Medical Law & Ethics: Evolution & Position in India

The idea of Medical Law and Ethics fundamentally investigates into the inalienable rights that patients have with...

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The idea of Medical Law and Ethics fundamentally investigates into the inalienable rights that patients have with respect to the security of their medical historical records, specialists understand confidentiality, the privilege to get crisis treatment in emergency cases and so on.

The career of medical education basically includes an individual investigating the different angles identified with the moral connection between a patient and his/her specialist. It additionally explores the up-keep of emotional holding between the care supplier and the patients themselves, with a specific end goal to guarantee that each of the necessities of the patient are held in goodness, amidst and after any medical examinational in a whole. [1]

In addition, the act of Medical Law and Ethics basically goes past the parts of simply guaranteeing absence of negligence amidst medical operations and counteractive action of individual harm to the patients. The concept of Medical Law and Ethics basically goes past the limits of these previously mentioned parts of medicinal morals and basically looks into giving guidance to medical doctors and medical associations, thus, helping in the plan and in the implementation  of wellbeing arrangements and health laws, and even reaches out to capacities, for example, guaranteeing legitimate assurance to people and execution of suitable hazard administration strategies so as to check the rate of unscrupulous procedures. [2] Subsequently, the beginning stage for an effective profession in Medical Law and Ethics begins with a degree in Law.[3]

Fast advancements in the medical field in the last century have reformed the field of medical practice. It is presently conceivable to analyze illnesses speedier and all the more precisely by utilizing progressed indicative techniques. Medicinal administration has turned out to be more viable with refined pharmaceuticals having more specific activities and fewer symptoms. Surgical treatment has moved towards less intrusive methods of administration with quicker recovery. Among every one of these improvements, the medical profession in India is at intersection facing numerous moral and lawful difficulties in the act of the profession. [4]

The medical field is ending up plainly being more reliant on innovation and market powers tend to impact basic leadership by the medical specialists. The main concerns of medicinal demand are that the doctor’s commitment is to keep the patients interest above everything else. The vital issues of self-sufficiency, privacy, justice, usefulness, etc. are key variables that ought to manage the everyday basic leadership by the doctors.

The moral rules of medical practice given by The Indian Medical Council (Professional Conduct, Etiquette, and Ethics) Regulations, 2002 is gone for reinforcing the moral guidelines among enrolled restorative experts in India. [5]

The health sector in India has seen a noteworthy change with social insurance turning into a productive segment pulling in speculators from differing and shifted foundations with gainful intentions. The Medical Council of India has a redressal system that offers disciplinary actions to the respective doctor after investigating enough. [6]

The medical sector that was once viewed as honorable is presently considered alongside different professions in the obligation of paying for damages. The patients who need fiscal amounts for the charged medical negligence used to be resolved by the common civil courts. This was the main road followed by many, earlier it used to be a lengthy procedure with its detailed formalities. The perplexity about the inclusion of doctors under the Consumer Protection Act, 1986 has been let go by the landmark decision of the Supreme Court in 1996 that puts the administrations of specialist doctors under the domain of the Consumer Protection Act. [7]

This brought about an expanding occurrence of consumer cases where specialists were embroiled for a wide range of allegations by patients. The current Supreme Court rules that call for strict assessment by the Consumer Courts before continuing with asserted medicinal negligence cases by the patients will be a boon to the doctors who won’t be pulled into superfluous litigation cases.[8]

It is usually seen that the present day medicinal specialists have been proceeding with medico-legal educational degrees. [9]Doctors have a lawful obligation to conform to the applicable moral and legal directions in their everyday practices. Ignorance of law and its consequences will be adverse to the specialist despite the fact that he treats the patient in compliance with common decency for the ease of the patient’s health. All activities that are done in accordance with good faith may not stand lawful testing.

 

PROBLEM AREAS RELATING TO MEDICAL ETHICS

There are some conflicting zones identifying with medical ethics like informed assent, Disclosure of data, Confidentiality, Patient’s self-rule, Euthanasia and Organ transplantation. For the reasonable understanding of this issue a detailed clarification is essential.

In Canada, and a considerable lot of the American States the courts have forced a high commitment upon a specialist to disclose data about a proposed medicinal strategy with a specific end goal to comprehend the patient’s entitlement to a sound decision whether to undergo the procedure or not.[10] This reflects great medical ethics.

Article 1 of the Universal Declaration of Human Rights takes it as a fundamental preface. In human rights convention, dignity is utilized to stress upon singular decision and its autonomy.[11]

POSITION IN INDIA

The Medical Council Act of 1956 as revised by Act is managing the expert wrongdoing of the medicinal specialists in India. [12] The apex body to manage the expert misconduct is the General Medical Council acting at state level. The State Medical Council has additional powers to expel and suspend medical experts from their administration. They are likewise enabled to enlist the specialists who experience disciplinary activities. The Code of Medical Ethics is for the maintaining upholding medical ethics of the specialist doctors.[13] The experts should act as per its set standards. The Code indicates the duties of doctors. The prime goal of the medicinal calling is to render administration to mankind. Doctor ought to be accessible to their patients and partners and furthermore for the advantages of their expert accomplishments. The right to die is not certain justified to the right to life. [14] India does not allow suicide or support abetting of suicide. The Law commission in its 42nd report expressed that “It is a huge process to perpetrate additionally enduring on a person who has effectively discovered life so miserable, his chances of satisfaction so slim, that he will face pain and death to stop living.”

Indian law permits foetus removal if the continuation of pregnancy would make a hazard the life of the pregnant lady or grave harm to her physical or mental health. [15]The Medical Termination of Pregnancy Act permitted medicinal end of pregnancy for, greater benefit’ of the nation in the light of the extending population. Abortion is seriously denounced in Vedic, Upanishadic, Puranic and Smriti writing. It is additionally against the Code of Medical morals stipulated by the Medical Council of India. [16]

MEDICAL ETHICS UNDER MEDICAL COUNCIL ACT

In the year 1993 the Indian Legislative Assembly passed the Indian Medical Council Act, 1933 which repeals and formed a new act, the Indian Medical Council Act, 1956 which is passed and reaches out to the entire of India. Apart from this, there is possibility of criminal conviction by criminal court for offenses including moral turpitude.[17] It was seen by the Apex Court  “Medicinal Profession is one of the most established callings of the world and is the most philanthropic one. [18]Medical Council Act considers publicizing of profession as unscrupulous. Soliciting of patients specifically or in an indirect way, by a doctor or by a gathering of doctors or by establishment or association is unscrupulous. [19]

In recent times, the self-administrative measures in this profession have declined because of commercialization of the medical sector. There are reports against exploitative medicinal practices, abuse of symptomatic systems, booking bargains available to be purchased of human organs and so forth. There is a requirement for outside direction and also improved self-control. The harmony amongst administration and business is disturbingly towards business.

CASE LAWS:

  1. When we think about landmark judgment in medical negligence cases the first judgment that comes into our mind is one of the high profile and most talked case with the highest amount of compensation granted till date. KUNAL SAHA VS AMRI [20](Advanced Medical Research institute ) famously known as Anuradha Saha Case, this case was filed in 1998 with the allegation of medical negligence on Kolkata based AMRI Hospital and three doctors namely Dr. Sukumar Mukherjee, Dr. Baidyanath Halder and Dr. Balram Prasad. In simple layman term, the wife was suffering from drug allergy and the doctors were negligent in prescribing medicine which further aggravated the condition of patient and finally led to death. In brief this was the facts and circumstances of the case, in this case the final verdict was given by the Supreme court and a compensation of around  6.08 crore for the death of  his wife.
  2. In the case of KRISHAN RAO VS NIKHIL SUPER SPECIALITY HOSPITAL[21] 2010, Krishna Rao, an officer in malaria department filed a complaint against the hospital for negligent conduct in treating his wife. His wife was wrongly treated for typhoid fever instead of malaria fever, due to the wrong medication provided by the hospital. Finally, the verdict was given and Rao was awarded a compensation of  Rs 2 lakhs.  In this case, the principle of res ipsa loquitor(thing speak for itself) was applied and the compensation was given to the plaintiff.
  3. In the case of APARNA DUTT v. APOLLO HOSPITAL ENTERPRISES LTD[22]. a women had a surgery of removal of cysts in her uterus. The operation was said to be successful but after few days of the surgery the women died due to severe pain in her lower abdomen. After her body was cremated a pair of scissors was found in her ashes. It was found by the court that when the hospital did the surgery for removal of cysts, one of the operators in the theatre dropped the pair of scissors in the abdomen of the women, negligently. The principle of vicarious liability is based on a latin maxim “qui facit per alium facit per se” which describes that the one who acts through another act in his or her own interest. This principle was established in the present case.
  4. In the case of PRAVAT KUMAR MUKHERJEE v. RUBY GENERAL HOSPITAL AND ORS.[23] National Commission of India delivered a land mark judgment for treating of  accident victim, what happened in this case the complainant were the parents of deceased boy named Samanate Mukherjee a 2nd year B.tech boy who studied in Netaji Subhas Chandra Bose Engineering College , the complaint was filed in National Commission of India. The boy was hit by a Calcutta transport bus and rushed to the hospital which was 1 km from the accident spot. The boy was conscious when he was taken to hospital and he showed his medical insurance card, which clearly says that the boy will be given Rs.65,000 by the Insurance company in case of accident, relying on it hospital started treating boy but after giving some initial treatment hospital demanded Rs15,000 and on the non- payment of the demanded money hospital discontinued treatment of the boy and the boy was rushed to another hospital in the way the boy died. This was the case and in this case the National Commission held Ruby hospital liable and provided Rs. 10 lakhs as compensation to the parents. So, in this case the court looked on humanitarian basis and compensation was awarded to the complainant.

These are the landmark cases on medical negligence. But there are uncountable numbers of cases on medical negligence. One thing is quite common among these cases; every doctor was in a hurry to finish the operation without even thinking what would happen to the patient if he’ll not be treated well.

CONCLUSION

 

Indeed, even after usage of Medical Council Act numerous unethical exercises exist in medicinal profession. So it is profoundly important to change Medical Council Act with arrangement to expel all deformities. This medical profession needs strict disciplinary activity. MCI takes up disciplinary activities just on complaints. The greater part of the casualties of medical negligence may not be keen on continuing against the case of the doctor or may not be aware of the methodology to be taken after. In such cases the council has nothing to do. Aside from this, the Medical Council Act, 1956 does not give any methodology to be taken after for directing an enquiry or neither have they have indicated at whatever time for its fulfillment. Such examination is frequently led by adhoc advisory groups and they set aside a long opportunity to submit reports because of their unaccountability. To sum up there are rarely any disciplinary activities initiated against specialists blaming them of medical negligence and barely ever are the specialists punished for the same. Some sort of lawful machinery must  be required with regards to new rising medicinal tourism, and its effect on business sectors. Medical tourism is widespread in India recently like going by markets. Progression of pharmaceutical and innovation has made new challenges in the medicinal field. Issues identifying with infertility treatment, artificial nourishment and hydration, treatment of patients in coma are a portion of the disputable issues. In the new world of medical innovation formal and casual controls by experts and institutions are important. So, an effective law can give better environment in medicinal practices.

[1] http://www.mciindia.org/ActsandAmendments/TheMedicalCouncilAct1956.aspx

[2] Shaun D.Pattinson, Medical Law and Ethics, Sweet & Maxwell, London, 2006, Edition, p.37

[3] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2779956/

[4] http://www.imalko.in/downloads/laws.pdf

[5] Potdar RD. Consumer protection law and pediatrician. Indian Pediatr 1997; 34: 283-286.

[6] http://www.indianpediatrics.net/sept2000/sept-961-966.htm

[7] http://navbharattimes.indiatimes.com/planet-campus/career/humanities/medical-law-and-ethics/planetcollegedetails/52278568.cms

[8] Joshi MK. Doctor and Medical Law, 2nd edn. Ahmedabad, 1995; pp 15-39.

[9] http://www.mlcd.in/sections.asp

[10] E. Picard, Legal liability of doctors and hospitals in Canada, 2nd ed, Cambridge University Press, Cambridge,    1984, p.312

[11] Dennis Brodear, Ethics and Health Care Reform; Institutional Contributions, Saint Louis University Law Journal, Vol.32, p.878

[12] Indian Medical Council Amendment Act of 1957

[13] Code 1 of Medical Ethics

[14] Das Guptra SM, Mercy Killing an analysis, based on human rights. In proceedings of the International Conference on Health Policy: Ethics and Human values, Journal of Indian Law Institute, 1999, Vol.1, p.24.

[15] Section 3 of Medical Termination of Pregnancy Act.

[16] Manu Smriti III.55

[17] A.S Mittal and Another v. State of U.P and others (1989) 3 SCC 223

[18] Ponnam Varma v. Ashwin Patel AIR 1996 SC 2111

[19] Section 16 of Medical Council Act

[20] AIR 1969,SC 128 

[21] AIR 1989 SC 1570

[22] 2002 ACJ   954 (Mad. HC)

[23] 2005 CPJ 35 (NC)

Author:

Charvi Arora, Research Assistant (2017-18)  at Legal Desire Media and Publication. She is also a 3rd Year student of College of Legal Studies, UPES, Dehradun.

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