{"id":17747,"date":"2025-01-02T17:50:55","date_gmt":"2025-01-02T15:50:55","guid":{"rendered":"https:\/\/zawia3.com\/?p=17747"},"modified":"2026-10-08T09:17:53","modified_gmt":"2026-10-08T07:17:53","slug":"doctors-imprisonment","status":"publish","type":"post","link":"https:\/\/zawia3.com\/en\/doctors-imprisonment\/","title":{"rendered":"Egypt\u2019s Medical Liability Bill: Fears of Prison Deepen a Crisis of Trust"},"content":{"rendered":"

Egypt\u2019s proposed medical liability law has triggered a dispute extending far beyond the medical profession. The government describes it as a balanced framework for protecting patients and holding healthcare providers accountable. Doctors fear that its criminal penalties could make an already difficult working environment more precarious\u2014and discourage practitioners from making urgent decisions for critically ill patients.<\/p>\n

The Senate approved the bill in late December 2024 before referring it to the House of Representatives. As of this report\u2019s publication on 2 January 2025, it remained a draft under parliamentary discussion, not an enacted law. The disagreement concerns both the distinction between complications, ordinary errors and gross negligence, and the procedures through which responsibility would be established.<\/p>\n

The Senate-approved text contains 30 articles. Under Article 27 of that version<\/a>, a medical error resulting in death could attract at least six months\u2019 imprisonment and a fine of up to EGP 100,000, or either penalty, with harsher provisions for aggravated circumstances. Article 29 required a prosecutor of at least chief prosecutor rank to issue a pretrial detention order. It did not create an unrestricted new power to detain doctors.<\/p>\n

The bill also provides for a Higher Committee for Medical Liability and Patient Protection, reporting to the prime minister. Its proposed responsibilities include examining complaints, building a database and developing patient-rights guidance with professional bodies. A compulsory insurance scheme would cover healthcare facilities and providers, while a government insurance fund would contribute to compensation for medical errors and potentially other harm associated with treatment.<\/p>\n

Health Minister Khaled Abdel Ghaffar told the Senate<\/a> that the legislation sought to balance the interests of patients and doctors and improve protection for medical teams, including against assaults. Parliamentary and Legal Affairs Minister Mahmoud Fawzy said it would strengthen trust and treatment quality through a definition of medical error and specified grounds for excluding liability.<\/p>\n

The Egyptian Medical Syndicate disagreed, initially calling an emergency general assembly for Friday 3 January. Syndicate head Osama Abdel Hay said the proposed text failed to serve either patients or physicians despite the need for legislation governing their relationship. Journalists Syndicate head Khaled El Balshy also expressed solidarity with the doctors and called for substantial amendments.<\/p>\n

On 31 December<\/a>, the House health committee announced that it had removed the pretrial detention article in response to doctors\u2019 demands. The syndicate initially maintained its call for the assembly. Its deputy head, Gamal Amira, said the change addressed only one of five demands and left fundamental concerns unresolved, including imprisonment for professional errors. He described such penalties as unprecedented internationally; that was his assessment, not an established comparative legal finding.<\/p>\n

Former syndicate secretary-general Mona Mina told Zawia3 that claims of a breakthrough concealed serious burdens. In her reading of the amendments then being discussed to Article 27, ordinary errors causing harm could result in fines of EGP 100,000\u20131 million, while gross errors could attract one to five years in prison and fines of EGP 500,000\u20131 million. These comments concerned proposed revisions, not a final enacted text.<\/p>\n

Mina stressed that a criminal fine is imposed on the individual doctor and differs from civil compensation covered by insurance. She also criticised what she considered broad definitions of medical error and the preservation of Article 23, which allowed more severe penalties under other legislation to apply.<\/p>\n

\n

For Mina, the central issue is whether the law clearly distinguishes a recognised complication from an ordinary mistake\u2014and either of those from gross negligence.<\/p>\n<\/blockquote>\n

\"Reported<\/figure>\n
<\/svg><\/div>\n

A postponed assembly deepens the dispute<\/h2>\n

On the afternoon of Thursday 2 January, the syndicate announced that the emergency assembly would be postponed for a month while discussions continued with parliament. Its statement referred to a meeting the previous day between Abdel Hay and the House health committee, chaired by Ashraf Hatem, at which the syndicate\u2019s proposed amendments had been considered.<\/p>\n

The syndicate said agreement had been reached on removing imprisonment for professional errors and pretrial detention, alongside a clearer distinction between medical error and gross medical error. Those were statements about amendments still being negotiated, rather than confirmation that a final law had entered into force.<\/p>\n

The unexpected postponement angered doctors who said they had not been consulted. A medical source who attended the preceding meetings at the syndicate told Zawia3 that its leadership had faced considerable pressure, without specifying its nature or source. According to this account, the council still intended to hold the assembly on Thursday morning. More than three hours of heated discussions between supporters and opponents followed before the postponement was announced.<\/p>\n

Council member Ibrahim El Zayat announced his resignation on Facebook after the decision. He said he had promised to leave if the attempt to convene an emergency assembly in doctors\u2019 interests failed.<\/p>\n

Mina sharply criticised the leadership\u2019s welcome for the proposed changes, arguing that the prison terms and fines remained excessive and that cancelling the assembly disregarded doctors\u2019 wishes. Khaled Samir, an Ain Shams University cardiac surgery professor and former syndicate treasurer, said the council had no legal right to postpone it. That was his position on the council\u2019s authority, not a court ruling.<\/p>\n

\"Historical<\/figure>\n
<\/svg><\/div>\n

What doctors are demanding<\/h2>\n

The syndicate says it has long supported a medical liability law, but wants accountability structured around professional assessment rather than the automatic criminalisation of adverse outcomes. During Senate discussions attended by Abdel Hay and Dental Syndicate head Ehab Heikal, it reiterated its opposition to imprisonment and pretrial detention for ordinary professional errors.<\/p>\n

Its demands included distinguishing such errors from unlawful acts or practice outside a doctor\u2019s specialty, providing compensation for unintended harm, giving the Higher Committee a central and impartial technical role in assessing complaints, and establishing a fund to pay compensation rather than leaving the doctor to bear the full award directly.<\/p>\n

Mina said the syndicate had called for legislation more than a decade earlier and submitted its own proposal, which was not adopted. She acknowledged that medical mistakes and serious negligence occur, as in other professions. Her objection was to a framework that failed to draw sufficiently clear boundaries between different kinds of harm and responsibility.<\/p>\n

Ahmed Hussein, a former syndicate council member, told Zawia3 that doctors were not rejecting regulation outright. They had spent years asking for a fair and objective law, he said, citing the United Arab Emirates and Jordan as regional examples from which Egypt could learn. His argument was that a functioning framework should promote patient confidence as well as professional accountability.<\/p>\n

Harvard diabetes specialist Osama Hamdy issued a stark warning on Facebook, describing the proposal as a threat to the future of medical practice in Egypt. He feared that doctors who had remained in the country would leave or stop practising if they faced detention or imprisonment over professional errors. His language conveyed alarm; it was not a statistical forecast of future migration or a verified survey of medical liability laws worldwide.<\/p>\n

<\/svg><\/div>\n

Separating complications, errors and crimes<\/h2>\n

Hussein argued that the public had been given a misleading impression of why doctors opposed the bill. He said their objection was not to criminal accountability in all circumstances. He cited female genital mutilation, unlawful abortion and working outside one\u2019s field of qualification as examples of acts that should attract criminal responsibility.<\/p>\n

By contrast, he argued, an unintended mistake by a qualified doctor working within their specialty in a licensed facility should be handled through compensation rather than imprisonment. This was the framework he advocated, not a statement that unintentional conduct can never be criminally negligent.<\/p>\n

Hussein believed the government\u2019s proposal blurred the distinction between a practitioner who made an ordinary mistake while lawfully providing care and one who committed a criminal act. For him, treating the two alike undermined the fairness of the legislation.<\/p>\n

Mina made a related distinction between an adverse result and a breach of professional standards. Even a relatively straightforward intervention, such as removing tonsils, can carry recognised risks. A doctor who follows accepted clinical practice should not, she argued, be punished simply because a known complication occurs. The obligation is to monitor the patient and manage that complication properly.<\/p>\n

She said ordinary, unintended errors should lead to compensation where harm is established, and potentially further training. Gross negligence, in her account, could involve practising outside one\u2019s competence, using an unrecognised technique, operating while intoxicated, or performing surgery in an inadequately equipped setting. Such conduct warranted a different level of scrutiny and potentially criminal accountability.<\/p>\n

\n

The question is not whether patients should receive redress. It is how responsibility is established\u2014and how a clinical complication is distinguished from negligent care.<\/p>\n<\/blockquote>\n

Mina said the syndicate\u2019s earlier proposal envisaged a committee comprising representatives of medical professional bodies and civil society. It would receive and assess complaints, determining whether a case concerned a recognised complication, an error warranting civil compensation or gross negligence requiring criminal proceedings.<\/p>\n

She criticised the government proposal for allowing complaints through multiple routes, including prosecutors, the Health Ministry and universities in cases involving university hospitals. In her view, overlapping procedures could expose a doctor to repeated investigations, while the committee\u2019s technical opinion remained advisory and prosecutors or judges could depart from it.<\/p>\n

The government argues that the bill does distinguish medical error from circumstances outside the practitioner\u2019s responsibility. Fawzy described an error as conduct contrary to established scientific standards or professional rules that causes harm. He said recognised complications, scientifically accepted treatment and harm caused by a patient\u2019s own conduct or failure to follow instructions were among the relevant exclusions.<\/p>\n

Fawzy also presented the Higher Committee as an additional safeguard because specialists would examine clinical issues. Patients could approach either the committee or the Public Prosecution, he said, while retaining the right to challenge committee decisions.<\/p>\n

Existing Egyptian criminal law already contains general provisions used in negligence cases. In its basic form, Penal Code Article 244 provides for up to one year\u2019s imprisonment and a fine of up to EGP 200, or either penalty, for causing injury through specified forms of fault. Article 238 provides, in its basic form, for at least six months\u2019 imprisonment and a fine of up to EGP 200, or either penalty, for causing death through fault. Both have aggravated provisions. Liability cannot be inferred from an unsuccessful treatment outcome alone.<\/p>\n

Figures about the scale of medical error require similar care. Coverage dated 13 October 2022<\/a> of a report by the Forum for Development and Human Rights Dialogue repeated an estimate of 180,000 errors annually and a claim that about 20 doctors were struck off each year. But the same coverage acknowledged the absence of an official comprehensive count. It did not provide a reproducible methodology or a detailed register of disciplinary cases. The figures should therefore not be treated as verified national statistics.<\/p>\n

\"Three<\/figure>\n
<\/svg><\/div>\n

Patients\u2019 rights and the conditions of care<\/h2>\n

Mahmoud Fouad, executive director of the Egyptian Centre for the Right to Medicine, told Zawia3 that a liability law was needed to protect both patients and doctors, rather than simply to imprison practitioners. Patients can suffer from individual mistakes, he said, but also from the conditions in which care is delivered.<\/p>\n

He described patients being prepared for scheduled operations only for surgery to be postponed because anaesthetic drugs or other supplies were unavailable, or because doctors were absent. He pointed to Health Ministry inspection visits as evidence that staffing and hospital management also required attention.<\/p>\n

Fouad said a report submitted by the Administrative Prosecution to the president in 2022 recorded 553 complaints against doctors. Zawia3 has not independently verified the report he cited. Complaints are not equivalent to proven errors, and Fouad said the figure would not capture disputes settled informally or all incidents in private hospitals.<\/p>\n

He also referred to an allegation that screenwriter Bashir El Deek had suffered a medical error. Zawia3 did not independently substantiate that allegation through medical documentation; it should not be read as an established clinical finding.<\/p>\n

Fouad stressed that doctors themselves face financial pressures, including the cost of postgraduate study and supporting a family. In his account, low government pay pushes practitioners to combine public hospital jobs with work in private clinics or medical centres, extending working hours and increasing exhaustion.<\/p>\n

Hussein likewise argued that a doctor cannot provide adequate treatment without the necessary medicines and supplies. He called for humane shifts of no more than eight hours, contrasting that demand with working stretches of 18 to 24 hours that he said some doctors faced, often with low pay and inadequate resources.<\/p>\n

Against that background, Hussein said, doctors were expected to make difficult emergency decisions while fearing criminal penalties if something went wrong. Addressing professional responsibility without considering those working conditions would leave a central part of the problem untouched.<\/p>\n

<\/svg><\/div>\n

Can legislation make hospitals safer?<\/h2>\n

A study published in Scientific Reports in May 2024<\/a> surveyed a convenience sample of 250 doctors across 13 Egyptian governorates, with data collected from January to April 2023. In that sample, 88% reported verbal violence, 42% physical violence and 13.2% sexual harassment. The categories could overlap, and the sample was not a nationally representative measure of prevalence.<\/p>\n

Among the 105 respondents reporting physical violence, 75.2% described the use of body parts, 29.5% blunt objects, 7.6% sharp objects and 1.9% firearms. Only 14.3% of that physically assaulted subgroup took legal action. Respondents linked incidents to shortages and waiting times, among other pressures, with night shifts a particular concern.<\/p>\n

Hussein described a practical dilemma: doctors could be blamed for asking patients to buy medicines outside a hospital, even when those medicines were unavailable inside it. He argued that the proposed law did not resolve that contradiction.<\/p>\n

He also questioned whether provisions punishing attacks on medical facilities would be sufficient. Existing criminal legislation already addressed assaults, he said, while effective protection required staffing, security and resources. He did not excuse violence; his argument was that some confrontations arose from failures in service provision that penalties alone would not remedy.<\/p>\n

Hussein called for a comprehensive health system that equipped practitioners to do their jobs and secured patients\u2019 access to safe treatment, alongside clear accountability for criminal conduct.<\/p>\n

Fouad raised concerns about the quality of medical education, pointing to differences in university entry requirements and comparing admission marks of 70% and 99%. Entry marks alone, however, do not establish a doctor\u2019s competence after training. The revised education system introduced for new cohorts in 2018\/19 comprises five academic years followed by two years of compulsory practical training, not just one.<\/p>\n

He also questioned whether public hospitals consistently met infection-control, equipment and accreditation standards. His criticism was that patient safety required attention to the full environment of care, rather than an exclusive focus on punishing individual doctors.<\/p>\n

\n

\u201cWhat we want is a fair law that guarantees everyone\u2019s rights,\u201d Fouad said\u2014patients\u2019 right to safe care and doctors\u2019 right to work with dignity and protection.<\/p>\n<\/blockquote>\n

A workforce already under strain<\/h2>\n

The dispute takes place against longstanding concerns about the supply and retention of doctors. One historical figure frequently cited in that debate is 8.6 doctors per 10,000 people\u2014approximately one for every 1,163 residents. It should not, by itself, be treated as an updated January 2025 workforce count or compared with international figures without matching dates and definitions.<\/p>\n

In Health Ministry statements reported in 2021<\/a>, Egypt was said to produce about 9,000 medical graduates annually, while more than 60% of registered doctors worked abroad. The latter claim concerned the registered workforce, not the proportion leaving from each graduating class.<\/p>\n

A historical government assessment drawing on 2018 data put the number working in healthcare bodies at about 82,000 out of 213,000 licensed doctors, roughly 38.5%. The gap between licensed and working doctors was not an independently measured total of emigrants. Separately, CAPMAS reported 97,400 doctors in the government sector in 2022, down 3.3% from 100,700 in 2021. Those figures did not cover the entire medical workforce.<\/p>\n

An April 2022 syndicate statement<\/a> recorded 11,536 resignations from government employment between 2019 and 20 March 2022. Annual resignations rose from 1,044 in 2016 to 4,127 in 2021. The latter equates to about 11.3 per day, or one roughly every two hours\u2014in 2021. It was neither a measured rate for 2025 nor proof that every doctor who resigned had emigrated.<\/p>\n

Pay figures cited by the syndicate in 2022 put a resident doctor\u2019s average monthly salary at approximately EGP 3,700 and a doctor\u2019s average pension after around 35 years of government service at EGP 2,300. A separate figure attributed to the comprehensive health insurance system placed doctors\u2019 average monthly pay within that system at about EGP 17,000. These are historical figures for different employment arrangements and pensions, not a single national pay scale or a current comparison.<\/p>\n

In its April 2022 warning, the syndicate urged action over doctors leaving government service and seeking work abroad. The doctors interviewed for this report believe retention depends on economic security, safe workplaces and fair professional accountability. Their fear is that a punitive law, without corresponding improvements in those conditions, could intensify the pressures it is meant to address.<\/p>\n","protected":false},"excerpt":{"rendered":"

A postponed doctors\u2019 assembly intensifies the dispute over Egypt\u2019s medical liability bill, as practitioners demand clear distinctions between complications, ordinary errors and gross negligence.<\/p>\n","protected":false},"author":4,"featured_media":10342,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"om_disable_all_campaigns":false,"footnotes":""},"categories":[413],"tags":[],"kateb":[6247],"class_list":["post-17747","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-society-en","kateb-rasha-ammar"],"jetpack_featured_media_url":"https:\/\/zawia3.com\/wp-content\/uploads\/2024\/08\/\u0623\u0637\u0628\u0627\u0621-\u0645\u0635\u0631-1.png","_links":{"self":[{"href":"https:\/\/zawia3.com\/en\/wp-json\/wp\/v2\/posts\/17747","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/zawia3.com\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/zawia3.com\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/zawia3.com\/en\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/zawia3.com\/en\/wp-json\/wp\/v2\/comments?post=17747"}],"version-history":[{"count":1,"href":"https:\/\/zawia3.com\/en\/wp-json\/wp\/v2\/posts\/17747\/revisions"}],"predecessor-version":[{"id":17748,"href":"https:\/\/zawia3.com\/en\/wp-json\/wp\/v2\/posts\/17747\/revisions\/17748"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/zawia3.com\/en\/wp-json\/wp\/v2\/media\/10342"}],"wp:attachment":[{"href":"https:\/\/zawia3.com\/en\/wp-json\/wp\/v2\/media?parent=17747"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/zawia3.com\/en\/wp-json\/wp\/v2\/categories?post=17747"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/zawia3.com\/en\/wp-json\/wp\/v2\/tags?post=17747"},{"taxonomy":"kateb","embeddable":true,"href":"https:\/\/zawia3.com\/en\/wp-json\/wp\/v2\/kateb?post=17747"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}