Why Doctors Kill At will and The New National Health Act : The Controversies by Job Osazuwa

When present Good­luck Jonathan signed the National Health Bill into law early this month, for the birth of the National Health Act (NHA) 2014, many Nigerians ap­plauded.

For those who praised the president and the National Assembly for making the Act possible, the coming of the law would address the country’s healthcare challenges.

However, controversy may dot the path of the Act over certain provisions. Indeed, such provisions, which gave medical practitioners or doctors the right to authorise the removal of the organ of people for transplant to other persons, in cases of emergency, is raising some flakes.

Yes, although the Act provides that for an organ to be taken from one person for transplant to another, the former would have to give consent, it also provides that during emergency, the doctor has the sole right to decide that an or­gan should be taken from anybody in the hospital.

Section 48 of the Act provides: “(1) Subject to the provision of section 53, a person shall not re­move tissue, blood or blood prod­uct from the body of another living person for any purpose except; (a) with the informed consent of the person from whom the tissue, blood or blood product is removed granted in prescribed manner; (b) that the consent clause may be waived for medical investigations and treatment in emergency cases; and (c) in accordance with pre­scribed protocols by the appropri­ate authority.”

Also, Section 51 of the NHA, states: (1) A person shall not remove tissue from a living person for transplantation in another living person or carry out the transplantation of such tissue except:- (a) in a hospital autho­rised for that purpose; and (b) on the written authority of: (i) the medical practitioner in charge of clinical services in that hospital or any other medical practitioner authorised by him or her; or (ii) in the case where there is no medi­cal practitioner in charge of the clinical services at that hospital, a medical practitioner authorised thereto by the person in charge of the hospital.”

In the Act, “emergency situation” was not defined, which means that it’s only the doctor, who could decide that there’s emergency and therefore authorise the removal of anybody’s organ, without the person’s consent.

Raising issues on this, Chair­man, Global Prolife Alliance (GPA), Prof. Philip Njemanze, condemned the Act, describing it as a way to kill Nigerians.

He stated that Nigerian popula­tion would be reduced through secret trading on human organs by international financial giants to save the lives of their citizens, while warning that human organs, such as the heart, liver, kidney, lens, cornea, ovarian eggs, sperms and so on, would be secretly trans­planted in designated hospitals.

His worry for Nigerians is that some certain medical practitioners at the designated hospitals had been empowered by the law to remove these vital organs of sick Nigerians who are on admission. This is so because, the law made provision for the right of consent from the patients, it also waives such right from the patient, in times of some certain medical emergency conditions, “conditions which the law did not categorically spell out.”

No matter the medical condi­tion, Njemanze described the sec­tion as an aberration and a crime against Nigerians’ right to life.

The professor alleged that there were international interferences while the bill was being drafted, even as he accused some wealthy foreign individuals of influenc­ing the NHA for their clandestine personal gains.

On the standard of hospital provided for by the Act, he said no Nigerian, including the Federal Government, can meet with the requirement to build the special hospitals mentioned in the Act.

Njemanze, who is a specialist in Neurocybernetics, frowned at sec­tion 51 of the NHA, which state: (1) A person shall not remove tis­sue from a living person for trans­plantation in another living person or carry out the transplantation of such tissue except:- (a) in a hospi­tal authorised for that purpose; and (b) on the written authority of: (i) the medical practitioner in charge of clinical services in that hospital or any other medical practitioner authorised by him or her; or (ii) in the case where there is no medi­cal practitioner in charge of the clinical services at that hospital, a medical practitioner authorised thereto by the person in charge of the hospital.

He said: “Section 51 does not mention any donor, which means the person who owns the organ. Only the medical doctor or manager of the hospital has the right to authorise that an organ (heart, liver, kidney, lens, cornea, ovarian eggs, sperms etc) can be taken from a living Nigerian called a donor, for transplantation into another living person who receives the organ called a recipient.

“For example, if a hospital in Nigeria receives an American pa­tient who has paid one million US dollars for a heart to the American hospital in Nigeria and you visit the hospital in an emergency, and your tissue matches that of the American patient, the medical director of that hospital can order that your heart be taken and given to the recipient under the provi­sions of Section 51 of the National Health Act 2014. You lose your life and the American organ tourist lives.

“Therefore, Section 51 is incon­sistent with the Right to Life of the Fundamental Rights under the 1999 Constitution of the Federal Republic of Nigeria.”

Njemanze pointed out that Section 48 (b) waives the right to consent in emergency. According to him, it is forbidden in medi­cal practice to waive the right of consent under any circumstances for living or even dead persons.

He explained further that even when a living patient is unconscious or unable to make decisions, that right of consent is temporarily transferred to his next-of-kin, guardian or parents in the case of a child, but is never waived.

The professor lamented that for the first time in the history of humanity and medicine, the right to consent to your own organ has been taken away in Nigeria through a law.

He said: “Note that Section 48 (3) forbids selling and buying of organs. This provision is decep­tive, because to pay money to the person whose organ was collected is illegal, but for the hospital to sell the organ to another person may not be in the scope of this law in Nigeria because the commercial transaction could take place on the internet, hence not under any territorial jurisdiction.

“In order to make sure that organs are collected from millions of Nigerians, who will die in organ poaching, the law in Section 20, declares Emergency Services free. Section 20 (1) says: “A health care provider, health worker or health establishment shall not refuse a person emergency medical treat­ment for any reason whatsoever.”

He stated that the Act may be misapplied by unscrupulous doctors as “all medical condi­tions could be considered an emergency under this law because there is no definition of what is an emergency. This would mean that the hospitals will admit many people in a purported emergency and under that clause the medical director decides, under Sections 48 and 51, that the organ of that patient be taken for transplantation to another living person, who is the ‘organ transplantation tourist,’ who paid hundreds of thousands of US dollars to receive the heart of a Nigerian who was admitted for stomach upset or any other minor condition. He would be operated unnecessarily to poach his heart and other organs.

“Since there will be no Nigerian owned hospitals, even if you ask for a post-mortem, their doctors will arrange the report to suit them. As a result, Nigerians will die in millions over time and the foreign recipients would go home with new organs. Note that since they own all the hospitals, they also control the ‘health research,’ so statistical figures of improved healthcare could be well arranged, and no questions asked.”

He stated that rich foreign­ers may likely come to Nigerian to build the specified standard of hospital so that they would capitalise on the provision waiving patients’ consent to removal of the organ and therefore, do indiscrimi­nate transplants, at the expense of Nigerians.

“The question arises, where would this be done? Is it in Nigerian-owned hospitals? Certainly not! The Nigerian hospitals, private, public, mission and Islamic would be closed down 24 months from now, accord­ing to Section 13. The foreign organ trafficking cartel intends to build over 260 so-called modern hospitals in Nigeria. A meeting was called by a major partner of the Bill Gates Foundation in this project to seek collaboration with the Association of General and Private Medical Practitioners of Nigeria (AGPMPN), at their Abuja headquarters in Nigeria, but no agreement was reached on any partnerships.

“The hospitals will be built ac­cording to the International Build­ing Code of hospitals. The Cer­tificate of Standards for hospital buildings is based on the Interna­tional Building Code of hospitals, which has stringent standards that no hospital in Nigeria meets. The plumbing is with conduit, all wiring with conduit, high floor to roof height, wide window width, 24-hour lighting, 24-hour air con­ditioning, 24-hour water, specific humidity, airflow purification etc. These standards could be met in very advanced countries, but are not easy to comply with under our own conditions.

“The law requires compliance in Section 13, which states: “(1) Without being in possession of a Certificate of Standards, a person, entity, government or organisation shall not:- (a) establish, con­struct, modify or acquire a health establishment, health agency or health technology; (b) increase the number of beds in, or acquire prescribed health technology at a health establishment or health agency; (c) Provide prescribed health services; or (d) Continue to operate a health establishment, health agency or health technology after the expiration of 24 months from the date this Bill took effect,” he said.

On the contrary, Vice Presi­dent, Commonwealth Medical Association, West Africa region, Dr. Osahon Enabulele, applauded President Jonathan for keeping faith with his promise to assent to the Bill. He said he received with a sense of fulfillment the news of the assent to the NHB by the President.

“I therefore, applaud President Jonathan for keeping faith with his promise to assent to the NHB. I also commend both houses of Nigeria’s Seventh National As­sembly for their legislative passage of the harmonised version of the NHB.

“Despite the alleged insertions of certain provisions that were not in either versions passed by the respective legislative houses of the Seventh National Assembly, I wish to thank all Nigerians, par­ticularly ordinary Nigerians, pro­fessional associations, such as the NMA, civil society organisations, the media and other Nigerians, who courageously undertook the tortuous journey towards the long-awaited assent to the Bill, whose provisions seek to substantially ad­dress Nigeria’s health challenges,” he said.

Enabulele, who was the former President of Nigerian Medical Association, said provision of a minimum package of basic healthcare services, including the provision of free medical care for children under age five, pregnant mothers, the elderly and people with disabilities are good.