T A B L E  O F  C O N T E N T S

 

DEDICATION i

PREFACE iii

ACKNOWLEDGMENTS v

LIST OF LEGAL INSTRUMENTS vii

TABLE OF CASES xiii

ABBREVIATIONS xxi

 

CHAPTER ONE: GENERAL INTRODUCTION

1.1 Background to the Study 1

1.2 Contextualising the Problem 9

1.3 Justification for the Study 10

 

CHAPTER TWO: THE NEED FOR THE REGULATION OF MEDICAL PRACTICE IN CAMEROON

2.1 Introduction 13

2.2 Human Rights Considerations for Regulating Medical Practice in Cameroon 15

   2.2.1 The Right to Health as a Common Concern for Humanity 16

      2.2.1.1 Respect of the Rights to Health under International Human Rights Laws 17

   2.2.2 The Right to Health as a State Responsibility 22

      2.2.2.1 Regulating Medical Practice as a Guarantee of the Right to Health in Cameroon 24

          a) Right to Access Health Services and Facilities 25

          b) Right to Medical Information 26

          c) Right to Confidentiality 28

          d) Right to Remedy in the Event of Malpractice 29

2.3 Administrative Considerations for Regulating Medical Practice in Cameroon 31

   2.3.1 Porous Trans-National Borders 32

   2.3.2 Ineffective Quality Control System 33

   2.3.3 Infrastructural Deficiencies 36

   2.3.4 Inaccessibility to Remote Areas 39

2.4 Economic Considerations for Regulating Medical Practice in Cameroon 40

   2.4.1 Low and Irregular Income 41

   2.4.2 Protection of Consumers Interests 42

   2.4.3 Taxation of Illegal Medical Products 44

   2.4.4 Poverty 45

   2.4.5 Corruption 46

2.5 Conclusion 47

 

CHAPTER THREE: COMPLIANCE WITH RULES AND PRINCIPLES OF MEDICAL PRACTICE IN CAMEROON

3.1 Introduction 49

3.2 Compliance with General Principles of Medical Ethics 51

   3.2.1 The Principle of Respect for Autonomy 52

   3.2.2 The Principle of Beneficence 56

   3.2.3 The Principle of Nonmaleficence 57

   3.2.4 The Principle of Justice 58

3.3 Compliance with Rules Prescribed by Statutory Instruments 59

   3.3.1 Compliance with Standards of the Cameroon Code of Medical Ethics 59

      3.3.1.1 Respect for Life 60

      3.3.1.2 Professional Secrecy 61

      3.3.1.3 Non- Advertisement of Practice 62

      3.3.1.4 Mutual Respect towards Colleagues and Professional Collaboration 64

   3.3.2 Compliance with the Provisions of the Law Organizing Medical Practice in Cameroon 65

      3.3.2.1 Obligation to Obtain a License 65

      3.3.2.2 Obligation to take an Insurance Policy 67

3.4 Compliance with Standards of Regulatory Bodies 68

   3.4.1 Compliance with Standards of National Regulatory Bodies 69

      3.4.1.1 Compliance with Standards Fixed by the Ministry in charge of Public Health 69

      3.4.1.2 Compliance with Standards of the Cameroon Medical Council 72

   3.4.2 Compliance with Standards of International Regulatory Bodies 76

      3.4.2.1 Compliance with Standards of World Health Organization 76

      3.4.2.2 Compliance with Standards of the World Medical Association 81

      3.4.2.3 Compliance with Standards of the African Medical Association 85

3.5 Conclusion 87

 

CHAPTER FOUR: REMEDIES FOR VIOLATION OF MEDICAL PRACTICE IN CAMEROON

4.1 Introduction 89

4.2 Legal Remedies 91

   4.2.1 Civil Remedies 91

      4.2.1.1 Remedies under the Law of Contract 93

          (a) Establishing Breach of contract 96

      4.2.1.2 Remedies under the Tort of Negligence 100

          (a) Doctor-Patient Relationship 102

          (b) Duty of Care 103

          (c) Breach of Duty of Care 108

          (d) Causation 112

          (e) Burden of Proof 115

          (f) Consequential Damages 119

          (g) Defences available to the Medical Practitioner under the tort of Negligence 120

      4.2.1.3 Tort of Battery 130

      4.2.1.4 Liabilities of Hospital Management for Violation of Medical Practice 133

          (a) Direct Liabilities of Hospital Management 133

          (b) Vicarious Liabilities of Hospital Management 135

      4.2.1.5 Criminal Offences for violation of Medical Practice 139

          (a) Capital Murder, Murder, Euthanasia 143

          (b) Unintentional Killing 143

          (c) Assault Occasioning Death 145

          (d) Grievous Harm, Simple Harm and Slight Harm 145

          (e) Abortion 146

          (f) False Medical Certificate 147

          (g) Failure to assist 148

          (h) Breach of confidentiality 148

           (i) False Arrest 149

4.3 Extra Legal Remedies 149

   4.3.1 Remedies by the Cameroon Medical Council 150

      4.3.1.1 Breach of Professional Secrecy 152

      4.3.1.2 Breach of Duty to Disclose Information to Patient 153

      4.3.1.3 Breach of Duty to Obtain Consent 154

      4.3.1.4 Charlatan Practices and Incompetence 155

      4.3.1.5 Collusion 157

      4.3.1.6 Commercialization of Medical Practice 158

   4.3.2 Amicable Settlement 161

4.4 Conclusion 165

 

CHAPTER FIVE: CONSTRAINTS TO THE REGULATION OF MEDICAL PRACTICE IN CAMEROON

5.1 Introduction 169

5.2 Legal Constraints to the Regulation of Medical practice in Cameroon 170

   5.2.1 Inefficient Enforcement of Existing Laws 171

   5.2.2 Ignorance of the law 172

   5.2.3 Access to Legal Redress 173

   5.2.4 Delay in Legal Proceedings 177

   5.2.5 Burden of Proof 178

   5.2.6 Corruption of the Judiciary 180

5.3 Extra-Legal Constraints to the Regulation of Medical Practice in Cameroon 183

   5.3.1 Weak Regulatory Mechanisms 183

   5.3.2 Absenteeism 186

   5.3.3 Corruption 188

   5.3.4 Inflated Hospital Bills 189

   5.3.5 Long Detention of Patients 191

   5.3.6 Inappropriate Medical Care 193

   5.3.7 Absence of Government Assistance 194

5.4 Conclusion 196

 

CHAPTER SIX: GENERAL CONCLUSION AND RECOMMENDATIONS

6.1 General Conclusion 197

6.2 Recommendations 204

 

BIBLIOGRAPHY 211

APPENDICES 231