Dr Paul John ,Port Harcourt,mazipauljohn@gmail.com,08083658038,Director , Centre for Medicolegal Research (CMR) https://web.facebook.com/cmr.legal

The recent interview granted by the commissioner of Health in Rivers state concerning the patient involved in the attempted dynamite explosion at Hotel Presidential Port Harcourt has raised a lot of questions bothering on whether or not the Health commissioner has violated the extant laws governing medical practice in Nigeria. Also, professional colleagues have inundated my social media handles with a lot of questions hence I have decided to put up this post as I cannot privately reply all the questions sent to me.


Rule 44 of the Code of Medical Ethics in Nigeria (hereinafter referred to as COME) takes very seriously the ethics of professional secrecy whereby any information about the patient that comes to the knowledge of the practitioner in the cause of the patient-doctor relationship constitutes a secret and privileged information, which must in no way be divulged by him/her to a third party.

Dr Adaeze Oreh,the honourable commissioner of health in Rivers state

Many people are arguing that based on the above stated rule of COME, that the commissioner of health has no right whatever to have divulged the information of the patient being managed in a facility under her ministry, this is in tandem with a line in the Hippocratic oath which states that: I WILL RESPECT the secrets that are confided in me, even after the patient has died.

The basic premise of their argument is based on  s26(1) of the National Health Act (hereinafter referred to as NHA ),which affirms the confidentiality of the patient’s secrets and privileged information; and  s37 of the Nigerian constitution ,as amended, which gives every citizen(including the patients )the right to private and family life .


Rule 43 of COME envisaged a scenario where the ownership of the patient may be in doubt hence it defines a Responsible Medical Officer (hereinafter referred to as RMO) as the practitioner who takes ultimate responsibility for the care of the patient in any health institution .In this case the consultants of the unit(s) managing the patient are the RMO’s hence they are the ones not allowed to divulge the secret of the patient. The first personal pronoun ‘I’ in the Hippocratic Oath applies to the RMO, which in this case the Commissioner of Health in Rivers is not.

Facility where the suspect was admitted

Also, rule 60 of COME empowers the head of any health institution to notify the security agencies of the presence of any suspect that is being wanted hence no health institution should be used as a hideout for any suspect or criminal and breach of such law constitutes infamous conduct in a professional respect. This is consonance with relevant section of the Compulsory Treatment and Care for Victims of Gunshot Act (2017).


It is trite in law that there are exceptions in every rule. S1 (3) of the Nigerian Constitution, as amended, affirms the supremacy of the Nigerian constitution and goes ahead to show that if at any point in time, any section of the Nigerian constitution conflicts with any other law (Medical or International laws inclusive) ,the Nigerian constitution shall prevail and that other law(s) shall to the extent of the inconsistency be void .

Chapter 4 of the Nigerian Constitution, which contains sections 33 through 46, dwells on the Fundamental Human Rights. These sections are said to be fundamental because they are very important to the existence of the citizens and that is the only thing that differentiates between humans and animals .Human right is regarded as just, correct, truth, fairness, justice, just or legal claim. It simply means freedom, immunities, and benefits which accorded to modern values hence all human beings should be able to claim their right in the society they live.

In Ransome Kuti v AG Fed, Kayode Eso stated that human rights are rights which stand above the ordinary laws of the land, and it exists before political society itself. He also said that it is a primary condition to a civilized existence.

Hotel Presidential Port Harcourt where the incident took place

However, S.45 of the Nigerian constitution gives the government (state or federal) the power to legally suspend some of these fundamental human rights provided that such violation, suspension, derogation and limitation of such rights is reasonably justifiable in a democratic society.

S.45 of the Nigerian constitution goes further to list the fundamental Human Rights that can be temporarily suspended as sections 37( Right to Private and Family Life) ; 38 (Right to Freedom of thought ,conscience and Religion ); 39 (Right to Freedom of expression and the press);40 ( Right to freedom of Assembly and Association ) and finally 41 (Right to Freedom of movement ).

In addition , s45(1a)  gives conditions under which the government can legally violate sections 37,38,40 and 41 of the constitution and the conditions include : interest of national defence ,public safety, public order, public morality and/or public health. There is no gainsaying the fact that Rivers state ministry of health is part of Rivers state government.

The map of Port Harcourt

There are three fundamental Human Rights that can never be legally violated by the government, no matter the circumstances and they are: Rights to Dignity in Human person (s.34) ; Right to Fair Hearing (s.36) ;Right to Freedom from discrimination (s.42).

There are decided cases that have shown that rights of the citizens are not absolute hence can be limited, suspended, derogated by the government and some of such cases are Onuoha Kalu v The State where the court held that right to life is not absolute hence death sentence is also statutory ; and Dokubo Asari V. FRN (2008), 2 SC 450 where the court held that where National security is threatened or there is the likelihood of being threatened then the rights of individual of those responsible take second place .

It is clear that section 37 of the Nigerian constitution and some rights of the patient can be legally suspended ,limited ,derogated for the sake of public health et cetera and that is why we have what we call ‘Notifiable diseases’ such that once a health practitioner suspects such a disease in a patient ,he is compelled by the ethics of the profession to immediately notify the medical authorities without the consent of the patient .This was why late Dr Stella Adedevo restricted the exit of Patrick Sawyer  ,the man that brought Ebola to Nigeria ,and immediately notified the medical authorities in Lagos state . She acted in the interest of public health.


Those accusing Dr Adaeze Oreh, the honourable commissioner of health in Rivers state , of violating the right of the patient are obviously ignorant of the relevant sections of the extant laws .First ,Rule 44 of COME ,where they based their argument ,also gives conditions where a practitioner can legally violate, limit, derogate, suspend the right to secrecy of the patient and one of the conditions is for public health/safety. It goes further to compel practitioners to anonymize the patient’s information and the commissioner adhered to this rule as she never mentioned the name of the patient ,the age of the patient ,where the patient hails from ,et cetera . This is in tandem with S.26 (2e) of the NHA.


The World health Organization(WHO) defines health as a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. It goes further to define public health as all organized measures (whether public or private) to prevent disease, promote health, and prolong life among the population as a whole.

The executive governor of Rivers state who appoints commissioners to carry out executive functions

Other patients in the health facility where the suspect was being treated were becoming apprehensive of any possible counterattack by the sponsors of the suspect and the press briefing by the commissioner helped in calming frayed nerves and to ally their fear hence her action was to maintain public safety and health.

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