Why medical debt should not be used to hold a body hostage

Recently a High Court judge, Justice Prof. Nixon Sifuna, directed a private health facility to release a deceased body to the family noting that the hospital should pursue other avenues to recover the outstanding bil of Ksh. 3.3million rather than detaining the body at the morgue.

It is noteworthy that grieving process is one of the most profound human experiences, a period when family and friends are most vulnerable, navigating loss while trying to honor the memory of the departed. It is precisely at this moment that our healthcare system should offer compassion, not coercion. Yet, a disturbing practice—or even the mere suggestion of it—where the bodies of the deceased are treated as leverage, or "security" for outstanding medical bills represents a profound failure of ethics, law, and human decency.

Let us be unequivocal: dead bodies cannot and must not be used as securities by hospitals to compel bill payment.

The notion that a hospital could withhold the remains of a loved one until a debt is settled is not just a harsh business practice; it is a fundamental violation of human dignity and rights. It turns the deceased into a bargaining chip, stripping away the basic respect afforded to every individual, living or dead. This practice is patently unethical and illegal in any society governed by the rule of law.

Hospitals and healthcare providers operate under a professional and moral contract to care for the living and to treat the dead with reverence. Standard billing and payment procedures exist for a reason. Families must never be manipulated or coerced into accepting unethical practices during their time of greatest sorrow. Any procedure that

suggests using the deceased as collateral transgresses the sacred trust placed in medical institutions and must be condemned without reservation.

When a patient passes away with outstanding medical bills, the legal and ethical path is clear. The responsibility for payment typically falls to the estate of the deceased. In some jurisdictions, specific family members may be liable under applicable laws, but this is a matter for probate and financial negotiation, not physical detention.

Hospitals have a legitimate right to seek payment for services rendered. However, they must operate within the bounds of the law and ethical standards. This means working with the family or the estate's executor to establish reasonable payment plans or negotiate settlements. It does not mean engaging in emotional blackmail or withholding a body, an act that inflicts maximum psychological distress for the sake of debt collection.

The problem of overwhelming medical debt is not solely a financial issue; it is a community crisis. It is a burden that often crushes families who have already endured the emotional strain of illness and loss. The pressure exerted by mounting medical bills can shatter financial stability, creating a ripple effect of hardship that extends far beyond the immediate family unit.

This is where the collective power of community becomes essential. We, as family, friends, neighbors, and village mates, cannot stand idly by while our members face this dual tragedy of loss and crushing debt. We must foster a culture of mutual support that steps in when the formal systems fail or become overly punitive.

The sheer complexity of medical finance and the legalities surrounding debt collection often leave ordinary people feeling helpless. This helplessness can be exploited. That’s why financial literacy and access to professional advice are vital. Families facing difficulties with medical bills must be encouraged to seek counsel from a financial counselor or a legal professional to understand their rights and explore options and protections under the law. We must make this support accessible and known.

To formalize our commitment to one another, we propose a clear, actionable step: Let us register with the Social Health Authority (SHA) to alleviate the medical expenses.

The dignity of the deceased is non-negotiable. It is a fundamental measure of our humanity. We cannot allow the cold arithmetic of outstanding bills to overshadow the moral imperative to treat every individual, even in death, with profound respect. The onus is on hospitals to adhere to the highest ethical and legal standards, and on us, the

community, to ensure that our neighbors never have to choose between burying their loved one and financial ruin.

Let us stand together. Let us register with SHA. Let us ensure that in life and in death, the dignity of our loved ones remains sacrosanct. The burden of debt belongs to the estate, but the responsibility to support the living belongs to us all.

The writer is a Consultant Nephrologist.