Q&A – 23 July 2018

Medical standards of care in war zones

I saw on tv with great dismay how medical staff were treating a patient in a war zone area in the Middle East. It was quite shocking at the way they were attending to the victim and it was clear to me that they did not meet the medical standards of care required of such doctors and nurses. How does one view such standards of care when there is a war?
CV, Mwanza

You must appreciate that there is a distinction between medical standards of care viz legal standards of care.

While medical and legal standards of care often are regarded as interchangeable, by many views that we read about they are in fact distinct concepts. According to one view, medical standards of care describe the types and levels of medical care dictated by professional norms, professional requirements, and institutional objectives. These standards of care vary (1) among different types of health care facilities, such as hospitals, clinics, and alternate care facilities; and (2) based on prevailing circumstances, including during emergencies. Although existing, routine medical standards of care are flexible, they do not reflect the guidance needed to assist health care practitioners attempting to allocate scarce resources and make difficult decisions (including the potential withholding or withdrawal of life-sustaining treatment) during severe conditions in a public health emergency.

Legal standards of care, on the other hand, may be defined as the minimum amount of care and skill a health care practitioner should exercise in particular circumstances based on what a reasonable and prudent practitioner would do in similar circumstances. Legal standards of care are necessarily fact-specific, flexible, and subject to differing interpretations by different Courts. They may reflect medical standards, but do not always. For example, a number of Courts assessing standards of care have determined at times that prevailing medical practice was insufficient or unacceptable in exceptional cases. In these instances, practitioners have been found liable for their actions even though, based on the circumstances, their acts were consistent with the prevailing medical standards of care.

You might be a doctor and invite you to do more research on this topic.

Banks asking for too much documentation

One of the larger banks in the country has been asking me for all kinds of details before allowing me to open an account there. Is this not discriminatory?
FT, Dar

We are not sure what questions the big bank asked you to answer whether they were discriminatory, but under the Anti Money laundering regulations of 2012, the banks, as reporting persons, have to mandatorily ask the following questions before dealing with a person.

Regulation 3 states that (1) Where a reporting person is dealing with an individual who is a citizen of, or resident in the United Republic he shall be required to obtain from such person the following information – (a) full names and residential address; (b) date and place of birth; (c) in case of a citizen, voters’ registration card or national identity card or in the absence of such information, a passport, birth certificate or driving license; (d) in case of a resident, a passport, travel document, residence permit or driving license of that person; (e) an introductory letter from relevant authority such as employer or government official; (f) employee identity card with an introductory letter from employer; (g) Tax Identification Number, if such a number has been issued to that person; (h) any or all of, telephone numbers, fax number, postal and e-mail address; (i) customer residential address including important landmarks close to the prospective customer’s residence; (j) where the customer is a student (k) an introductory letter from the customer’s institution signed by the head of the institution or a representative of the head of institution; (l) the student’s identity card; (m) nature of business activity; (n) signature and thumb print; (o) utility bills, where applicable.
(2) In case a reporting person is aware or ought reasonably to be aware that the person referred to in sub-regulation (1) does not have the legal capacity to establish a business relationship or conclude a single transaction without the assistance of another person, the reporting person shall, in addition to obtaining the particulars referred to in sub regulation (1), obtain from the person rendering assistance- (a) full names and residential address; (b) date and place of birth;
(c) Tax Identification Number, if such a number has been issued to that person; (d) any or all of, telephone number, fax number, postal and email address; (e) residential address including important landmarks close to his residence; (f) nature of business relationship with the person he is helping; and (g) signature and thumb print.
(3) Where the reporting person is taking finger prints under these Regulations, he shall use ink and pad of such quality as to enable the capturing of thumb prints. (4) The thumb prints shall be taken in the following sequence- (a) where that person has both hands, right hand thumb shall be captured; (b) where that persons has no right hand thumb, then the left hand thumb shall be captured; (c) in case that person does not have both thumbs, then the next available finger shall be used, starting with the right pointing finger; and (d) in case that person does not have fingers, the reporting person may take palm or toes print. (5) In case that person lacks both hands and feet, then an exceptional approval from the management of the reporting person shall be obtained after recording such situation.

You can see from the above that the law is very strict in terms of what information must be obtained from you, which includes your e mail address and finger prints. We are aware that other banks do not follow this but that would mean they are contravening our anti money laundering laws, which offence is not bailable.