Patients Seeking Free Treatment
Q: As a doctor working in an army hospital, I am often requested by relatives and poor people for free treatment, which could involve admission to hospital for examination, treatment and even operations. I request my specialist colleagues to see them and they do so freely, although this is against the rules. I often give such colleagues small gifts in appreciation of their help. Is what I am doing permissible? On the other hand, the number of patients I have to see on my round is very large and I am often exhausted. Some patients try to exaggerate their cases in order to stay in hospital or to have some drugs, which I have to prescribe. The choice is often between acceding to a patient’s request and turning rigid. Please advise.
A: Your first question concerns helping people to receive medical treatment from the army hospital when the rules and regulations do not allow it. It is important to realize that such rules must be put in place in order to ensure that the hospital functions well and provides the service for which it is intended. If it was a free-for-all situation, it will become chaotic and the patients who are really in need of medical care may not be able to obtain such care. However, even the authorities setting the rules realize that there will always remain a margin of courtesy to some people, such as relatives of workers in the hospital and poor patients one comes across. When you help some of these, you are going against the letter of the law, but you are not doing anything for your own benefit. You are helping someone in need. Having said that, I realize that there are cases where a doctor in your situation is asked to arrange free consultation and treatment for a person who can afford to pay the cost. Yet you will be hard pressed to refuse because that person is a relative or close friend.
When you are helping a genuine case, such as a person who is in real need for treatment and cannot afford to pay, you should not hesitate to help. You are not taking anything for yourself, and you are only using a facility run by the government or the army, which is paid for by people’s taxes. Thus, you are helping someone who is entitled to receive help. The government of a country is responsible to look after its population, and providing accessible medical care, free when the patient cannot pay, is part of the government responsibility. Therefore, when you look after such a case, even at a facility where the rules do not allow, you are helping the government and the country. Your difficulty is where the case is not genuine, or not deserving. In these cases, you should try to minimize the abuse. You can do so by giving a general impression that such services are not easy to obtain, or protest that the doctor specialized in this area will not be helpful, etc.
As for your second point, you should try with your colleagues to ensure that medical doctors and nurses are not overworked, so that they do not mess up with the treatment of their patients. You should not work when you are exhausted. You will be liable to make mistakes in diagnosis and treatment. With regard to patients trying to take advantage, you should try what you can, not to be deceived. If you are genuinely deceived, this counts as a mistake, which God forgives. The Prophet, peace be upon him, says: “My community will not be accountable for what they do by genuine mistake, out of forgetfulness, or for what they are forced to do.