Buhari and his doctors: The 4 principles you should know about

by Alexander O. Onukwue

President Muhammadu Buhari should be back to Nigeria now if only his doctors will let him.

That is discernible from the statements that have emerged from the recent visit of the Presidential aides to Buhari in London. Buhari’s doctors are supposed to give the clearance for him to be able to leave Abuja House – where he has been for close to 100 days – for Abuja.

Buhari’s health has been among the most trending issues in Nigeria throughout the year, but moreso in the last three months. The object of his ailment remains a tightly held secret despite the pressures from several quarters, local and international, for the President’s ailment to be revealed. As has been defended by his aides, more recently Lauretta Onochie, President Buhari has enjoyed the usual patient-doctor confidentiality that guarantees the matter of his health to be unknown to the public.

Besides, patient-doctor confidentiality, there are other aspects of the relationship between a doctor and a patient that are instructive to note. With the return of the President now tied to the “green light” of his doctors, it is worthwhile to revisit the words of Buhari’s former physician, Prof Sadiq Suleiman Wali.

In an interview with the Daily Trust in February, Prof Wali enumerated the four principles guiding the relationship between doctors and patients.

“There are four ethical principles, namely:

Autonomy, where a doctor has to explain any action he intends to take with its advantage and disadvantage, possible harms and benefits. The patient has the right to accept or reject the recommendations.

Then there is Beneficence, where all actions and procedures should be of benefit to the patient.

In the case of Malfeasance, it’s ‘do no harm’.

Then there is Justice, when benefit to the patient and community should be assessed. If there is a danger to the community, the doctor can override the wishes of the patient like Lassa fever, Ebola disease and so on. In such cases, the doctor is obliged to report to appropriate health authorities.

Of the four, the matter of deciding whether he is well enough to return to Nigeria or not would appear to be under the principle of autonomy. It is expected that the doctors would respect the decision-making capacity of individuals to make choices that are rational. Again, if the doctors determine that it would be in Buhari’s best interests to remain for a while longer in London, it would be in subscription with the principle of beneficence. As it appears, the President has chosen to do whatever his doctors say.

That would be hoping it does no malfeasance to Nigerians, many of who have not held back showing their frustrations with the elongated absence of the President for the undisclosed illness.

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