would be paid
in due course? Sad to say, Mrs. Oduyoye eventually died at LUTH on
December 13, 2014 while still in detention.

It is high time Nigerian governments understood that access to
affordable health care is no longer a privilege: it is a human
right of the citizenry. Nigeria’s greatest challenge over the years
is making basic primary health care accessible to her citizenry.
Come to think of it, provision of basic primary health care is no
rocket science. All it takes the government to achieve that
laudable goal is for it to get its priorities right. For example,
instead of wasting $2 billion in constructing a railway line from
Kano to Niger Republic, the Buhari administration should have spent
the aforesaid amount in re-equipping public hospitals in Nigeria or
providing affordable public health Insurance for Nigerian citizens.
After assuming power in 2015 President Buhari promised that he
would ensure that many Nigerians had unimpeded access to primary
health care services. In one speech, President Buhari said: “Our
goal of revitalizing the Primary Health care Centres is to ensure
that quality basic health care services are delivered to the
majority of Nigerians irrespective of their location in the
country”. Till date, the President has not fulfilled this promise
and other promises.

Beyond the government, the citizens cannot turn their back on
their fellow citizens who are sick. To achieve this goal, it is
imperative that we establish a broader consensus about the meaning
of humanitarianism, and about its role in the promotion of human
welfare. We need to identify common values from which to erect an
ethical framework for human solidarity. In identifying this ethical
framework, the pitiable situation of the sick particularly merits
top priority. The citizens should build a strong solidarity for the
welfare of the sick. We must set out in earnest to set up
formidable blocks of social institutions to alleviate the
sufferings of the sick in our midst. No man is an island unto
himself. We cannot live in our little cocoons unmindful of the
plight of the sick in our midst.

Sonnie Ekwowusi writes that the detention of
patients by hospitals is wrong

Last week I found myself in a certain big hospital in Lagos
(name withheld) trying to assist a terminally-ill patient who had
been detained by the hospital for non-payment of hospital bills.
That was not the first time I was encountering such a patient being
maltreated by a hospital. Over the years I have been encountering
patients who had been detained by hospitals for non-payment of
bills. Increasingly hospital managers in Nigeria are detaining
their patients for their inability to pay hospital bills. As far as
the managers of these hospitals are concerned, the most effective
way of compelling poor patients to pay their hospital bills is to
detain them at the hospital immediately after treatment or midway
during treatment. Que barbaridad!

The dying patient who solicited my assistance last week
underwent a major surgery at the hospital. Prior to the surgery,
the patient, with the assistance of many charities and generous
public donors, paid the hospital in question a gargantuan sum of
N17.5 million. The sum covered all pre-surgical and surgical
expenses. But unfortunately the surgery was unsuccessful. Before he
was wheeled into the hospital operating room he wasn’t experiencing
any severe pains in his stomach. But since he underwent surgery he
had in the last one month been writhing in great pain. As at last
week, the patient could hardly eat, let alone sleep at night due to
the intense pain. Not even his wife, children, brother and friends
frequenting the hospital to accompany him could console him or
cheer him up. The pain seems unbearable. The pathetic aspect is
that the hospital is unsure of the time the patient would be
relieved from the intolerable pain. To add insult to injury, the
hospital had slammed additional N6.2 million post-surgery bills on
the patient. To avoid incurring more hospital bills and expenses,
the family and friends of the patient had applied last week to the
hospital to temporarily discharge the patient from the hospital so
that he could go home and be attending hospital from home. The
hospital turned down the application. Instead of acceding to the
application, the hospital insisted that the patient must pay at
least 50% of the N6.2 million additional post-surgery bills. Before
I left the hospital last week the patient was still being detained
despite all pleadings. I even had a meeting with the hospital
management wherein I pleaded with them to allow the dying patient
to go home. As we struggle to live with multiple perceptions of the
truth, we should aim at building one world rooted in common
humanity in which care for the sick occupies a primordial place.
The sick are always with us and we cannot afford to remain in our
respective cocoons unmindful of their plight.

Clearly the detention of the patient by the hospital is
unconstitutional and illegal. By placing the patient under a false
imprisonment for non-payment of bills, the hospital had flagrantly
violated his right to freedom of movement and right to human
dignity as enshrined in our 1999 Constitution and African Charter
on People’s and Human Rights. Secondly, by acting as the offended
party, complainant, accuser, prosecutor and the judge in their own
case, the hospital had violated the rule of natural justice
expressed in the well-known Latin maxim Nemo judex in causa
sua.

You see, two wrongs cannot make a right. If the hospital was
aggrieved that the patient had not settled his hospital bills
before applying to leave the hospital, all it could have done was
to request the patient or his relatives to enter into a written
undertaking agreeing to the mode of and precise date of settling
the bills. Subjecting the patient, who had earlier paid the
hospital a whopping sum of N17.5 million, to psychological torture
and humiliation simply because he was unable to pay his
post-surgery bills is, in my humble view, inhumane. More
importantly, recourse to force and self-help in settling disputes
is a recipe for chaos and anarchy. A hospital not governed by the
rule of law poses great danger to society. This probably explains
why the law court has been vested with the jurisdiction to
determine or settle all matters relating to the civil rights and
obligations of the citizens.

Consequently, Nigerian hospitals should stop detaining patients
for non-payment of bills. Aggrieved patients should approach the
law court to seek remedy. Nigeria and Cameroun, I gather, are
holding the world record as countries with hospitals where patients
are routinely detained for non-payment of hospital bills. Why is
Nigeria always featuring bad things? I also gather that some
Nigerian pregnant women who had been detained in some hospitals for
non-payment of hospital bills had died. Remember Mrs. Folake
Oduyoye, a pregnant lady who was detained at the Lagos University
Teaching Hospital (LUTH) for non-payment of her hospital bills
despite the entreaties of her husband that the bills would be paid
in due course? Sad to say, Mrs. Oduyoye eventually died at LUTH on
December 13, 2014 while still in detention.

It is high time Nigerian governments understood that access to
affordable health care is no longer a privilege: it is a human
right of the citizenry. Nigeria’s greatest challenge over the years
is making basic primary health care accessible to her citizenry.
Come to think of it, provision of basic primary health care is no
rocket science. All it takes the government to achieve that
laudable goal is for it to get its priorities right. For example,
instead of wasting $2 billion in constructing a railway line from
Kano to Niger Republic, the Buhari administration should have spent
the aforesaid amount in re-equipping public hospitals in Nigeria or
providing affordable public health Insurance for Nigerian citizens.
After assuming power in 2015 President Buhari promised that he
would ensure that many Nigerians had unimpeded access to primary
health care services. In one speech, President Buhari said: “Our
goal of revitalizing the Primary Health care Centres is to ensure
that quality basic health care services are delivered to the
majority of Nigerians irrespective of their location in the
country”. Till date, the President has not fulfilled this promise
and other promises.

Beyond the government, the citizens cannot turn their back on
their fellow citizens who are sick. To achieve this goal, it is
imperative that we establish a broader consensus about the meaning
of humanitarianism, and about its role in the promotion of human
welfare. We need to identify common values from which to erect an
ethical framework for human solidarity. In identifying this ethical
framework, the pitiable situation of the sick particularly merits
top priority. The citizens should build a strong solidarity for the
welfare of the sick. We must set out in earnest to set up
formidable blocks of social institutions to alleviate the
sufferings of the sick in our midst. No man is an island unto
himself. We cannot live in our little cocoons unmindful of the
plight of the sick in our midst.