Medical Duty of Care in Saudi Arabia and in Egypt: A Comparative Study
Introduction
Duty of care in medical practice is an important concept in consideration of medical malpractices according to the laws of different nations. As there are diverse nations and national cultures and beliefs, so are there diverse opinions regarding how medical duty of care is approached from different perspectives. However, one of the common issues regarding medical malpractice and duty of care is that doctors owe their patients a duty of care. This duty is varied in scope with regards to the patients to whom it applies. Across national boundaries, the medical duty of care also varies depending on the nature of care as it is applied. Similarly, different countries have different litigation measures against a breach of the medical duty of care. Recognizing what constitutes a violation of this duty is thus one of the key challenges when addressing any cases of medical malpractice.
According to an article by Dean and others, medical duty of care can be explored by considering various contexts under which such duty needs to be implored. For instance, in many countries such as Australia and the U.K, the duty of care in medical practice can be proven to be in existence based on proof of three key conditions. The authors suggest that a medical duty of care can exist either on legal basis or with respect to ethical concerns. In either case, it has to be established that the doctor in question may not have wished to render medical services; may have failed to offer help when it was required of him/ her or may have refused to identify himself/ herself as a doctor or even refused to offer help after self identification[1]. In any case, it is the responsibility of the body mandated to evaluate medical practice to ascertain the accuracy of the allegations in question.
Problem statement and Research Question
The subject of medical duty of care is one that raises concern across many nations particularly with respect to how to confirm the presence of that duty. As such, many country specific studies have been carried out in the past to explain the extent of medical duty of care in different countries. Despite the presence of some academic articles on the subject of medical duty of care, there is still a challenge in that the available information is still limited with reference to its application and reference to the duty. In particular, not many comparative studies have been carried out on the subject of medical duty of care. As such, it is necessary for such comparative studies to be carried out to address the limit in the available information. On this basis, a study is proposed that will undertake to compare the extent and application of the medical duty of care in Saudi Arabia and in the Egyptian contexts. The key objective of the study will be to analyze the laws of the two countries with respect to medical duty of care and subsequently to compare the two. In order to achieve this objective, the following research questions will be answered through the proposed study:
- What is the scope of the medical duty of care in Saudi Arabia?
- What is the scope of the medical duty of care in Egypt?
- How does reference to medical duty of care in Saudi Arabia compare to that in Egypt?
It is believed that these questions will help to address the key information challenge in medical law i.e. to understand the extent and relevance of medical duty of care in different contexts.
Literature review
Various studies have been done on the subject of medical duty of care. For instance, a study by Dean and others cites various conditions under which the medical duty of care can be established. From the work done by Dean and others, medical duty of care can only be confirmed in conditions where the doctor holds either ethical or common law basis care to the patient. This implies that either a patient or potential patient of a doctor is entitled to the doctor’s duty of care. Emergency situations are most often cited as those in which the doctors have the greatest duty of care to their patients. According to Dean et al, in emergency situations doctors posses a duty of care, which may violated through refusing to accept one’s identity as a doctor, failure to render services when desired and failing to volunteer as a doctor after personal identification. The case of Lowns v. Woods is cited by the authors as involving a violation of the duty of care as the doctor refused to attend to a patient after being approached in an emergency situation.[2]
The findings of Dean and others resonate well with other findings made by various authors particularly in Egypt and Saudi Arabian law. According to the medical professional ethics in Egypt, the Forensic medical Authority is mandated to evaluate and address all cases that may involve medical duty of care. In such cases, reported as medical malpractice, the authority is tasked with confirming that a duty of care existed between the doctor and the patient. According to Hassan and others, medical duty of care is invoked in the Egyptian law following medical malpractice cases that arise due to medical negligence. Hassan and the others define medical negligence in this case as conducts that result in a breach of duty of care as they are preventable mistakes. For the authority to establish the presence of a duty of care there has to be a connection between the observed harm and the mistake made.[3] Constitute also reports that denying medical treatment to a patient in need is recognized to be a case of breach of duty of care. As such, it can be argued that medical duty of care in the Egyptian context is limited to the ability to create a connection between the injury incurred and the purported action. Hassan et al recognize mistakes in patient care, complications, wrong or inappropriate treatment and therapeutic omissions as some of the conditions that may warrant investigations into the presence of a duty of care.[4]
In the Saudi Arabian Context, a similar case exists. Most of the studies done on medical duty of care are based on the litigation of medical malpractice cases. According to a study by Al-Saeed, practices involving malpractice that results in mortality or morbidity. From the study, the way in which medical duty of care is handled in Saudi Arabia is dependent on Sharia laws. Islamic Sharia laws guide medical practice in Saudi Arabia. The law addresses cases of mortality and morbidity that can arise from medical malpractice. According to this study, medical malpractice in the Saudi Arabian context is determined based on negligence in service delivery. Medical staff can only be held liable for negligence if they are established to be qualified to provide the service they provided; they are experienced in providing that service and are licensed for practice. If all these conditions are satisfied, the medical personnel can then be investigated for negligence, the most essential indicator of which is that the personnel denied medical treatment to a patient or potential patient in an emergency. In addition to this, doctors who are confirmed to be qualified should uphold the integrity of the profession in accordance to the Islamic Sharia law through avoiding preventable mistakes. The ability to assist a patient get better and physical proximity to the patient comprises key aspects of consideration in this perspective.[5]
Based on the findings of the key literature pieces considered, it is eminent that there is still a lot that needs to be addressed with regards to medical duty of care. The existing information is still limited in terms of exploring the extent of duty of care in the medical practice field in Egypt and Saudi Arabia. It is therefore essential for greater studies to be carried out on the subject.
Methodology
Based on the nature of the expected results from the proposed study, a qualitative approach to the study will be adopted. According to Creswell (2013), qualitative research is the most applicable method of study for subjects requiring theoretical resolutions. Based on the research questions, the particular research methodology that will be used is explorative. This is because the study will focus more on explaining the factors that arise from the research questions. In particular, the study will take a combined secondary and primary research approach to answer the research question. In secondary research, the study intends to achieve sufficient information on Egypt and Saudi Arabia law practice. This part is crucial in that the background information on the laws of the two countries will help to develop a strong background to the intended study. Based on the secondary research, it will also be possible to build an effective primary research instrument for acquiring the intended information. The primary research will be carried out using an interview technique.
Based on the findings of Bergold and Thomas, interviews are an effective approach for obtaining specific information from trusted primary sources.[6] The interviews will target at least five individuals who are expected to be doctors who have practiced for not less than five years. According to the researcher, the primary study will help to identify some of the common areas of medical duty of care in the international medical professional practice. The key objectives of the interview would be to determine how the doctors in the country perceive the national law concerning the duty of care. The use of interviews has also been established to be effective for participatory research such as that in which the researcher intends to conduct.
Although the interview strategy has been confirmed effective in achieving the objectives of explorative research, the use of interviews is also associated with several key concerns, particularly with regards to ethical consideration. For instance, it will be essential for the researcher to maintain a sense of confidentiality throughout the study by keeping the identities of the participants’ secret. In addition to this, the research will also be based on honesty and clarity as the core foundations of obtaining credible information. While conducting the study, the researcher will also focus on maintaining accuracy and validity of all the information obtained and presented.[7]
Conclusion
The proposed study is planned to be effective in addressing the aforementioned research questions. Because of this, it is believed that the study will be essential in adding value to the academia with regards to expanding the dearth of knowledge available on medical duty of care in Egypt and Saudi Arabia. On the contrary, it is expected that the study will be difficult to accomplish due to the limited academic information that is already available on the subject of study. In addition to this, the study is also expected to be limited in terms of scope since it will only focus on the extent of the medical duty of care across the two countries. The challenges involved in the study will make it all the more satisfying to work on.
Bibliography
Al-Saeed, A.H. ‘Medical liability Litigation in Saudi Arabia’ (2010) SJA 4(3) 122, 126.
Bergold, J. and Thomas, S. ‘Participatory Research Methods: A Methodological Approach in Motion’ (2012) QSRF 13(1).
Constitute. Egypt’s Constitution of 2014. Constitute Project, Translated by International IDEA (2014).
Creswell, J. Qualitative Inquiry and Research Design: Choosing among Five Approaches. Sage Publications [2013].
Dean, J., Mahar, J., Loh, E. and Ludlow, K. ‘Duty of Care or a Matter of Conduct? Can a Doctor Refuse a Person in Need of Urgent Medical Attention?’ (2013) 41(10) DC
[1] Jessica Dean, Patrick Mahar, Erwin Loh and Karinne Ludlow. ‘Duty of Care or a Matter of Conduct? Can a Doctor Refuse a Person in Need of Urgent Medical Attention?’ (2013) 41(10) DC 746, 748.
[2] Ibid.
[3] Constitute. Egypt’s Constitution of 2014. Constitute Project, Translated by International IDEA (2014).
[4] Dalia Abd-Elwahab Hassan, Alaa Shehab and Heba Kotb. ‘Alleged Medical Malpractice: A Retrospective Study of Forensic Evaluation of Cases in Cairo amd Giza Regions- Egypt (2009- 2011)’ (2014) JFR 5(239).
[5] Abdulhamid Hassan Al-Saeed. ‘Medical liability Litigation in Saudi Arabia’ (2010) SJA 4(3) 122, 126.
[6] Jarg Bergold and Stefan Thomas. Participatory Research Methods: A Methodological Approach in Motion (2012) QSRF 13(1).
[7] Larry Luton. ‘Review of Qualitative Research Approaches for Public Administration’ (2014) JPAE 17(2) 305, 308.