Is it right for hospitals to insist on police reports before treating patients with gunshot wounds? A legal expert Tochukwu Onyiuke examines the position of the law on the matter.
An accountant Odiri Onosigho was shot by armed robbers at Festac in Amuwo Odofin Local Government Area of Lagos State. He was with a friend identified as Michelle, who fled the scene only to return to see Odiri bleeding. Help did not come from commuters and other passersby. Michelle and some good Samaritans rushed Odiri to various hospitals but they rejected him because there was no police report. Shortly afterwards, Odiri lost his life.
The eighth National Assembly passed The Compulsory Treatment and Care for Victims of Gunshot Wounds Act (2017) into law.
The legislation is aimed at putting an end to the pervasive ugly situation where victims of gunshot wounds upon being rushed to hospitals or clinics for emergency treatment are required to produce a police clearance before treatment can be administered.
In some instances, in the process of complying with this unwieldy requirement as requested by hospitals and clinics, most of the victims bleed out and lose their lives. The frequency in the absurdity of this sad recurring situation propelled the National Assembly to enact The Compulsory Treatment and Care for Victims of Gunshot Wounds Act 2017, criminalising the refusal or delay in the treatment of gunshot wound victims by medical practitioners.
Enacting a law is one thing, enforcing and ensuring the strict compliance of the enacted law has sordidly continued to remain a huge challenge as instances of hospitals refusing to treat gunshot wounds victims are still being recorded. The blatant violation of the stipulations of this law is still being perpetrated. This is tantamount to saying that there is a low to zero level of compliance to this enactment by hospitals and clinics.
Origin of requirement
Before this monster of a challenge will be addressed in this discourse, it is pertinent to examine the genesis of this unsavoury scourge in the land.
The devastating Nigerian Civil War of 1967 – 1970 came and left with a plethora of woes. From the proliferation of arms and ammunitions to using of these arms to carry out nefarious activities especially armed robbery. Armed robbery was so rife in the 70’s and 80’s; several household names began to emerge from the depths of the underworld. This led to the promulgation of the Armed Robbery and Firearms Decree of 1986 to curb this growing mania.
A section of this Decree bothered explicitly on “Offences Relating to Sheltering and Treating Armed Robbers”, Section 4 of this Decree to be precise, whence it was stated that:
“4. (1) It shall be an offence punishable under this Act for any person to knowingly house, shelter, or give quarters to sheltering any person who has committed an offence under section 1(2) of this Act.
(2) It shall be the duty of any person, hospital or clinic that admits, treats or administers any drug to any person suspected of having bullet wounds to immediately report the matter to the police.
(3) Any – (a) person who; or (b) hospital or clinic which, fails to report as stipulated in subsection (2) of this section shall be guilty of an offence under this Act.
(4) A person convicted of an offence under subsections (l ) and (3) of this section shall be liable- (a) in the case of an individual, to imprisonment for a term not exceeding five years; and (b) in the case of a hospital or clinic, to a fine of ten thousand naira and in addition the hospital or clinic shall be closed down.”
Hasty misinterpretation
A cursory glance at Section 4 (3) (b) of the above reproduced Decree will subtly suggest stiff sanctions for any hospital that fails to report gunshot wound victims.
The hasty misinterpretation of this Section of the Decree gave rise to the widespread misconception that gunshot victims have to provide police report before they get admitted into the hospital or get treated. This erroneous impression has lingered on for the longest time.
A thorough perusal of Section 4 (3) (b) of the Armed Robbery and Firearms Decree surmises that only wounded armed robbers are to be reported to the authority.
Although it will be sort of tasking to tell who is an armed robber from who is not, it was never the contemplation of any law to refuse treatment of any gunshot wound victim until police clearance has been obtained. Out of the overt compliance to the provisions of the aforesaid decree, the widespread of this misconceived perilous trend began its horrendous budding till this very day.
No police clearance requirement
Upon the advent of the Robbery and Firearms (Special Provisions) Act Cap R11 LFN 2004, it is clear to see that the provisions of the Armed Robbery and Firearms Decree of 1986 were retained verbatim.
However, it is worthy of note to restate for the sake of emphasis and public enlightenment that these laws never mandated hospitals and clinics to demand any form of police clearance before administering treatment to gunshot wound victims armed robbers or not.
For emphasis sake, this law states clearly that in Section 4 (2): It shall be the duty of any person, hospital or clinic that admits, treats or administers any drug to any person suspected of having bullet wounds to immediately report the matter to the police.
The hospital or clinic having commenced treating the victim is then obligated to inform the police of the incident. This position cannot be overemphasised enough, as the misinterpretation of the provisions of this law has led to the countless loss of lives.
Compulsory Treatment Act
The promulgation of The Compulsory Treatment and Care for Victims of Gunshot Wounds Act (2017) sought to stem this societal menace by criminalising these unbridled practices by hospitals and clinics.
From the wordings of this 2017 Act, it posits unequivocally in its 16 Sections as contained therein the immensity of the importance of accepting and treating gunshot wound victims without police clearance and the requisite consequences for the affront to this promulgation. The jurisprudential postulate was to cure the menace where hospitals refuse gun-shot victims.
In the exposition of this legislation, the purport of the draftsmen having been elucidated and enunciated, this article intends to bring into vogue, further enlighten, encourage and remind medical practitioners of their first duty as a Doctor under the Hippocratic Oath which they all took before being accorded the title of medical practitioners which is to save lives first at all cost.
No legislation by any government anywhere in the world will place the life of its citizenry secondary to a police clearance or a police report as it is fondly called, considering the bureaucratic processes associated with going to the police.
Avoidable deaths due to misconception
It is disheartening to note that the misconstruction of the Robbery and Firearms Act has led to the loss of loved ones. In recent times, there has been an alarming spate and spike in the number of victims of violent crimes in the motherland. This is consequent upon the continuous rise of insecurity and widespread crime within neighbourhoods.
It can be said categorically that the victims of gunshot wounds are majorly innocent people suffering causalities from assailants. This presupposes that wounded innocent people will clearly require immediate treatment upon suffering injuries from criminals.
Family, friends or good Samaritans rushing victims to the hospitals are then faced then the huge mountain of being told to obtain police clearance before victim are to be attended mindless of the circumstances of the incident.
Instances of treatment refusal
To name but a few instances where the refusal of treatment by hospitals and clinics for want of police clearance has led to the loss of life and public outcry, sometime in July 2019 at Abuja, a member of the National Youth Service Corp Precious Owolabi who was a reporter for a popular television station in Nigeria was hit by a stray bullet in the course of his duty.
Upon being rushed to the hospital for emergency treatment, the demand of a police clearance reared its ugly head and the Precious Owolabi’s life was ended abruptly.
Also in January 2021, David Ntekim – Rex, a 22-year budding I.T Engineer and computer expert was shot by robbers in Lagos. In the flagrant violation of the provisions of The Compulsory Treatment and Care for Victims of Gunshot Wounds Act 2017, both the law enforcement and medical personal at the scene of the tragic event carried on as onlookers, stood by and did nothing until the bright future of the young man was short-lived pronto.
The list of gunshot wound victims who have lost their lives as a result of neglect and refusal of hospitals and clinics to treat is ever-growing. Medical practitioners are somewhat oblivious to the provisions of the Compulsory Treatment and Care for Victims of Gunshot Wounds Act 2017, which prescribe punishment for failure to comply with the law.
It may further interest you that this law is not restricted to medical practitioners alone. Section 2 of the Act states that: – ”Every person including security agents shall render any possible assistance to anybody with gunshot wounds and ensure that the person is taken to the nearest hospital for immediate treatment.”
The act imposes a clear duty to everyone to assist gunshot wound victims.
What the law says
In section 3 (1) & (2) of the Act where the fears of every hospital and clinic lies, is the Notification of the Police. The act provides that; ”(1) a hospital that receives or accepts any person with a gunshot wound for treatment shall report the fact to the nearest police station within two hours of the commencement of treatment.”
It is clearly understood to mean that after treating a gunshot wound victims for about two hours, the hospital can then notify the police about the situation.
Section 5 of the Act prescribes the punishment for hospitals that fail to make the report as required in Section 3. Having stated the above position of the law, it is imperative to state however that the mandatory imposition of this duty on the hospitals and clinics is stringent and over-demanding. The primary duty of the doctors is to save lives and not solve a crime.
Compelling every clinic to report every gunshot wound victims within two hours of commencement of treatment is over labouring the doctors. What if the treatment is not concluded under two hours? What if the hospitals do not have any spare person to send to make the report at the nearest police station?
Consequences of violation
Moving forward with the postulates of the legislation, Sections .9, 11, 13 & 14 prescribe specified punishments for violating the provisions of the Act i.e. prescription of punishment for any violation of the provisions of this Act.
Section 9 of the Act provides: A person who commits an offence which leads to or causes substantial physical, mental, emotional and psychological damages to the victim, commits and offence and is liable on conviction to imprisonment for a term not more than 15 years and not less than 5 years without the option of a fine.
The Act further provides for restitution for victims who suffer from this scourge.
Section 14 (1) & (2) of the Act states: ”(1) In addition to any other penalty under this Act, the High Court shall order a person or a corporate body convicted of an offence to make restitution to the victim by directing that person or corporate body to pay an amount equivalent to the loss suffered by the victim.
“(2) An order of restitution may be enforced by the victim or by a prosecutor on behalf of the victim in the same manner as a judgment in a civil action.”
Within this law, the family or even the victim has a cause of action against the hospital and clinic as the law imposes it as a duty.
From the foregoing, it can be seen clearly that restitution does not only come to the picture for the victims if the inaction of the hospital and clinics lead to the death of the victim.
A victim of a gunshot wound may seek restitution if he is denied treatment from any medical practitioner or any person at all if any of the provisions of this Act is breached. To further buttress the afore-stated position, Section 11 of the Act prescribes an Offence for Standing By.
The Act posits: Any person or authority including a police officer or other security agent or hospital who stands by and fails to perform his duty under the Act which results in the unnecessary death of any person with gunshot wounds commits an offence and is liable on conviction to a fine of N500, 000.00 or imprisonment of a term of five years or both.
Hope for a new dawn
Having delved into much emphasis and details on the clear positions of The Compulsory Treatment and Care for Victims of Gunshot Wounds Act (2017), I hope that a new dawn will begin in our hospitals and clinics as regards treating gunshot wound victims without demanding a police clearance or any other frivolous requirement. Also, I beseech the general public not to shy away from rendering the necessary assistance to any victim of gunshot wounds out of fear as the requisite protection from any form of harassment has been enshrined in the Act.
Finally, it is the position of the writer that the Nigerian Medical Association shall reach out to its members, in view of the provisions of the law authorising hospitals and clinics to treat gunshot wound victims, to sensitise the medical profession of the development, in the hope that in a not too distant future, stories of people losing their lives to this scourge will be a thing of the past.
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Onyiuke is a partner in Accendolaw law firm, Lagos.
