The medical profession is undoubtedly one of the oldest professions in the world. I dare to say man is obliged, by the very nature, to go in quest for what will cure whatever ailment afflicts him – thus, reasonably innate to an extent. Interestingly, law is a far more universal, permanent and inevitable phenomenon in its various forms. Law essentially exists to guide other aspects of human existence.
The medical profession is not an exception. It is the thrust of this article to reaffirm the laws that guide medical practice and re-echo the accountability the law has equally placed on the medical professionals.
OVERVIEW OF NIGERIAN LAW GOVERNING MEDICAL PRACTICE AND NEGLIGENCE
The legal framework for medical practice in Nigeria is designed to balance the professional autonomy of practitioners with the protection of patient rights through statutory oversight and judicial review.
The medical profession in Nigeria is primarily regulated by the Medical and Dental Practitioners Act of 2004, which established the Medical and Dental Council of Nigeria (MDCN) to manage practitioner registration and enforce the 2008 Code of Medical Ethics. To maintain professional standards, the Act created a two-tier disciplinary system: the Investigating Panel conducts preliminary inquiries into allegations of “infamous conduct”, while the Disciplinary Tribunal oversees formal trials for cases deemed credible.
INDIGENOUS CASES ON MEDICAL NEGLIGENCE
MDPDT V OKONWO (2001) 7 NWLR (Pt. 711) 206
The case arose from the treatment of Mrs. Okorie, a patient who had recently given birth and was admitted to Kenayo Specialist Hospital in August 1991. Mrs. Okorie and her husband were Jehovah’s Witnesses and, based on their religious beliefs, strictly refused to consent to a blood transfusion. The respondent, Dr. Okonkwo, honored their wishes and proceeded with treatment without transfusing blood. Unfortunately, the patient died a few days later.
Dr. Okonkwo was charged before the Medical and Dental Practitioners’ Disciplinary Tribunal (MDPDT) with “conducting himself infamously in a professional respect” and acting in a manner contrary to medical ethics.
The core of the disciplinary action rested on the allegation of medical negligence. The tribunal initially found Dr. Okonkwo guilty on two counts, determining that he had attended to the patient in a negligent manner by failing to provide the standard of care (transfusion) that might have saved her life, despite the patient’s refusal of that specific treatment. He was suspended for six months.
In the context of medical negligence, this case serves as a landmark precedent establishing that a doctor is not negligent for failing to perform a procedure (like a blood transfusion) when a competent patient has expressly withheld consent. The “negligence” alleged by the tribunal was overturned because the practitioner’s duty to provide care is bound by the patient’s personal right to religion and the constitutional requirement that any charge of professional misconduct must be specific and clearly communicated to ensure a fair hearing.
DENLOYE V MEDICAL AND DENTAL PRACTITIONERS DISCIPLINARY COMMITTEE (1968) All NLR 306
In Dr. E.O.A. Denloye v. Medical and Dental Practitioners Disciplinary Committee (1968), the allegation of medical negligence centred on Dr. Denloye’s prolonged neglect of a critically ill patient, Fatilatu Bisiriyu, between 29 June and 10 July 1966. As a medical practitioner under the Ministry of Health, Western Nigeria, Dr. Denloye had direct responsibility for her treatment. Evidence showed that the patient was seriously ill and in need of continuous medical attention, yet Dr. Denloye failed to attend to her adequately over an extended period, a lapse that amounted to a clear abandonment of his professional responsibility.
The Disciplinary Tribunal held that this sustained failure constituted “infamous conduct in a professional respect.” It emphasised that once a doctor assumes responsibility for a patient, particularly one in a life-threatening condition, the duty of care is non-delegable and continuous. The Tribunal made it clear that prolonged neglect alone, even without proof of malicious intent or criminal liability, is sufficient to ground a finding of professional misconduct in medical practice.
Dr. Akintade v. MDPDT (2005) 9 NWLR (Pt. 930) 338
Dr. Akintade was arraigned before the Medical and Dental Practitioners’ Disciplinary Tribunal on two charges relating to medical negligence and professional malpractice. Following the trial, the tribunal found him guilty and sentenced him to a six-month suspension from medical practice.
The tribunal’s finding of negligence was based on the opinion that the patient’s condition constituted an “acute emergency” which any reasonable doctor should have diagnosed and treated
The Court of Appeal found that the evidence actually showed he was aware of the patient’s deteriorating condition and had acted on what the patient told him. Because this evidence was never challenged or discredited during the trial, the tribunal had no justification for its finding of negligence.
The court ultimately resolved the issues in favor of Dr. Akintade, emphasizing that a finding of medical negligence requires more than a tribunal’s subjective opinion; it requires a direct link between the evidence and the alleged failure in care.
Lessons from the Bench on Medical Negligence
The following cases illustrate the delicate balance between a doctor’s duty and a patient’s rights under Nigerian law:
The Right to Say “No” (MDPDT v. Okonkwo): This landmark case established that a doctor is not negligent for respecting a competent patient’s refusal of treatment, such as a blood transfusion. It affirms that the duty of care is bounded by the patient’s right to self-determination and constitutional fair hearing.
The Sin of Abandonment (Denloye v. MDPDC): In contrast to respecting a patient’s choice, this case highlights that “prolonged neglect” of a critically ill patient constitutes “infamous conduct”. Once a doctor assumes responsibility, the duty of care is continuous; failing to attend to a patient in a life-threatening condition is a clear breach of professional responsibility.
The Requirement for Hard Evidence (Dr. Akintade v. MDPDT): This case serves as a shield for practitioners against arbitrary judgment. The Court of Appeal ruled that negligence cannot be based on the subjective “opinion” of a tribunal alone; it must be proven by credible, unchallenged evidence that links the doctor’s specific actions to a failure in care.
Beyond the Outcry—A Call for Radical Reformation
The heartbreaking loss of Nkanu Nnamdi in January 2026 has done what decades of legal theory could not: it has forced a mirror in front of the Nigerian healthcare system. The “silence” is finally broken, but noise without reform is merely a eulogy. To ensure that the “slumber” does not return, we must move beyond the courtroom post-mortems of MDPDT v. Okonkwo and Akintade v. MDPDT and enact systemic legislative change.
The Path to Accountability
The Medical and Dental Practitioners Act of 2004 is a relic of a different era. To protect the modern Nigerian patient, we must advocate for three critical reforms:
From Individual to Institutional Liability: Our current laws focus almost exclusively on the individual doctor. As seen in the recent allegations against elite facilities, negligence is often a result of systemic failure including broken equipment, lack of oxygen, or poor staffing. We must amend our laws to hold hospitals as corporate entities vicariously liable, ensuring that institutions, not just individuals, bear the cost of incompetence.
Specialized Health Courts: The years-long delays in the MDCN Disciplinary Tribunal are a denial of justice. Nigeria requires specialized “Medical Coroners’ Courts” or health tribunals staffed by both legal and medical experts to fast-track negligence cases, ensuring that evidence remains fresh and justice is swift.
Mandatory Professional Indemnity Insurance: Much like motor insurance, no facility or practitioner should operate without robust negligence insurance. This ensures that when the law finds a breach, the family of the victim is compensated
The Adichie tragedy has reminded us that in the theater of medicine, the difference between a miracle and a catastrophe is often the thin line of accountability. If we do not wake up the law to meet the cries of the grieving, then our healthcare system remains not just in slumber, but in a state of terminal neglect. The era of “God’s will” is over; the era of the Patient’s Right must begin.
About the Author
TOHEEB OMOTAYO ALIMI is a graduate of the faculty of Law, Lagos state University. A persuasive communicator passionate about growth, leadership, and peer mentorship, with a strong commitment to excellence in legal service delivery. His interest spans across core litigation, energy law, tax and medical ethics.