By Daniel Okonkwo
The requirement of upfront deposits for medical treatment at hospitals in Nigeria has become a deeply concerning and potentially lethal practice, particularly in emergencies. The tragic case of Kemi, a pregnant woman who lost her life after being denied treatment due to her inability to pay a ₦500,000 deposit, highlights the devastating consequences of such policies. This article explores the legal, ethical, and regulatory issues surrounding hospital deposit requirements, calls for urgent reforms, and discusses the role of the Ministry of Health and international human rights organizations in addressing this systemic problem.
The Nigerian Constitution guarantees the right to life under Section 33, which includes the right to receive adequate medical care in times of need. However, the practice of requiring deposit payments before providing treatment, especially in life-threatening situations, is a violation of this constitutional right. Hospitals, both public and private, are legally obligated to provide emergency care without delay or preconditions.
The Consumer Protection Act of 1986 grants patients the right to seek redress through Consumer Courts if they suffer harm due to the negligence or unethical practices of healthcare providers. To establish negligence, it must be proven that the healthcare provider’s actions directly caused harm to the patient. Healthcare providers are expected to exercise a reasonable standard of care, and failure to do so can result in legal consequences, including civil liability. If the negligence is severe enough to demonstrate a reckless disregard for life and safety, criminal charges, such as manslaughter, may be brought against the responsible parties.
In the case of Kemi’s death, the refusal of medical treatment until the deposit was paid can be viewed as medical negligence. The hospital’s failure to act promptly led to a fatal delay, and the family has the legal right to seek compensation for their loss under the principles of negligence and wrongful death. Furthermore, the Medical and Dental Council of Nigeria (MDCN), which regulates the practice of medicine in Nigeria, has the authority to impose sanctions, including suspension or revocation of medical licenses, for breaches of professional conduct. However, there are concerns about the effectiveness of these regulations in preventing such tragedies from recurring.
Healthcare providers have an ethical duty to prioritize the well-being of their patients, particularly in emergencies. The Hippocratic Oath requires doctors to “do no harm” and to provide care regardless of the patient’s ability to pay. The requirement of an upfront deposit before providing emergency care stands in direct contradiction to these ethical principles.
In Kemi’s case, the refusal to provide treatment until payment was made shows a clear disregard for both the ethical obligation to care for the patient and the legal duty to act in emergencies. The husband of the deceased, Akinbobola Folajimi, pleaded with the hospital staff to begin treatment immediately, but his request was rejected. Instead, he was told to gather the deposit before any action could be taken. The heart-wrenching consequence of this delay was Kemi’s death. This practice not only undermines the ethics of medical care but also exacerbates the vulnerability of families who are already facing immense emotional and financial stress during emergencies.
Under Nigerian law, patients can seek redress for medical negligence through the Consumer Protection Act of 1986 and other legal avenues. Negligence claims must demonstrate that the healthcare provider’s failure to provide a reasonable standard of care directly caused harm to the patient. In Kemi’s case, the hospital’s refusal to treat her unless the deposit was paid constitutes a failure to act according to the standard of care required in an emergency. The law allows for compensation for the physical harm, pain and suffering, and economic losses caused by the negligence.
If a healthcare provider’s actions or omissions are found to be grossly negligent, they may be subject to civil liability for damages. Furthermore, in extreme cases where negligence shows a flagrant disregard for human life, criminal charges such as manslaughter may be brought against the responsible individuals or institutions.
The Ministry of Health and the Medical and Dental Council of Nigeria (MDCN) must take immediate action to investigate such practices and ensure that hospitals comply with the ethical and legal standards of care. A failure to do so would perpetuate the vulnerability of patients who are already at the mercy of a fragile healthcare system.
The tragic death of Kemi underscores the urgent need for reform in Nigeria’s healthcare system, particularly regarding the practice of requiring upfront deposits for emergency medical care. Several actions are necessary:
Nigerian laws must be revised to prohibit hospitals from demanding deposits before providing treatment in emergencies. Clear legislation should be introduced to protect patients’ rights to life-saving care without financial preconditions.
Healthcare providers must be reminded of their ethical obligations to provide care without delay, especially in emergencies. Ethical training should be mandatory for all healthcare workers to ensure that patient welfare is prioritized.
The regulatory bodies, such as the Medical and Dental Council of Nigeria (MDCN), should enforce strict penalties for hospitals and healthcare providers found guilty of negligence. These penalties should include suspension, revocation of licenses, and, where appropriate, criminal charges for reckless disregard for patient safety.
Public awareness campaigns should be launched to educate Nigerians on their rights within the healthcare system. Patients must be informed about how to seek legal redress if they are denied care or suffer harm due to negligence.
International human rights organizations must lend their voices to these reforms. As advocates for equitable access to healthcare, they can support efforts to push for changes in Nigerian healthcare laws and practices to prevent such preventable deaths.
The loss of Kemi due to the hospital’s insistence on a ₦500,000 deposit highlights the systemic issues within Nigeria’s healthcare system, particularly in private hospitals. No patient should face a life-threatening situation only to be turned away due to an inability to pay. It is imperative that the Nigerian government, through the Ministry of Health and regulatory bodies, take swift action to ensure that emergency care is provided immediately, regardless of financial constraints. The tragic ordeal suffered by Kemi and her family must catalyze change, sparking a movement toward a healthcare system that upholds the principles of justice, fairness, and compassion.
As international human rights advocates have consistently emphasized, access to healthcare is a fundamental human right. No person should be denied medical treatment due to financial barriers, especially in life-or-death situations. It is time for Nigeria to implement the legal and ethical reforms necessary to prevent such heartbreaking events from happening again.
Daniel Okonkwo is the founder of Profiles International Human Rights Advocate, a journalist, and a professional writer committed to promoting equitable access to healthcare in Nigeria.
