EARNING FROM YOUR CHILD’S DEATH (And wife’s critical illness!)

Scenario:

            Mrs. A walks into the hospital with pregnancy 8 months, raised B.P. and her unborn child, she has been told by her attending obstetrician, is sick. We examine her and find that she indeed has a very high B.P. This process has affected her kidneys to some extent and her unborn child is actually dead. There is no heart sounds coming from the fetus. We perform a sonography and inform the pregnant woman and her family of the situation. We also inform them of the need for early delivery now that the fetus is dead within. They agree.

Labour is induced and in due course of time she has a still born delivery. After nearly a week to ten days her high B.P. and associated sicknesses get cured and it is time to discharge the subject.

           

          This is the time when the parents of the patient walk into our chamber and pay the bill. This middle-aged couple pays the bill. After the bill has been paid, the son-in-law walks in and produces all the forms, prescriptions and documents that are to be submitted for claiming reimbursement from Health Insurance company. Quizzically we look at the parents of the patient who have paid the bill who now tell that their son-in-law gets medical expenses repaid through his employing company. The company has insured him and his family’s medical expenses (Mediclaim). The files and papers are prepared for the son-in-law to present the claim.

            It is only at this stage that the son-in-law appears on the horizon. Till now he was nowhere on the scene. The entire crisis when his wife was critically so sick and she had a still-born delivery, this gentleman and most of the times even his parents and relatives are nowhere around. But when the health insurance papers are to be processed he takes over.

            Typically when all this is on, he requests to inflate the bill (which is always refused by us). He then tells that the money paid by his in-laws would not be returned to them once his claim is passed. He will be retaining the money himself. In other words, he will earn from the medical insurance claimed for the treatment of his sick wife and dead child. He will not pay himself but he will claim the money from the insurance company.

“It is her parents’ duty to pay” or “It is a custom that the maternity expenses are to be borne by the parents of the woman” are the typical statements made. So why not give the money reimbursed to the lady’s parents? Typical answers follow “they won’t accept”. (Have asked? Silence!) “They don’t need”. Even the parents say at times “We will manage; we can’t take money from son-in-law”. “How will it look” and the ubiquitous expression “What will people say”!

            So the entire amount of money of medical bill for treatment of this sick wife and delivering their dead baby paid by her parents is ruthlessly pocketed by the son-in-law making an earning. The son-in-law pockets the entire amount and the average middle class parents watch helplessly “What will people say!!!!”

            Sometimes (rarely of-course), exceptions occur when the son-in-law walks in to pay the bill, just refuses to let the in-laws even enter the doctor’s chambers (lest they get emotional) and himself pays up. I have also seen a situation once when the son-in-law rushed in for paying the bill at least an hour before the in-laws were to visit the hospital so that the latter don’t get on opportunity to pay. But these are exceptions and happen scarcely. Most of the times the in-laws pay the bill and the son-in-law pocket the amount when the insurance company reimburses ruthlessly earning from his wife’s sickness and his dead baby.

The ethical and legal aspects:

            Legally the son-in-law is not wrong. We as the hospital provided the services. We were paid, who-so-ever pays is legally immaterial. He is entitled to reimbursement from insurance companies for medical bills of his family and he claims it and all is okay in the eyes of law. But lest we forget, ethics are much beyond law. As Immanuel Kant said; “In law a man is guilty when he violates the rights of others. In ethics he is guilty if he only thinks of doing so.” One may be legally right but ethically wrong. This applies here. The parents of the girl foot the bill. Many a times they are not strong financially to take this burden so the hospital reduces the bill of its services on humanitarian grounds. But the son-in-law pockets this entire amount without offering even a part payment to the in-laws. Thereby he has earned from the sickness of his wife and death of his baby.