High incidence of maternal deaths: Does medical and clinical practice needs stringent regulation?


High incidence of maternal deaths:  Does medical and clinical practice needs stringent regulation?

It is often asserted that tort law, and the threat of tort law with regulation, is unhelpful in terms of medical care and treatment as the fear of litigation discourages the open admission of medical and clinical errors. To this end, the severe option of criminalising such errors is also viewed negatively from a safety culture perspective.

But as maternal mortality ratio remains stubbornly high due to sepsis, haemorrhage and eclampsia, there is an urgent need for the Government to take measures that would strengthen the regulation of healthcare and clinical practices so as to prevent preventable deaths. It is indeed obligatory on the State to provide the resources and the necessary infrastructures to promote effective healthcare delivery. But also necessary for the Government to adopt a strategy to increase its steering and regulatory capacity; with object of influencing clinical practice if it is to curtail medical malpractices. Without effective legislative framework, patients cannot receive good healthcare necessary to preserve lives.  

The gaps in our healthcare system requires us  to put into place a set of systems and activities intended to ensure that health care practitioners and providers have the necessary resources, knowledge and skills, in order to  provide safe health care to ordinary people.  Therefore, in these circumstances it would be proportionate to pursue healthcare providers and professionals directly; for failing to provide safe and acceptable standard of clinical practices because it is just to provide remedy injuries caused by reckless care.  In fact; by the reason of the practitioner’s breach of duty, if but for the professional’s reckless act the patient has suffered injuries, to my mind, it is right and proper for the law to provide adequate monetary compensation. It may well be entirely justifiable to criminalise medical malpractices that are so palpable and had caused irreparable injury to patients. We cannot remained trapped in the erroneous belief that medical and clinical errors that led to fatality are acts of Allah/God because such deaths are meant to happen anyway. I think it is only fair that healthcare professionals and providers be held accountable for medical negligence practice for the interest of justice

 Conversely, some may argue that juridification of medical malpractices would lead to practice of defensive medicine given the adversarial nature of such process, which could damage patient-practitioner relationship.

While overregulation may be seen as counterproductive and expensive, there is a legitimate reason to regulate healthcare professionals and providers as regulation is central to theattainment of good heath outcome for patients.  Thus it is optimistically assumed that regulation will prevent culture of cover-ups and professional collegium that tend to affect professionals’ ability to whistle blow on poor practice and ensurethat justice is served accordingly.

Indeed, the law must also support the ethical case for honesty by imposing a legal duty on healthcare professionals and providers of care to openly disclose adverse events to their patients. That way, trust and confidence in medical and clinical practice can be restored to imbue good patient- practitioner relationship.

The overriding consideration here, is to ensure that healthcare professionals and providers provide effective and safe healthcare to the public, in particular to the most vulnerable patient group, pregnant women. For this reason, regulation seems a legitimate and proportionate means to curtail medical malpractice in response to unacceptable maternal deaths in the Gambia. This, in my view, makes the regulation of medical and clinical practiceindisputable public interest. 

In conclusion, the high maternal deaths should serve as a lightbulb moment for everyone to find ways in preventing preventable deaths. More importantly, if the State is to protect its citizens from harm, it must proportionately regulate healthcaredelivery and clinical practice so as to root out medical malpractices and improve health outcomes in the Gambia.

Solomon Demba


Join The Conversation