Governing patient safety through law, policy and institutional frameworks in Bangladesh: opportunities and challenges

Bangladesh has suffered numerous healthcare crises. The country currently lacks a coherent legal, policy and institutional framework to promote patient safety in healthcare, with inadequate mechanisms to enforce standards or provide access to justice for patients aggrieved by breaches of care standards. To date, patients have no real recourse to submit complaints concerning medical malpractice and the enforcement culture fails to promote accountability among medical professionals. This has contributed to a high incidence of medical malpractice, adverse events and medical errors. This thesis is mainly focused on three main challenges: 1) health governance, 2) a code of medical ethics and 3) judicial commitment to promote patient safety and hold the healthcare system accountable for quality healthcare service.

This thesis critically reviews and evaluates the healthcare framework, particularly patient safety legislation and the supporting tools and institutions that promote patient safety in Bangladesh. This thesis draws upon both theories of human rights and governance to develop recommendations for law and policy reforms that will promote the right to health and patient safety in accordance with international law. It will also consider the code of ethics of health professionals in regard to patient safety. This thesis further examines the potential role of the judiciary in reinforcing healthcare outcomes for citizens of Bangladesh. It argues that judicial intervention, through the interpretation of domestic and international law, may provide a viable mechanism and function as a ‘catalyst’ for strengthening governance, fulfilling the main claim of this thesis. The thesis makes significant contributions to the field of quality healthcare services research by way of reviewing relevant law, policy and institutional frameworks regarding patient care and safety and suggesting avenues for law and policy reform.