Law gives patients new ‘right to die’

Doctors will no longer face prosecution for failure to resuscitate people who are suffering from incurable terminal illness.

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ABU DHABI // Doctors will no longer be compelled to resuscitate dying patients under sweeping changes to the law governing health care.

The new rules permit medical staff to allow natural death to take its course and refrain from performing CPR on dying patients who are suffering from conditions that are probably incurable.

If all treatment has failed, or at least three doctors advise against resuscitation, a patient will be allowed to die naturally.

Until now, any doctor who fails to resuscitate a patient has been liable to prosecution. The change in the law follows a report in April by a task force set up by the Health Authority Abu Dhabi to examine where improvements could be made in palliative care.

Nesreen Al Alfi, of Fatima College for Health Care Sciences in Abu Dhabi, and a member of the task force, said there were challenges in overcoming cultural beliefs and a legal system with no approved policies until now for “do not resuscitate” or “allow natural death”.

The new law brings about other sweeping changes to the way health care is delivered and how medical staff work, including exempting doctors from criminal liability in many cases where they now face prosecution.

Under the new law, if harm to a patient is self inflicted, or a result of refusal of treatment or failure to follow medical advice, then the doctor concerned will not be liable to prosecution.

A doctor will also not be liable if unexpected complications arise that are not caused by medical error.

Legal experts told The National in June that convicting health professionals of misconduct and sending them to prison was contributing to unnecessary medical tests and the over-prescription of medication.

Stephen Ballantine, a solicitor at Galadari Advocates and Legal Consultants in Dubai, and a medical malpractice specialist, said doctors were hugely concerned about their exposure to accusations of malpractice.

Decriminalising the issue would help to attract the best doctors to the UAE and encourage medical tourism, one of the key elements in Dubai’s future vision for growth, Mr Ballantine said.

Dr Sherbaz Bichu, chief operating officer at the Aster Hospital in Dubai, welcomed the change for giving doctors the security to act in the best interests of patients without the threat of prosecution if something went wrong.

“Now there is a process to it, so people can’t just go and complain,” Dr Bichu said. “My doctors are scared. ‘Should I really do this? Will it bite me back?’ This will give them more comfort to practise, and there will be professional evaluation.

“Until now, a patient could complain, the health authority would start an inquiry and your licence could be kept on hold. Now this fear factor is being diminished.”

The new law also proposes a tougher stance on health-insurance fraud and profit-chasing by doctors and hospitals.

As well as inflating costs for health insurers and employers, doctors and pharmacies’ wide prescription of antibiotics to treat minor ailments has worsened the problem of micro-bacterial resistance.

Stephen MacLaren, a senior executive at insurer Al Futtaim Willis, said the new law was a positive step to reduce healthcare costs.

“This shows the Government is aware of the overuse and is now doing something about it,” he said.

Sex-change surgery will also now be permitted under the new law. Operations will be allowed if a person’s sex is unclear, or if a medical examination indicates that their physical features do not match their physiological, biological and genetic characteristics.

The law, Federal Decree No 4 of 2016 on Medical Responsibility, has been approved by the President, Sheikh Khalifa, and published in the Official Gazette.

Mark Adams, chief executive of Anglo Arabian Healthcare, said most doctors were already in compliance.

“Ninety-nine per cent of doctors would follow these guidelines through inherent principles of medicine and long years of training,” he said. “It is, however, good to have a clear and unambiguous decree that everyone can follow.”