MANAGEMENT OF BROUGHT-IN-DEAD (BID) PERSONS IN NIGERIA: MEDICOLEGAL IMPLICATIONS
Brought-in-dead (BID) or dead-before-arrival, is a term used to define persons who were evaluated by a physician to have no sign of life, at the time of presentation to a health facility. Emergency medical services in Nigerian hospitals, especially with respect to the management of suspected BID persons, are plagued by a lack of standard protocol for the management of BID, poor infrastructure and nonavailability of life-saving equipment; low manpower to handle the huge burden of patients presenting at the emergency department; and poorly trained or lack of emergency response team. Legal provisions are sometimes ignored by some hospitals and may lead to medicolegal issues later. Withholding resuscitation and/or discontinuation of life-saving treatment is unethical and could have serious medicolegal implications. Objections to hospital care-of-the-dead and autopsy, by relatives of the deceased, based on religious and cultural beliefs, have become an ethical and medicolegal dilemma for medical experts. This article examines the medicolegal implications concerning the management of BID patients in Nigeria. A medical practitioner has a legal responsibility towards his/her patient, dead or alive, and may be called upon to appear in a panel or court. It is therefore essential that all medical practitioners are armed with the basic knowledge and understanding of the law to perform their professional responsibilities with due diligence. There is a need for a standardized definition of BID, based on the proper definition of death using electrocardiographic (ECG) and electroencephalographic (EEG) criteria. The need for all hospitals in Nigeria to establish a legal medicine department or a medicolegal unit, cannot be overemphasized. More efforts are needed towards community sensitization and health education, aimed at reducing cases of BID.
Keywords: Brought-in-dead, Resuscitation, Medicolegal.
