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Are large compensation payouts for negligence good for medicine in India?

BMJ 2014; 349 doi: https://doi.org/10.1136/bmj.g5229 (Published 27 August 2014) Cite this as: BMJ 2014;349:g5229
  1. Kunal Saha, private consultant and president1,
  2. Devi Shetty, senior consultant cardiac surgeon and chairman 2
  1. 1People for Better Treatment, 2704 Bridgewatch Lane, Hilliard, Ohio 43026, USA
  2. 2Narayana Hrudayalaya Private Limited, No 258/A, Bommasandra Industrial Area, Hosur Road, Anekal Taluk, Bangalore 560099, India
  1. Correspondence to: K Saha anku1{at}earthlink.net, D Shetty devishetty{at}nhhospitals.org

The Indian Supreme Court recently awarded a record compensation payout for medical negligence that resulted in the death of a patient. Kunal Saha says such payments are essential when other accountability is lacking, but Devi Shetty fears the emergence of a US style compensation culture that stifles doctors

Yes—Kunal Saha

The limitless financial compensation and punitive damages often imposed for medical errors in developed countries such as the United States may have some inherent flaws. In India, however, healthcare is supposed to be regulated by a quasi-judicial medical council that has failed to protect against widespread negligent and irrational treatment. Large payouts awarded by the courts of law may therefore be the only way to instil accountability for wayward doctors and to save lives.

Compensation became a hot topic in India after the Supreme Court awarded more than Rs110m (£1m; €1.4m; $1.8m) in damages (including interest) against several doctors and a private hospital in Kolkata for the wrongful death of a patient.1 This was by far the biggest payout in Indian medicolegal history. Until now, Indian courts have generally awarded meagre compensation for death from medical negligence, rarely exceeding Rs300 000-Rs600 000, and often less, which has failed to have any deterrent on affluent doctors and hospitals.

For the legal right to compensation (tort liability) to be useful in curbing medical negligence, it should serve at least two purposes. Firstly, it must provide adequate financial support for the victim’s family (compensation) to fill the irreparable vacuum created by the wrongful death as best as possible. Secondly, and perhaps more importantly, the award must act as a deterrent against future negligent behaviour by other doctors and hospitals.

Paltry compensation for avoidable loss of human life is unlikely to pose any threat for the errant doctors and hospitals. And a meagre financial payment can never …

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