This document discusses consumer protection laws in the medical profession in India. It outlines the duties of doctors, including providing standard care, obtaining informed consent from patients, and maintaining confidentiality. It also discusses when a doctor-patient relationship is established and what constitutes negligence. The document advises doctors to prevent malpractice complaints by communicating effectively with patients, maintaining accurate documentation, obtaining professional indemnity insurance, and staying up to date on medical ethics and laws through continuing education.
2. Contents
Rights of a Consumer
Where can a Consumer complain??
Definitions
Laws in Medical profession
Consumer Protection Act – 1986 (CPA)
Who is liable and Who is not?
Duties of a doctor
Prevention is better
SWOT Analysis
3.
4. Dutiesofa
doctor
On the basis of Codes of Ethics (MCI, 2002) and
Declarations, the duties of a doctor are;
1. Duties to the Patient: These are : Standard Care,
Providing Information to the Patient /Attendant ,
Consent for Treatment, and Emergency Care.
2. Duties to the Public.
3. Duties towards Law Enforcers.
4. Duties not to violate Professional Ethics.
5. Duties not to do anything illegal or hide illegal acts.
6. Duties to each other.
5. Whendoesa
questionof duty
arise?
Duty towards a patient begins the moment a doctor
agrees to take on the case. He must not, therefore,
abandon his patient1
Supreme court ruling “every doctor, at the
governmental hospital or elsewhere, has a professional
obligation to extend his services with due expertise for
protecting life”- restricted to situations where there is
danger to the life of the person.
Reference
1.Laxman Joshi v Babu Godbole, AIR 1969 SC 128
2.Parmanand Kataria vs. Union of India[1996]
6. Doctor-patient
Contract
The doctor-patient contract is almost always of the
implied type, except where a written informed consent
is obtained.
An implied contract is where one person renders
services under circumstances indicating that he
expects to be paid and the other person knowing such
circumstances, avails himself of benefit of those
services
Express consent
Express oral consent is obtained for relatively minor
examinations or therapeutic procedures, preferably in
the presence of a disinterested third party.
7. Informed
Consent
Express written consent is to be obtained for : (i) all
major diagnostic procedures and surgical operations,
(ii) general anesthesia, (iii) intimate examinations, (iv)
examination for determining age, potency and
virginity, and in medico-legal cases
Must be explained in comprehensible non-medical
terms preferably in local language about the (a)
diagnosis, (b) nature of treatment,(c) risks involved, (d)
prospects of success, ( e) prognosis if the procedure is
not performed, and (f) alternative methods of
treatment.
8. ReasonableCare
It means that the degree of care and competence that
an “ordinary competent member of the profession who
professes to have those skills would exercise in the
circumstance in question.”
Generalist and specialist are expected to take
reasonable care but what amounts to reasonable care
with regard to the specialist differs from what amount
of reasonable care is standard for the generalist.
The law expects the specialist to exercise the ordinary
skill of his speciality and not of any ordinary doctor.
9. TreataccordingtoReasonableSkill
Not to undertake any procedure beyond his skill
TAKE HELP in;
Any complicated cases
Performing an operation which may be dangerous to life
or requiring amputation
Operating on a case in which there has been a criminal
assault, • Performing an operation which may affect the
intellectual or reproductive functions of a patient.
10. Professional
Secrets
A professional secret is one which a doctor comes to
learn in confidence from his patients, on examination,
investigations or which is noticed in the ordinary
privacies of domestic life.
A doctor is under a moral and legal obligation not to
divulge any such secret except under certain
circumstances.
Privileged communication is defined as a
communication made by a doctor to a proper authority
who has corresponding legal, social and moral duties to
protect the public.
11.
12.
13. Dutynottodo
anythingillegalor
hideillegalacts
1. Perform illegal abortions /
sterilization’s
2. Issue death certificates where cause of
death is not known.
3. Not informing police a case of accident,
burns, poisoning, suicide, grievous hurt,
gas gangrene.
4. Not calling Magistrate for recording
dying declaration.
5. Unauthorized, unnecessary ,
uninformed treatment and surgery or
procedure. Sex determination
14.
15.
16. PREVENTIONAT
PERSONAL
LEVEL
Communication
This is the key to doctor-patient relationship.
Increasing crowds of patients and improper
communication to patient about diagnostics and
treatment procedures, complications and claims of
guarantee success are main reasons for patient
dissatisfaction.
Answer all queries of the patients/relative without
getting irritated and patiently.
Do not be averse of any demand/suggestion for second
opinion by patient/relatives.
Keep empathy
17. PREVENTIONAT
PERSONAL
LEVEL
Interpersonal behaviour
The whole system of medical establishment should be
made courteous, and polite.
The special training should be imparted to experts
about dealing with patients/relatives under grievous
mental stress due to some loss/injury.
Academic & technical up gradation
To keep pace with fast changing scenario of technical
advancement, one should regularly attend CME’s,
workshops and other academic sessions should also be
organized to upgrade our junior staff and nursing team
19. PREVENTIONAT
PRACTICE
The key steps are exercising reasonable skill and care
in diagnosis and treatment, documentation and legally
valid informed consent.
The reasonable skill & care
There are 3 aspects of reasonable skill and care
1. Medical
2. Social
3. Legal
20.
21. PREVENTIONAT
PRACTICE
Medical aspect
First and foremost it is imperative for every
doctor/hospital/nursing home to exercise reasonable
skill and care expected of an average person with
equivalent qualification and experience in similar
circumstances.
Social aspect
We should always exhibit our reasonable skill and care
to the patient/attendants/relatives, through
expressions, body language, actions and discussions.
These must be visibly palpable
23. PREVENTIONBY
PROFESSIONAL
INDEMNITY
" indemnity " means reimbursement, to compensate.
Insurance cover
Provides the claim of compensation awarded against
doctor/hospital
Gives a sense of mental security (even in cases of same
negligence).
Arrange advocates for the legal help
24. PREVENTIONBY
PEOPLESUPPORT
GROUPS
Societies
Provides social security
Regular fellowship that prohibit the doctors speaking
foul against their own colleague.
Acts as an update as time to time discussions about
various provisions of acts, cases fought and their
results and the lessons learnt from them.
Acts as a pressure group on the dissatisfied patient on
moral and emotional grounds.