₦airaland Forum

LEGAL AND ETHICAL RESPONSIBILITIES OF ‘TREATMENT OF EMERGENCY CASES WITHOUT A POLICE REPORT: FOCUS ON VICTIMS OF ACCIDENTS, GUNSHOT WOUNDS, AND CRITICAL INJURIES IN NIGERIA.

PART 1.
INTRODUCTION
We read in the Holy Book of the Christians (Bible), the story of a certain man who was robbed, beaten, helpless, and left to die. While many saw him in this dire state, only a soul moved by compassion came to his aid despite being in desperate need for help.
This story often emphasizes the actions of the one good man who rendered help, but it also raises important questions. Why did others not help? What could have possibly prevented them from coming to the aid of the dying man and many more?.

In today’s society, fear of legal consequences, financial commitment and sometimes, unexpected trouble with law enforcement agencies among others may culminate into why individuals might be hesitatant to assist victims in dire need of help.

Often time, considerable victims of kidnappers, ritualists, bandits, and armed robbery attacks survive their ordeals but are left on the brink of death owing to lack of timely medical intervention as a result of the reasons adduced above.

Generally, emergency healthcare is a fundamental right that cuts across societal, legal, and moral boundaries. However, in countries like Nigeria, the intersection of healthcare, law enforcement, and societal norms creates a complex scenario, especially when treating accidents, gunshot wounds, or victims of critical injuries.

For decades, hospitals in Nigeria have been faced with the dilemma of whether to provide emergency treatment without a police report.

In this article, we shall focus our attention on the legal and ethical implications of treating such cases and the evolving stance of the country’s healthcare laws and ethics.

Legal Framework
Historically, Nigerian hospitals and clinics often refused to treat patients with gunshot wounds, critical injuries, or accidents until a police report was presented. This was primarily driven by regulations ambiguities and fear of being implicated in criminal investigations.

However, this stance has gradually changed due to legislative reforms and increased awareness of the importance of timely medical intervention.

Continuous awareness is however, required by the relevant agency as many of the hospitals still insist on police reports before commencing treatment for such victims.

THE ‘OLD PRESUMED LAW’
While the Police Act (CAP p19, laws of the Federation of Nigeria, 2004), section 4 1 mandates police reports for injuries caused by firearms or other dangerous weapons. It is important to note that the regulation was a mere police rule and never a law or legislation of the Federal Government of Nigeria. It’s also noteworthy that many lives have been lost because of these reckless and insensitive bottlenecks.

Whilst the Constitution of the Federal Republic of Nigerian (1999 as amended) guaranteed every citizen the right to life and before such life can be taken, such person must not only be found guilty of an offence by a competent court of record, he must be so convicted and sentenced accordingly.

Further to the above, Coronal Law (CAP C35, laws of the federation of Nigeria, 2004) section 9 (1) mandates healthcare workers to report deaths or injuries caused by violence or which in their opinion is unnatural causes.

THE LAWS.

Gunshot Wounds Act (2017): One of the most critical legislative interventions came in 2017 with the passing of the Compulsory Treatment and Care for Victims of Gunshot Wounds Act. This law mandates that hospitals and healthcare professionals treat gunshot victims immediately, without the need for a police report.

Under this Act, hospitals, whether public or private, must provide immediate treatment to any person with gunshot wounds. See Section 1 of the Act.
However, as an addendum to the Act, such Healthcare providers are mandated to report such cases to the police within two hours after commencing treatment, but the lack of an immediate report should not delay medical care. See Section 3 (1), while failure to comply with this law may result in sanctions, including fines or imprisonment for healthcare professionals. See Section 5 of the Act.

This act is a significant departure from past practices and reflects Nigeria’s commitment to aligning healthcare with global human rights standards. Prior to this law, gunshot victims were often left untreated due to fears that treating them without police approval would involve medical personnel in legal issues or criminal investigations.

The National Health Act (2014): The National Health Act also plays a critical role in ensuring the rights of emergency patients. It states that all citizens have the right to emergency treatment, and refusal of such treatment due to the absence of a police report or upfront payment is illegal. This law sets a standard for all healthcare providers and reinforces the human right to life-saving treatment. The Act ensures that emergency care, including road accidents and critical injuries victims can not be denied healthcare due to financial or bureaucratic reasons. See Section 20 of the said Act even though enforcement remains a challenge, with many healthcare providers still hesitating to treat victims without police involvement, largely due to fear of legal repercussions, inadequate training, or lack of proper awareness of the law.

ROLES OF INDIVIDUAL, LAW ENFORCEMENT OFFICERS AND MEDICAL PERSONEL
Section 2 of the Act provides:

Every person, including security agents, shall render every possible assistance to any person with gunshot wounds and ensure that the person is taken to the nearest hospital for immediate treatment.
Accordingly-
(a) a person with a gunshot wound shall be received for immediate and adequate treatment by any hospital in Nigeria with or without initial monetary deposit, and
(b) a person with a gunshot wound shall not be subjected to inhuman and degrading treatment or torture by any person or authority, including the police or other security agencies.

According to the above provision, the law mandates that everyone, including security agents and medical personnel, must promptly and without hesitation attend to victims of gunshot wounds, accidents, and other emergencies. This is a mandatory requirement of the law without more. See also Section 20 of the National Health Act.

Ethical Responsibilities.
The ethical responsibilities of healthcare professionals come into sharp focus when handling emergency cases. The Hippocratic Oath, which emphasizes a duty to preserve life and prevent harm, is at odds with practices that delay treatment pending police clearance. From an ethical standpoint, the decision to prioritize administrative procedures over a patient’s immediate care contradicts the core values of medical practice.

Ethical Dilemma of Life versus Law: Healthcare professionals in Nigeria have faced a long-standing ethical dilemma—whether to prioritize life-saving treatment over bureaucratic processes like obtaining a police report. For instance, a good number of patients have died due to delayed treatment caused by hospitals insisting on a police report before providing care. This situation raises critical ethical questions about the role of the medical community in preserving life above all else.
Patient Confidentiality and Trust: Another ethical concern is patient confidentiality. Reporting to the police, especially in gunshot cases, may compromise patient privacy and trust in the healthcare system. Although the law mandates reporting after initial treatment, healthcare professionals must navigate the delicate balance between cooperating with law enforcement and upholding patient confidentiality and,
Access to Emergency Care. Access to emergency care without unnecessary obstacles is fundamental. Denying or delaying treatment due to the absence of a police report can be seen as a violation of a patient’s right to life and dignity. Nigeria’s efforts to improve this situation through the aforementioned laws represent an important step toward ensuring that medical ethics align with international human rights standards.


Should you have further enquiries or seek clarification on part one of this article, visit for more interesting topics on https://soaringeaglesattorneys.com/blog/

The world is progressing in technology and technology has made things easier. Nigeria needs to follow and stop stressing people for police report when someone is dieing.

There are better ways than this Nigeria pattern

Good

Something meaningful must be done

Safe a soul..........

Start the treatment first and call the police yeah

Una sha.

This country, we need divide am and hand pick some people.


You religious fanatics go Dey with north.

Gun shot or accident victims should be treated immediately.

Doctors are not police. Neither are they to do police work for police.

The medical facility must within 2 hours get a police report. In interior settlements, how's this feasible when a police post is kilometers away?

The police killed the society trust in many ways

As a healthcare professional, I only help to facilitate police report by telling them to visit nearest police station. Give first aid while awaiting report with their consent.

Summary please for those of us who can't understand all that.

They pretend they care...now there is a law to give you full support, yet they still claim they fear the interpretation of the law.

If the police knows it is illegal, and they do not pressure any hospital otherwise, what now is stopping hospitals from doing the needful?!

Patient loses his right to privacy, if he must get emergency priority care...and on credit.

alot of people have died even after this law was passed in 2017 and people are still dying till now because of police reports before treatment

As a doctor, my position has always been this: I treat whoever comes to the hospital during my call.

While at FUTHO, I once had a small issue with some fierce-looking and heavily armed policemen who came to the A and E trying to disrupt my treatment. Of course, I alerted my chief about the situation.

Police report will be obtained, but every life, whether armed robber or law enforcer, must be saved whenever and wherever possible.

If I see a gunshot case, while stabilizing, hospital management can quickly call any of the hotlines of the police to notify them of the case. I, of course, will notify my MD.

The police should do something about educating their people. Half-baked knowledge is extremely dangerous. We've seen overzealous policemen trying to be holier that the law, and they are easily trigger happy.

Nice write-up. The heath institutions across Nigeria needs to know or have this in their custody

Chinny024:
As a healthcare professional, I only help to facilitate police report by telling them to visit nearest police station. Give first aid while awaiting report with their consent.

Why?
Why give first aid and wait?
The law requires the hospital to make the report.
It is as simply as calling 911 to notify them.
It is not the hospital's duty to go to police station to write report.
Reporting to the police simply means calling to inform the police.
It is the police that have the responsibility of coming to access the situation.

derico:
They pretend they care...now there is a law to give you full support, yet they still claim they fear the interpretation of the law.

If the police knows it is illegal, and they do not pressure any hospital otherwise, what now is stopping hospitals from doing the needful?!

Patient loses his right to privacy, if he must get emergency priority care...and on credit.

Boss, you can't blame health workers. Law in Nigeria? How many of these court laws have been disobeyed? How many extra-judicial killings have gone unanswered in Nigeria?

Even with the law, health workers are harassed, beaten, put in cells, subjected to the stress of going to court, and even labelled an accomplice. The law hardly protects them, and even if they come out innocent, it'll be after months or years of torture.

The police can fabricate anything, any claim and all that. They can cook evidence too..see, lots of things can go wrong in this Nigeria.

Don't turn this discussion into an avenue to attack health workers. You just don't know what they go through.

Sad.

This should be disseminated to all hospitals through the Federal Ministry of Health

But they wont do it,because someone is sleeping on their job

derico:
Why?
Why give first aid and wait?
The law requires the hospital to make the report.
It is as simply as calling 911 to notify them.
It is not the hospital's duty to go to police station to write report.
Reporting to the police simply means calling to inform the police.
It is the police that have the responsibility of coming to access the situation.

Nigeria puts law upside down...
We aren't talking about western culture in this context..
How many police have gone to the hospital to access casualties?..
Well,till then,Our hands are tide
Shalom.

TONYE001:
Boss, you can't blame health workers. Law in Nigeria? How many of these court laws have been disobeyed? How many extra-judicial killings have gone unanswered in Nigeria?

Even with the law, health workers are harassed, beaten, put in cells, subjected to the stress of going to court, and even labelled an accomplice. The law hardly protects them, and even if they come out innocent, it'll be after months or years of torture.

The police can fabricate anything, any claim and all that. They can cook evidence too..see, lots of things can go wrong in this Nigeria.

Don't turn this discussion into an avenue to attack health workers. You just don't know what they go through.

Sad.

That means the police are the ones that need the education.
The medical association board should champion this cause.
Fight for their people and shout it loud enough, that no police is permitted to harass them.
There should be public enlightenment and orientation for the masses...and the police.
Let it become public conventional knowledge.

Esthered:
The medical facility must within 2 hours get a police report. In interior settlements, how's this feasible when a police post is kilometers away?

The police can even deliberately fruatrate the medical facility's efforts at getting a police report within two hours. Abi no be Nigerian police again?

Chinny024:
As a healthcare professional, I only help to facilitate police report by telling them to visit nearest police station. Give first aid while awaiting report with their consent.

there is a law passed, mandating health professionals to treat gunshot or accident victims immediately without a police report. Why then do you still do the facilitate police report thing?

derico:
That means the police are the ones that need the education.
The medical association board should champion this cause.
Fight for their people and shout it loud enough, that no police is permitted to harass them.
There should be public enlightenment and orientation for the masses...and the police.
Let it become public conventional knowledge.

Absolutely!

Very correct and exact.

Police should take educating their personnel seriously.

The treatment of accident victims should be unconditional but my reservations is who is going to foot the bills?,I think a compulsory health insurance scheme should be available for every citizen of the country that will enable the hospitals get payment for their services.one major discouragement is who will foot the bills and what happens if the patient dies in situations where family of the victim couldn't be assertained.

But Rehabilitating terrorists with tax payers money and getting them also ebi is Okay Nigeria is upside-down
Treat the victim first then call the police before realizing such victims for clearance. This stuff has ended many innocent lives

Arostar2023:
The police can even deliberately fruatrate the medical facility's efforts at getting a police report within two hours. Abi no be Nigerian police again?

Hospitals are understaffed. How would they deploy a staff to a police station to get a medical report within 2 hours?
The reason why some hospitals would rather reject the accident victims than go through the stress.

Obviouslyblunt:
there is a law passed, mandating health professionals to treat gunshot or accident victims immediately without a police report. Why then do you still do the facilitate police report thing?

Well, haven't met gunshot victim for a while now.
I don't pray for such after all..

Hmmm. So how can you report seamlessly without funny funny behaviour from Nigerian police?