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Medicine and the Law

There is need for drastic change in the way society approaches medical negligence, writes Anshritha Rai.

Medicine and the Law

Recently, a 2-cm needle was found lodged in the hip joint of a one-month-old child. The needle was allegedly left after a vaccination session was carelessly conducted when he was three days old. It was detected only after the baby developed a persistent fever.

Earlier this month, some 29 newborns died in a Madhya Pradesh hospital allegedly due to medical negligence. In yet another distressing incident of medical negligence, soon after giving birth, a pregnant woman passed away.

Although her husband made several frantic calls to an ambulance service to take his wife to the community health centre, he received no response.

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A few weeks ago, a consumer forum in West Bengal directed a government hospital to pay a sum of Rs 19 lakh as compensation to the aggrieved family of the deceased patient.

The patient had died over 22 years ago due to improper medical treatment in administering anti-rabies vaccination. The fifteen-year-old boy had been taken to the hospital after being bitten by a street dog but the vaccine was ineffective owing to improper dosages.

Medical negligence is widespread and is not just confined to India’s overburdened public sector, but its private health sector too. An omission in carrying out one’s professional duty by doctors, consultants, physicians, surgeons, attendant personnel, pharmacists, nurses, medical assistants, hospital staff and all other medical service personnel is treated as medical negligence.

Although the menace thrives across the country, it is particularly rampant in rural India, where people are unaware of the intricacies of negligence. Here, erring practitioners get away scot free and are hardly ever subject to punishment.

Riddled with an ineffective compensation mechanism and the unwillingness of doctors to testify against their colleagues, medical negligence poses a number of difficulties for all those seeking justice. Section 304A of the Indian Penal Code prescribes the punishment for medical negligence which results in death.

It stipulates that “Whoever causes the death of any person by doing any rash or negligent act…shall be punished with imprisonment of either description for a term which may extend to two years, or with fine, or with both.”

The incidence of medical negligence in India is on a steep rise. Sixty-six per cent of the cases reported arose because health centres neither obtained the consent of the patient nor the patient’s family before carrying out surgery or changing hospitals, and because of incorrect documentation during the process of diagnosis and treatment. This takes place primarily due to the lack of awareness among the medical community.

Health advocates stress that the problem lies in India devoting a mere 1 per cent of its GDP to the healthcare sector. While the World Health Organisation recommends a doctor for every 1,000 patients, in India, there is only one doctor for a staggering 2,000 patients.

In fact, all of India has approximately 900,000 registered doctors. Activists are also of the view that the cases lodged with the Medical Council are indefinitely delayed and adjourned.

In most cases, the charges of medical negligence pressed against doctors pertain to obtaining improper consent before conducting a medical procedure or not obtaining consent at all.

Even though relatives can lodge an appeal to higher courts, before their cases can make headway, they are burdened with the additional task of presenting considerable evidence of wrongdoing.

Activists opine that consumer dispute tribunals, which were set up to deal with medical negligence cases, suffer from the want of expertise to handle difficult medical issues. Statistics indicate that just one in thousand complaints cases filed are awarded any compensation.

In a landmark judgment, the Supreme Court held that “A medical practitioner would be liable where his conduct falls below the standards of a reasonably competent practitioner.”

A patient meets a doctor with the expectation of being treated with the relevant expertise and knowledge that the doctor possesses. All medical practitioners owe a specific set of obligations towards their patients and medical negligence is the outcome of a breach of their duties.

Even though they may not always be able to save their patient’s lives, they are expected to apply their knowledge, keeping in mind the best interests of their patients.

Accordingly, a fresh look at the existing system is a must. Medical students must be well-acquainted with the concepts of ethics, morality and the law.

Medico-legal matters must be incorporated in their curriculum. Each and every student must have an adequate understanding of the Medical Council of India Regulations, 2002.

There is a crying need to make disciplinary procedures far more patient oriented and transparent. Unless the menace is eliminated it will prove costly to the country. A drastic change in the way patients are treated in health centres demands urgent attention.

The writer is a student at ILS Law College, Pune.

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