In general, the meaning of the term abandonment means the forsaking of one's duty. Thus when a practitioner client relation gets established there is a 'duty of care' which includes the protection of the client, maintain records of the clients, and to always provide the client with due care with maximum application of the physicians skills. If one or all these have been breached, there is deficiency of service. However if the relationship is broken because of non-functioning from the part of the physician then there is abandonment. (Davis, 2008)
Medical abandonment is a concept that is broadly covered under the malpractice laws. Medical malpractice is found to have been taken cognizance of in the British and American laws for a century now. The Second World War and aftermath saw the expansions of the concept and the possibility of physician liability. It also was broadened by the reinterpretation off the res ipsa loquitur doctrine. (Donald, 1978-1979) A practitioner may be found guilty and made liable to pay damages for a wrongful termination of a treatment or abandonment. There is a requisite of a medical relationship, that required a particular standard of care, and that abandonment did occur. Thus to prove abandonment there must be evidence to show that the action of the provider was done without a valid reason and sufficient notice of the withdrawal of service to the patient. If there was no time for the client to obtain alternate care without notice it is abandonment. Suits that rely on abandonment have to be based on the fact that the injury complained of directly was a result of the practice of the care giver. (Davis, 2008)
There must have thus been a client and care giver relationship that required further treatment or care which has been abruptly halted without notice to the patient. Thus abandonment can also be the abrupt withdrawal from the patient even for a time without giving an alternate. If for example a private practitioner leaves for another place on a tour without providing a patient being treated by him with an alternate physician inn his place until he returns commits abandonment and if this absence leads too some deterioration to the patient the liability sets in. Thus the entire issue can centre on the relation and the position that the care giver and the client stand at any given time. If the purpose of the care is not yet fulfilled the care giver must continue with the care until the proposed cure or benefit is affected. Thus until the treatment comes to a full close and the patient is not in need of the care giver, the obligations of the care giver is given. When the care giver defaults there is negligence and also a medical abandonment.
Medical abandonment goes hand in hand with negligence. Thus the ultimate test is to see if there was negligence, or seen in another way, was there an ending of the treatment prematurely. Because abandonment can also be defined as ending a therapy or process without giving the client proper notice to expect the end of the relationship. Exception to this rule is that if a practitioner is terminated by the hospital through which the practitioner is treating a patient, the practitioner is not obliged to work further and hence there cannot be an accusation of client abandonment. However the onus lies on the care giving hospital to give notice to the patient or provide with an alternate practitioner immediately.
In deciding the cases therefore courts always have looked into the actions of the care giver to see if there was first, negligence and then if there was a harm that resulted from the withdrawal to the patient. It connotes that if the withdrawal of service resulted in a chain of the patient being harmed; it is negligence and also may be seen as abandonment when no further services were provided to the patient. Thus negligence may result in abandonment, and abandonment may be a simple form of negligence when the doctor leaves the patient for a time without notice and the patient suffers injury or harm. Thus a doctor who leaves the patient without providing an alternate doctor in his absence is negligent and also has abandoned his patient in theory for that period of time. It has so been emphasized by the courts that negligence could go hand in hand with abandonment.
Decided cases on the issue show that abandonment thus could result from negligence, or negligence could be a type of abandonment. Mostly this concerns with the physician being absent without notice, moving away for a time without creating alternate care for patients, or closing the business or profession without notice. Thus the physician is to have an alternate strategy for managing patients in his absence or even demise and if the patients have had a gap inn their treatment that resulted in grievance that is actionable it becomes abandonment. Insurance companies avoid coverage for these types of claims. (Madden, 1998)
In all the cases, the obligations of the care giver are a deciding factor. A formal definition of medical abandonment was given in Brand tV Grubin, (1974) as a failure to give the necessary care by a professional and withdrawing care before the need is fulfilled and the care giver is not relieved. (Madden, 1998) Thus in a case of a mental health patient, erroneous termination before the cure or stability occurs may lead to danger and thus a suit for damages. It is not only that the practitioner abandoned the patient or that he or she withdrew from the relationship before the purpose of the care was completed, but a negligent handling of the patient care could also be abandonment if such care was withdrawn or done negligently. (Madden, 1998)
In the case where a change of the doctor resulted in increased symptom and distress of the patient it was held that it was abandonment and the termination of a client who needs further treatment for what so ever reason is also abandonment. It was highlighted in Cranford Insurance V Allwest Insurance (1986). (Madden, 1998) Further it was emphasized that each client is entitled to get his or her treatment with proper planning that includes the ability to pay, and the degree of dependency that may be created with the physician and care giver and if the care giver is going to be withdrawn the new suggested person must have interacted with the client and the client must be satisfied with the new care giver. Merely suggesting another person will not absolve the care giver of his or her duties. Generally abandonment is a cause of action where the care giver is not found when needed, or the provider has such a relationship with the patient that the assumed relation exists and is broken as in an emergency call, or that the practitioner did not follow all requisite steps in the patients care. All these could be the ground for malpractice and in some cases abandonment suits. (Hafter; Fedor, 2003)
Certain activities like the client having a sexual affair with the care giver ends the contractual relation of doctor and patient and thus the obligation comes to an end. In a case where these types of relationship exist the patient cannot claim abandonment or in a litigation where the doctor was terminated by the hospital and the client was given another doctor the abandonment claim fails. (Madden, 1998) In cases where hospitals are encouraged to take in foundlings abandoned by their mothers, the laws do not apply. Where likewise the physician has taken great care and the substitution was effective and care was given, the patient complaining about the need and dependence on the earlier care giver…