Once a Supreme Court judge has written a judgment, under article 141 of the constitution it becomes a binding.

Most of us seeing a patient with terminal illness or a serious medical disorder are in a similar situation. Our medical or surgical interventions is the final word for the life of that patient at that moment.

Recently, Supreme Court advocates requested Justice Arun Mishra to be patient while dealing with lawyers after the judge warned a lawyer of contempt while arguing a land acquisition case.

We, as doctors are in the same situation as Justice Mishra when dealing with a case where our clinical judgment is the final decision for the patient.

We have no right to lose our cool or misbehave with the relatives who are in a situation of panic and mental distress.

Communication is the key in such cases. If we follow the principle of Lord Shiva who is depicted as a God with blue neck, matted hair, half-moon and river Ganga on his head with inward directed snake.

It basically indicates that whenever we are in acute stress and face internal anger or ego, we should keep our anger in our throat (blue neck) and not spit it out (anger out) or take it in (anger in) but continuously (matted hairs) with cool mind (moon) and with a positive flow of thoughts (ganga) keep our Ego under control (sheshnag) neutralize it and then calmly over a period of time act on it to find the solutions.

So, the underlying principal of communication is to act and not react. We the doctors must remember that we are often in situations where we are the final answer and no further appeal is possible countering our decision. Our duty therefore is to act and not react and help the patient and relatives under extreme duress, to be calm. 

References

Article 141 in The Constitution of India 1949

141. Law declared by Supreme Court to be binding on all courts: The law declared by the Supreme Court shall be binding on all courts within the territory of India

Dr KK Aggarwal

Padma Shri Awardee

President Confederation of Medical Associations in Asia and Oceania (CMAAO)

Group Editor-in-Chief IJCP Publications

President Heart Care Foundation of India

Past National President IMA