Authored By: Raji Oreoluwa Precious
Osun State University
ABSTRACT
Medical malpractice and the protection of patient rights are important concerns in Nigeria’s healthcare system. Medical malpractice occurs when a healthcare professional acts carelessly or fails to meet the required standard of care, leading to harm to a patient. In Nigeria, patient rights are protected through constitutional provisions, statutes, professional regulations, and common law principles. The Constitution of the Federal Republic of Nigeria 1999 (as amended) guarantees fundamental rights such as the right to life, dignity, and privacy, which also apply in healthcare settings. The National Health Act 2014 further protects patient rights by providing for informed consent, confidentiality, access to medical records, and emergency treatment. However, enforcement of these rights is weak due to high litigation costs, difficulty in proving negligence, low public awareness, and institutional challenges. This article examines Nigeria’s legal framework on medical malpractice and patient rights, discusses enforcement challenges, and recommends reforms to improve accountability and patient protection. It concludes that although Nigeria has strong laws on paper, effective implementation remains a major challenge.
1.0 Introduction
Medical malpractice is a significant issue worldwide, and Nigeria is no exception. It occurs when a healthcare provider breaches the standard of care owed to a patient, resulting in injury or death (Odunlami, 2026). Globally, medical malpractice lawsuits aim to hold healthcare providers accountable, compensate victims, and improve medical standards. In Nigeria, however, enforcing patient rights remains a challenge despite the existence of numerous legal instruments (Elgujja et al., 2025).
Historically, Nigeria’s legal approach to medical malpractice has evolved from English common law principles inherited during colonial rule. Tort law, particularly negligence, was introduced to regulate healthcare and protect patients (Adejumo, 2020). Over time, constitutional provisions and statutory reforms such as the National Health Act 2014 formalized patients’ rights, including emergency treatment, informed consent, confidentiality, and complaint mechanisms (National Health Act, 2014).
Despite these advancements, malpractice and rights violations persist. According to Okonofua (2026), many Nigerian patients experience harm due to medical negligence but rarely pursue legal redress due to lack of awareness, high costs, and systemic inefficiencies. Public trust in the healthcare system is compromised, and incidents of malpractice erode confidence in both public and private hospitals. For example, the death of a child at a Lagos hospital in early 2026 drew national attention and highlighted systemic failures in patient protection (Okonofua, 2026).
The purpose of this article Is to analyze Nigeria’s legal framework for medical malpractice and patient rights, evaluate enforcement mechanisms, explore institutional challenges, and propose practical reforms. This includes a comparative perspective with other jurisdictions to identify lessons for strengthening Nigeria’s healthcare accountability system.
2.0 Legal Framework Governing Medical Malpractice and Patient Rights in Nigeria
2.1 Constitutional Provisions
The Constitution of the Federal Republic of Nigeria 1999 (as amended) is the foundation of patient rights in Nigeria. Although it does not expressly provide a justiciable right to health, Chapter II directs the state to ensure adequate medical and health facilities for all citizens (Constitution of the Federal Republic of Nigeria, 1999). While these provisions are not enforceable in court, they guide the interpretation of fundamental rights.
Section 33 guarantees the right to life, which has been interpreted to include access to emergency medical care. Refusal to provide emergency treatment may therefore violate this right (Adedayo Adesanya–Peters Chambers, 2025). Section 34 protects human dignity and prohibits inhuman or degrading treatment, including neglect or abuse of patients. Section 37 guarantees privacy, which extends to the confidentiality of medical records and information (Constitution of the Federal Republic of Nigeria, 1999).
2.2 National Health Act 2014
The National Health Act 2014 is the main statute regulating healthcare delivery and patient rights in Nigeria. Section 20 requires healthcare providers to give emergency medical treatment without demanding prepayment, reinforcing the constitutional right to life (National Health Act, 2014, s. 20).
Section 23 provides for informed consent by requiring healthcare providers to inform patients about their diagnosis, treatment options, risks, benefits, and costs before treatment (National Health Act, 2014, s. 23). Failure to obtain informed consent may amount to medical negligence even if the treatment was properly carried out.
Section 26 protects the confidentiality of patient information and prohibits unauthorized disclosure (National Health Act, 2014, s. 26). Sections 27 and 28 give patients the right to access their medical records. The Act also establishes complaint mechanisms for reporting violations of patient rights (National Health Act, 2014).
2.3 Medical and Dental Practitioners Act
The Medical and Dental Practitioners Act establishes the Medical and Dental Council of Nigeria, which regulates medical practice and disciplines erring practitioners. Medical professionals may be punished for infamous conduct, including negligence and ethical breaches (Medical and Dental Practitioners Act, Cap. M8, LFN).
Although disciplinary proceedings do not provide financial compensation to victims, they promote professional accountability. In Medical and Dental Practitioners Disciplinary Tribunal v. Okonkwo (1987), the Supreme Court held that failure to obtain informed consent amounts to professional misconduct and violates patient autonomy.
2.4 Criminal Liability
Medical negligence may also result in criminal liability under the Criminal Code. Section 303 requires healthcare providers to possess reasonable skill and exercise reasonable care. Section 343 criminalizes negligent or rash acts that endanger life or cause harm (Adejumo, 2020). These provisions apply where negligence is serious enough to justify criminal punishment.
2.5 Civil Liability and Case Law
Civil liability for medical malpractice is based on the tort of negligence. A patient must prove duty of care, breach of duty, causation, and damage (Odunlami, 2026). Nigerian courts apply the standard of what a reasonably competent medical practitioner would have done in similar circumstances.
In Ojo v. Gharoro (2006), the Supreme Court held that a doctor is negligent if their conduct falls below the required professional standard. The court also stressed that the burden of proof lies on the patient, often requiring expert medical evidence (Ojo, 2006).
2.6 Analysis and Discussion
Despite the comprehensive legal framework, enforcement remains weak due to multiple factors:
High Proof Burden: Medical negligence cases require expert evidence to establish a breach of duty. Odunlami (2026) notes that patients often cannot afford expert witnesses, making litigation inaccessible. Courts also favor medical judgment over lay opinions, further disadvantaging plaintiffs.
Cost and Delay: Litigation in Nigeria is expensive and protracted. Less than 2% of malpractice cases reach court (Elgujja et al., 2025). High costs and delays discourage claims, leaving many patients without remedies.
Low Awareness: Patients often lack knowledge of their rights under the National Health Act and the Constitution (Adedayo Adesanya–Peters Chambers, 2025). Similarly, some healthcare providers are unaware of statutory obligations, perpetuating a paternalistic healthcare culture.
Institutional Weakness: MDCN disciplinary processes are slow and under-resourced, and patients often do not know how to file complaints. Overlapping responsibilities among regulatory bodies create inefficiency and confusion (Elgujja et al., 2025).
2.7 Socioeconomic and Cultural Barriers
Many patients cannot afford litigation or fear retaliation from healthcare institutions. Social and economic constraints reduce the likelihood of seeking legal redress (Okonofua, 2026).
2.8 Comparative Perspective
Nigeria’s patient rights framework is less robust than in other jurisdictions:
South Africa: The Constitution explicitly guarantees access to healthcare (Section 27), and courts enforce this right. Health ombudsmen provide alternative avenues for complaints.
United Kingdom: Patients can pursue claims through tort law or complain to the Parliamentary and Health Service Ombudsman.
United States and Canada: High litigation rates and malpractice insurance incentivize patient safety. Legal remedies are widely accessible.
These comparisons suggest that Nigeria could improve patient protection through specialized tribunals, ombudsman services, and expanded enforcement mechanisms (Elgujja et al., 2025).
2.9 Institutional and Policy Challenges
Fragmented Enforcement: Multiple agencies (courts, MDCN, Consumer Protection Commission) share responsibility, creating confusion.
Limited Funding: Regulatory bodies lack resources to enforce statutory protections effectively. Cultural Paternalism: Doctors are seen as ultimate decision-makers, limiting patient autonomy.
Lack of Awareness Campaigns: Few initiatives educate patients on their rights, particularly in rural areas.
2.10 Practical Recommendations
• Justiciable Right to Health: Amend the Constitution or pass a Health Rights Act to enforce patient rights in court (Elgujja et al., 2025).
• Harmonize Laws: Consolidate the NHA, Criminal Code, and professional regulations into a coherent framework.
• Specialized Health Tribunals: Establish courts or tribunals for medical negligence cases to reduce delays and costs.
• Alternative Dispute Resolution: Encourage mediation and arbitration for malpractice claims.
• Public Awareness: Implement nationwide campaigns on patient rights and informed consent.
• Professional Training: Include statutory and ethical obligations in medical and nursing education.
• Regulatory Strengthening: Empower MDCN and the Consumer Protection Commission to investigate complaints proactively.
• Comparative Learning: Adopt features from South Africa and the UK, such as ombudsman services, mandatory malpractice insurance, and compensation funds.
2.11 Case Studies
Lagos Hospital Incident, 2026: Death of a child due to alleged negligence highlighted systemic enforcement gaps (Okonofua, 2026).
University College Hospital HIV Disclosure Case: Breach of confidentiality led to privacy litigation, emphasizing the importance of section 26 of the NHA.
Rural Health Facility Malpractice: Reports indicate frequent informed consent violations in rural hospitals due to low patient literacy and cultural barriers (Adedayo Adesanya–Peters Chambers, 2025).
2.12 Findings and Observations
The study finds that Nigeria has sufficient laws to protect patient rights, but enforcement is weak. Economic barriers, procedural difficulties, and institutional inefficiencies limit access to justice. Although courts recognize patient rights in theory, many victims of medical malpractice cannot obtain effective remedies.
3.1 Conclusion
Medical malpractice and patient rights are critical issues in Nigeria’s healthcare system. While the Constitution, the National Health Act, and other laws provide significant protections, their practical impact is limited. Patients often face difficulties in accessing justice due to high litigation costs, complex legal procedures, low awareness of rights, and weak enforcement mechanisms. Although legal frameworks exist on paper, there is a clear gap between theory and practice. Strengthening enforcement, improving public awareness, and enhancing professional accountability are essential to ensure that patient rights are respected and medical care meets acceptable standards.
3.2 Recommendations
1. Make the Right to Health Justiciable – Amend laws to allow patients to enforce their right to healthcare in courts.
2. Strengthen Enforcement of Existing Laws – Ensure the National Health Act and other regulations are effectively implemented.
3. Establish Specialized Medical Tribunals – Create courts or tribunals focused on medical negligence to reduce delays and simplify procedures.
4. Expand Legal Aid Services – Provide affordable or free legal assistance to patients seeking redress for malpractice.
5. Increase Public Awareness – Educate patients and healthcare providers about patient rights and responsibilities.
6. Enhance Professional Regulation – Improve the efficiency and transparency of disciplinary bodies for healthcare professionals.
7. Promote Accountability and Transparency – Encourage reporting of malpractice and ensure timely investigation of complaints.
3.3 Reference(S):
Adejumo, O. A., & Adejumo, O. A. (2020). Legal perspectives on liability for medical negligence and malpractices in Nigeria. Pan African Medical Journal, 35, 44. https://doi.org/10.11604/pamj.2020.35.44.16651
Adedayo Adesanya–Peters Chambers. (2025, August 13). Protecting patients rights in Nigeria. Legal Matters (blog). Retrieved [date], from https://aapchambers.com/protecting-patients-rights in-nigeria
Ezeuko, M. I. (2019). Nigerian laws on informed consent before a surgical procedure. Medicine and Law, 87(4), 185–187. https://doi.org/10.1177/0025817219868098
Okonofua, F. (2026, January 20). Q&A: Medical negligence in Nigeria—what’s known, and what needs to be done. The Conversation. Retrieved [date], from https://medicalxpress.com/news/2026- 01-qa-medical-negligence-nigeria.html
Odunlami, M. L. (2026, January 21). When doctors fail to warn patients about risks: Personal injury claims in Nigeria. TheCable. Retrieved [date], from https://www.thecable.ng/when-doctors fail-to-warn-patients-about-risks-personal-injury-claims-in-nigeria
Ojo v. Gharoro & Ors (2006) CLR 3b (SC)
Opara, M. C. (2025). Legal framework for proof of medical negligence in Nigeria. Asian Journal of Advanced Research and Reports, 19(3), 20–32. https://doi.org/10.9734/ajarr/2025/v19i3918
The National Health Act, 2014. Laws of the Federation of Nigeria. (2014). (Sections 20–30) Medical and Dental Practitioners Disciplinary Tribunal v. Okonkwo (1987) 7 NWLR (Pt. 65) 498
Constitution of the Federal Republic of Nigeria, 1999 (as amended). (1999). (Ch. IV, ss. 33, 34, 37, 42; Ch. II, Part II, s. 4)
Elgujja, A. A., Alkali, U., & Musa, H. (2025). Navigating the chasm between right and remedy: An analysis of the judicial enforceability of patients’ rights in Nigeria [Preprint]. OSF Preprints. https://doi.org/10.31234/osf.io/gsk6h_v1
Habeeb, T., & Opara, E. (2023). Medical and dental practitioners disciplinary tribunal v. Okonkwo: The doctrine of informed consent in surgical practice. Annals of African Medicine, 10(2), 70–74. (Discusses the Okonkwo case)
