Index

1. Introduction 
2. Legal And Ethical Dimensions Of Medical Negligence
3. Legal Duties In Medical Negligence Cases
4. Duties In Medical Practice: Indian Medical Council Regulations
5. Ethical Standards For Medical Professionals
6. Rights Of Patients
7. Criminal Liability In Cases Of Medical Negligence
8. Disciplinary Measures For Medical Negligence And Misconduct
9. Defences Available To Doctors Under Indian Penal Code
10. Conclusion 

Introduction 

An estimated 225,000 individuals annually lose their lives due to medical malpractice or negligence, encompassing issues such as incorrect dosages, misdiagnoses, and surgical errors. Shockingly, statistics reveal that around 12,000 deaths occur each year due to unnecessary surgeries alone.

Medical negligence in India has compelled Indian laws to advocate the emergency cases arising as the result of medical negligence whereas catering to the protection of medical professionals in certain cases. 

Legal And Ethical Dimensions Of Medical Negligence 

Medical negligence refers to the failure of medical practitioners to provide adequate care or take necessary precautions, leading to a breach of their duties and harm to patients. Common causes include procedural lapses, dosage errors, surgical mistakes, contamination in operation theatres or blood transfusions, mistreatment, and misdiagnosis. In the case of Moni v. State of Kerala, negligence is defined as a failure to meet the standards expected of reasonably skilled medical professionals at the time. There can be multiple acceptable standards of care, and adherence to any of these standards absolves the practitioner of negligence.

Unlike other professions where mistakes may result in financial loss, medical errors carry the risk of life-threatening consequences. Patients often view doctors as paragons of perfection and trust them implicitly in the healing process, making the stakes exceptionally high in medical practice.

Medical negligence, also known as medical malpractice, arises from improper, unskilled, or negligent treatment provided to patients. It constitutes an offence under various legal frameworks including the law of torts, the Indian Penal Code, the Indian Contracts Act, and the Consumer Protection Act of 1986, among others. Understanding and addressing medical negligence is crucial for upholding legal and ethical standards in healthcare.

Legal Duties In Medical Negligence Cases

Patients have the right to pursue legal action for negligence when medical professionals breach their duties, which include:

1. The duty to assess whether to accept a particular case.
2. The duty to determine appropriate therapy or treatment.
3. The duty to administer treatment correctly.

Every medical practitioner owes a duty of care to their patients, and breaching this duty can lead to patient harm and subsequent legal actions for negligence.

Duties In Medical Practice: Indian Medical Council Regulations

The duties and ethical responsibilities of physicians are outlined in the Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations, 2002, which are enacted under the Indian Medical Council Act, 1956.

1. Obligation to the Sick: Physicians are not obligated to treat every patient who requests their services, but they must be prepared to respond to the needs of the ill, recognizing the noble nature of their profession and their duty towards their patients. While advising patients to seek another doctor’s services is acceptable, in emergencies, doctors must provide immediate care. Refusal to treat a patient is only justified if the illness falls outside the doctor’s expertise.
2. Diagnosis: Physicians must provide accurate information about a patient’s condition, neither exaggerating nor downplaying its severity. They must ensure that the patient, their family, or responsible parties are well-informed about the condition, always prioritising the patient’s best interests and well-being.
3. Confidentiality and Disclosure: Physicians must maintain patience, delicacy, and confidentiality regarding patient details and ailments. However, exceptions may arise, such as in cases of new, hazardous diseases where public safety or individual well-being overrides confidentiality.
4. Patient Care and Negligence: While physicians have the freedom to choose their patients, they must respond to emergencies and provide adequate information and care once they accept a case. Negligence, whether willful or unintentional, that deprives patients of standard medical care is strictly prohibited.
5. Obstetric Engagements: In obstetric cases, if the attending physician is absent, the substitute physician who successfully manages the delivery is entitled to professional fees. However, this must be done with the patient’s consent, and the original physician must be informed upon their return.

Ethical Standards For Medical Professionals

1. Abuse of Professional Position: It is unethical for medical practitioners to misuse their professional status, including engaging in adultery, improper conduct, or forming inappropriate associations with patients.
2. Informed Consent: Performing any medical procedure, especially operations, without obtaining written consent from the patient or their legal guardian is considered misconduct. Consent must be obtained from both spouses if the procedure may lead to sterility.
3. Compliance with Regulations: Medical professionals are obligated to adhere to the regulations and laws outlined in the Indian Medical Council’s guidelines regarding their duties and responsibilities.

Rights Of Patients 

The Ministry of Health and Family Welfare (MoHFW) has circulated the Charter of Patients’ Rights to all state governments in India. This charter outlines the rights of patients in India, which include:

1. Right to Information: Patients have the right to receive accurate and relevant information about their medical condition, diagnosis, treatment options, and potential complications.
2. Right to Records and Reports: Patients have the right to access their medical records and reports, including case papers, indoor patient records, and investigation reports.
3. Right to Emergency Medical Care: Patients have the right to receive emergency medical care without being turned away from government or private hospitals.
4. Right to Informed Consent: Patients have the right to give informed consent for any medical treatment or procedure, and healthcare providers must obtain written consent before performing any operation.
5. Right to Confidentiality, Privacy, and Dignity: Patients have the right to maintain confidentiality, privacy, and dignity during their medical treatment.
6. Right to Second Opinion: Patients have the right to seek a second opinion from any doctor of their choice.
7. Right to Transparency in Rates: Patients have the right to know the costs of medical services, tests, and treatments provided by healthcare establishments.
8. Right to Non-Discrimination: Patients have the right to receive medical care without discrimination based on gender, sexuality, caste, religion, race, place of birth, or illnesses.
9. Right to Safety and Quality Care According to Standards: Patients have the right to receive safe and quality care according to established standards.
10. Right to Choose Alternative Treatment Options: Patients have the right to choose alternative treatment options if available.
11. Right to Choose Source for Obtaining Medicines and Tests: Patients have the right to choose where they obtain medicines and tests.
12. Right to Proper Referral and Transfer: Patients have the right to receive seamless referral and transfer services without any perverse commercial influence.
13. Right to Protection for Patients Involved in Clinical Trials: Patients involved in clinical trials have the right to claim compensation in case of trial-related injury or to maintain confidentiality of personal information.
14. Right to Protection of Participants Involved in Biomedical and Health Research: Participants in biomedical and health research have the right to protection of their rights, including the right to claim compensation in case of injury or to maintain confidentiality of personal information.
15. Right to Take Discharge of Patient or Body of Deceased from the Hospital: Patients have the right to take discharge or leave from the hospital at any point during their treatment, and caretakers of deceased patients have the right to receive their body from the hospital.
16. Right to Patient Education: Patients have the right to receive education about their medical condition and healthy living practices.
17. Right to Be Heard and Seek Redressal: Patients have the right to be heard and seek redressal for any grievances they may have against healthcare providers or hospital administration.

Criminal Liability In Cases Of Medical Negligence

Criminal liability refers to legal responsibility for committing a crime. In cases of medical negligence, the following sections of the Indian Penal Code are often applied:

1. Section 304-A: This section deals with culpable homicide caused by a rash or negligent act. The punishment can include imprisonment for up to two years, a fine, or both.
2. Section 337: This section addresses rash or negligent acts that endanger human life or personal safety. The penalty can include imprisonment for up to six months, a fine of up to five hundred rupees, or both.
3. Section 338: Similar to Section 337, this section covers rash or negligent acts that threaten human life or personal safety. The punishment can include imprisonment for up to two years, a fine of up to one thousand rupees, or both.

Disciplinary Measures For Medical Negligence And Misconduct

Chapter 8 of the Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations, 2002, established under the Indian Medical Council Act, 1956, outlines disciplinary actions and punishments for medical negligence and misconduct. If a medical practitioner is found guilty of misconduct by the relevant Medical Council, they may face the following penalties and they are:

1. Removal of the practitioner’s name from the medical register permanently or for a specified period.
2. Suspension of practice during the investigation period.
3. Publicising the removal through local press and publications of Medical Associations.

Defences Available To Doctors Under Indian Penal Code

Doctors have certain defences available to them under the Indian Penal Code, which include:

1. Section 80: Accidental or unintentional acts, performed while carrying out a lawful act in a lawful manner with proper care and caution, are not considered offences.
2. Section 81:Acts done with knowledge of likely harm, but without criminal intent and in good faith to prevent or avoid other harm to person or property, are not offences.
3. Section 88: Acts performed in good faith for the benefit of others, without intent to cause harm even if there is a risk, and with the patient’s explicit or implicit consent, are not considered offences.

Conclusion 

Medical negligence refers to the failure of medical practitioners or doctors to provide adequate care and necessary safeguards, resulting in a breach of their duties and harm to patients. This misconduct often arises due to improper, unskilled, or negligent treatment provided to patients. Every medical professional has a duty of care towards their patients, and breaching this duty leads to patient injury and potential legal actions for negligence. Medical negligence can result in civil liability, criminal liability, and disciplinary measures.