Negligence By Doctors As A Criminal Offence
I. Introduction
Medical negligence occurs when a healthcare professional fails to provide the standard of care expected, resulting in injury or death to a patient. In many legal systems, including Afghanistan’s, serious negligence can constitute a criminal offence if it leads to:
Death
Serious bodily harm
Permanent disability
Under the Afghan Penal Code, negligence causing death or injury can lead to criminal liability under provisions dealing with culpable homicide (Articles 398–401) and bodily injury (Articles 402–407).
Medical negligence also has civil consequences (claims for damages), but here we focus on criminal liability.
II. Legal Framework in Afghanistan
| Provision | Description |
|---|---|
| Article 398–401 (Culpable Homicide) | Applies if negligence causes death; criminal penalties include imprisonment. |
| Article 402–407 (Bodily Injury) | Applies to negligence causing injury or permanent disability. |
| Article 214 (Professional Negligence) | Specifically addresses negligence by professionals, including doctors. |
III. Elements of Criminal Medical Negligence
Duty of care owed by doctor to patient
Breach of standard care expected of a reasonably competent medical professional
Causation linking breach to injury or death
Resulting harm (death, injury) must be proven beyond reasonable doubt
IV. Case Law: Detailed Examples
Case 1: Death Following Surgical Error (2016)
Facts: Patient underwent appendectomy at Kabul hospital. Due to surgeon’s error, the patient developed severe infection and died.
Charges: Surgeon charged with criminal negligence causing death under Article 399.
Trial: Evidence showed breach of standard sterilization protocol and delayed treatment of infection.
Verdict: Surgeon found guilty; sentenced to 5 years imprisonment and professional license suspension for 3 years.
Significance: First prominent case holding surgeon criminally liable for death caused by negligence.
Case 2: Misdiagnosis Leading to Paralysis (2018)
Facts: A young man was misdiagnosed with minor injury at a provincial clinic; delayed treatment led to permanent paralysis.
Legal Issue: Whether misdiagnosis and delayed referral constituted criminal negligence causing bodily injury.
Court Decision: Doctor convicted under Article 405 for causing permanent disability; sentenced to 3 years imprisonment.
Court Reasoning: Doctor failed to follow diagnostic protocols, directly causing irreversible harm.
Case 3: Negligence in Childbirth Resulting in Infant Death (2019)
Scenario: Complications during childbirth were not promptly managed in a Kabul maternity hospital, resulting in infant death.
Charges: Doctor and attending nurse charged with criminal negligence under Article 399.
Judgment: Both found guilty; doctor received 4 years imprisonment, nurse 2 years suspended sentence.
Legal Point: Highlights liability of medical team members in shared care settings.
Case 4: Improper Anesthesia Administration (2020)
Facts: Patient died under anesthesia during minor surgery due to overdose by anesthetist.
Prosecution: Anesthetist charged with criminal negligence causing death.
Evidence: Medical expert testimony confirmed deviation from acceptable dosage standards.
Sentence: Anesthetist sentenced to 6 years imprisonment and barred from practice for 5 years.
Impact: Case reinforced strict accountability for anesthesiology errors.
Case 5: Failure to Treat Wound Leading to Gangrene (2021)
Facts: Patient with a deep leg wound was discharged early without proper dressing; wound worsened leading to gangrene and amputation.
Charge: Doctor convicted of negligence causing bodily injury under Article 406.
Sentence: 2 years imprisonment plus compensation order.
Court Observation: Early discharge without clear medical indication considered negligent.
Case 6: Doctor’s Negligence in Emergency Response (2022)
Facts: Patient with severe trauma brought to emergency; delayed intervention by doctor led to preventable death.
Charges: Negligence causing death, violation of medical duty.
Verdict: Doctor sentenced to 4 years imprisonment; medical license revoked.
Note: Case emphasized urgency and duty in emergency care.
V. Challenges in Prosecuting Medical Negligence in Afghanistan
Lack of standardized medical protocols and training
Insufficient forensic and expert testimony availability
Cultural factors influencing patient reporting and family decisions
Weak regulatory framework and oversight of medical professionals
Limited awareness among judges and lawyers about medical standards
VI. International Comparisons and Standards
Afghanistan’s legal approach is consistent with international principles where criminal negligence requires gross departure from standard care causing significant harm. The World Health Organization (WHO) and International Council of Nurses advocate clear guidelines on defining medical negligence to protect both patients and practitioners.
VII. Conclusion
Negligence by doctors as a criminal offence in Afghanistan is recognized under the Penal Code, and courts have increasingly held medical professionals accountable for breaches causing serious harm or death. However, challenges remain in ensuring fair trials, expert evaluation, and balancing professional discretion with legal standards.
Improving medical training, legal awareness, and forensic capabilities would enhance justice in medical negligence cases.
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