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Y was from a family known in the village for abnormal behavior including some members being frankly mad. Y was different from the rest of his siblings. He managed to complete primary school and proceed to secondary school in the capital. His behavior was normal until the final year of High School when he started behaving abnormally. The teachers took him to the hospital where a schizoid illness was diagnosed and he was put on appropriate medication. He stabilized and was able to pass his examinations and was admitted to medical school. He then proposed to his high school fiancé but she was reluctant having noticed bizarre behavior from him towards the end of high school. Her parents decided to investigate. They talked to several people in the village who told them about Y’s good behavior different from the rest of the family. The parents then decided to confront Y’s mother telling her they had a proposal from him but that they were worried about going ahead because of bizarre behavior in the last year of high school. The mother explained that her son is very stable mentally and that the bizarre behavior was due to an episode of cerebral malaria which was controlled quickly by anti-malarial therapy. The family was not convinced and advised their daughter to cancel the engagement.
Y was devastated by the cancellation and it could not have come at a worse time because he was anxious about the first year examinations that would determine whether he would continue with his medical studies or would have to look elsewhere. He started smoking and drinking alcohol to forget but to no avail. A friend who found him agitated advised him to try illicit drugs that would be powerful enough to make him forget his misery. He tried cocaine only once and was very sick with a lot of vomiting and decided not to try again. His depression and anxiety continued for 2-3 weeks until he experienced a nervous breakdown and was admitted to a normal ward. While on the ward he became violent abusing and physically attacking patients and doctors. When calmed down by sedation he refused admission to the psychiatric ward claiming that he was not crazy. The doctors not wanting to get into too much trouble just left him alone. They started him on anti-psychotic drugs but he refused to take any more because of side effects. He was not interested in therapy sessions for his drug abuse and often quarreled with the therapist. Two weeks from his admission he left the ward without telling anyone and went and killed his former fiancée at her home. He later became very agitated and depressed and within 10 hours he also committed suicide. His parents and the parents of his ex-fiancee jointly sued the hospital for negligence.
Discussion:
- List ethico-legal issues in this case.
- If you are the judge in this case, what would be your opinion about finding the hospital guilty of medical negligence. Justify your answer.