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Medico-Legal: Clinicians owe duty to treat you well and with dignity

Differences between Criminal Law and Civil Law Criminal Law: In criminal law, the action of the government is represented and conducted by the Ministry of Justice of either the federal or state government. If a crime is committed by an individual, say unintentional death in the hands of a clinician, the government can step in to determine if prosecution is necessary.

The agency of the Ministry (the Police) would have investigated the case and pass the file to the prosecutor in the ministry. The decision on persecution or court appearance rests with the prosecutor (the government). Such criminal case is between the alleged criminal and the government (the state).

Criminal cases are about making a deterrent to others not to commit such crime and a punishment to current alleged criminal for his bad behaviour. The punishment varies from community service, deferred imprisonment, house arrest, imprisonment or whatever punishment the court sees fit.

Civil Law: In civil claim under civil law, the battle is between two individuals either biological individuals or businesses. The government have no role to play but the claim can itself be against any level of the government or their agencies and aggrieved members of the society. Very often, civil claim is about making restitution. The aim of restitution is to place the victim in the position that he or she would have been had the alleged injury never occurred. Court can order under civil claims such restitutions as apologies and monetary rewards or both. The court can order anything it sees fit and even the court can go as far as recommending prosecution of the participants.

In some situations, some cases can both be in the remit of criminal and civil laws. We shall see such a case under clinical negligence.

Clarification of Terms Clinic: Often operating as an out-patient as distinguished from a hospital, a clinic is a place where medical treatment is given to patients.

Clinician: Unlike someone who does laboratory or research work, a clinician is a qualified health professional, such as a physician, psychologist, or nurse, who is directly involved in patient care.

Clinical Practice: Clinical Practice is relating to or based on place and or work done with real patients: It relates to the medical treatment that is given to patients in hospitals, clinics and other health centres.

Hospital: Hospital is an extension of a clinic but with admission facilities for patients (in-patients unlike out patients).

Patient/Client/Service User: Is a person receiving or a person who is registered to receive medical or clinical treatment.

Laboratory and Researchers: Are personnel that works in laboratory and very often do not come in direct contact with or participate in direct management of the patient.

Law of Assault in Nigeria: Section 252 of Criminal Code: “A person who strikes, touches, or moves, or otherwise applies force of any kind to, the person of another, either directly or indirectly, without his consent, or with his consent, if the consent is obtained by fraud, or who by any bodily act or gesture attempts or threatens to apply force of any kind to the person of another  without his consent, in such circumstances that the person making the attempt or threat has actually or apparently a present ability to effect his purpose, is said to assault that other person, and the act is called an assault.”

Assault: The threat or the use of force on another that causes that person to have a reasonable apprehension of imminent harmful or offensive contact. The act of putting another person in reasonable fear or apprehension of an immediate battery by means amounting to an attempt or threat to commit a battery.

The act of the defendant must have been such that a reasonable man might fear that violence was about to be applied.

An assault is unlawful, and constitutes an offence unless it is authorised or justified or excused by law.

The application of force by one person to the person of another may be unlawful, although it is done with the consent of that other person.

Salient Features of Clinician-Patient Relationships: I will now discuss some crucial features that all patients should expect from their carer. These features are in fact enshrined in the law that regulates the clinicians. Such regulatory law is called the code of conducts.

Confidentiality: Clinicians (doctors, nurses and so forth) are duty bound to keep secret and private all information that the patient had disclosed to the clinician. Except as may be ordered in and by court of law, such information must not be passed to anyone that is not handling or be part of the caring for the patient.

Consent: Agreement of the care receiver must be sought in all procedures and operations that the patient may engage in. Minors who are between 13-16years may consent for themselves if they understand the procedures and operations in question. Otherwise, guardians and parents are allowed to provide consents.

Failure to obtain consent by a clinician before undertaking a procedure and surgery is deemed an assault.

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