Law and Medicine

 Different Systems of Medicine

 Different Medical Specialists
 Right to Health in the Constitution
 National Medical Commission
 Medical Ethics
 Medical Negligence
 Doctor-Patient Contractual Relationship
 Rights of Medical Practitioner
 Duties of Medical Practitioner

Applicability of Statutes

 The Consumer Protection Act, 1986

 The PCPNDT Act, 1994
 The Transplantation of Human Organs and Tissues Act
 The Drugs and Magic Remedies (Objectionable Advertisements) Act, 1954

Medico-Legal Case (MLCs)

 Road accidents
 Causes of Road Accidents
 Pattern Injuries to Pedestrians in Road Accident
 Pattern Injuries to Cyclists/ Motor Cyclists in Road Accident
 Pattern Injuries to Occupants of Vehicle in Road Accident
 Sexual Assaults
 Human Experimentations

Concept Application:

 Law and Medicine Questions 1 to 20 (3 Marks)

 Law and Medicine Questions 21 to 40 (3 Marks)
 Law and Medicine Questions 41 to 60 (3 Marks)

Medical Jurisprudence
Different Systems of Medical Treatment

 Post authorBy Hemant More

 Post dateMay 21, 2022
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Law > Medical Jurisprudence > Different Systems of Medical Treatment

India has a rich heritage of medical wisdom derived from the Vedas that prevailed as
Ayurveda. This was further enriched by the ancient Saints (Rishi’s) with Siddha system and
Yoga practices. These were the principal medical practices of the country for centuries,
forming part of Indian ethos and culture. Unani Tibb that was known from period of
Hippocrates came to India during 8th Century A D. Subsequently, the Western medicine
that is based on biomedical concepts, commonly known as Allopathy, came to India and also
got assimilated into the Indian medical practice. Homeopathy, a system developed in
Germany in 18th century quickly gained popularity and has got blended with the Indian
traditional medical practices due to similarity in its holistic medical philosophy and
principles. Naturopathy, a drug less system of healthy living practices of all civilizations got
organized and also become part of the medical pluralism of the country. Thus, there evolved
a unique medical paradigm with traditional practices along with the Bio medicine. After
Independence, the Government started supporting all the medical systems for their
growth, thereby offering the public a choice for their routine health care need. Because of
this as now there are public patronage and institutional support to widen the strength of
these systems in curative, preventive, promotive aspects of health care. In this article, we
shall study different systems of medical treatment used in India.

AYUSH Mantralaya:

AYUSH is the acronym of the medical systems that are being practiced in India such
as Ayurveda, Yoga & Naturopathy, Unani, Siddha and Homeopathy. These systems are
based on definite medical philosophies and represent a way of healthy living with
established concepts on prevention of diseases and promotion of health. The basic
approach of all these systems on health, disease and treatment are holistic. Because of this,
there is a resurgence of interest on AYUSH systems. A separate ministry was created for
AYUSH in 2014.

Medical Systems Available in India:

Different systems of medical treatment available in India are as follows:

Ayurveda:
 Lord Dhanvantari
Ayurveda often referred as “the mother of all healing”, is an ancient Indian system of
healing. It is 5000 to 10000 years old. It is a system of preventive, promotive and curative
healthcare. Reference of this system can be seen in the Rigveda and the Atharva Veda.
“Ayur” means life and “veda” means “knowledge”, thus “Ayurveda” means knowledge of
life. Major books on this system are Charak Sanhita and Sushruta Sanhita. This system has
holistic approach of treating the patient. The medicines are mainly plant based.

Diagnosis in Ayurveda takes in the form of general physical examination, involving

examination of the pulse, tongue, eyes, vein sans faeces. Regulation of diet as a therapy
plays an important role in Ayurvedic treatment.

“Charak Sanhita” is a massive compilation containing several chapters on therapeutic and

internal medicine. It contains reference to more than six hundred types of medications of
plant, animal, and mineral origin. This collection is believed to date back to 400 – 200 BC
and is the oldest and most important authorative text on this system of medicine. There is
no confirmation whether it was the work of one scholar called Charak or a compilation
made by a group of scholars who were followers of Charak. This compilation is in Sanskrit
and is in poetic style. Its translation in English was made by P. V. Sharma and has been
published in four volumes.

“Sushrut Sanhita” is an ancient scholarly work dedicated to surgery. In the whole world this
is the oldest compilation on surgery. The book s written in the sixth century B.C. by an
ancient Ayurvedic scholar “Sushruta”.
The book contains descriptions of surgical procedures which are relevant even today.
Modern surgeons get marveled at the achievements of surgeons in ancient India. This book
convers various fields like anatomy, toxicology, embryology, and therapeutics. It has
chapters on dissection and operative procedures, which are explained with reference to
dead animals and plants. This book contains detailed procedures relating to the
reconstruction of a fractured nose and broken ear lobe. Hence many claims origin of Plastic
Surgery can be traced to this book. It explained 101 type of blunt and 21 types of sharp
surgical instruments like scalpels, forceps, specula, etc.

Doctrine of Ayurveda:

Body is made up of Pancha Mahabhootas: Prithvi (earth), Jal (water), Agni (fire), Vayu (air)
and Akash (ether). There are three doshas in the body: Tridosha: the Vata (ether + air), Pitta
(fire) and Kapha (earth + water) and Trigunas: the Satva, Rajas and Tamas, which are the
psychological properties
Any imbalance in above factors due to internal and external factors causes disease and
restoring equilibrium through various techniques, procedures, regimes, diet and medicine
constitute treatment. Over the years, Kshar Sutra and Panchakarma therapies of Ayurveda
have become very popular among the public.

Ayurveda believes that positive health is the basis for attaining four cherished goals of life
(chaturvidh purushartha) viz., Dharma, Artha, Kama, Moksha. All these four goals cannot be
achieved without sound positive health. Positive health is defined as

 Dosha Dhatu samya (well balanced metabolism)

 Prasanna Atma, Indriya, Manah (happy state of the soul, senses and the mind).

Senses here mean the five organs of perception Gyanendriya viz., smell, taste, sight, touch,
and hearing coupled with the organs of action – Karmendriya viz., mouth, hands, foot and
organs of excretion and reproduction.

Homeopathy:

The systematic foundation of Homeopathic techniques was made by German physician Dr,
Samuel Hahnemann. The word homeopathy is derived from two greek words, ‘homois’
means similar and ‘pathos’ means sufferings. Homeopathy is based on following three
principles:
  The Law of Similars: Main principle is Similia Similibus Curantur meaning likes are
cure by likes or likes be treated by likes.
 The Law of Minimum Dosage: In Homeopathy patient is given minimum dose so that
toxic effect of dose can be eliminated. The dose is to stimulate internal immune
system.
 The Law of Single Remedy: Homeopathy will try to treat patient by using single
remedy, which is the most similar to the symptoms shown by the patient.

Homeopathy adopts holistic approach towards the patient. Hence Homeopathy may give
two different medicines to two different patients suffering from the same problem.
Homeopathy uses animal, plant, mineral and synthetic substances in the preparation of
medicines.

Similia similibus curantur’ is a phrase coined by Dr Samuel Hahnemann, the founder of

homoeopathy. Its meaning is likes are cure by likes or likes be treated by likes. Nearly 180
years ago, he did an experiment with a drug decoction made from the bark of the cinchona
tree, known for its curative properties in the treatment of malaria. He drank the decoction,
though he was healthy, and developed the symptoms of malaria. This made him believe that
a drug which possesses the property of curing an ailment can create symptoms of the
disease n a healthy person who takes the drug in large doses. So he proposed that those
substances which can cause certain symptoms in a normal person can cure a sick person
suffering from the same symptoms f administered in a proper form. For example if arsenic is
consumed by a healthy person he gets symptoms of vomiting and diarrhoea. Now, if a
person suffering from vomiting or diarrhoea is treated with diluted for of arsenic gets cured
from those symptoms.

Hypothesis: One can select therapies on the basis of how closely symptoms produced by a
remedy match the symptoms of the patient’s disease. This system is based on the belief
that one’s body has the power to heal itself.

Hahnemann developed his treatments for sick patients by matching the symptoms
produced by a drug to symptoms in sick patients. Homeopathic Dosages are given in very
small amount to avoid side effects. Hence due to potentially nonexistent material dosages,
there is a priori skepticism in the scientific community about its efficacy.
The Law of Similars:

This law is the first principle of Homeopathy. This law is the principle of Similia Similibus
Curentur i.e. let likes be treated by likes. Law of Similars teaches that every homoeopathic
remedy experimentally observed to have certain properties of producing a set of symptoms
on healthy human beings and when these symptoms. matches with a natural disease, it act
as therapeutic agent and help the body to correct the disorder.

As per this concept, the symptoms produced by the substance during the drug proving are
the signature of that drug. Therefore, in strict sense, this signature of the drug is the one
and only one that qualify into the principle of Similia Similbus Curentur. This is the most
important concept in Homoeopathy.
Quinine (derived from Cinchona bark) given in daily doses to a healthy person can cause
symptoms similar to malaria fever. Indeed, the Cinchona Officinalis, a homoeopathy
medicine prepared from cinchona bark, is curative in many patients with similar symptoms.

The Law of Minimum Dosage:

The similar remedy selected for a sick person should be prescribed in minimum dose, so that
when administered, there is no toxic effect on the body. It just acts as a triggering or
catalytic agent to stimulate and strengthen the existing defence mechanism of the body. It
does not need to be repeated frequently. The method of drug dynamization or
potentization achieved, not only the reduction of drug quantity in each dose of
homoeopathic medicine, but also the dynamic power gets increased progressively. This
aspect of homoeopathy and the method discovered by Hahnemann 200 years before is to
be only evaluated by new researches and studies which are now underway in nanoscience.

The Law of Single Remedy

Only one homeopathic medicine should be prescribed at a time and directs to choose and
administer such a single remedy, which is most similar to the symptoms of the sick person.
In homeopathy, the drug proving to ascertaining the curative property of a drug is done with
a single remedy derived from a single source – primarily plant, mineral or chemical. This rule
helps to avoid confusing and potentially complex remedy interactions.

Homeopathic remedies are used by the public for viral diseases, different forms of allergic
conditions, skin disorders, behavioral problems and several chronic long term diseases.Its
strength also lies in its effectiveness on certain clinical conditions for which there is less
treatment in other medical systems. This medicine is used as a standalone treatment for
various women and children diseases, hormonal disorders, pain and palliative care,
infertility and so on. Similarly it is used as an adjunct/ adjuvant in Cancer, COPD, Diabetes
and its complications. In preventive care, Homeopathic medicines are used on a unique
concept of Genus epidemicus.The strength of Homeopathy in promotive health is
its constitutional and anti-miasmaticapproach.

Acupuncture:

Traditional Chinese medicine (TCM) is a complete system of healing that dates back to 200
B.C. in written form. Acupuncture is TCM. Acupuncture is a form of treatment that involves
inserting very thin needles through a person’s skin at specific points on the body, to various
depths. There is no scientific proof that the meridians or acupuncture points exist, and it is
hard to prove that they either do or do not, but numerous studies suggest that acupuncture
works for some conditions.
Acupuncture points are seen as places where nerves, muscles, and connective tissue can be
stimulated. The stimulation increases blood flow, while at the same time triggering the
activity of the body’s natural painkillers. It is useful in low back pain, neck pain,
osteoarthritis, knee pain, headache and migraine

Doctrine of Acupuncture

Traditional Chinese medicine explains that health is the result of a harmonious balance of
the complementary extremes of “yin” and “yang” of the life force known as “qi,”
pronounced “chi.” Illness is said to be the consequence of an imbalance of the forces. It is
believed that there are 14 meridians in the human body, through which bioenergy or
bioelectricity flows. It is assumed that one end of each meridian lies in hand, leg, or face and
the other end in the organ to it is connected. By puncturing balance is obtained. Some
studies have concluded that acupuncture offers similar benefits to a patient as a placebo,
but others have indicated that there are some real benefits.

Acupressure:

Traditional Chinese medicine (TCM) is a complete system of healing that dates back to 200
B.C. in written form. Acupuncture is TCM. Acupressure is a form of treatment that involves
applying pressure at specific points on the body, to various depths. There is no scientific
proof that the meridians or acupressure points exist, and it is hard to prove that they either
do or do not, but numerous studies suggest that acupressure works for some conditions.
Acupressure points are seen as places where nerves, muscles, and connective tissue can be
stimulated. The stimulation increases blood flow, while at the same time triggering the
activity of the body’s natural painkillers.

The doctrine of acupressure and acupressure is the same. The difference is that in
acupuncture needles are used while in acupressure fingers are used to press certain points
on the patient’s body by pressing the point gently but firm. It is useful in insomnia,
headache, menstrual cramps, motion sickness, muscle tension and pain, nausea or vomiting,
stress management

Hypnosis or Mesmerism:

Hypnosis is a trance-like mental state in which people experience increased attention,

concentration, and suggestibility. While hypnosis is often described as a sleep-like state, it is
better expressed as a state of focused attention, heightened suggestibility, and vivid
fantasies.
18th century with Franz Mesmer, a German physician who used hypnosis in the treatment
of patients in Vienna and Paris. English physician James Braid studied the phenomenon and
coined the terms hypnotism and hypnosis, after the Greek god of sleep, Hypnos. There are
many misconception about hypnosis. Before hypnosis session, a consent of client must be
taken.
Reiki

Reiki is spiritual life force energy that is directed by higher consciousness. The wisdom of
higher consciousness guides energy in support of life and spiritual evolution. It is potentially
inclusive of all philosophical and religious systems of belief. Mikao Usui, a Japanese scholar,
is considered as the founder of this system of healing. Lama Tséwang Rikdzen developed it
further.

Benefits of Reiki include: decreases Pain, reduces stress & promotes relaxation, assists the
body in eliminating toxins, balances energy flow throughout the body, brings comfort and
peace to those who are terminally ill, promotes health & well-being, enhances and
accelerates the normal healing processes of the body. It is useful in treatment of backache,
arthritis, headaches, migraines, mental tension.
Aromatherapy:

Aromatherapy is a holistic healing treatment that uses natural plant extracts to promote
health and well-being. Sometimes it’s called essential oil therapy. Aromatherapy uses
aromatic essential oils medicinally to improve the health of the body, mind, and spirit.
Essential oils have been used for nearly 6,000 years, with the aim of improving a person’s
health or mood. It enhances both physical and emotional health.

Before doing aromatherapy allergy test must be done. After noting patient’s history, the
therapist prepares a mixture of essential oils which are best suited to the patient’s
condition. Therapy is administered by vapourizers or inhalation. It is useful in treatment of
high and low blood pressure, burns, insomnia, muscular pain, and skin ailment.

Bach Flower Therapy:

Edward Bach, a medical doctor and homeopath, created these remedies in the early
1900s. Homeopathy is the belief that the body can cure itself. It uses small amounts of
natural substances like plants and minerals to treat the body or mind. The idea behind Bach
flower remedies is similar to homeopathy. But they use fewer materials and don’t work
directly on physical symptoms, but instead on the emotions.
According to the emotional issue or issues at the root of patient’s problem a remedy of one
flower or mix several together is selected. The extraction of these flowers is extremely
diluted and administered orally to the patient. It is useful in treatment of mental illness,
tension, feeling of panic

Yoga:

Derived from the Sanskrit word ‘yuj’ which means ‘to unite or integrate’, yoga is a 5,000-
year-old Indian body of knowledge. Yoga is all about harmonizing the body with the mind
and breath through the means of various breathing exercises, yoga poses (asanas),
mudras (hand positions) and meditation (dhyana).

There are eight limbs of yoga namely, Yam, Niyam, Asana, Pranayama, Pratyahara, Dhara,
Dhyana, Samadhi. Maharishi Patanjali who is regarded as the Father of Yoga, compiled in his
book called “Patanjali Yog Sutra”. Most of the Asnas work on the principle of stretching a
body. June, 21 every year is celebrated as the International Yoga day
Yoga is an Art and Science of healthy living. It is a spiritual discipline based on an extremely
subtle science, which focuses on bringing harmony between mind and body. The holistic
approach of Yoga is well established and it brings harmony in all walks of life and thus,
known for disease prevention, promotion of health and management of many lifestyle –
related disorders. Today, Yoga is popular across the globe, not just because of its efficacy in
the management of some diseases, but also of its strength in providing relief to the
practitioner, from mental and emotional distress and providing a feeling of well-being.
Hence, now-a-days Yoga is being practiced as part of healthy life style across the globe.

Naturopathy:

According to the manifesto of British Naturopathic Association, “Naturopathy is a system of

treatment which recognizes the existence of the vital curative force within the body.” It
therefore, advocates aiding human system to remove the cause of disease i.e. toxins by
expelling the unwanted and unused matters from human body for curing diseases. Dr.
Vincent Priessnitz who lived in 19th century is widely regarded as the Father of Naturopathy.
Naturopathy is an art and science of healthy living and a drug less system, It has its own
concept of health and disease and also principle of treatment. In today’s age, Naturopathy is
Recognized and well accepted as an independent System of medicine. Naturopathy
advocates aiding human system to remove the cause of disease i.e. toxins by expelling the
unwanted and unused matters from human body for curing diseases. Nature is the greatest
healer. The human body itself has the healing power to prevent itself from disease and
regain health if unhealthy.
In Naturopathy, it is not the disease but the entire body of the patient which is caused and is
renewed. Naturopathy cures patients suffering from chronic ailments in comparatively less
time than any other form of medicine. Naturopathy treats all the aspects like physical,
mental, social and spiritual at the same time. Naturopathy treats the body as a whole.
According to Naturopathy, “Food is only the Medicine”, no external medications are used.

Some important treatments of naturopathy are: Mud pack, Mud Bath, Spinal Bath, Spinal
Spray Bath, Steam Bath, Sauna Bath, Sun Bath, Wet Sheet Pack, Chest Pack, Abdomen Pack,
Magnet Therapy, Acupuncture, Acupressure, Reflexology, Physiotherapy Treatments –
Exercise Therapy and Electro Therapy. Naturopathic doctors treat their patients holistically
i.e. taking into consideration their individual biochemistry, bio mechanics and emotional
predispositions.

Doctrine of Naturopathy

The human body is endowed with sufficient defence mechanisms to cure itself and dugs are
totally unnecessary, and often harmful. Identify and remove obstacles to recovery, allow for
natural healing. Rather than stopping symptoms, underlying physical or mental issues must
be resolved by treating the body, mind, and spirit. Treatment plans should not have harmful
side effects or control symptoms negatively. Treat all aspects of a person’s health
effectively. Direct treatment towards a whole person than to specific part of body. Teach
self-care to help and empower people against ill health. It is good to remove toxic
substances from a lifestyle to prevent problems from arising.

Magnet Therapy:

It is an ancient form of treatment and can be used in acute as well as chronic illness without
any side effects. It decreases blood pressure and cholesterol level and can be used in
treatment of muscle pain, joint pain, headaches, back pain, insomnia. This treatment should
not be used with patient who are pregnant or fitted with pace maker and insulin pump.
It is used in form of magnetic belts, bracelets, necklace. Scientific studies on human subjects
have failed to show the efficacy of using magnets to treat pain or joint and muscle stiffness.

Doctrine of Magnet Therapy

Dr. William Gilbert of England propounded that the earth itself is a magnet and it exerts
magnetic field on individual. Magnetic field therapy uses different kinds of magnets on the
body to help boost your overall health and to help treat certain conditions. The doctrine
behind therapy is ”Human body naturally has magnetic and electric fields. All the molecules
in the human body have a small amount of magnetic energy in them. The illness is nothing
but imbalance in magnetic fields of the human body. By keeping magnets near body, this
imbalance in magnetic field in the body can be removed”.

Emchi (Sowa-Rig-pa):

It is the traditional medicine of many parts of the Himalayan region used mainly by the
Tribal and bhot people. Sowa-Rig-pa (BodhKyi) means ‘science of healing’ and the
practitioners of this medicine are known as Amchi. It provide a holistic approach to health
care on the basis of harmony and understanding of human being and universe i.e. the
environment. In India, this system of medicine has been popularly practiced in Ladakh and
Paddar-Pangay regions of Jammu and Kashmir, Lahul-spiti, Pangi, Dhramshala and Kinnar
region of Himachal Pradesh, Uttrakhand, Arunachal Pradesh, Sikkim, Darjeeling-Kalingpong
(West Bengal).
According to the Amchi system, proper alignment of the three Dosha, seven body Tissue
(seven Dhatus) and three excretory products (Malas) in the state of equilibrium constitutes
a healthy body. Any disequilibrium in any of these energies leads to disease or ill-health.

The diagnostic techniques in Sowa-Rigpa include visual observation, touch and

interrogation. For treatment of health problems, the system makes use of herbs, minerals,
animal products, spring and mineral water, moxibustion mysticism and spiritual power. The
medicines are used usually in the form of decoctions, powders, pills and syrups etc. Mantra
and tantra components are also very important of Sowa-rig-pa.

Unani Tibb:

Unani-tibb or Unani Medicine is a form of traditional medicine practiced in Middle- East and
South-Asian countries. It refers to a tradition of Graeco-Arabic medicine, which is based on
the teachings of Greek physician Hippocrates and Roman physician Galen and developed
into an elaborate medical system in middle age era by Arabian and Persian physicians, such
as Rhazes (al-Razi), Avicenna (Ibn-e-Sina), Al-Zahrawi, and Ibn Nafis.
It originated in Greece almost 2500 years back, which is herbo- animo- mineral in origin
(Approximately 90% herbal, 4-5% animal and 5-6 % mineral). It is not only the original
science of medicine but also a rich store house of principles and philosophies of medicine
which can be of immense value to the medicine in particular and science in general. It is a
comprehensive medical system, which meticulously deals with the various states of health
and disease. It provides promotive, preventive, curative and rehabilitative healthcare.

Unani system of medicine is a comprehensive medical system, which provides preventive,

promotive, curative and rehabilitative health care. The system is holistic in nature and takes
into account the whole personality of an individual rather than taking a reductionist
approach towards disease. The fundamentals, diagnosis and treatment modalities of the
system are based on scientific principles.

The thrust areas of Unani medicine include; skin diseases, liver disorders, non-
communicable diseases including life style diseases, metabolic & geriatric diseases and
menstrual / gynaecological disorders etc.

Doctrine of Unani-Tibb Therapy

The basic framework of this system is based on the Hippocratic theory of four Humours,
according to which any disturbance in the equilibrium of humours causes disease and
therefore the treatment aims at restoring the humoral equilibrium.

The system also believes that Medicatrix Naturae (Tabiat Mudabbira-i Badan) is the
supreme power, which controls all the physiological functions of the body, provides
resistance against diseases and helps in healing naturally. Temperament (Mizaj) of a patient
is given great importance both in diagnosis and treatment of diseases. Unani system of
medicine described four mode of treatment viz., Ilaj-bil-Tadbir (Regimenal Therapy), Ilaj-bil-
Ghidha (Dietotherapy), Ilaj-bilDawa (Pharmacotherapy) and Ilaj-bil-Yad (Surgery).

Siddha Therapy:

It is 5000 year old system of medicines. It is based on the similar principles of Ayurveda. The
word “siddha” means “achievement” and practitioner of this system of treatment were
called “Siddhars”. This system is said to be developed by many Siddhars. Agatsya was the
first Siddhar. It is mostly practiced in South India, particularly in Tamil Nadu. April 14 is
celebrated as World Siddha Day.

The Siddha system of medicine is mainly practised in the Southern part of India. It is one of
the earliest traditional medicine systems in the world which treats not only the body but
also the mind and the soul. The word Siddha has its origin in the Tamil word Siddhi which
means “an object to be attained” or “perfection” or “heavenly bliss”. India being the birth
place of many traditional philosophies also gave birth to Siddha. The roots of this system are
intertwined with the culture of ancient Tamil civilization.

“Siddhargal” or Siddhars were the premier scholars of this system in ancient times. Siddhars,
mainly hailing from Tamil Nadu laid the foundation for Siddha system of medicine. Hence, it
is called Siddha medicine. Siddhars were spiritual masters who possessed the ashta (eight)
siddhis or unique powers. Agastyar or Agasthya, is believed to be the founding father of
Siddha Medicine. Eighteen Siddhars are considered to be pillars of Siddha Medicine. Siddha
medicine is claimed to revitalize and rejuvenate dysfunctional organs that cause the disease.
Kayakarpam, a special combination of medicine and life style, Varmam therapy, Vaasi
(Pranayamam) and Muppu the universal Salt are the specialities of Siddha system of
medicine. Thus this system connects both spiritual and physical and treats the person as a
whole i.e. it concentrates the physical, psychological, social and spiritual well being of an
individual.

This system treats the individual as a microcosm of the universe. It believes that the human
body is made up of five tatvas or elements namely: earth, water, air, fire, and space. It
considers food as basic building block of human body, which gets processed into humors,
tissues and waste matter. The equilibrium of humors contribute to the health of a person
and its imbalance or disturbance leads to disease. It puts emphasis on the body, mind, and
spirit and work for harmony of the human body. It is particularly effective in allergy, skin
problems, arthritis, and general debility.

The Siddha system of Medicine emphasizes on the patient, environment, age, sex, race,
habits, mental frame work, habitat, diet, appetite, physical condition, physiological
constitution of the diseases for its treatment which is individualistic in nature Diagnosis of
diseases are done through examination of pulse, urine, stool, eyes, skin, study of voice,
colour of body, tongue and status of the digestion of individual patients.

System has unique treasure for the conversion of metals and minerals as drugs and many
infective diseases are treated with the medicines containing specially processed mercury,
silver, arsenic, lead and sulphur without any side effects.

The strength of the Siddha system lies in providing very effective therapy in the case of
Psoriasis, Rheumatic disorders, Chronic liver disorders, Benign prostate hypertrophy,
bleeding piles, peptic ulcer including various kinds of Dermatological disorders of non
psoriatic nature.

Doctrine of Siddha Therapy

According to the Siddha system, the individual is a microcosm of the universe. The human
body consists of the five primordial elements-earth, water, fire, air and space, the three
humours-vatha, pitta and kapha and seven physical constituents. Food is the basic building
material of the human body and gets processed into humours, tissues and wastes. The
equilibrium of humours is considered as health and its disturbance or imbalance leads to a
diseased state.

Treatment is aimed at restoring balance to the mind-body system. Diet and lifestyle play a
major role not only in maintaining health but also in curing diseases. This concept of the
Siddha medicine is termed as pathiam and apathiam, which is essentially a list of do’s and
don’ts.
Allopathy:

The system of medical practice which treats disease by the use of remedies which produce
effects different from those produced by the disease under treatment. The term “allopathy”
was coined in 1842 by C.F.S. Hahnemann to designate the usual practice of medicine
(allopathy) as opposed to homeopathy, the system of therapy that he founded based on the
concept that disease can be treated with drugs (in minute doses) thought capable of
producing the same symptoms in healthy people as the disease itself.
Allopathy is also known as Biomedicine or Western Medicine. Treatment is done by
medication, surgery, radiation, or and other therapies and procedures. The criticism to the
system is that allopathic medicines like pills and injection do not cure disease, they merely
mask the symptoms of disease.

Doctrine of Allopathy

It believes that germs, bacteria, and viruses that causes disease are destroyed when drugs
and chemical agents are administered in the patient. Modern diagnostic methods like X-
rays, sonography, ECG, instruments and techniques like use of radioisotopes are used.
Millions of dollars are spent annually on research and development of allopathic drugs.
Main drugs used include, antipyretics, antibiotics, antifungal, antibacterial, antihistamine,
antifertility, narcotics, sulpha drugs, etc. Allopathy has had the most evidence-based
scientific research, data collection, and drug testing. It’s also the most regulated by a neutral
party like the Food and Drug Administration (FDA) or the Indian Medical Association.

Conclusion:

The system of medicines which are considered to be Indian in origin or the systems of
medicine, which have come to India from outside and got assimilated in to Indian culture
are known as Indian Systems of Medicine. India has the unique distinction of having six
recognized systems of medicine in this category. They are-Ayurveda, Siddha, Unani and
Yoga, Naturopathy and Homoeopathy. Though Homoeopathy came to India in 18 th Century,
it completely assimilated in to the Indian culture and got enriched like any other traditional
system hence it is considered as part of Indian Systems of Medicine. Apart from these
systems there are large number of healers in the folklore stream who have not been
organized under any category.
In many places, the Indian Systems of Medicine continues to be widely used due to their
accessibility, and sometimes, because they offer the only kind of medicine within the
physical and financial reach of the patient. The Indian medicine system is also embedded in
the beliefs of a wide section of the public and continues to be an integral and important part
of their lives and for some, it is also a way of life.

Physicians and Their Skills:

A physician is a general term for a doctor who has earned a professional medical degree
from institution recognized by Medical Council of India and who is registered with
appropriate Medical Council. He should have following skills

1. Patient care. Physicians have to provide compassionate, appropriate, and effective

care to promote health and treat health problems in their patients.
2. Medical knowledge. Physicians must be experts in established and new biomedical,
clinical, and cognate sciences and how to apply this knowledge to patient care.
3. Practice-based learning and improvement. Physicians must always investigate and
evaluate their own care and look for ways to improve.
4. Interpersonal and communication skills. Physicians must be able to communicate
effectively with patients, their families, and other health professionals.
5. Professionalism. A commitment to professionalism includes carrying out
professional responsibilities, sticking to ethical principles, and being sensitive to a
diverse patient population.
6. Systems-based practice. Physicians must be aware of and responsive to the larger
context and system of health care. They must also be able to find and use resources
to provide the best care possible.

Responsibilities of a Physician:

Physicians work to maintain, promote, and restore health by studying, diagnosing, and
treating injuries and diseases. Physicians diagnose and treat injuries and illnesses. Other
responsibilities include:

 Giving advice on diet, hygiene, and preventative care

 Examining patients
 Prescribing medications
 Ordering, giving, and interpreting diagnostic tests
 Taking and keeping medical histories

Electroencephalogram EEG:

An electroencephalogram (EEG) is a test that detects electrical activity in human brain using
small, metal discs (electrodes) attached to his scalp. The brain cells communicate via
electrical impulses and are active all the time, even when asleep. This activity shows up as
wavy lines on an EEG recording. An EEG is one of the main diagnostic tests for epilepsy.
An EEG can also play a role in diagnosing other brain disorders.

Electrocardiogram (ECG)

An electrocardiogram (ECG or EKG) is a medical test that detects heart problems by

measuring the electrical activity generated by the heart as it contracts. Each beat of the
heart is triggered by an electrical impulse generated from special cells in upper right
chamber of heart. An electrocardiogram is a painless, non-invasive way to help diagnose
many common heart problems in people of all ages. It is used to determine or detect:
  Abnormal heart rhythm (arrhythmias)
 If blocked or narrowed arteries in your heart (coronary artery disease) are causing
chest pain or a heart attack
 Whether you have had a previous heart attack
 How well certain heart disease treatments, such as a pacemaker, are working

Radiology:

Radiology is a medical speciality that uses imaging to diagnose diseases seen within the
body. It includes X-ray, Computed Tomography (CT), Nuclear medicine including positron
emission tomography (PET), Magnetic resonance imaging (MRI)

Ultrasonography:

Ultrasonography uses sound waves to generate an image for assessment and diagnosis of
various medical conditions. It can be used to diagnose a variety of medical conditions in the
body, and is often associated with imaging during pregnancy

Different Medical Specialists

 Post authorBy Hemant More

 Post dateMay 5, 2022
 No Commentson Different Medical Specialists

Law > Medical Jurisprudence > Law and Medicine > Different Medical Specialists

In this articles we shall study about different kinds of medical specialists. Medical specialists
are experts in certain fields of medicine. They either treat specific parts of the body, such as
the back or the brain, or they specialize in certain diseases, such as cancer. Family doctors
keep a list of local specialists and can help patients choose the right specialist for each
medical issue.

General Practitioners and Physicians:

General Physician or Family Practitioner:

General Physicians are highly trained specialists who provide a range of non-surgical health
care to adult patients. He/she treats many different medical conditions and ailments on an
outpatient basis.
They care for difficult, serious or unusual medical problems and continue to see the patient
until these problems have resolved or stabilized. They are popularly known as a ‘general
practitioner’ or a ‘family physician’ in many countries.

Anesthesiologist:

An anesthesiologist is a doctor who practices anesthesia. Anesthesiologists are physicians

specializing in perioperative care, developing anesthetic plans, and the administration of
anesthetics. Anesthesiologists help ensure the safety of patients undergoing surgery.

The anesthesiologist provides care for the patient to prevent the pain and distress they
would otherwise experience. He/she is responsible for keeping the patient anesthetized
(sedated) and for monitoring the vital signs like airway, breathing and circulation during
surgery. They monitor input and output during the surgery like delivery of intravenous
fluids, blood and other drugs.

Surgeons:
A surgeon is a doctor who specializes in evaluating and treating conditions that may require
surgery, or physically changing the human body. Surgeries can be done to diagnose or treat
disease or injury.

 : General surgeons are doctors who specialize in surgical procedures. Surgery is any
procedure that alters body tissues to diagnose or treat a medical condition.
 Cardiothoracic Surgeon: A cardiothoracic surgeon is a medical doctor who
specializes in surgical procedures of the heart, lungs, esophagus, and other organs in
the chest. This includes surgeons who can be called cardiac surgeons, cardiovascular
surgeons, general thoracic surgeons, and congenital heart surgeons.
 Neuro-Surgeon: Neurosurgeons are medical doctors that diagnose and treat
conditions related to the brain, spine, and other parts of your nervous system.
 Oral or Maxillofacial Surgeon: Maxillofacial surgeons, sometimes called oral and
maxillofacial surgeons, are trained to handle a wide variety of conditions and injuries
that affect the head, neck, mouth, jaw, and face.
 Otolaryngologist Surgeon: Otolaryngologist Surgeon treats issues in ears, nose, or
throat as well as related areas in the head and neck. They can do surgeries in these
areas.
 Surgical Oncologist: They are surgical counterparts of medical oncologist. They are
general surgeons with specialty training in procedures for diagnosing, staging
(determining the stage of cancer), or removing cancerous growths.
 Pediatric Surgeon: Pediatric surgeons are doctors who specialize in treating children.
They’re trained to do operations on infants, children, and young adults.
 Plastic Surgeon: Plastic surgeons are focused on reconstructive procedures. They can
treat patients who have conditions like birth disorders, injuries, illnesses, or burns.
Many plastic surgeons choose to become cosmetic surgeons and do procedures to
change a patient’s appearance or aesthetic.
 Orthopedic Surgeon: An orthopedic surgeon is qualified to diagnose orthopedic
problems, perform or prescribe treatments, and assist with rehabilitation.
 Vascular Surgeon: Vascular surgeons are doctors who treat diseases and problems
within the vascular system, the network of arteries and veins that carry blood
throughout the body.
Internal Medicine Practitioner/ Internist:

Internal medicine physicians, or internists, are specialists who apply scientific knowledge
and clinical expertise to the diagnosis, treatment, and compassionate care of adults across
the spectrum from health to complex illness.

They are especially well trained in the diagnosis of puzzling medical problems, in the
ongoing care of chronic illnesses, and in caring for patients with more than one disease.
Internists also specialize in health promotion and disease prevention. He/she deals with the
diagnosis, management and non-surgical treatment of unusual and serious diseases.

Doctors Treating Children:

Pediatrician:

A pediatrician is a medical doctor who manages the physical, behavioral, and mental care
for children from birth until age 18. A pediatrician is trained to diagnose and treat a broad
range of childhood illnesses, from minor health problems to serious diseases.
They focus on the prevention, detection and management of physical, behavioral,
developmental and social problems that affect children. They work to diagnose and treat
infections, injuries, and many types of organic disease and dysfunction and bring about
improvement in the life of children with chronic problems.

Neonatologist:

A neonatologist is a specialist in caring for premature and ill newborns and generally works
in hospital’s neo-natal care or baby special care units. Newborns can present a unique set of
health challenges that require a high level of skill and medical expertise to treat.

This specialist does tests to make sure that newborn babies are well- developed and free
from infections and organ deformities.

Pediatric Cardiologist:

Pediatric cardiologists specialize in diagnosing and treating heart problems in children. In

those children who might need heart surgery, pediatric cardiologists work closely with
pediatric heart surgeons to determine the best treatments and interventions.

Pediatric Endocrinologist:

Pediatric endocrinologist specialize in diagnosing and treating hormone or gland problems in

children.

Pediatric Oncologist:

Pediatric oncologists are doctors who diagnose and treat cancer in children and teens.

Doctors Treating Old People:

Geriatrician:
Geriatricians are primary care doctors who have additional training in treating older adults,
especially those 65 and up. People in that age range often have multiple or complex health
matters and need specialized care.

Geriatrician at times requires to take an interdisciplinary approach to a problem as many

patients suffer from not only medical but have social problems too. A Geriatrician may work
with other physicians, nurses, social workers, occupational therapists and family members
to take care of the needs of his patient.

Gerontologist:

A gerontologist is a doctor studying and treating conditions arising in the aging process. He
mostly works with senior citizens, studying their biological, medical and social issues at that
age. These specialists work in hospitals, nursing homes and laboratories and may form a
part of government health policies for the old. A gerontologist is a licensed physician and
diagnoses and treats old age diseases like Alzheimer’s disease, Parkinson disease and
osteoporosis.

Doctors Treating Heart and Vascular Problems:

Cardiologist:

Cardiologists are qualified to treat heart attacks, heart failure, heart valve disease,
arrhythmia, and high blood pressure. He may collaborate with cardiac surgeons to decide
the course of treatment for his patients.
Cardiology is a specialty, which has many subspecialties like interventional cardiology,
nuclear cardiology, electro physiology, or echocardiography, which help in making
diagnostic studies.

Vascular Medical Specialist:

Vascular surgeons are doctors who treat diseases and problems within the vascular system,
the network of arteries and veins that carry blood throughout the body.

Doctors Treating Hormone/Gland Problems:

Endocrinologist:

Endocrinologists are doctors who specialize in glands and the hormones they make. They
deal with metabolism, or all the biochemical processes that make the body work, including
how the body changes food into energy and how it grows.
He/she diagnoses and treat diseases like diabetes, thyroid diseases, metabolic disorders,
over or under production of hormones, menopause, osteoporosis, hypertension, cholesterol
disorders, infertility, lack of growth and endocrine glands cancer..

Doctors Treating Stomach/ Liver/Bowel, Colon Related Problems:

Gastroenterologist:

A Gastroenterologist is a physician with dedicated training management of diseases of the

gastrointestinal tract and liver. They are specialist in digestive diseases.
He/she is mainly concerned about the prevention, diagnosis, and treatment of conditions
and disorders in the gastrointestinal tract involving the esophagus, stomach, small and large
intestine, rectum, liver and pancreas of adults.

Hepatologist:

Hepatologists are medical doctors who diagnose, treat, and manage problems associated
with liver, gallbladder, bile ducts, and pancreas. He deals in disorders like serious and
chronic hepatitis, chronic alcoholism, and liver disorders due to certain medications.

Colorectal Surgeon:

Colorectal surgeon is a doctor, who treats disorders of the rectum, anus, and colon.

Doctors Treating Kidney and Urinary System:

Urologist:

A Urologist specializes and treats the urinary tract problems of both men and women and
on the reproductive organs of men.

He/she treats problems in the urinary system, which includes kidneys, bladder, ureters, and
urethra. He also treats a man’s reproductive system, which includes the penis, testes,
scrotum, and prostate.

Nephrologist:
Nephrologists are doctors who specialize in conditions that affect the kidney. They diagnose,
treat, and manage acute and chronic kidney problems and diseases. They also treat
associated issues like high blood pressure, fluid retention, and electrolyte and mineral
imbalances. In addition, these specialists are in charge of kidney dialysis treatment.

Doctors Treating Reproduction / Sex Problems:

Andrologist:

Andrologists are urologists who focus entirely on the treatment of conditions affecting male
fertility and sexuality, rather than practicing a broader form of urology.

This specialty includes the treatment of physical conditions affecting the genitalia, such as
undescended testes, as well as injuries and diseases that can affect fertility or sexual
function.

Gynecologist:

A gynecologist is a doctor who specializes in female reproductive health. They diagnose and
treat issues related to the female reproductive tract. This includes the uterus, fallopian
tubes, and ovaries and breasts. They diagnose and treat reproductive system disorders such
as endometriosis, infertility, ovarian cysts, and pelvic pain.
They may also care for people with ovarian, cervical, and other reproductive cancers.

Obstetrician:

An obstetrician is a specialist who has specialized in the management of pregnancy, labor,

childbirth, and a woman’s reproductive system. They also called an OB/GYN.

They take care throughout pregnancy, and give follow-up care.

Sexologist:

A sexologist is a person who has studied human sexuality. Sexologists have studied the
science of sex, which means they have studied human anatomy and physiology (how the
body works and why) and psychology (how our minds work) regarding sexuality. Sexologists
help people with all things to do with sexuality.

Fertility Specialist:
Fertility specialists are obstetrician or gynecologists who have undergone specialized
training for reproductive endocrinology.

Venereologist:

Venereologists deal with the study and treatment of sexually transmitted diseases caused
by sexual contact. A person may just be a carrier without realizing it or may actively suffer
the symptoms. They may be engaged in research working out methods of prevention, and
innovations in treatment. These specialists may have to deal with social issues and moral
norms at times in certain societies, however they do play an important role in educating the
patients, their family and general public about sexual infections and diseases and about
their preventive measures.

Doctors Treating Immunology/ Allergy Problems:

Allergist:

Allergists are doctors who specialize in treating allergies and other immune problems. As
allergies are an overreaction of the immune system, allergists must have a thorough
understanding of how your body fights infection to treat the hypersensitivity that leads to
allergies.

Immunologist:

Immunologists are doctors who diagnose, treat, and work to prevent immune system
disorders. They study the complex immune system consisting of cells and molecules that
help fight infection. These specialists treat people born with a defective immune system or
those that acquire a defective immune system when they are affected by virus, bacteria and
fungi that do not affect healthy persons.

Doctors Treating Cancer:

Medical Oncologist:

Medical oncologist deals with the diagnosis, treatment, and prevention of cancer. He/she
takes care of cancer patients by using things like chemotherapy, hormone therapy, targeted
therapy, or immunotherapy.

Radiation Oncologist:

Radiation oncologists work closely with medical oncologists, surgeons, and other doctors to
determine the most appropriate course of treatment for people diagnosed with cancer.
Before performing radiation procedures, radiation oncologists use software to carefully map
out where they will deliver radiation to their patients. They also decide which type of
radiation therapy to use.

Surgical Oncologist:
They are surgical counterparts of medical oncologist. They are general surgeons with
specialty training in procedures for diagnosing, staging (determining the stage of cancer), or
removing cancerous growths.

Doctors Treating Lungs and Blood Problems:

Pulmonologist:

A pulmonologist is a doctor who diagnoses and treats diseases of the respiratory system viz:
the lungs and other organs that help to breathe. They are concerned with diseases of the
respiratory tract, bronchial tubes and lungs as well as the heart. These specialists have
extensive training in chest diseases and conditions such as pneumonia, asthma,
tuberculosis, emphysema, or complicated chest infections.

Hematologist:

Hematologists are internal medicine doctors or pediatricians who have extra training in
disorders related to your blood, bone marrow, and lymphatic system. They may work in
specialized areas that aid in diagnosis like electrophoresis, flow cytometry, or coagulation.

Doctors Treating Brain/Nervous System Problems:

Neurologist:

Neurologists are doctors who diagnose and treat problems with the brain and nervous
system. neurologists focus on non-surgical treatment. Neurologists may also specialize in
dealing with dementia, epilepsy, headache medicine, Parkinson and Movement Disorders,
or Sleep Disorders.

Neuro Surgeon:

Neurosurgeons are medical doctors that diagnose and treat conditions related to
the brain, spine, and other parts of your nervous system. They are specifically trained and
certified in the use of surgical treatments.

Doctors Treating Joints / Bones/ Muscle Problems:

Orthopedist:

Orthopedist is a doctor who specializes in the branch of medicine concerned with the
correction or prevention of deformities, disorders, or injuries of the skeleton and associated
structures

Orthopedic Surgeon:

An orthopedic surgeon is qualified to diagnose orthopedic problems, perform or prescribe

treatments, and assist with rehabilitation. They also help to develop long-term strategies to
treat illnesses, disorders, and issues relating to bones, joints, ligaments, tendons, and
muscles. These specialists help treat broken bones, joint problems, like arthritis, and
degenerative conditions, like osteoporosis. In addition orthopedic doctors treat sports
injuries, infections or congenital conditions related to, and tumors in the bones.

Rheumatologist:

A rheumatologist is a medical practitioner who specializes in treating arthritis, rheumatic

diseases, systemic autoimmune diseases and conditions involving the bone, joints and
muscles. Since many of these diseases involve the immune system, rheumatologist have an
in-depth knowledge of the immune system. Rheumatologists work closely with their
patients and orthopedic surgeons, neuro-surgeons, and radiologists who perform joint
replacements, soft tissue reconstruction and repair and nerve decompression, and report on
X-rays, CT, MRI and ultrasound scans.

Podiatrist:

Podiatrists are medical specialists who help with problems that affect feet or lower legs.
They can treat injuries as well as complications from ongoing health issues like diabetes.
Podiatrists deal in painful feet irritations like corns, bunions, plantar warts, plantar fasciitis,
hammertoes, arch problems and circulatory problems in diabetics.

Osteopath:

Osteopathic medicine is a special science devoted to treating and healing the patient as a
whole by using methods called osteopathic manipulative treatment to make sure the body
moves freely ensuring that all the body’s healing systems are working efficiently.
Osteopath, is a doctor of osteopathic medicine (DO) who aims to improve people’s overall
health and wellness by treating the whole person, not just a condition or disease they may
have. This includes osteopathic manipulative medicine, which involves stretching,
massaging, and moving the musculoskeletal system.

Doctors Treating Problems of Specific Part of Body:

Otolaryngologist ENT Surgeon:

Otolaryngologist is a doctor who treats issues related to ears, nose, or throat as well as
related areas in head and neck. They’re called ENT Specialist for short.

Audiologist:

Audiologists are healthcare professionals who specialize in hearing and balance disorders.

Dentist:
A dentist, also known as a dental surgeon, is a health care professional who specializes in
dentistry (the diagnosis, prevention, and treatment of diseases and conditions of the oral
cavity).

Periodontist:

A periodontist is a dentist who specializes in the prevention, diagnosis, and treatment of

periodontal disease (a chronic inflammatory disease that affects the gums and bone
supporting the teeth also known as gum disease), and in the placement of dental implants.

Dermatologist:

A dermatologist is a doctor who specializes in conditions involving the skin, hair, and nails.
He/she deals with not only study, research and diagnosis of normal disorders, diseases,
cancers, cosmetic and ageing condition of the skin, hair and nails but also includes
specializations like dermato-histopathology and topical and systemic medications. It also
includes dermatological cosmetic surgery, immunotherapy, laser therapy, radiotherapy and
photodynamic therapy. Common skin diseases treated by dermatologists include skin
cancer, warts, fungal infections, dermatitis, psoriasis, acne, atomic eczema and herpes
simplex.

Ophthalmologist:

Ophthalmologists are medical doctors who specialize in the diagnosis and treatment of eye
and vision problems. He/she is a specialist trained in the medical and surgical preventive
care of the eyes. He is well trained in giving comprehensive care by carrying out visual
examinations, prescribing glasses and contact lens and treating eye ailments and diseases
such as glaucoma, cataracts, eye injuries, cornea disorders and also eyelid problems.

Doctors Treating Problems with Blood / Due to Parasites:

Parasitologist:

Parasitologists study the life cycle of parasites, the parasite-host relationship, and how
parasites adapt to different environments. They may investigate the outbreak and control of
parasitic diseases. They study protozoan and metazoan parasites and try to find ways to
spread disease. They work in a close relationship with other sciences such as immunology,
cell biology, microbiology, and molecular biology

Microbiologists

A microbiologist works is a lab personnel engaged in the study and analysis of the structure
and processes of microorganisms. They may also be engaged in collecting and analyzing
cultures and air, water and soil samples to learn about the microorganisms present in them.
They work to develop vaccines, biological medicines and biofuels.

Epidemiologist:
Epidemiologists study outbreaks of diseases, the causes, locations, and how various
communities are affected, utilizing relative information to aid in the prevention of future
outbreaks. Epidemiologists help to keep the public informed of methods to maintain and
improve public health.

Serologist:

A serologist is a medical scientist who specializes in blood serum analysis. He is often

associated with forensic investigations related to criminal inquiries, but may also be
instrumental in medical diagnostic procedures. A serologist may also examine and analyze
blood found in the place of a crime also. A serologist carries on a wide range of laboratory
tests by carrying on specific antigen and antibody reactions.

Doctors Treating Psychological Problems:

Psychiatrist:

A psychiatrist is a medical doctor who specializes in the mental health field. He/she deals
with rge prevention, diagnosis, and treatment of mental, behavioral, and emotional
disorders. He helps to enhance the quality of a person’s life by making assessments of the
mind and emotions, providing treatment and rehabilitation care to mentally disturbed
patients. They may also deal with phobias of all types. They may offer a mix of treatment in
some cases, which includes medication, psychotherapy, and counseling.

 General Psychiatrist: General Psychiatrist is a medical professional who specializes in

the study, treatment and diagnosis of mental disorder and behavioural problems.
 Neuropsychiatrists: Neuropsychiatrists is a medical professional who specializes in
mental and brain health.
 Geriatric Psychiatrist: Geriatric Psychiatrist is a medical professional who specializes
in mental complications in elderly individuals.
 Forensic Psychiatrists: Forensic Psychiatrists is a medical professional who
specializes in the study of correlation between psychology and crime.

Supporting Specialists:

Diagnostician:

A Diagnostician is a doctor who diagnoses and treats medical conditions and solves complex
medical mysteries. All Doctors are technically Diagnosticians because they diagnose
ailments.

Pathologist:

A pathologist is a specialist who examines body tissues and fluids to analyze the origin of a
disease. A pathologist generally works in laboratories on samples collected for investigation
and helps physicians and surgeons to diagnose diseases. Such pathologists are called clinical
pathologists. Other works of area are anatomical pathology, molecular pathology, surgical
pathology, forensic pathology and speech pathology.

Paleopathologist:

Paleopathologists studies evidence of trauma, disease and congenital defects in human

remains. This group of specialists may be drawn from archaeologists, geneticists, and
physical anthropologists. These specialists research the prehistoric or ancient populations,
but also study epidemics in prehistoric times.

Radiologist:

Radiologists are medical doctors that specialize in diagnosing and treating injuries and
diseases using medical imaging (radiology) procedures (exams/tests) such as X-rays,
computed tomography (CT), magnetic resonance imaging (MRI), nuclear medicine, positron
emission tomography (PET) and ultrasound.

Nuclear Medicine Practitioner:

Nuclear medicine physicians, also called nuclear radiologists, are medical specialists that use
tracers, usually radiopharmaceuticals administered by injection, swallowing, or inhalation
for diagnosis and therapy. These RA tracers are attracted to specific parts of the body and
show up as gamma rays detected externally by cameras. Nuclear medicine imaging
procedures have been successful in identifying abnormalities much earlier than radiological
procedures. Nuclear medicine practitioners carry on bone scans to examine orthopedic
injuries, fractures, tumors, or unexplained bone pain and heart scans to identify normal or
abnormal blood flow to the heart muscle, measure heart function or determine the
existence or extent of damage to the heart muscle after a heart attack. Besides they conduct
breast scans to locate cancerous tissues in the breast, and liver, gall bladder and kidney
scans to judge the functioning of liver, gallbladder and kidney. Besides they also carry on
thyroid and lung scans and also scans to detect the causes of gastrointestinal bleeding.

Diabetologist:

A Diabetologist is a doctor who specializes in the treatment of Diabetes, which is a

metabolic disorder and, therefore, forms a part of endocrinology. He deals and specializes in
diseases and conditions like diabetes mellitus type 1, diabetes mellitus type 2, non-insulin
dependent diabetes, hyperglycemia, hypoglycemia, diabetic ketoacidosis, arteriosclerosis,
peripheral neuropathy, foot ulcer and diabetic retinopathy. He may also deal in gestational
diabetes.

Dietician:

A dietitian, is an expert in identifying and treating disease-related malnutrition and in

conducting medical nutrition therapy. He/she is an expert in the field of food and nutrition.
Many individuals, companies, families, schools, hospitals and other institutions seek their
help to make meal plans that could be healthy, cost-effective and beneficial to them. They
can also help one to plan their diet to lose weight.

Physiotherapist:

A physiotherapist, or physical therapist, works with patients to help them manage pain,
balance, mobility, and motor function. He/she helps patients who have been disabled by
injury, illness and age to gain their normal range of movements, prevent further damage
and increase their functionality. A physiotherapist diagnoses the patient’s problem and
helps the patient to do physical exercises that would tone his muscles and strengthen them.
They may also do massages and stretch the patient’s muscles and offer advice regarding
nutrition, body conditioning and prophylactic care.

Forensic Medicine Expert or Coroner:

A Forensic Medicine Expert or Coroner is a medical professional who works in coordination

with others like a coronary investigator to determine the cause of death of a person who
may have died in mysterious circumstances. This medical examiner is responsible for
performing actual autopsy on the body, while a coroner investigator examines the body, the
scene of the crime. So coroner investigators may be from the medical profession, law or
with training in criminal law.

Toxicologist:

A toxicologist is engaged in the development and implementation of laboratory and field

studies to find out the short- and long- term effects of different toxins on human beings,
animals, plants and the environment. He/she also thinks of ways and means to eliminate
and minimize the negative effects of the already existing toxins.

Geneticist / Clinical Geneticist:

A clinical geneticist is a medical specialist who applies his knowledge of genetics and is
skilled enough to evaluate birth defects, genetic disorders, familial cancers and
chromosomal abnormalities. They work closely with genetic counsellors to support patients,
families and clinical teams in the management of genetic conditions. Clinical geneticists help
identify families at possible risk of a genetic condition by assessing a patient’s physical
features and medical history, gathering and analyzing family history and inheritance
patterns and calculating chances of recurrence. They provide information about genetic
testing and related procedures. A clinical geneticist could easily advice on options, including
treatment options, for patients when the doctor suspects a genetic problem.

Physiologist:

Physiologists are highly trained medical person with zeal and expertise in studying how
humans, plants, animals and cell function. A physiologist generally focuses on the
functioning of the human body such as energy procurement and utilization, blood
circulation, excretion, defence systems against infection, repair mechanisms reproduction,
nutrition, digestion, absorption, metabolism and diseases.

Conclusion:

This long list of medical specialties and subspecialties shows the many options students
have for making their career in medicine. Select a career that challenges you, aligns with
your career goals, and provides your desired lifestyle. Narrowing down your options and
working toward your intended field of medicine early on in your medical school journey can
give you an advantage
Right to Health in the Constitution
 Post authorBy Hemant More
 Post dateJuly 4, 2022
 No Commentson Right to Health in the Constitution

Law > Medical Jurisprudence > Law and Medicine > Right to Health in
the Constitution
Health is a vital indicator of human development and human development is the basic
ingredient of economic and social development. According to the World Health
Organization (WHO), health is a state of complete physical, mental and social well-being and
not merely the absence of disease. The right to health for all people means that everyone
should have access to the health services they need, when and where they need them,
without suffering financial hardship. No one should get sick and die just because they are
poor, or because they cannot access the health services they need. Good health is also
clearly determined by other basic human rights including access to safe drinking water and
sanitation, nutritious foods, adequate housing, education and safe working conditions.
Everyone has the right to privacy and to be treated with respect and dignity. Nobody should
be subjected to medical experimentation, forced medical examination, or given treatment
without informed consent. The Indian Constitution has granted certain fundamental
rights to its citizen under part III of it these rights play an important role with reference to
the health and health care.

In CESC Ltd. v. Subash Chandra Bose, AIR 1992 SC 573 case, the Supreme Court relied on
international instruments and concluded that right to health is a fundamental right. It went
further and observed that health is not merely absence of sickness: “The term health implies
more than an absence of sickness. Medical care and health facilities not only protect against
sickness but also ensure stable manpower for economic development. Facilities of health
and medical care generate devotion and dedication to give the workers’ best, physically as
well as mentally, in productivity. It enables the worker to enjoy the fruit of his labour, to
keep him physically fit and mentally alert for leading a successful economic, social and
cultural life. The medical facilities are, therefore, part of social security and like gilt edged
security, it would yield immediate return in the increased production or at any rate reduce
absenteeism on grounds of sickness, etc. Health is thus a state of complete physical, mental
and social well-being and not merely the absence of disease or infirmity.”

Constitutional Provisions:

There is no direct mention of the “Right of Health” in the Constitution. But Article 21 refers
to right to life which includes living with a good Health. In a leading case, the Supreme Court
held that the right to life implies the right to live healthy life. The Constitution of India not
only provides for the health care of the people but also directs the state to take necessary
measures to improve the condition of health of the people. Though the provisions
enshrined under this part have no direct link with the healthcare, however from various
judicial interpretations it has been established that the intention of the legislature were
there to cover the health as a right of the citizens.
Fundamental Rights:

Article 14:

Article 14 speaks about equality before law where the State shall not deny to any person
equality before the law or the equal protection of the laws within the territory of India.

Article 15:

Article 15 contains provisions for a particular application of the general principle of ‘equality
of treatment’ embodied in Article 14. It prohibits discrimination against citizens on the
grounds only of religion, race, caste, sex, place of birth or any of them. Even nothing in this
Article shall prevent the State from making any special provision for women and children for
their betterment of life.

Article 19(1)(g):

According to Article 19 (1) (g) all citizens shall have the right to practice any profession, or
carry on any occupation, trade or business subject to restrictions imposed in the interest of
general public under clause (6) of Article 19.

In Burrabazar Fire Works Dealers Association v. Commissioner of Police, Calcutta, AIR 1998
Cal 121 case, the Supreme Court held that Article 19 (1) (g) does not guarantee the freedom
which takes away that community’s safety, health and peace.

Article 21:

According to Article 21 of the Constitution of India “no person shall be deprived of his/her
life or personal liberty except according to the procedure established by law. Right to life
under Article 21 of the Constitution has been generously deciphered to mean something
more than only human presence and incorporates the right to live with nobility and
conventionality. The use of word ‘Life’ in Article 21 of the Constitution has a lot more
extensive importance which includes human nobility, the right to livelihood, right to health,
right to pollution free air, and so forth.

In Bandhua Mukti Morcha v. Union of India, AIR 1984 SC 802 case, Bhagwati, J. observed:
“This right to live with human dignity enshrined in Article 21 derives its life breath from the
Directive Principles of State Policy and Particularly clauses (e) and (f) of Article 39 and Article
41 and 42.” Since the Directive Principles of State Policy are not enforceable in a Court of
law, it may not be possible to compel the State through judicial process to make provision
by statutory enactment or executive fiat for ensuring these basic essentials which go on to
ensure a life of human dignity.

In Paschim Banga Khet Mazdoor Samity v. State of West Bengal, (1996) 4 SCC 37 case,
while widening the scope of Article 21 and the government’s responsibility to provide
medical aid to every person in the country, the Apex Court held that in a welfare state, the
primary duty of the government is to secure the welfare of the people. Providing adequate
medical facilities for the people is an obligation undertaken by the government in a welfare
state. The government discharges this obligation by providing medical care to the persons
seeking to avail of those facilities.

In Unnikrishnan, J.P. v. State of Andhra Pradesh, AIR 1993 SC 2178 case, the Court held
that the maintenance and improvement of public health is the duty of the State to fulfil its
constitutional obligations cast on it under Article 21 of the Constitution.

In the State of Punjab v. M.S. Chawla, AIR 1997 SC1225 case, the Court held that-the right
to life ensured under Article 21 incorporates inside its ambit the right to health and clinical
consideration.

in Consumer Education and Research Center v. Union of India, AIR 1995 SC 922 case, the
Supreme Court held that right to health, medical aid to protect the health and vigour of a
worker while in service or postretirement is a fundamental right under Article 21.

In Parmananda Katara Vs Union of India, AIR 1989 SC 2039 case, the apex court held that
every doctor is bound to provide medical aid to the victims irrespective of the cause of
injury; he cannot take any excuse of allowing law to take its course. Hence, if now a doctor
refuses treatment, in case of emergency, he/she could be sued under the law. Once the
doctor accepts the case and starts treatment, then the doctor-patient relationship is
established. The Court further stated that preservation of health is of paramount
importance. Once life is lost it cannot be restored. Hence, it is the duty of doctors to
preserve life without any kind of discrimination.

Article 32:

Under Article 32 of the Constitution, any person whose fundamental rights are violated can
approach the Supreme Court for restoration of his fundamental right. Similarly, under
Article 226 of the Constitution, any person whose fundamental rights are violated can
approach High Court of respective State for restoration of his fundamental right.

Directive Principles:

The Directive Principles of State Policy (DPSP), enshrined in Chapter IV of the Constitution of
India, require the state to, among other duties.

Article 38:

Article 38 provides that, “the State shall strive to promote the welfare of the people by
securing and protecting, as effectively as it may, a social order in which justice– — social,
economic and political, shall inform all the institution of the national life”. Thus, a
constitutional liability is imposed on state that the State will secure a social order for the
promotion of welfare of the people including public health because without public health
welfare of people is practically meaningless.
Article 39:

Article 39 enjoins upon the State that (i) that the health and strength of workers and the
tender age of children are not abused and that citizens are not forced by economic necessity
to enter avocations unsuited to their age or strength and (ii) that children are given
opportunities and facilities to develop in a healthy manner and in conditions of freedom and
dignity and that childhood and youth are protected against exploitation and against moral
and material abandonment.

In Lakshami Kant Pandey v. Union of India, 1987 AIR 232 case, Bhagawati, J. while
delivering the opinion of the court observed that: “It is obvious that in civilized society the
importance of child welfare cannot be overemphasized because the welfare of the entire
community, its growth and development depends upon the health and well-being of its
children. Children are a „supremely important national asset and the future well-being of
the nation depends on how its children grow and develop.”

In Sheela Barse v. Union of India, 1986 SCALE (2) 230 case, the Supreme Court held that “A
child is a national asset and therefore, it is the duty of the State to look after the child with a
view to ensuring full development of its Personality.”

Article 41:

Article 41 deals with right to work, education and public assistance in certain cases and thus
imposed duty on the State to public assistance basically for those who are old, sick and
disable. This Article specifically says that “the state shall within the limits of its economic
capacity and development, make effective provisions for securing the right to work, to
education and to public assistance in case of unemployment, old age, sickness and
disablement, and in other cases of undeserved want”. Their implications in relation to
health are obvious.

In Mahendra Pratap Singh v. State of Orissa, AIR 1997 Ori 37 case, the Court held that in a
country like ours, it may not be possible to have sophisticated hospitals but definitely
villagers within their limitations can aspire to have a Primary Health Centre. The government
is required to assist people, get treatment and lead a healthy life. Thereby, there is an
implication that the enforcing of the right to life is a duty of the state and that this duty
covers the providing of right to primary health care.

Article 42:

Article 42 provides for just and humane conditions of work and maternity relief and gives
the power to the State for making provisions in this regard, which implies that this Article is
intended to protect the health of infants and mothers by providing maternity benefit.

In U.P.S.E. Board v. Harishankar, AIR 1980 SC 65 case, the Supreme Court held that Article
42 provides the basis of the larger body of labour law in India. Further referring to Article 42
and 43, the Supreme Court has emphasized that the Constitution expresses a deep concern
for the welfare of the workers. The Court may not enforce the Directive Principles as such,
but they must interpret law so as to further and not hinder the goal set out in the Directive
Principles.

In P Sivaswamy v. State of Andhra Pradesh, AIR 1988 SC 1863 case, the Supreme Court held
that Article 42 of the Constitution makes it the obligation of the State to make provisions for
securing just and humane conditions of work. There are several Articles in Part IV of the
Constitution which indicate that it is the State’s obligation to create a social atmosphere
befitting human dignity for citizens to live in.

Article 43:

Article 43 lays down that alia that the State must endeavour to secure a decent standard of
life to all workers.

Article 45:

Article 45 lays down that the State must endeavour to provide any childhood care and
education to all children under the age of six years.

Article 47:

Article 47 imposes duty on the State to raise the level of nutrition and the standard of living
and to improve public health. It categorically provides that “the State shall regard the raising
of the level of nutrition and the standard of living of its people and the improvement of
public health as among its primary duties and, in particular, the State shall endeavour to
bring about prohibition of the consumption except for medicinal purposes of intoxicating
drinks and of drugs which are injurious to health.”

In Vincent Panikurlangara v. Union of India, AIR 1987 SC 994 case, the Court stated that
“maintenance and improvement of public health have to rank high as these are
indispensable to the very physical existence of the community and on the betterment of
these depends, the building of the society of which the Constitution makers envisaged.
Attending to public health, in our opinion, therefore is of high priority perhaps the one at
the top”. The Supreme Court while interpreting Article 47 has rightly stated that
public health is to be protected for the betterment of the society. Further it has been held
that, in this welfare era raising the level of nutrition and improvement in standard of living
of the people are primary duties of the State.

Article 48A:

Article 48A ensures that State shall endeavour to protect and impose the pollution free
environment for good health.

In M.C. Mehta v. Union of India, Writ Petition (civil) 13029 of 1985 Case, the Court held
that, “Art 39 (a), 47 and 48-A by themselves and collectively cast a duty on the State to
secure the health of the people, improve public health and protect and improve the
environment”
In Virender Gaur v. State of Haryana, 1995 (2) SCC 577 case, the Supreme Court held that
environmental, ecological, air and water pollution, etc., should be regarded as amounting to
violation of right to health guaranteed by Article 21 of the Constitution.

Fundamental Duties:

Article 51A:

Article 51 A (g) under Part IV – A of the Constitution says that “it shall be the duties of every
individual to protect and improve the natural environment including forests, lakes, rivers
and wild life, and to have compassion for living creatures.”

Euthanasia:

Euthanasia is described as the deliberate and intentional killing of a person for the benefit of
that person in order to relieve him from pain and suffering. The term ‘Euthanasia’ is derived
from the Greek words which literally means “good death” (Eu= Good; Thanatos=Death).
Euthanasia is defined as the act of bringing the death of a person (patient) for the purpose
of relieving the patient’s intolerable and incurable suffering. Typically, the physician’s
motive is merciful and intended to end suffering. In voluntary euthanasia, a consent from
the patient is taken. In non-voluntary euthanasia, the consent of patient is unavailable due
to some reason.

In active euthanasia, the death of patient is brought directly by giving him a lethal dose of
poisonous drug. In passive euthanasia, the life supporting system to the patient is
discontinued and ultimately patient dies. In Aruna Shanbaug v. Union of India, the Supreme
Court opposed active euthanasia but has given nod to passive euthanasia.

Conclusion:

From the above discussion, it is evident that right to life also includes right to health and
therefore the state and its instruments, are duty bound to provide health care facilities and
services to all its citizens without any discrimination. The Constitution also stipulates certain
duties for the citizens towards contributing to the promotion of health in the country.
National Medical Commission
 Post authorBy Hemant More
 Post dateJanuary 26, 2021
 No Commentson National Medical Commission

Law > Medical Jurisprudence > National Medical Commission

In this article, we shall study the former association of medical professionals called the
Medical Council of India and present the National Medical Commission (NMC)

Medical Council of India is a statutory body. Initially, it was set up in 1934 under the Indian
Medical Council Act, 1933. The Council was later reconstituted under the Indian Medical
Council Act, 1956 that supplanted the 1934 Act. Thus The Medical Council of
India (MCI) was set up under the Medical Council Act 1956, for setting standards for medical
professionals, new medical colleges, and revision of curriculum, among others. It establishes
the uniform and high standards of medical education in India. It also registers doctors to
practice in India.

Objectives:

 To promote and advance medical and allied sciences in all their different branches
and to promote the improvement of public health and medical education in India
 To maintain the honour and dignity and to uphold the interest of the medical
profession and to promote co-operation amongst the members thereof;
 To work for the abolition of compartmentalism in medical education, medical
services, and registration in the country and to achieve equality among all members
of the profession.

Amid allegations of corruption against MCI office bearers and probe into opaque
accreditation to medical colleges, the Supreme Court in May 2016 directed the government
to set up an oversight committee with the authority to oversee all statutory functions of
MCI until the new legislation comes in. In view of these developments and to put an
alternative mechanism in place of MCI so as to bring transparency, accountability, and
quality in the governance of medical education in the country.

The NITI Aayog has suggested the substitution of the Medical Council of India (MCI) with the
National Medical Commission (NMC). Accordingly, it was decided to supersede the
MCI through the Indian Medical Council (Amendment) Ordinance, 2018, promulgated on
26th September 2018, and entrust its affairs to a Board of Governors consisting of eminent
doctors. Once the National Medical Commission becomes operational, the Board of
Governors will be dissolved. In April 2020, due to the COVID-19 pandemic, the Medical
Council of India permitted the practice through telemedicine by its registered medical
practitioners. The practice of Telemedicine involves remote diagnosis and treatment of
patients through telecommunications such as video, phone, and apps.
National Medical Commission Act, 2019:

National Medical Commission Bill, 2019 was introduced by the Minister of Health and Family
Welfare, Dr Harsha Vardhan in Lok Sabha on July 22nd 2019. The Bill seeks to repeal the
Indian Medical Council Act, 1956. The Bill was passed in Lok Sabha on July 29, 2019. It was
passed in Rajya Sabha in August 2019.

Objectives of National Medical Commission Act 2019:

 To set up of the National Medical Commission (NMC), for development and

regulation of all aspects of medical education, profession and institutions.
 To make sure that there are sufficient highly qualified medical professionals.
 To give an impetus to Grievance Redressal Mechanisms.
 Medical Institutions will be evaluated to make sure that standards do not
deteriorate.
 To make sure that medical professionals give importance to medical research and
adopt the latest developments in the field of medical science.

National Medical Commission (NMC):

The National Medical Commission (NMC) has been constituted by an act of Parliament
known as the National Medical Commission Act, 2019 which came into force on 25.9.2020
by gazette notification dated 24.9.2020. The Board of Governors in supersession of Medical
Council of India constituted under section 3A of the Indian Medical Council Act, 1956 stands
dissolved thereafter. The head office of the Commission shall be at New Delhi.

Objectives:

The Aim of the National Medical Commission are

 To improve access to quality and affordable medical education,

 To ensure availability of adequate and high-quality medical professionals in all parts
of the country;
 To promote equitable and universal healthcare that encourages community health
perspective and makes services of medical professionals access to all the citizens;
 To encourages medical professionals to adopt latest medical research in their work
and to contribute to research;
 To objectively assess medical institutions periodically in a transparent manner;
 To maintain a medical register for India;
 To enforce high ethical standards in all aspects of medical services;
 To have an effective grievance redressal mechanism.
Constitution of the National Medical Commission:

 The Act sets up the National Medical Commission (NMC).

 As per the Act, State Governments need to set up State Medical Councils.
 The National Medical Commission will consist of 25 members and will include
Chairperson, Presidents of Post Graduate Medical Education Boards and
Undergraduate Education Boards, Director General of Indian Council of Medical
Research (ICMR), and Director General of Health Services.

Functions of the National Medical Commission:

 lay down policies for maintaining a high quality and high standards in medical
education and make necessary regulations in this behalf;
 lay down policies for regulating medical institutions, medical researches and medical
professionals and make necessary regulations in this behalf;
 assess the requirements in healthcare, including human resources for health and
healthcare infrastructure and develop a road map for meeting such requirements;
 promote, co-ordinate and frame guidelines and lay down policies by making
necessary regulations for the proper functioning of the Commission, the
Autonomous Boards and the State Medical Councils;
 ensure co-ordination among the Autonomous Boards;
 take such measures, as may be necessary, to ensure compliance by the State
Medical Councils of the guidelines framed and regulations made under this Act for
their effective functioning under this Act;
 exercise appellate jurisdiction with respect to the decisions of the Autonomous
Boards;
 lay down policies and codes to ensure observance of professional ethics in medical
profession and to promote ethical conduct during the provision of care by medical
practitioners;
 frame guidelines for determination of fees and all other charges in respect of fifty
per cent. of seats in private medical institutions and deemed to be universities which
are governed under the provisions of this Act;
 exercise such other powers and perform such other functions as may be prescribed.

National Medical Commission (NMC) – Autonomous Boards:

The National Medical Commission will have 4 Boards. They are

1. Under-Graduate Medical Education Board (UGMEB)

2. Post-Graduate Medical Education Board (PGMEB)
3. Medical Assessment and Rating Board
4. Ethics and Medical Registration Board.

Functions of UGMEB:
  Determine standards of medical education at the undergraduate level and oversee
all aspects relating thereto;
 Develop competency-based dynamic curriculum at the undergraduate level in
accordance with the regulations made under this Act;
 Develop competency-based dynamic curriculum for addressing the needs of primary
health services, community medicine, and family medicine to ensure healthcare in
such areas, in accordance with the provisions of the regulations made under this Act;
 Frame guidelines for setting up of medical institutions for imparting undergraduate
courses, having regard to the needs of the country and the global norms, in
accordance with the provisions of the regulations made under this Act;
 Determine the minimum requirements and standards for conducting courses and
examinations for undergraduates in medical institutions, having regard to the needs
of creativity at local levels, including designing of some courses by individual
institutions, in accordance with the provisions of the regulations made under this
Act;
 Determine standards and norms for infrastructure, faculty, and quality of education
in medical institutions providing undergraduate medical education in accordance
with the provisions of the regulations made under this Act;
 Facilitate development and training of faculty members teaching undergraduate
courses;
 Facilitate research and the international student and faculty exchange programs
relating to undergraduate medical education;
 Specify norms for compulsory annual disclosures, electronically or otherwise, by
medical institutions, in respect of their functions that has a bearing on the interest of
all stakeholders including students, faculty, the Commission and the Central
Government;
 Grant recognition to a medical qualification at the undergraduate level.

Functions of PGMEB:

 Determine the standards of medical education at the postgraduate level and super-
speciality level in accordance with the regulations made under this Act and oversee
all aspects relating thereto;
 Develop competency based dynamic curriculum at postgraduate level and super-
speciality level in accordance with the regulations made under this Act, with a view
to develop appropriate skill, knowledge, attitude, values and ethics among
postgraduates and super-specialists to provide healthcare, impart medical education
and conduct medical research;
 Frame guidelines for setting up of medical institutions for imparting postgraduate
and super-speciality courses, having regard to the needs of the country and global
norms, in accordance with the regulations made under this Act;
 Determine the minimum requirements and standards for conducting postgraduate
and super-speciality courses and examinations in medical institution, in accordance
with the regulations made under this Act;
 Determine standards and norms for infrastructure, faculty and quality of education
in medical institutions conducting postgraduate and super-speciality medical
education, in accordance with the regulations made under this Act;
  Facilitate development and training of the faculty members teaching postgraduate
and super-speciality courses;/li>
 Facilitate research and the international student and faculty exchange programmes
relating to postgraduate and super-speciality medical education;
 Specify norms for compulsory annual disclosure, electronically or otherwise, by
medical institutions in respect of their functions that has a bearing on the interest of
all stakeholders including students, faculty, the Commission and the Central
Government;
 Grant recognition to the medical qualifications at the postgraduate level and super-
speciality level;
 Promote and facilitate postgraduate courses in family medicine.

Functions of Medical Assessment and Rating Board:

 Determine the procedure for assessing and rating the medical institutions for their
compliance with the standards laid down by the Under-Graduate Medical Education
Board or the Post-Graduate Medical Education Board, as the case may be, in
accordance with the regulations made under this Act;
 Grant permission for establishment of a new medical institution, or to start any
postgraduate course or to increase number of seats, in accordance with the
regulations made under this Act;
 Carry out inspections of medical institutions for assessing and rating such institutions
in accordance with the regulations made under this Act;
Provided that the Medical Assessment and Rating Board may, if it deems necessary,
hire and authorise any other third party agency or persons for carrying out
inspections of medical institutions for assessing and rating such institutions:
Provided further that where inspection of medical institutions is carried out by such
third party agency or persons authorised by the Medical Assessment and Rating
Board, it shall be obligatory on such institutions to provide access to such agency or
person;
 Conduct, or where it deems necessary, empanel independent rating agencies to
conduct, assess and rate all medical institutions, within such period of their opening,
and every year thereafter, at such time, and in such manner, as may be specified by
the regulations;
 Make available on its website or in public domain the assessment and ratings of
medical institutions at regular intervals in accordance with the regulations made
under this Act;
 Take such measures, including issuing warning, imposition of monetary penalty,
reducing intake or stoppage of admissions and recommending to the Commission for
withdrawal of recognition, against a medical institution for failure to maintain the
minimum essential standards specified by the Under-Graduate Medical Education
Board or the Post-Graduate Medical Education Board, as the case may be, in
accordance with the regulations made under this Act.

Functions of Ethics and Medical Registration Board:

 Maintain National Registers of all licensed medical practitioners;

  Regulate professional conduct and promote medical ethics in accordance with the
regulations made under this Act:
Provided that the Ethics and Medical Registration Board shall ensure compliance of
the code of professional and ethical conduct through the State Medical Council in a
case where such State Medical Council has been conferred power to take disciplinary
actions in respect of professional or ethical misconduct by medical practitioners
under respective State Acts;
 Develop mechanisms to have continuous interaction with State Medical Councils to
effectively promote and regulate the conduct of medical practitioners and
professionals;
 Exercise appellate jurisdiction with respect to the actions taken by a State Medical
Council.

National Medical Council (NMC) – Functions

1. Medical institutions and Medical Professionals will be regulated.

2. State Medical Councils will have to comply with the guidelines issued by the council.
3. To handle the exorbitant fees charged in private institutions, this Act provides
authority to the Council to fix the fees for 50% of the seats in private medical
colleges including deemed universities.
4. Assess the requirements of healthcare-related infrastructure and human resources.

Medical Advisory Council

1. Under the National Medical Commission Bill 2019, the Central Government will
constitute a Medical Advisory Council (MAC).
2. The Council will advise the NMC on measures to determine and maintain standards
of medical education.

National Exit Test (NEXT)

1. As per the NMC Act, it has proposed a common final year MBBS exam which will be
known as National Exit Test (NEXT).
2. NEXT results would be used for obtaining a license to practice and will also be used
for admissions to Post – Graduate Medical Courses.
3. It would also act as an entrance test for medical graduates from other nations.

Ranking of Medical Colleges

1. Medical Colleges would be ranked by the Medical Assessment and Rating Board of
the National Medical Commission.
2. Ranking systems would help students to choose their institutes.
3. It would also help in the transparent admission proces

Medical Ethics

 Post authorBy Hemant More

  Post dateJanuary 26, 2021
 No Commentson Medical Ethics

Law > Medical Jurisprudence > Medical Ethics

Morality and ethics are exclusively matters of human concern. It is deeply influenced by
several factors, such as history, traditions, education and culture, and so on. The term
‘ethics’ refers to understanding and implementing moral values within a society. It is related
to the value perspectives and principles that regulate our daily activities. Ethics is the study
of the rightness or wrongness of human conduct or the philosophical study of morality. The
term ethics is derived from ethos, which means the distinguishing character or guiding
beliefs of a person, institution, etc. Different branches of ethics are Metaethics, normative
ethics, and applied ethics. Metaethics studies philosophical questions about the meaning of
ethical words, or the nature of ethical facts. Normative ethics studies what features make
something good/bad, an act right/wrong, or a trait virtuous or vicious. Applied ethics deals
with difficult moral questions and controversial moral issues that people actually face in
their lives. Medical ethics is a branch of applied ethics.

Applied Ethics:

Applied ethics deals with difficult moral questions and controversial moral issues that
people actually face in their lives. Applied ethics is further classified into three types:
bioethics, business or professional ethics, and environmental ethics. Bioethics refers to the
study of ethical issues in healthcare, reproduction, biology, and genetics. Business or
professional ethics is the application of theories of right and wrong to transactions and
activity within and between commercial enterprises and between commercial enterprises
and their broader environment. Environmental ethics deals with questions of rightness and
value regarding our relationship with the rest of the natural world.

Bioethics:

Bioethics refers to the study of ethical issues in healthcare, reproduction, biology, and
genetics. It includes in its scope, medical ethics, nursing ethics, and ethical issues raised in
the other paramedical and welfare professions such as psychiatric care and social work. It
also refers to a number of moral issues that arise in the context of life-saving and life-
enhancing technologies, reproductive technologies, and the technology that concerns
genetic engineering. Broadly bioethics refers to ‘medical ethics’ and the social, ethical,
economic problems in the context of medical ethics. It includes social issues like abortion,
suicide, euthanasia, surrogacy, informed consent, doctor-patient relationship, etc.

Medical Ethics:

Medical ethics, though a part of bioethics, has now become a separate discipline in itself
due to its vast area of inquiry. Medical ethics is the analysis of choices and decisions in the
medical sphere. It includes the rights and obligations of patients and physicians on the basis
of social values. It has to consider not only health care but also a harmonious living of
human being in society. The development of medical ethics took place not only by the
progress of science but also by the progress of human thinking. The historical progress of
humanity and the concept of human dignity have also been reflected in the progress of
medical ethics.

Four Principles of Medical Ethics:

Tom L. Beauchamp and James F. Childress in their book “The Principle of Biomedical Ethics”
proposed four principles of medical ethics. These principles are

 The Principle of Autonomy

 Non-maleficence
 Beneficence and
 Justice

The Principle of Respect of Autonomy:

Autonomy literally means self-rule and it refers to the ability to act independently without
the influence of others. It is the capacity to think, decide and act out of the freedom of
thought of one’s own. It also includes liberty, rights, choice, individual privacy, freedom of
will, and acknowledgment of the capacity of an individual to make his/her own decisions,
etc. the social and economic conditions of the patient determine the autonomy. In medical
practice, autonomy is usually expressed as the right of competent adults to make informed
decisions about their own medical care. The principle underlies the requirement to seek
the consent or informed agreement of the patient before any investigation or treatment
takes place. Where patients lack the capacity to make a decision, it follows necessarily that
decisions must be made on their behalf. Family or friends stand as important agents in
decision-making when medical professionals deal with the chronic condition of a patient.

In the medical profession, the principle of autonomy means that patient has the autonomy
to act independently and to take decisions on the basis of information received from
physicians, and choose a course of treatment. Similarly, for taking a decision, the patient
and the patient’s family should respect other fellow patients and physicians. Neither the
patient nor the decision should be either controlled or imposed upon him by another
individual or a group of individuals. It is to be noted that an infant, lacks this competence to
take decisions, and thus the question of autonomy in the context of medical decisions in the
case of infants does not arise. Similarly, a patient in a vegetative state or in a coma is
incapable of making medical decisions.

Requirements:

 The patient has full autonomy of thought, intention, and action when making
decisions regarding health care procedures.
 The decision-making process must be free of coercion or coaxing.
 In order for a patient to make a fully informed decision, she/he must understand all
risks and benefits of the procedure and the likelihood of success.

The Principle of Non-maleficence:

The principle of non-maleficence expresses the rule “do not harm”, which means we should
not intentionally create harm or injury to others either through acts of commission or
omission. This principle of non-maleficence has greater importance in the medical field
because the negligence or carelessness of health care professional creates harm to patient.

According to Childress and Beauchamp the principle of non-maleficence includes number of

specific moral rules which supports a number of specific rules, including the following:

 Do not kill.
 Do not cause pain or suffering.
 Do not incapacitate.
 Do not cause offense.
 Do not deprive others of the good life

There are however many occasions when the physician has to cause some harm to the
patient, which results in some good of the patient himself. Such an action won’t be termed
as a violation of the principle of non-maleficence. For example, during surgery, the surgeon
uses sharp edged instruments for conducting operations, which is beneficial for the patient.
A harmful act will be considered justifiable when there is a just and lawful excuse for the
apparent harmful act. Thus according to this principle, no deliberate harm is caused to the
patient and also makes certain that if any harm or injury is inevitable it is only in order to
bring about a greater good to secure the patient’s health.
Principle of Beneficence:

The term beneficence denotes acts of mercy, kindness and charity. It includes love, altruism
and a sense of humanity. Under the principle of beneficence, one ought to prevent harm
and promote good. According to Childress and Beauchamp, the principle of beneficence
supports a number of specific rules, including the following:

 Protect and defend the rights of others

 Prevent harm from occurring to others.
 Remove conditions that will cause harm to others.
 Help persons with disabilities.
 Rescue persons in danger

Try to understand in the principle of non-maleficence the rules are negative. They start with
“do not”, while in the principle of beneficence are positive. They ask prompts the health
care provider to take a positive step to prevent harm to the patient. But the principle of
beneficence raises the question of who should be the judge for the best of the patient.

Principle of Justice:

Principle of justice in medical ethics means that medical resources should be available to all
patients in an equitable manner. For example, if there are two patients in a hospital, both in
a similar situation with reference to the state of health, they ought to be treated in exactly
the same manner regardless of their financial or social status. This principle of justice is
traditionally attributed to Aristotle and it says that equals must be treated equally and
unequal must be treated unequally. This principle of justice is also called the principle of
formal equality. In medicine all persons irrespective of age, sex etc. should be equally
treated in terms of medical care.

According to Childress and Beauchamp, proposed each of the following principles as a valid
material principle of distributive justice;

 to each person an equal share

 to each person according to need
 to each person according to effort
 to each person according to contribution
 to each person according to merit
 to each person according to free market exchanges

Case Study:

Let us study the principles of medical ethics with the following case study: A middle aged
married female patient has an ovarian cyst that, if left untreated, will result in renal (kidney)
failure. An operation to remove the cyst is the best treatment for the problem. The patient
is frightened of needles and is against the surgery.
In given case study the patient is frightened of needles and is against the surgery (her
autonomy). For performing the operation anaesthesia must be administered using needles.
During surgery, sharp-edged instruments are used for making cuts in the body. During
operation under the influence of anaesthesia, she may not feel the pain but when the effect
of anaesthesia diminish she can feel the pain inflicted during the operation. The medical
professional must work with the patient to respect the fact that she dislikes needles and
doesn’t want the operation, and must explain the benefit of being operated that the
operation would prevent her from going into renal failure, which is in her best interest
(beneficence). This principle of beneficence clashes with the principle of respect for
autonomy. The benefits of acting beneficently would need to be weighed against the dis-
benefits of failing to respect the patient’s autonomy. If without getting consent from the
patient, if she is administered anaesthesia, she would resist and may get harmed. The health
professional should avoid anything that would harm the patient (non-maleficence). Now the
decision of patient should be viewed with respect to other patients. The doctor needs to
consider the impact that the patient’s choices might have on others if she starts to go into
preventable kidney failure, she’ll need dialysis, which affects other people who need the
same treatment (justice). Similarly, the cost-effectiveness of patient’s decision must be
considered. Thus before making the final decision the doctor must consider all the four
principles of health care ethics, which will help the physician make the choice that will have
the best possible benefits for both the patient and society.

UNESCO Universal Declaration on Biomedical Ethics and Human Rights:

UNESCO has contributed to the formulation of basic principles in bioethics through in

particular the Universal Declaration on the Human Genome and Human Rights, adopted
unanimously and by acclamation by the General Conference in 1997 and endorsed by the
United Nations General Assembly in 1998, and the International Declaration on Human
Genetic Data, adopted unanimously and by acclamation by the General Conference on 16
October 2003

The UNESCO Universal Declaration on Biomedical Ethics and Human Rights identifies fifteen
biomedical principles

1. Human dignity and human rights.

2. Benefit and harm.
3. Autonomy and individual responsibility.
4. Consent.
5. Persons without the capacity to consent.
6. Respect for human vulnerability and personal integrity.
7. Privacy and confidentiality.
8. Equality, justice and equity.
9. Non-discrimination and non-stigmatization.
10. Respect for cultural diversity and pluralism.
11. Solidarity and cooperation.
12. Social responsibility and health.
13. Sharing of benefit.
14. Protecting future generation.
 15. Protection of the environment; the biosphere and biodiversity.

Conclusion:

Medical ethics is the analysis of choices and decisions in the medical sphere. It includes the
rights and obligations of patients and physicians on the basis of social values. It has to
consider not only health care but also a harmonious living of human being in society. The
four principle of ethics applied to the field of medicine are that of autonomy, non-
maleficence, Beneficence, and justice. According to these principles for a patient’s choice to
be autonomous, the decision taken by the patient ought to be a voluntary one, the choice
made by the patient must be adequately informed and the patient must have the capacity
to take the decision. Similarly, no deliberate harm is caused to the patient and also makes
certain that if any harm or injury is inevitable it is only in order to bring about a greater good
to secure the patient’s health and for the benefit of the patient. A care should be taken that
medical resources are available to all patients in an equitable manner

Medical Negligence

 Post authorBy Hemant More

 Post dateJuly 4, 2022
 No Commentson Medical Negligence

Law > Medical Jurisprudence > Law and Medicine > Medical Negligence

A tort is a residuary civil wrong. Duties in tort are fixed by the law and such duties are owed
in rem or to the people at large generally. Such wrongs can be remedied by filing for
unliquidated damages. Negligence is a tort. A negligence is the omission to do something
which a reasonable man, guided by those considerations which ordinarily regulate the
conduct of human affairs, would do or doing something which a prudent and reasonable
man would not do. In this article, we shall discuss medical negligence.

Medical Negligence basically is the misconduct by a medical practitioner or doctor by not

providing enough care resulting in breach of their duties and harming the patients which are
their consumers. Medical negligence occurs when a doctor, dentist, nurse, surgeon or any
other medical professional performs their job in a way that deviates from this accepted
medical standard of care. A medical professional is not liable in all cases where a patient has
suffered an injury. He might have a valid defense that he has not breached the duty of care.

Medical negligence has caused many deaths as well as adverse results to the patient’s
health. Some examples of medical negligence are as follows:

 improper administration of medicines.

 performing the wrong or inappropriate type of surgery.
 not giving proper medical advice.
 leaving any foreign object in the body of the patient such as a sponge or bandage,
etc. after the surgery.

Mens Rea at Medical Negligence:

Negligence is a tort. The concept of mens rea is not applicable in torts. If doctor’s rash or
negligent act endangers human life or personal safety of his patient, he can be tried for
criminal liability. In Jacob Mathew case the Court held that in criminal law medical
professionals are placed on a pedestal different from ordinary mortals. It was further held
that to prosecute the medical professionals for negligence under criminal law, something
more than mere negligence had to be proved. Medical professionals deal with patients and
they are expected to make the best decisions in the circumstances of the case. Sometimes,
the decision may not be correct, and that would not mean that the medical professional is
guilty of criminal negligence. Such a medical professional may be liable to pay damages but
unless negligence of a high order is shown the medical professionals should not be dragged
into criminal proceedings.

In King v. Phillips, (1953) 1 QB 429 case, the Court observed that the question of negligence
arises only when there is a direct harm to the plaintiff by the misconduct and the harm
should be foreseeable. Damage is an important ingredient to bring negligence under tort.

In Calcutta Medical Research Institute vs Bimalesh Chatterjee December 09,1998 case, the
Court held that the onus of proving proofs against negligence and deficiency in service was
clearly on the complainant.

In Sishir Rajan Saha v. The state of Tripura, AIR 2002 Guwahati 102 case, the Court
held that if a doctor did not pay enough attention to the patients in government hospitals as
a result of which the patient suffers, the doctor can be held liable to pay compensation to
the patient.

In State of Haryana v. Smt Santra, 24 April, 2000 case, the Supreme Court held that it is the
duty of every doctor to act with a reasonable degree of care. However, no human in this
world is perfect and even specialists make mistakes, a doctor can be made liable only if he
fails to act with such reasonable care that every doctor with ordinary skills would be able to
do.

Types of Medical Negligence:

Misdiagnosis:

The first step in any medical treatment is diagnosis. When a medical professional fails to
diagnose what condition a patient is suffering from, then it may result in misdiagnosis. if a
patient is not treated properly due to any mistake in diagnosis, the doctor can be made
liable for any further injury or damages caused as a result of the wrong diagnosis.

In V. Kishan Rao Vs Nikhil Super Speciality Hospital, 8 March, 2010 case, where a lady who
was to undergo the treatment for malaria fever was treated differently. An officer in the
Malaria Department filed a suit against the hospital authorities for performing the
treatment of his wife negligently, who was undergoing the treatment for typhoid fever
instead of malaria fever. The husband got the compensation. In this case, the principle
of res Ipsa loquitor was applied.
Delayed Diagnosis:

A delayed diagnosis is treated as medical negligence if another doctor would have

reasonably diagnosed the same condition in a timely fashion. A delay in diagnosis can lead
to an undue injury to the patient if the illness or injury is allowed to progress rather than
being treated. In these cases the doctor / hospital / clinic may even be held liable for any
damages resulting from the delay in diagnosis and treatment.

Surgical Negligence:

Medical negligence during a surgical procedure can often result in further surgeries,
infection and sepsis, internal organ damage, immune system failure and even death.
surgery, unintentional lacerations of an internal organ, uncontrolled blood loss, perforation
of an organ or a foreign object being left in the patient’s body.

Unnecessary Surgery:

Unnecessary surgery is usually associated with the misdiagnosis of patient symptoms or a

medical decision without proper consideration of other options or risks. Sometimes surgery
is chosen over more conventional treatments for their expediency and ease compared to
other alternatives. Surgical negligence can also take place where an operation wasn’t
necessary in the first place or the patient didn’t fully consent.

Errors in Anesthesia:

Anesthesia is a risky part of any major medical operation and requires a specialist
(anesthetist) to administer and monitor its effect on the patient. Medical negligence can
occur as a result of the improper application anesthesia or a failure to monitor how it is
impacting the patient. The results can range from patients waking up during surgery to brain
damage as a result of a lack of oxygen.

In Jagdish Ram v. State of H.P., AIR 2007 (NOC) 2498 (H.P.) case, the Court held that before
performing any surgery the chart revealing information about the amount of anesthesia ad
allergies of the patient should be mentioned so that an anesthetist can provide ample
amount of medicines to the patient. The doctor in above case failed to do so as a result of
the overdose of anesthesia the patient died and the doctor was held liable for the same.

Childbirth Trauma and Labour Malpractice:

There are many instances of medical negligence during childbirth including the mishandling
of a difficult birth, complications with induced labour, misdiagnosis of a new-born medical
condition, etc. Birth injuries can include any harm the mother or baby suffers either during
and after the pregnancy. These injuries can have life-changing ramifications for both mother
and child.

In Jasbir Kaur v. State of Punjab, AIR 1995 P H 278 case, a newly born child was found
missing from the bed in a hospital. The child was found bleeding and near the wash-basin of
the bathroom. The hospital authorities argued that the child had been taken away by a cat
which caused the damage to him. The court held that the hospital authorities were
negligent and had not taken due care and precaution. The Court awarded the
compensation.
Negligent Long-Term Treatment:

Most medical conditions are not cured overnight. Instead, it is likely that a patient will need
long-term treatment or care. Where a medical professional fails to monitor the impact of
the treatment properly or does not schedule the correct follow-up appointment, medical
negligence can take place.

Prescription and Medication Errors:

These mistakes may take the form of the wrong medication or dosage being given to the
patient, medications being prescribed together that should not be, or medications being
given to patients despite knowing they are allergic to them. Taking the wrong medication, or
an incorrect dose of medication, can have serious consequences including brain damage,
allergic reaction, digestive problems, psychological illness and in some cases even death.

In Dr. Kunal Saha v. Dr. Sukumar Mukherjee, 21 October, 2011 case, which is famous as
the Anuradha Saha Case. In this case, the wife was suffering from drug allergy and the
doctors were negligent in prescribing appropriate medicines for the same which ultimately
aggravated her condition and led to the death of the patient. The court held the doctor
liable for medical negligence and awarded compensation.
In the case of C.P. Sreekumar (Dr.), MS (Ortho) v. S. Ramanujam, 1 May, 2009 case, the
respondent was injured while going on a bicycle. He sustained severe injuries and a hairline
fracture of the neck. On considering the various options available the doctor chose to
perform hemiarthroplasty instead of internal fixation procedure. The surgery was
performed the next day. The respondent filed a case against the doctor for not adopting the
internal fixation procedure for the injury. The Supreme Court held that the appellant’s
decision in choosing hemiarthroplasty with respect to a patient of 42 years of age was not
so palpably erroneous or unacceptable as to dub it as a case of professional negligence.

Negligent Medical Advice:

Patient trusts medical professional’s expertise for treatment, Still doctor must advise on any
risks, side effects or alternatives available. This advice is integral to being able to make an
informed decision.

In Gian chand v. Vinod kumar Sharma, AIR 2008 H.P. 97 case, the Court held that shifting of
the patient from one ward to another in spite of requirement of instant treatment to be
given to the patient resulting in damage to the patient’s heath then the doctor or
administrator of the hospital shall be held liable under negligence.
Civil Liabilities of Doctor in Medical Negligence:

Civil liability usually includes the claim for damages suffered in the form of compensation. If
there is any breach of duty of care while operating or while the patient is under the
supervision of the hospital or the medical professional they are held to be vicariously liable
for such wrong committed. At times the senior doctors are even held vicariously liable for
the wrongs committed by the junior doctors. Monetary compensation can be imposed
under the general law by pursuing a remedy before appropriate Civil Court or Consumer
forums.

In Mr. M Ramesh Reddy v. State of Andhra Pradesh, 2003 (1) CLD 81 (AP SCDRC) case the
Court held the hospital authorities negligent, inter alia, for not keeping the bathroom clean,
which resulted in the fall of an obstetrics patient in the bathroom leading to her death. A
compensation of Rs. 1 Lac was awarded against the hospital.

Criminal Liabilities of Doctor in Medical Negligence:

There are various degrees of negligence and a very high degree of Gross Negligence is
required to be proved beyond reasonable doubt for certain acts to be made punishable
under the provisions of Criminal Law. As per existing Laws, cases for medical negligence
caused by

Doctors can be filed under following enactments at the option of the Patients:

 A complaint for deficiency of service can be filed before the Consumer Forum under
the Consumer Protection Act, 1986.
 A Civil Suit for the Recovery of Damages in the appropriate Civil Court.
 A complaint under Section 304–A of the Indian Penal Code, 1860 in the appropriate
 Criminal Court.
 A complaint to the Medical Council of India or The State Medical Council for de
registration of a Doctor on account of negligence.

In Dr. Suresh Gupta vs Govt. Of N.C.T. Of Delhi, Appeal (crl.) 778 of 2004 case,
the Supreme Court of India held that the legal position was quite clear and well settled that
whenever a patient died due to medical negligence, the doctor was liable in civil law for
paying the compensation. Only when the negligence was so gross and his act was as reckless
as to endanger the life of the patient, criminal law for offence under section 304A of Indian
Penal Code, 1860 will apply.
In Vinod Jain v. Santokba Durlabhji Memorial Hospital, 5 February, 2019 case, the Supreme
Court has mentioned the factors to be considered while establishing the liability in medical
negligence cases. The Supreme Court made the below-mentioned observations:

 A doctor cannot be said to be negligent if his acts are in accordance with the set
guidelines, merely because a body is there which holds a contrary view.
 A doctor need not have special expertise in medicine and it is enough if he exercises
ordinary skills that an ordinary man of that profession would be able to do.
 A doctor cannot give assurance for any recovery as it is not in his hands and he can
only try his best. The only assurance he can give is that he holds requisite skills in the
profession and while undertaking this he should perform his duties as a reasonable
man of the profession and in accordance with the standard of care in the medical
profession.

Contributory Negligence:

A person is guilty of contributory negligence if he ought reasonably to have foreseen that if

he did not act as a reasonable prudent man he might be hurt himself. In his reckonings he
must take into account the possibility of others being careless. When plaintiff contributes to
the incident his role should be duly regarded when liability is determined and quantum of
damages is assessed. Contributory negligence is a good defence available to doctor in all
claims of civil nature. Contributory negligence of a patient is any unreasonable conduct or
absence of ordinary care on the part of the patient or his personal attendant which
combined with the doctors’ negligence contributed to the injury complained of as a direct
proximate cause and without which the injury would not have occurred

Contributory negligence include

 Failure to give the doctor accurate medical history

 Failure to cooperate with his doctor in carrying out all reasonable and proper
instruction
 Refusal to take the suggested treatment
 Leaving the hospital against the doctors advise
 Failure to seek further medical assistance if symptoms persist

Doctrine of Res Ipsa Loquitur:

Res ipsa loquitur is a Latin maxim whose meaning is “the things tells its own story”. The
doctrine of Res Ipsa Loquitur has three elements:

1. the injury that had occurred under the circumstances must be explicit and can only
occur due to someone’s negligence and it cannot occur in the ordinary situations.
2. the injury caused by the defendant to the plaintiff must have been done with the use
of some instrument which was exclusively under the control of the defendant.
3. the injury caused to the plaintiff must be under the scope of the defendant’s duty
and it must not be due to the voluntary act or the contribution from the plaintiff’s
side.
The first condition of doctrine is technical in nature and is difficult to prove plaintiff being
the layman in respect to medical science cannot prove the medical negligence based on
his/her common knowledge.

In Jaspal Singh v. Medical college case, the patient, blood group was A+ was give n B+ blood
on two different fays, and he died soon thereafter.

Defences Available to Medical Practitioner:

 The Medical Practitioner has to prove that there is no existence of duty of care
towards the patients.
 Medical Practitioner has to prove that he has conducted the treatment to his best
effort with due care and the course of treatment which he chooses to perform is
suitable in the situation of case and as per medical norms.
 Another defence which is available with the Medical Practitioner is to prove that the
patient did not suffer any injury from the treatment performed by him.
 The doctor may claim that the injury was caused by the patient not following proper
medical advice. (Contributory negligence).
 That the injury complained of was the result of an unavoidable risk connected to that
particular line of treatment, which was fully explained to the patient and for which
the patient’s informed consent was obtained.
 That the patient himself insisted on a particular line of treatment, despite having
been told by the doctor about the risk and consequences attached to that line of
treatment.

 Section 80 of the Indian Penal Code, 1860, says that anything which happens as a
result of an accident or misfortune and without any criminal intention or knowledge
in the doing of a lawful act in a lawful manner by lawful means and with proper care
and caution is not an offense.
 Section 81 of the Indian Penal Code, 1860, states that if anything is done merely by
the reason that it is likely to cause harm but if the same is done without any
intention to cause harm and in good faith in order to avoid other damages to a
person or his property is not an offense.
 Section 88 of the Indian Penal Code, 1860, says that no one can be made an accused
of any offense if he performs an act in good faith for the good of other people and
does not intend to cause harm even if there is a risk involved and the patient has
given the consent explicitly or implicitly.

Precautions to be Taken by Medical Practitioner:

1. He must always respect the right of self-determination of the patient

2. He must treat the patient with due care and skill expected by the patient from a
person trained in the medical profession.
3. He must adhere to standard and accepted practices of the medical profession when
giving any treatment to the patient.
4. He must never give guarantee to the patient that the patient will be cured by him
 5. After making full disclosure, all doctors must obtain an informed consent in writing
from the patient, or his parent or guardian or near relative if patient is minor.
6. He must carefully record all the symptoms of the patient, the treatment given and
progress made by the patient time to time and must kept record of this treatment.
7. He must consult a specialist wherever the need for such consultation arises.
8. He must not leave the patient unattended especially in the case of emergency.

Case Laws:

Dr. Jacob Mathew v. State of Punjab case:

A patient named Jiwan Lal was admitted to a private ward in CMC Hospital, Ludhiana. The
patient suddenly had difficulty in breathing. His elder son called the nurse and doctor after
seeing his father’s condition. No doctor turned up for about 20-25 minutes. After that, Dr.
Jacob Mathew and Dr. Allen Joseph came to the room for the patient. The patient was
immediately connected with an oxygen cylinder to his mouth which was empty. The son
went to the adjoining room and brought another gas cylinder. During this, the doctor
confirmed that the patient is dead. The younger son, Ashok Kumar Sharma filed a First
Information Report (FIR) under Section 304A (causing death by negligence) read with
Section 34 (common intention of criminal activity) of the IPC.

The Court observed that all the averments made in the complaint, even if held to be proved,
do not make out a case of criminal rashness or negligence on the part of accused-appellant.
There was no challenge to qualifications or method of treatment by the doctors. It is a cause
of non-availability of oxygen cylinder for which hospital may be held liable in civil law but
the accused-appellant cannot be proceeded against under Section 304-A of IPC on the
parameters of Bolam’s test. Hence, the prosecution of the accused-appellant under Section
304A/34 is quashed. The Supreme Court prescribed following guidelines:

 A private complaint may not be entertained unless the complainant has produced
prima facie evidence before the Court in the form of a credible opinion given by
another competent doctor to support the charge of rashness or negligence on the
part of the accused doctor.
 The investigating officer should, before proceeding against the doctor accused of
rash or negligent act or omission, obtain an independent and competent medical
opinion preferably from a doctor in government service qualified in that branch of
medical practice who can normally be expected to give an impartial and unbiased
opinion applying Bolam’s test to the facts collected in the investigation.
 A doctor accused of rashness or negligence, may not be arrested in a routine manner
(simply because a charge has been leveled against him). Unless his arrest is
necessary for furthering the investigation or for collecting evidence or unless the
investigation officer feels satisfied that the doctor proceeded against would not
make himself available to face the prosecution unless arrested, the arrest may be
withheld.
 That is why in Jacob Mathew’s case the Court held that in case of criminal negligence
against a medical professional it must be shown that the accused did something or
failed to do something in the given facts and circumstances of the case which no
 medical professional in his ordinary senses and prudence would have done or failed
to do.

In Poonam Verma v. Ashwin Patel 1996 (4) SCC case, Pramod Verma, husband of the
appellant, Mrs. Poonam Verma fell ill and complained of fever and so, Ashwin Patel, who
was an authorized Homeopathic kept him under mediation and gave him some allopathic
medicines for viral fever for two days. But even after these medications the condition of
Ashwin Patel didn’t improve so Ashwin Patel shifted the medications from viral fever to
Typhoid Fever because according to Ashwin Patel these two diseases were prevalent in the
locality. But even then the condition of Pramod Verma deteriorated and so Ashwin Patel
asked the appellant to shift Pramod Verma to Sanjeevani Maternity and General Nursing
Home under Dr. Rajeev Warty. Then Pramod Verma was shifted to Hinduja Hospital in an
unconscious state where, after four and a half-hour of admission, he died. The Appellant
therefore filed a petition before the National Consumer Disputes Redressal Commission,
New Delhi. The issue was whether there was a breach of duty of care by Ashwin Patel in the
treatment of Pramod Verma and whether this will amount to actionable negligence. The
honourable Court found Ashwin Patel guilty for negligence and was made to pay
compensation.

In Roe v. Minister of Health (1954 2 Q. B. 66), the case revolved around how anesthetic
drugs are to be stored by a medical professional. The facts leading to the case occurred in
1947, when an anesthetist kept such drugs in a manner that was considered to be safe at
that time. Seven years later, that in 1954, it was found that undetectable crack could
develop in the ampules if stored in that manner, and therefore it was dangerous practice.
Acquitting the anesthetist the Court commented that in 1947, the drug was kept in a
manner considered safe at that time which was found to be unsafe later. Subsequent
knowledge cannot be used to hold doctor negligent and commented “An incident of 1947
cannot be seen with spectacles of 1954”.

Conclusion:

Medical Negligence is the misconduct by a medical practitioner or doctor by not providing

enough care resulting in breach of their duties and harming the patients which are their
consumers. Any deviation from the accepted medical standard of care is considered to be
medical negligence, and if it causes undue injury to a patient the doctor, staff and/or
hospital may be held liable. Medical negligence becomes medical malpractice when the
doctor’s negligent treatment causes injury to the patient—makes the patient’s condition
worse, causes unreasonable and unexpected complications, or necessitates additional
medical treatment. Medical negligence can occur in many different ways, the general theme
is that a medical professional deviates from the level of care that is required by his or her
duty to patients

Doctor-Patient Contractual Relationship

 Post authorBy Hemant More

 Post dateMay 28, 2021
 No Commentson Doctor-Patient Contractual Relationship
Law > Medical Jurisprudence > Contractual Doctor-Patient Relations

A doctor–patient relationship (DPR) is considered to be the core element in the ethical

principles of medicine. A good doctor–patient relationship is necessary for a good practice
of healthcare. DPR is usually developed when a physician tends to a patient’s medical needs
via check-up, diagnosis, and treatment in an agreeable manner. The trust that a patient
places on a doctor or surgeon is important because this trust is directly linked with the
health of a person. Due to the relationship, the doctor owes a responsibility to the patient
to proceed toward the ailment or conclude the relationship successfully. In this article, we
shall discuss contractual nature of doctor-patient relationship and very important concept
called informed consent.

Elements of Valid Contract:

 There are Two Parties: In a contract minimum, two parties are involved.
A contract can only be bilateral and the same party cannot be a party on both sides.
 It is An Agreement: An agreement occurs when two minds meet
for a common purpose. i.e. the same thing in the same sense at the same time. This
meeting of the mind is called consensus ad idem, i.e., consent to the matter. The
consent to the proposal should be free (free from coercion, fraud,
misrepresentation, mistake and undue influence).
 It is An Agreement With Consideration: It is an agreement with legal consideration.
 Other Essentials: The agreement should be among competent parties and should be
for lawful acts.
 It is an Obligation: An obligation is a legal duty to do or abstain
from doing something. The agreement enforceable by law is obligatory on all the
parties involved in the contract. Thus social, religious and domestic obligations
cannot be termed as a contract because in such obligation there is no intention
to give rise to any legal obligation. An agreement to agree in the
future is not a contract because unless all important terms of the contract are
settled, there cannot be any binding obligation. The parties that are subject to a
contract must have clear intentions of creating a legal relationship between them.
Before understanding contractual nature of doctor-patient relationship, we have to
understand some terms related with valid contract.

 Contract: Under Section 2(h) of the Indian Contract Act, contract is anything that is
an agreement and enforceable by the law of the land.
 Consideration: According to section 2(d) of the Indian Contract Act “when at the
desire of the promisor, promisee or any other person has done or abstained from
doing or does or abstains from doing or promises to do or to abstain from doing
something, such act or abstinence, or promise is called a consideration for the
promise.”
 Consent: According to Section 13 of the Indian Contract Act, ” two or more persons
are said to be in consent when they agree upon the same thing in the same sense
(Consensus-ad-idem). According to Section 14, Consent is said to be free when it is
not caused by coercion or undue influence or fraud or misrepresentation or mistake.

Contractual Nature of Doctor-Patient Relationship (DPR):

Doctor-Patient Relation as Contract:

 Proposal and Acceptance: Patient goes to doctor, seeking treatment for illness
(proposal). Doctor gives him an appointment and accepts him as a patient
(Acceptance)
 Competencies of the Parties: According to the Contract Act, contracting parties
should be major, and of sound mind. If patient is minor, the doctor is entering in
contract with parents or guardians of minor.
 Free Consent: Here parties are agree on the same thing in the same sense and the
consent is not caused by coercion or undue influence or fraud or misrepresentation
or mistake.
 Lawful Consideration and Object: In Doctor-Patient contract both the consideration
and object are lawful. There is no unlawful in the treatment of a patient.
 The agreement should not be expressly prohibited by Ss. 27 to 30 of the Indian
Contract Act: The Contract between patient and Doctor is not prohibited by these
provisions.

Thus doctor-patient relation has all the requisites of a valid contract. Hence Doctor-Patient
relation is a Contractual Relationship.

Case Laws: Everett v. Griffiths, Morris v. Winsburry White, Edwards v. Mullan.

Consent:

Consent is when one person agrees to or gives permission to another person to do

something. According to Section 13 of the Indian Contract Act, ” two or more persons are
said to be in consent when they agree upon the same thing in the same sense (Consensus-
ad-idem). The consent may be expressed or implied. Oral consent is sufficient in the eyes of
law, but is often difficult to prove in the Court. Hence such consent is taken by doctor in
presence of nurse or another doctor, who can testify to the same in case of litigation.
Expressed Consent:

It is valid consent given in writing or orally. Express consent is when the patient directly
communicates their positive and explicit consent to the doctor or healthcare provider. This
is usually done in writing by signing papers. It can also be supported through oral or verbal
communication with the doctor. Express consent is not time-limited unless the user
withdraws their consent.

Expressed consent includes:

 The condition or illness which requires treatment

 The name of the proposed procedure or treatment
 A detailed description of the treatment or procedure, including a discussion of the
potential benefits and risks
 Description of risks associated with choosing non-treatment
 The anticipated results of having the procedure or treatment
 The possible alternative forms of treatment or the lack of any alternative forms of
treatment
 Why the doctor believes this treatment or procedure is the best choice

Implied Consent:

Implied consent is more difficult to prove than express consent. Implied consent occurs
through the actions or conduct of the patient rather than direct communication through
words. For example, informed consent can be implied from patient’s nodding of the head,
or by them showing up at the agreed upon time for surgery. If the patient has prepared
themselves for surgery by fasting for the previous 24 hours, this might also serve as proof of
implied consent.

Implied consent is sufficient in the eyes of law, but is often difficult to prove in the Court.
Hence such consent is taken by doctor in presence of nurse or another doctor, who can
testify to the same in case of litigation.

Distinguish between express consent and implied consent.

Express Consent Implied Consent

Implied consent occurs through the

It is valid consent given in writing or actions or conduct of the patient rather
orally. than direct communication through
words.

This is usually done in writing by signing

papers. It can also be supported through This is usually is shown by the conduct
oral or verbal communication with the and behavior of both the parties.
doctor.
 It is comparatively easy to prove in Court,
It is comparatively difficult to prove in
as a witness can be placed at the time of
Court.
consent.
Informed Consent:

Informed consent is defined as voluntary acceptance by a competent patient of a plan for

medical care after physician adequately discloses the proposed plan, its risks and benefits,
and alternative approaches. This requires a process of effective communication and
education between the physician and patient. Informed consent is a process with the
elements of autonomous authorization, free from coercion or manipulation, decision-
making capacity, disclosures to the patients, and comprehension.

There are four major components of informed consent:

 That the patient has the capacity to make the decision.

 The medical provider discloses information on the treatment, test, or procedure in
question. This includes explaining the expected benefits and risks, as well as the
probability of these benefits and risks occurring.
 The patient must comprehend the information told to them.
 The patient must voluntarily give their consent, without any coercion from the
healthcare professional.

An informed consent agreement should include the following information:

 diagnosis of patient’s condition

 name and purpose of treatment
 benefits, risks, and alternative procedures
 benefits and risks of each alternative

Informed consent for research or clinical trials is also required. It informs the participants
about the trial and lets them make educated decisions about taking part in the study. The
process is similar to informed consent in healthcare. It should include the following:

 purpose and procedure of the study

 relevant information about the study, including risks and benefits
 your ability to understand this information
 your voluntary decision to participate

Informed consent continues until the study is completed.

The informed consent may be express or implied. Before the procedure, the patient /
patient’s next keen has to complete and sign a consent form. This form is a legal document
that shows their participation in the decision and your agreement to have the procedure
done. In emergencies, when a decision must be made urgently, the patient is not able to
participate in decision making, and the patient’s next keen is not available, physicians may
initiate treatment without prior informed consent. In such situations, the physician should
inform the patient/the next keen at the earliest opportunity and obtain consent for ongoing
treatment in keeping with these guidelines.

Termination of DPR

Innumerable situations might bring about a physician’s discharge of patients and the ending
of DPR. The relationship may come to an end when:

 the physician concludes that the patient needs the care of different specialists;
 successive missing of appointments by the patient;
 the physician refuses treatment due to nationality, religion, and other causes;
 neglecting a patient from prompt professional care without making arrangements
for the continuance of such care (patient abandonment).

Rights of Medical Practitioners

 Post authorBy Hemant More

 Post dateMay 21, 2022
 No Commentson Rights of Medical Practitioners

Law > Medical Jurisprudence > Rights of Medical Practitioners

Medical practitioners have duties, at the same time they have constitutional and statutory
rights. In this article, we shall discuss constitutional and statutory rights of medical
practitioners.

Registered Medical Practitioner:

Under the Transplantation of Human Organs and Tissues Act, 1994 and the Pre-conception
and Pre-natal Diagnostic Techniques (Prohibition of Sex Selection) Act, 1994, the expression
“Registered Medical Practitioner means a medical practitioner who possesses any
recognised medical qualification as defined in clause (h) of section 2 of the Indian Medical
Council Act, 1956 (102 of 1956), and who is enrolled on a State Medical Register as defined
in clause (k) of that section;

Under Drugs and Magic Remedies (Objectionable Advertisements) Act, 1954, the expression
“Registered Medical Practitioner means any person,—

 who holds a qualification granted by an authority specified in, or notified under,

section 3 of the Indian Medical Degrees Act, 1916 (7 of 1916) or specified in the
Schedules to the Indian Medical Council Act, 1956 (102 of 1956); or
 who is entitled to be registered as a medical practitioner under any law for the time
being in force in any State to which this Act extends relating to the registration of
medical practitioners;

Some rights of medical practitioners are as follows:

Right to choose his patients:

Medical practitioner has right to choose his patient but once treatment begins, he cannot
refuse. In an emergency, however, he should not refuse to give treatment but should render
service to the best of his ability. Having undertaken the care of a patient, he may not neglect
him; and unless he has been discharged, he may discontinue his services only after giving
adequate notice.

Right to use his titles and qualifications:

He is entitled to use his title (Dr.) and qualifications approved by central and state Medical
Councils.

Right to receive and recover fees and expenses:

Irrespective of the patient cured or not he has right to receive reasonable fees for the
treatment given by due care and skill. He can charge for medicines given by him. He can
charge for conveyance for his home visits. If the lawful charges are not paid by the patient,
then he can take recourse of legal proceedings to recover this amount.

Right to get appointed in Hospitals and Institution:

He has right to get appointed in local body, Government, or private hospital and institution.
But this appointment depends on the policy of respective organization responsible for such
appointment.

Right practice medicine and dispense medicine:

He has right to practice the line of medicine in which he holds the required qualification
from his clinic, dispensary, or hospital. He can dispense medicines to patients. It is expected
that he prescribes generic names of the medicines.
Medical practitioner should practice the line of medicine in which he holds the required
qualification. In Poonam Verma v. Ashwin Patel 1996 (4) SCC case, Pramod Verma, husband
of the appellant, Mrs. Poonam Verma fell ill and complained of fever and so, Ashwin Patel,
who was an authorized Homeopathic kept him under mediation and gave him some
allopathic medicines for viral fever for two days. But even after these medications the
condition of Ashwin Patel didn’t improve so Ashwin Patel shifted the medications from viral
fever to Typhoid Fever because according to Ashwin Patel these two diseases were
prevalent in the locality. But even then the condition of Pramod Verma deteriorated and so
Ashwin Patel asked the appellant to shift Pramod Verma to Sanjeevani Maternity and
General Nursing Home. Then Pramod Verma was shifted to Hinduja Hospital in an
unconscious state where, after four and a half-hour of admission, he died. The Appellant
therefore filed a petition before the National Consumer Disputes Redressal Commission,
New Delhi. The issue was whether there was a breach of duty of care by Ashwin Patel in the
treatment of Pramod Verma and whether this will amount to actionable negligence. The
honourable Court found Ashwin Patel guilty for negligence and was made to pay
compensation.\

Right to issue medical certificates:

Issuing medical certificates is integral responsibility of medical practitioner. He has right to

issue medical certificates required

 by employers, schools, colleges, etc.

 to obtain passport or driving license
 under Factories Act, Vaccination Act, etc.

Sometimes medical practitioner issue false certificate, which is an offence.

Right to Give Evidence:

Under the doctrine of privileged communication, a medical practitioner must keep the
reports and communication with patient confidential. If doctor is sued for medical
negligence by the patient, then the doctor may disclose information to the Court similarly if
a doctor sues patient for non-payment of fees, the patient can disclose information to the
Court. If Court orders to produce medical reports containing confidential information, then
the doctor can appear as a witness and he is supposed to submit evidence to the Court.

Right to remove organs and tissues from a dead body:

A medical practitioner has a right to remove organs and tissues from a dead body for the
purpose of transplantation or inquest. Transplantation is needed when the recipient’s organ
has failed or has been damaged due to illness or injury. It is the act of surgical removal of an
organ from one person and placing it into another person. Organ transplantation is the life-
saving therapy for end-stage organ failure. The most commonly transplanted organs are the
kidney, liver, heart, lungs, pancreas and intestines. When using this right, the medical
practitioner must obey the legal provisions associated with the removal of organs from a
dead body.
Right to perform medical termination of pregnancy:

Abortion or medical termination of pregnancy is a medical procedure to end a pregnancy. It

uses medicine or surgery to remove the embryo or fetus and placenta from the uterus. The
procedure is done by a licensed health care professional.

There are situations in pregnancy, such that the life of the mother or the life of the child in
the womb, is in danger. The Medical Termination of Pregnancy Act, 1971 has been enacted
mainly with a view to save the life of the mother. Under this Act, the pregnancy of the
mother can be terminated

 On medical grounds, like when the physical or mental health of the mother is at risk;
 On humanitarian grounds, like when there is a forced pregnancy because of rape;
 There is a possibility of the birth of a deformed child.

Right to disclose confidential information in exceptional circumstances:

Under the doctrine of privileged communication, a medical practitioner must keep the
reports and communication with patient confidential. But in case of special circumstances,
public interest he can disclose confidential information.

In Mr. X v. Hospital Z, AIR 1999 SC 495 case, the Appellant was diagnosed as HIV (+) after he
attempted to donate blood at the Respondent hospital. This information was disclosed by
the Respondent and as a result, the Appellant’s marriage was called off and he was
ostracized by his relatives and community. He filed an appeal on the grounds that disclosure
of his HIV (+) status by the Respondent-Hospital was violative of medical ethics pertaining to
confidentiality and also infringed upon his right to privacy under Article 21. The apex court
held that in special circumstances, public interest would override the duty of confidentiality,
as where there is an immediate or future health risk to the community or to a specific
person.

Right to disclose and report injuries:

He has a right as well as a duty to disclose an report all cases of injuries and burns, where
the circumstances suggest the commission of a crime. Similarly, he must report cases of self-
infliction of injuries or attempted suicide.

Right to access information:

Subject to laws in force, a medical practitioner can access medical information from state or
private institutions.

Right not to be unfairly discriminated:

A medical practitioner has right not to be discriminated on the basis of race, caste, creed,
religion, gender, place of birth, place of origin, etc.
Right to have political views:

Without infringing the ethics or the laws, regulations and rules, he can participate in political
activities and can take political view or decisions.

Right to refuse to conduct an unlawful bodily search or seizure:

He has a right not to be harassed or arrested or detained for having refusal to conduct an
unlawful bodily search or seizure that is unlawful under the law.

The Pre-Conception and Pre-Natal Diagnostic Techniques (Prohibition of Sex Selection) Act

 Post authorBy Hemant More

 Post dateMay 23, 2022
 No Commentson The Pre-Conception and Pre-Natal Diagnostic Techniques (Prohibition
of Sex Selection) Act

Law > Medical Jurisprudence > The Pre-Conception and Pre-Natal Diagnostic Techniques
(Prohibition of Sex Selection) Act

Female Foeticide:

Sex selection is any act of identifying the sex of the foetus and elimination of the foetus if it
is of the unwanted sex. It is heavily biased against the female sex. Amniocentesis is the
process used for determination of sex of the foetus. Amniocentesis is a procedure in which a
small amount of amniotic fluid is removed from the uterus for testing or for treatment.
Amniotic fluid is the fluid that surrounds and protects the baby during pregnancy. The fluid
contains foetal cell and various chemicals produced by the baby and can be used to
determine the sex of the unborn baby.
Female foeticide is the procedure of abortion to terminate female foetus from the womb of
the mother before taking birth after the sex recognition tests like an ultrasound scan.
Reasons for female foeticide can be attributed to the following

 Patrilineal line of succession

 Dowry system, violence against women
 Low status of women
 Preference for son due to financial security
 Small family norm
 Religious and social taboos
 Misuse of diagnostic techniques.

Impact of Female Foeticide:

Sex ratio denotes the ratio of females to males in a specific region. As per the decennial
Indian census, Sex Ratio of India is 107.48. It means 107.48 males per 100 females in 2019.

Objects of PCPNDT Act:

The objects of the Act are as follows:

 To ensure the implementation of all promotional schemes for girl children at the
district level.
 Monitoring and evaluation of the implementation of the PCPNDT Act through
community participation.
 Ensure accountability of implementing agencies through monitoring implementation
of the Act through community participation.
 Tracking pregnancies, MTPs, and birth registration with the help of Anganwadi
workers, ASHAs.
 Identifying violators of the Act through conducting detailed audits of form ‘F’ filled in
for the pregnant women in the clinics.
 Develop a national, state, and district annual Plan.

Salient Features of the PCPNDT Act:

The salient features of the Act are as follows:

 The pre-conception and pre-natal diagnostic techniques (prohibition of sex selection)

act was enacted by the parliament on 20th September, 1994 and is applicable to the
whole of India.
 The Act provides for the prohibition of sex selection, before or after conception.
 It regulates the use of pre-natal diagnostic techniques, like ultrasound and
amniocentesis by allowing them their use only to detect: Genetic abnormalities,
metabolic disorders, chromosomal abnormalities, certain congenital malformations,
haemoglobinopathies and sex-linked disorders.
 No laboratory or centre or clinic will conduct any test including ultrasonography for
the purpose of determining the sex of the foetus.
  No person, including the one who is conducting the procedure as per the law, will
communicate the sex of the foetus to the pregnant woman or her relatives by words,
signs or any other method.
 Any person who puts an advertisement for pre-natal and pre-conception sex
determination facilities in the form of a notice, circular, label, wrapper or any
document, or advertises through the interior or other media in electronic or print
form or engages in any visible representation made by means of hoarding, wall
painting, signal, light, sound, smoke or gas, can be imprisoned for up to three years
and fined Rs. 10,000.

Important Definitions Under the PCPNDT Act:

 Embryo: According to Section 2(bb), “embryo” means a developing human organism

after fertilization till the end of eight weeks (fifty-six days).
 Foetus: According to Section 2(bc), “foetus” means a human organism during the
period of its development beginning on the fifty-seventh day following fertilization
or creation (excluding any time in which its development
has been suspended) and ending at the birth.
 Conceptus: According to Section 2(ba), “conceptus” means any product of
conception at any stage of development from fertilization until birth including extra
embryonic membranes as well as the embryo or foetus. The period of conception is
divided into two parts by the Act. From the time of conception till the end of fifty-six
days, the developing human being is called embryo and from the fifty-seventh day
onwards untill the child is born is called foetus.
 Genetic Counseling Centre: According to Section 2 (c), “Genetic Counseling Centre”
means an institute, hospital, nursing home or any place, by whatever name called,
which provides for genetic counselling to patients.
 Genetic Clinic: According to Section 2 (d), “Genetic Clinic” means a clinic, institute,
hospital, nursing home or any place, by whatever name called, which is used for
conducting pre-natal diagnostic procedures.
 Genetic Laboratory: According to Section 2 (e), “Genetic Laboratory” means a
laboratory and includes a place where facilities are provided for conducting analysis
or tests of samples received from Genetic Clinic for pre-natal diagnostic test
 Pre-natal Diagnostic Procedures: According to Section 2 (i), “pre-natal diagnostic
procedures” means all gynaecological or obstetrical or medical procedures such as
ultrasonography, foetoscopy, taking or removing samples of amniotic fluid, chorionic
villi, blood or any other tissue or fluid of a man, or of a woman for being sent to a
Genetic Laboratory or Genetic Clinic for conducting any type of analysis or pre-natal
diagnostic tests for selection of sex before or after conception.
 Pre-natal Diagnostic Techniques: According to Section 2 (j), “pre-natal diagnostic
techniques” includes all pre-natal diagnostic procedures and pre-natal diagnostic
tests.
 Pre-natal Diagnostic Test: According to Section 2 (k), “pre-natal diagnostic test”
means ultrasonography or any test or analysis of amniotic fluid, chorionic villi, blood
or any tissue or fluid of a pregnant woman or conceptus conducted to detect genetic
or metabolic disorders or chromosomal abnormalities or congenital anomalies or
haemoglobinopathies or sex-linked diseases
  Sex Selection: According to Section 2 (o), “sex selection” includes any procedure,
technique, test or administration or prescription or provision of anything for the
purpose of ensuring or increasing the probability that an embryo will be of a
particular sex

Situations Which Allow the Conduct of Pre-natal Diagnostic Techniques:

According to Section 4(2) of the Act, no pre-natal diagnostic techniques shall be conducted
except for the purposes of detection of any of the following abnormalities, namely:

1. Chromosomal Abnormalities
2. Genetic Metabolic Diseases
3. Haemoglobinopathies
4. Sex-Linked Genetic Diseases
5. Congenital Anomalies
6. Any Other Abnormalities or diseases as may be specified by the Central Supervisory
Board

Conditions to be Fulfilled for the Conduction of Pre-natal Diagnostic Techniques:

According to Section 4(3) of the Act, no pre-natal diagnostic techniques can be used or
conducted unless the person qualified to do so is satisfied, for reasons to be recorded in
writing, that any of the following five condition is fulfilled, namely:

 age of the pregnant woman is above thirty-five years;

 the pregnant woman has undergone of two or more spontaneous abortions or foetal
loss;
 the pregnant woman had been exposed to potentially teratogenic agents such as
drugs, radiation, infection or chemicals;
 the pregnant woman or her spouse has a family history of mental retardation or
physical deformities such as, spasticity or any other genetic disease;
 any other condition as may be specified by the Central Supervisory Board;

Written Consent from Pregnant Woman and Non-Communication of the Sex of Foetus:

According to Section 5(1) of the Act, no person referred to in clause (2) of section 3 shall
conduct the pre-natal diagnostic procedures unless— NDT Act, 1994 & Amendments

(a) he has explained all known side and after effects of such procedures to the pregnant
woman concerned;

(b) he has obtained in the prescribed form her written consent to undergo such procedures
in the language which she understands; and

(c) a copy of her written consent obtained under clause (b) is given to the pregnant woman.
According to Section 5(2) of the Act, no person including the person conducting pre-natal
diagnostic procedures shall communicate to the pregnant woman concerned or her relatives
or any other person the sex of the foetus by words, signs or in any other manner.

Prohibition of Determination of Sex:

According to Section 6 of the Act,

(a) no Genetic Counselling Centre or Genetic Laboratory or Genetic Clinic shall conduct or
cause to be conducted in its Centre, Laboratory or Clinic, pre-natal diagnostic techniques
including ultrasonography, for the purpose of determining the sex of a foetus;

(b) no person shall conduct or cause to be conducted any pre-natal diagnostic techniques
including ultrasonography for the purpose of determining the sex of a foetus;

(c) no person shall, by whatever means, cause or allow to be caused selection of sex before
or after conception.

Central Supervisory Board:

State Supervisory Boards:

Advisory Committees:

Appropriate Authority:

The Transplantation of Human Organs and Tissues Act

 Post authorBy Hemant More

 Post dateMay 23, 2022
 No Commentson The Transplantation of Human Organs and Tissues Act

Law > Medical Jurisprudence > The Transplantation of Human Organs and Tissues Act

In India there are many health legislations e.g., Drugs and Cosmetics Act,1940, The
Prevention of Food Adulteration Act, 1954, The Medical Termination of Pregnancy Act,
1971, Maternity Benefit Act,1961, Insecticides Act 1968, Narcotic Drugs and Psychotropic
Substances Act and Rules 1985, The Pre-Natal Diagnostics Techniques Act, 1994, Food
Safety and Standards (Contaminants, Toxins and Residues) Regulations, 2011, Food Safety
and Standards (Prohibition and Restrictions on Sales) Regulations, 2011, amongst others. In
this article we shall discuss one such Act called the Transplantation of Human Organs and
Tissues Act, 1994.

With the advent of advanced medical technology in transplant procedures an end stage
organ failure patients got a ray of hope to lead a healthy and prolonged life by undergoing
organ transplant. Human body has certain essential organs like kidneys, lungs, cornea that
are in pairs, making it possible to part away with one of the two during the lifetime and still
be able to lead a healthy life. Whereas other significant organs like heart, pancreas etc. can
be used only after the death of a human being but before the organs become obsolete on
account of discontinuation of blood supply. There are regenerative and non-regenerative
transplantable tissues/organs like liver, blood, bone marrow, stem cells etc. To facilitate
transplants for saving the lives of organ failure patients and to safeguard the interests of the
organ donors, the Transplantation of Human Organs and Tissues Act was passed in India in
1994. Various organs can be legally transplanted by virtue of the Transplantation of Human
Organs and Tissues Act, 1994 giving gift of life to people otherwise doomed to die on
account of failure of vital organs.

The Act relates to the regulation, storage, and transplantation of human organs for
therapeutic purposes and prevention of commercial dealings of human organs. This Act
provide guidelines and rules regarding who can give or donate the organs as well as who can
receive the organ and how should the organ donation should take place. This Act for the
first time in India recognized the brain stem death under some guidelines.

Historical Background of the Act:

Transplantation of Human Organs Bill, 1992 was introduced in Lok Sabha on 20 August
1992. This Bill was assented by the President on 08 July 1994. It became ‘The
Transplantation of Human Organs Act’, 1994 (42 of 1994). The Act was enacted on February
4, 1995, in the states of Goa, Himachal Pradesh, and Maharashtra and all the union
territories. Thereafter, all states adopted these regulations, with the exception of the states
of Jammu and Kashmir and Andhra Pradesh, which they had enacted their own legislation.
Presently The Transplantation of Human Organs Act, 1994, is applicable to all over India

Objects of the Transplantation of Human Organs and Tissues Act, 1994:

The objects of the Transplantation of Human Organs and Tissues (TOHO) Act, 1994 are as
follows:
  To provide for the regulation of removal, storage, and transplantation of human
organs for therapeutic purposes and for the prevention of commercial dealings in
human organs.
 To illegalize the buying and selling of human organs and makes cash-for-kidney
transactions a criminal offence.
 To establish an institutional structure to authorize and regulate human organ
transplants and to register and regulate, through regular checks, hospitals that are
permitted to perform transplants.

Salient Features of the Transplantation of Human Organs and Tissues Act, 1994?

 There are 7 Chapters and 25 Sections in the Act.

 The Transplantation of Human Organs and Tissues Act, 1994 is meant to provide for
the regulation of removal, storage, and transplantation of human organs for
therapeutic purposes and for the prevention of commercial dealings in human
organs. The Central Act illegalizes the buying and selling of human organs and makes
cash-for-kidney transactions a criminal offence.
 The law establishes an institutional structure to authorize and regulate human organ
transplants and to register and regulate, through regular checks, hospitals that are
permitted to perform transplants.
 It recognizes, for the first time in India, the concept of brain-stem death, paving the
way for a cadaver-based kidney transplant programme.
 The Act details actions that amount to direct participation in or abetment of the
organ trade; these offences are punishable under Section 19 of the Act.
 The Act defines two categories of donors:-
o First, it permits a near relative, defined as a patient’s spouse, parents,
siblings, and children, to donate a kidney to the patient.
o Secondly, in Section 9(3) of the Act, live donors who are not near relatives
but are willing to donate kidneys to the recipients by reason of affection or
attachment towards the recipient or for any other special reasons, are
permitted to do so, provided that the transplantations have the approval of
the Authorization Committee, established under the Act.
 The Act makes the offence of kidney trading non-cognizable. In other words, the
police cannot look into complaints of kidney trading independently but must wait for
a complaint to be made by the Appropriate Authority set up under the Act or by an
officer authorized by it or by an individual who has given prior notice of not less than
60 days to the Appropriate Authority.
 It is not clear whether Section 9(3) was deliberately meant – under pressure from
special interests – to provide a loophole that could be exploited in practice, or
whether the law-makers thought they were sympathetically making provision for
donations from second-degree relatives and others who might act out of genuine
love and affection or altruism. But whatever be the reasoning and motivation behind
the provision of a loophole, the practical operation of Section 9(3), combining with
the non-cognizability of the offences to be prosecuted, has rendered the 1994 Act
virtually unenforceable.
 The Act very sensibly provides for registration of hospitals claiming to have the
necessary competence and facilities to perform particular organ transplantation. This
 is a regulatory measure intended to protect the interests of patients. It is with the
Appropriate Authority, set up by the State government under the Act, which
hospitals intending to do transplants must register. Approvals are granted only after
the institutions fulfill certain technical, infrastructural and medical requirements.

Important Definitions in the Transplantation of Human Organs and Tissues Act, 1994:

 Brain-Stem Death: According to Section 2(d), “brain-stem death” means the stage at
which all functions of the brain-stem have permanently and irreversibly ceased and
is so certified under sub-section (6) of section 3 of the Act.”
 Deceased Person: According to Section 2(e), “deceased person” means a person in
whom permanent disappearance of all evidence of life occurs, by reason of brain-
stem death or in a cardio-pulmonary sense, at any time after live birth has taken
place.
 Donor: According to Section 2(f), “donor” means any person, not less than eighteen
years of age, who voluntarily authorises the removal of any of his human organs for
therapeutic purposes under sub-section (1) or sub-section (2) of section 3 of the Act”
 Hospital: According to Section 2(g), “hospital” includes a nursing home, clinic,
medical centre, medical or teaching institution for therapeutic purposes and other
like institution.
 Human Organ: According to Section 2(h), “human organ” means any part of a human
body consisting of a structured arrangement of tissues which, if wholly, removed,
cannot be replicated by the body;”
 Near Relative: According to Section 2(i), 1994, defines near relatives as ““near
relative” means spouse, son, daughter, father, mother, brother, sister, grandfather,
grandmother, grandson or granddaughter”
 Recipient: According to Section 2(m), “recipient” means a person into whom any
human organ or tissue or both is, or is proposed to be, transplanted;
 Registered Medical Practitioner: According to Section 2(n), “registered medical
practitioner” means a medical practitioner who possesses any recognized medical
qualification as defined in clause (h) of section 2 of the Indian Medical Council Act,
1956 (102 of 1956), and who is enrolled on a State Medical Register as defined in
clause (k) of that section;
 Therapeutic Purposes: According to Section 2(o), “therapeutic purposes” means
systematic treatment of any disease or the measures to improve health according to
any particular method or modality;
 Transplantation: According to Section 2(p), “transplantation” means the grafting of
any human organ from any living person or deceased person to some other living
person for therapeutic purposes;

Brain-Stem Death:

Brain stem is the “stalk of the brain” which connects the spinal cord to various parts of the
brain. It sends messages to the rest of your body to regulate balance, breathing, heart rate
and more. It is very vital part of the body. Section 2(d) of the Transplantation of Human
Organs and Tissues Act, 1994, defines brainstem death as ““brain-stem death” means the
stage at which all functions of the brain-stem have permanently and irreversibly ceased and
is so certified under sub-section (6) of section 3 of the Act.”

Identification of brain stem death carries important prognosis for the survival of the patient,
because the heart may keep on beating for few days after brain stem death, or even for
weeks if the patient is in the Intensive Care Unit of hospital with all forms of medical and
cardiac support. The person cannot perform fundamental work of an organism. The person
is practically dead but may have heart beat and such person may still able to breathe. Such
brain stem death must be certified by a Board of Medical Expert referred to in Section 3(6)
of the Act. The Board should contain

 the registered medical practitioner in charge of the hospital in which brain-stem

death has occurred;
 an independent registered medical practitioner, being a specialist, to be nominated
by the registered medical practitioner specified in clause (i), from the panel of names
approved by the Appropriate Authority;
 a neurologist or a neurosurgeon to be nominated by the registered medical
practitioner specified in clause (i), from the panel of names approved by the
Appropriate Authority: Provided that where a neurologist or a neurosurgeon is not
available, the registered medical practitioner may nominate an independent
registered medical practitioner, being a surgeon or a physician and an anaesthetist
or intensivist subject to the condition that they are not members of the
transplantation team for the concerned recipient and to such conditions as may be
prescribed;
 the registered medical practitioner treating the person whose brain-stem death has
occurred

Organ Donor:

Organ donation is basically giving or gifting organ in order to help someone who needs
organ transplant to be operated, it could be near relative or any other person. the
Transplantation of Human Organs and Tissues Act strictly prohibits commercial dealing in
organs of any sort. Generally, in case of organs: heart, kidneys, liver, lungs, intestine,
pancreas and tissues being, skin, bones, blood vessels, heart valves, corona, ear drums can
be donated for the therapeutic purpose.

According to Section 2(f), “donor” means any person, not less than eighteen years of age,
who voluntarily authorises the removal of any of his human organs for therapeutic purposes
under sub-section (1) or sub-section (2) of section 3 of the Act”. Under the virtue of Section
3 of the Act, Donor would fall under the following two categories;

 Living Donor: any person not less than 18 years of age, who voluntarily authorizes
the removal of any of his organ and/or tissue, during his or her lifetime solely for
therapeutic purposes.
 Deceased Donor: Anyone, regardless of age, race or gender can become a donor of
any organ and/or tissue after his/her death (Brainstem/Cardiac). A person who is in
lawful possession of the dead body or the free consent of ‘near relative is required
 for the said purpose. If the deceased donor is under the age of 18 years, then the
consent required from one of the parents or any near relative authorized by the
parents is necessary.

Under section 2(i) of the Act, ‘near-relative’ means spouse, children, grandchildren, brother-
sister, parents and grandparents of the patient can donate the organ after taking prior
permission from the doctor in-charge of the transplant center to donate his organ. A non-
related donor needs prior permission of Authorization Committee established by the state
under the Act in order to donate his organs.

In case of living person the age of donor should not be less than 18 years, and in case of
tissues, age usually does not matter and generally depends upon the physical structure of
the body of person. The cost of donor management, retrieval, transportation and
preservation is to be borne by the recipient/ institution/ government/ NGO or society, and
not by the donor’s family.

Authorization of Removal of Human Organs or Tissues:

 Under Section3(1) of the Transplantation of Human Organs and Tissues (TOHO) Act,
1994 any donor may, in such manner and subject to such conditions as may be
prescribed, authorise the removal, before his death, of any human organ or tissue or
both of his body for therapeutic purposes.
 The donor may be any person defined under Section 2(f) of the Transplantation of
Human Organs and Tissues (TOHO) Act, 1994 or a person who has given an
unequivocal written authorization in presence of two or more witnesses, at least one
of whom should be a near relative, for the removal of any human organ or tissue or
both of his body after his death for therapeutic purposes.
 The use of the phrase “for therapeutic purposes” means the systematic treatment of
any disease or the measures to improve health according to any particular method
or modality.

Restrictions on Removal of Human Organs and Tissues:

Section 9 of the Act deals with the restrictions on removal of human organs and tissues.

 No human organ or tissue or both removed from the body of a donor before his
death shall be transplanted into a recipient unless the donor is a near relative of the
recipient.
 Where the donor or the recipient being near relative is a foreign national, prior
approval of the Authorization Committee shall be required before removing or
transplanting human organ or tissue or both. Without such prior approval no human
organ or tissue or both can be removed from the body of a donor.
 No human organs or tissues or both shall be removed from the body of a minor
before his death for the purpose of transplantation except in the manner as may be
prescribed.
 No human organs or tissues or both shall be removed from the body of a mentally
challenge person before his death for the purpose of transplantation.
  Where any donor authorizes the removal of any of his human organs or tissues or
both after his death under sub-section (2) of section 3 or any person competent or
empowered to give authority for the removal of any human organ or tissue or both]
from the body of any deceased person authorizes such removal, the 1 [human organ
or tissue or both may be removed and transplanted into the body of any recipient
who may be in need of such human organ or tissue or both].
 If any donor authorizes the removal of any of his human organs or tissues or both
before his death under sub-section (1) of section 3 for transplantation into the body
of such recipient, not being a near relative, as is specified by the donor by reason of
affection or attachment towards the recipient or for any other special reasons, such
human organ or tissue or both shall not be removed and transplanted without the
prior approval of the Authorization Committee.

Appropriate Authority under the Transplantation of Human Organs and Tissues (TOHO)
Act, 1994:

The Central Government is empowered by the Act to appoint, by notification one or more
officers as the Appropriate Authority for the purposes of the Act, for each of Union
Territories. Likewise, every State must by notification, appoint one or more persons as the
Appropriate Authority of that State.

Functions of Appropriate Authority:

Section 13 of the Act gives functions of the Appropriate Authority under the TOHO Act,
1994.

 to grant registration under sub-section (1) of section 15 or renew registration under

sub-section (3) of that section;
 to suspend or cancel registration under sub-section (2) of section 16;
 to enforce such standards, as may be prescribed,— (A) for hospitals engaged in the
removal, storage or transplantation of any human organ: (B) for Tissue Banks
engaged in recovery, screening, testing, processing, storage and distribution of
tissues;
 to investigate any complaint of breach of any of the provisions of this Act or any of
the rules made thereunder and take appropriate action;
 to inspect Tissue Banks periodically;
 to inspect hospitals periodically for examination of the quality of transplantation and
the follow-up medical care to persons who have undergone transplantation and
persons from whom organs are removed; and
 to undertake such other measures as may be prescribed

Punishment for Commercial Dealing of Human Organs:

Commercial dealing of human organs is strictly prohibited under this Act. Any sort or any
kind of commercial dealings in human organ would lead to punishment under this Act.
Under Section 19 of The Transplantation of Human Organs Act, 1994, In case of commercial
dealings of any kind in human organs, the punishment has been mentioned as under:

The person found doing so shall be punishable with imprisonment for a term, which shall
not be less than 2 years but which may extend to 7 years and shall be liable to fine, which
shall not be less than ten thousand rupees but may extend to twenty thousand rupees.

Where any offence punishable under this Act has been committed by a company, every
person who, at the time the offence was committed was in charge of, and was responsible
to, the company for the conduct of the business of the company, as well as the company,
shall be deemed to be guilty of the offence and shall be liable to be proceeded against and
punished accordingly

The Drugs and Magic Remedies (Objectionable Advertisements) Act

 Post authorBy Hemant More

 Post dateMay 23, 2022
 No Commentson The Drugs and Magic Remedies (Objectionable Advertisements) Act

Law > Medical Jurisprudence > The Drugs and Magic Remedies (Objectionable Advertisements) Act

Advertisement and media are playing a significant role in our daily lives. Drug industries also
promote their products using such unscrupulous methods, such as misleading the buyer.
Many products are brought into the market without much research and data-based
credibility. However, their advertisements claim success stories and even have testimonials
from people to vouch for them. Many of them claim make the users fairer, increase the
height of children miraculously, reduce weight and cure some diseases like diabetes and
cancer etc. The Drugs and Magic Remedies (Objectionable Advertisements) Act, 1954 is an
Act passed by the Parliament of India that regulates drug advertising in the country. The Act
makes it illegal to market medications and treatments that claim to have magical powers,
and it makes it a criminal offence to do so.

Need of the Act:

Before the enactment of this Act, there was no law to punish the unprincipled and
unscrupulous people who were engaged in false advertisements and claimed miraculous
health, particularly health. The people were engaged in false advertisements of various
drugs
and medical remedies were also advertised without any fear. Their advertisements not only
possessed a threat to society at large but also to the people who believed in such
advertisements and acted accordingly. The government enacted strict rules to prevent the
self-medication by the consumers regarding various diseases and conditions.

Important Definitions of the Act:

 Advertisement: According to Section 2(a) of the Act, “advertisement” includes any

notice, circular, label, wrapper or other document, and any announcement made
orally or by any means of producing or transmitting light, sound or smoke;

 Drug: According to Section 2(b) of the Act, “drug‟ includes—

o a medicine for the internal or external use of human beings or animals;
o any substance intended to be used for or in the diagnosis, cure, mitigation,
treatment or prevention of disease in human beings or animals;
o any article, other than food, intended to affect or influence in any way the
structure or any organic function of the body of human beings or animals;
o any article intended for use as a component of any medicine, substance or
article, referred to in sub-clauses (i), (ii) and (iii);
 Magic Remedy: According to Section 2(c) of the Act, magic remedy‟ includes a
talisman, mantra, kavacha, and any other charm of any kind which is alleged to
possess miraculous powers for or in the diagnosis, cure, mitigation, treatment or
prevention of any disease in human beings or animals or for affecting or influencing
in any way the structure or any organic function of the body of human beings or
animals;
 Registered Medical Practitioner: According to Section 2(cc) of the Act, “registered
medical practitioner‟ means any person,—
o who holds a qualification granted by an authority specified in, or notified
under section 3 of the Indian Medical Degrees Act, 1916 (7 of 1916) specified
in the Schedules to the Indian Medical Council Act, 1956 (102 of 1956); or
o who is entitled to be registered as a medical practitioner under any law for
the time being in force in any State to which this Act extends relating to the
registration of medical practitioner;

Prohibition of Advertising of Certain Drugs for the Treatment of Certain Diseases and
Disorders:

Under Section 3 of the Act, advertisement of following drugs is banned

 the use of drugs will either results in procurement of miscarriage of women or it will
prevent the conception of the women; or
 the use drug will either results in the maintenance or improvement of the capacity of
human beings for sexual pleasure; or
  drugs dealing with the menstrual disorder in women in; or
 drugs dealing with diagnosis, cure, mitigation, treatment or prevention of any
disease, disorder or condition which have been specified in the schedule or any
other disease or condition as specified under the Drugs and Magic Remedies
Objectionable Advertisement Act, 1954.

Prohibition of Misleading Advertisements Related to Drugs:

Section 4 of the Drugs and Magic Remedies Objectionable Advertisement Act, 1954 provides
that no person shall take a part in the publication of advertisement relating to a drug if that
advertisement contains any one of the matters, as mentioned below which may result
either:

 directly or indirectly gives a false impression regarding the true character of the
drug; or
 is engaged in making a false claim for the drug; or
 Is engaged in misleading in any material particular.

Prohibition of Advertisement of Magic Remedies for the Treatment of Certain Diseases

and Disorders:

Section 5 of the Drugs and Magic Remedies Objectionable Advertisement Act, 1954 provides
that no person shall be allowed to work on administering magic remedies and shall not
engage themselves in the publication of the advertisement of magic remedies for the
treatment of certain diseases and disorders as mentioned under Section 3 of the Drugs and
Magic Remedies Objectionable Advertisement Act, 1954.

Prohibition Of Import Into, and Export from, India of Certain Advertisements:

Section 6 of the Drugs and Magic Remedies Objectionable Advertisement Act, 1954 states
no person shall be allowed to import or export from, any documents which are prohibited
under Section 3, 4 and 5 of the Drugs and Magic Remedies Objectionable Advertisement
Act, 1954.

Penalty For Contravention:

Section 7 of the Drugs and Magic Remedies Objectionable Advertisement Act, 1954 states if
any person contravenes the Act or any rules made under this Act are:

• For the first conviction, the person shall be liable for either imprisonment which may
extend to six months or with fine or both if the situation arises.

• For the second time involving the same offence, the person shall be liable for either
imprisonment which may extend to one year or with fine or both if the situation arises.

Jurisdiction to Try Offences:

Section 10 of the Drugs and Magic Remedies Objectionable Advertisement Act, 1954 states
that no court inferior to that of a Presidency Magistrate of the first class shall be allowed to
try an offence which is punishable under this act.

Medico-Legal Case (MLCs)

Medico-Legal Aspect of Road Accidents

 Post authorBy Hemant More

 Post dateJuly 2, 2022
 No Commentson Medico-Legal Aspect of Road Accidents

Law > Medical Jurisprudence > Law and Medicine > Medico-Legal Aspect of Road Accidents

A Medico-Legal Case (MLC) can be defined as a case of injury or ailment, etc., in which
investigations by the law-enforcing agencies are essential to fix the responsibility regarding
the causation of the injury or ailment. It may be a legal case requiring medical expertise
when brought by the police for examination. In this article we shall discuss medico-legal
aspect of road accidents

List of Medico-Legal Cases:

 All cases of injuries and burns -the circumstances of which suggest commission of an
offense by somebody. (Irrespective of suspicion of foul play)
 All vehicular, factory or other unnatural accident cases specially when there is a
likelihood of patient’s death or grievous hurt.
 Cases of suspected or evident sexual assault.
 Cases of suspected or evident criminal abortion.
 Cases of unconsciousness where its cause is not natural or not clear.
 All cases of suspected or evident poisoning or intoxication.
 Cases referred from a court or otherwise for age estimation.
 Cases brought dead with improper history creating suspicion of an offense.
 Cases of suspected self-infliction of injuries or attempted suicide.
 Any other case not falling under the above categories but has legal implications

Medical professionals are often unsure of the course of action in medico-legal cases. Thus,
they are rather reluctant to attend to cases of accident for fear of being involved in
unnecessary litigation later on. Even in cases of serious accidents, medical professionals
hesitate to offer help, sometimes resulting in patient’s death. The first question that arises
in such cases is whether any medical man can be forced to accept an accident victim. The
answer to this till some time back was very clear. The doctor could choose patients
according to his own will.

In Parmananda Katara Vs Union of India, AIR 1989 SC 2039 case, the apex court held that
every doctor is bound to provide medical aid to the victims irrespective of the cause of
injury; he cannot take any excuse of allowing law to take its course. Hence, if now a doctor
refuses treatment, in case of emergency, he/she could be sued under the law. Once the
doctor accepts the case and starts treatment, then the doctor-patient relationship is
established.

Medico-Legal Aspect of Road Accidents:

Immediate Treatment:

Some key factors that doctors need to keep in mind while receiving an road accident victim
are:

 Inject TT Immediately: The doctor may forget to inject TT, and in such cases, if the
patient develops tetanus, the doctors can face trial for negligence.
 Take X-rays: Taking X-rays of all possible parts to exclude fractures is crucial.
 Bleeding Points: Internal or external bleeding points should be examined, and
should not be missed.
 Ophthalmoscopic Examination: Ophthalmoscopy is an examination of the back part
of the eye (fundus), which includes the retina, optic disc, choroid, and blood vessels.

Procedure For Registering a Medico Legal Case:

1. Treatment: Treatment should start immediately. All legal formalities to be

suspended till the patient is resuscitated.
2. Identification: When the patient is resuscitated , the medical practitioner must find
whether the said case falls under Medico Legal Case or not.
3. Intimation to Police: if the case does fall in Medico Legal category, then he must
register the case as an MLC and/ or intimate the same to the nearest police station,
either by telephone or in writing.
4. Acknowledgement Receipt : He shall obtain from the police, the acknowledgement
receipt for future reference.

Preparation for Medico Legal Case Report:

 The attending doctor should record all the findings and prepare a proper MLC report.
 He/she must record the preliminary particulars including full name, age, sex,
occupation, date, and time, brought by whom and history of dying declaration
whether necessary or not.
 Identification marks of the patient (details of minimum 2) should also be recorded.
 Date, time, finding, and description of injury (accurate measurements), whether the
simple, grievous, or dangerous need to be recorded.
  The record of investigations performed on the patient like X-ray, USG, CT scan, and
MRI must be maintained.
 Details of the injuries should be issued to the police or court on demand in the form
of certificates. In the case of grievous injury, the details can be issued to the police
even without a demand.
 The medical practitioner should fill a “wound certificate” and obtain a “written
consent” from bystanders. The matter should be intimated to the police.
 Each page of the MLC report should bear the signature of the doctor and the patient,
or a thumb impression of the latter.
 The report must be written meticulously, expending thought on language and
content. This report should demonstrate competence as MLC reports involve
litigation, insurance claims, medical negligence claims, and worker compensation
issues.

Investigation of Road Accident as MLC:

The Investigation of the accident must be done as soon as possible after it occurs because it
helps in observing the conditions as they were at the time of the accident. Investigation
officer may take help from an automobile expert and a medical expert. Establishment of
facts includes visiting site of accident, examination of mechanical damages. If the driver of
the vehicle is survived, his medical examination is mandatory. It should be ascertained if he
was under the influence of alcohol or drugs at the time of accident. Medical examination of
the victims must be conducted immediately. Medical examination includes noting of injuries
suffered, place, angle, extent, and depth of injury. It also includes noting of blood stains on
body, tears, grease marks, mud and soil stains, etc.

Generally, there are multiple causes. The investigation officer must consider all possibilities.
He should also consider contributing factors which include environmental factors, design
factors, human behaviour (carelessness, rushing, and fatigue, etc.). When determining
negligence of one of the drivers, the contributory negligence of the other person has also to
be taken into account.

In case of accidental death, an autopsy (post mortem) is often performed to ascertain the
cause of death. An autopsy or post-mortem is a surgical procedure involving a thorough
examination of the corpse by dissection to determine the cause and manner of death. The
procedure is performed by specialist pathologists.

Punishment to Offender:

Where offence is committed, the offender must be punished. Rash and negligent driving,
drunken driving, over-speeding, red light jumping, etc. are punishable offences. The
punishment has dual purpose. It warns the offender that he should take care in future and it
also deters other persons from rash and negligent driving.

Compensation to Victim:
Under the law, compensation is recoverable by the victim of the accident, and if he is dead,
by his next-of-kin. It is mandatory for all vehicles to be properly insured at all the times.

According to Section 1A of the Fatal Accident Act, 1855 “Whenever the death of a person
shall be caused by wrongful act, neglect or default, and the act, neglect or default is such as
would (if death had not ensured) have entitled the party injured to maintain an action and
recover damages in respect thereof, the party who would have been liable if death had not
ensued shall be liable to an action or suit for damages, notwithstanding the death of the
person injured, and although the death shall have been caused under such circumstances as
amount in law to felony or other crime. Every such action or suit shall be for the benefit of
the wife, husband, parent and child, if any, of the person whose death shall have been so
caused, and shall be brought by and in the name of the executor, administrator or
representative of the person deceased.

Concept of Golden Hour:

The ‘Golden Hour’ is the first hour after the Trauma. However, Golden hour is not always a
predefined time period. Sometimes, according to the severity of the situation the golden
hour can range from a few minutes to several hours. It is a concept that emphasises the
urgency of care required by major trauma patients to prevent ‘early deaths’ predominantly
from haemorrhage.

R. Adams Cowley, founder of Shock Trauma Institute, Baltimore came up with the term
‘Golden Hour’ in the year 1975. He called this time as the time between life and death.
According to him, if a person is critically injured, rather than dying right away, that person
might have less than sixty minutes for any chance of survival. The concept of golden hour
plays an important role even in the current situation as these spreads the importance of
seeking urgent medical treatments in cases of traumas. The validity of this concept remains
controversial

If proper and timely first aid is given, road accident victims have a higher chance of survival.
Prompt action may also reduce the severity of the injuries. Many deaths and impact of
injuries can be prevented with First Aid if causalities are treated immediately. One of the
misconceptions about road accidents death is that most of them happen due to sever injury
and loss of blood. But reality is that most common cause of death in road accidents due to
loss of oxygen supply. Normally it takes less than four minutes for a blocked airway to cause
death. It is said that these four minutes are crucial. It is not always possible that proper
medical care reaches the victim within an hour. In that case the passer-by, onlookers and
other people involved can provide the first aid to serious victims.

Good Samaritan Law:

According to the World Health Organisation (WHO), in the absence of established

emergency medical services, bystanders can play a game changing role in saving lives. They
can call for help, provide first-aid to the injured and even rush them to the nearest hospital,
if an ambulance does not arrive in time.
A good Samaritan is a person who is good in faith, and without any expectation of any
reward or payment, voluntarily comes forward to help and give immediate assistance and
emergency care to a person injured in the accident or other mishap. Such person contacts
the police and other authorities, provide first-aid to the injured person, and sometimes even
take the person to a hospital if ambulance does not come in time.

In Save Life Foundation v. Union of India, AIR 2016 SC 1617 case, the Supreme Court gave
following guidelines.

 A good Samaritan will not be liable for any civil or criminal action for any injury to
the victim, or even his death.
 When such a person informs the police authorities or emergency services, he cannot
be compelled to give his personal details.
 Such persons cannot also be forced to make the initial payments for the treatment
of injured person.
 A good Samaritan cannot be compelled to appear as a witness in the court. But he
may do it voluntarily.

Conclusion:

A Medico-Legal Case (MLC) is a case, in which investigations by the law-enforcing agencies

are essential to fix the responsibility regarding the causation of the injury or ailment. It is the
legal duty of the treating doctor to report it to the nearest police station immediately after
completing primary lifesaving medical care of the victim. Quick action by the police also
helps to avoid the destruction of evidence by the treating physician.

Causes of Road Accidents

 Post authorBy Hemant More

 Post dateMarch 30, 2021
 1 Commenton Causes of Road Accidents

Law > Medical Jurisprudence > Causes of Road Accidents

A traffic or road accident is defined as an accident involving at least one vehicle on a road
open to public traffic in which at least one person is injured or killed. The main cause of
accidents and crashes are due to human errors. Most of the road users are quite well aware
of the general rules and safety measures while using roads but it is only the laxity on part of
road users, which cause accidents and crashes. In this article, we shall explain some of the
common behaviour of humans which results in accident i.e. causes of road accidents.

Over Speeding:
Over speeding is one of the most common causes of road accidents. There is a temptation
to push the speed limit when running late or sometimes drivers are obsessed with the
natural psyche of humans to excel and over speed. But the driver has to understand that the
road is a shared resource and many other vehicles are also using it. The increase in speed
increases the risk of accident and severity of injury during the accident.
Due to higher speed, the momentum of the vehicle is high. At high speed, the vehicle needs
a greater distance to stop i.e. braking distance. Hence there is a possibility of skidding the
vehicle for a longer distance. At the same time, it is difficult to control the steering.
A vehicle moving at high speed will have a greater impact during the crash and hence will
cause more injuries. Due to higher speed, the time of response is not sufficient to judge the
forthcoming events. Hence, it is advisable to drive within the specified limits even when you
are running late.

Distracted Driving:

Distraction during driving a minor cause, but can result in a fatal accident. The distraction
may be outside or inside the vehicle. Due to distraction, most of the part of the brain starts
thinking of the distraction, and thus lesser part of the brain handles driving. This division
results in a decrease in the reaction time and ability of judgement. Thus the possibility of
accident increases. The major reasons for distraction while driving are:

1. Talking on mobiles
2. Looking at the GPS system
3. Talking to passengers
4. Adjusting music controls
5. Adjusting mirror
6. Applying makeup
7. Handling children or pet
8. Reaching for a thing on the back seat
9. Eating while driving
10. Holding full bladder
11. Use of mind-altering substances such as alcohol, illicit drugs
 12. Prescribed medication (sedative/tranquilizer)
13. Daydreaming
14. Not looking at the road
15. Looking at Banners and Billboards
16. Looking at the scene outside
17. Animals on the road

Distraction seems to be a part of our everyday lives. Many times, people frequently drive
distracted and escape consequences. But one day it can result in a fatal accident. It only
takes a split second of distraction to create a lifetime of pain and suffering, hence care
should be taken when driving by keeping the focus on the road.

Drunken Driving:

Drunken driving or driving under the influence of drugs is also one of the major causes of
road accidents. The use of mind-altering substances such as alcohol, illicit drugs, or even
prescription medication makes it difficult to focus the attention of the driver on the road. At
the same time, alcohol reduces concentration and delays the response time. Limbs take
more to react to the instructions of the brain. It hampers vision due to dizziness. Alcohol has
another psychological effect. It dampens fear and incites humans to take risks.
Consumption of alcohol is not recommended but If you have had a drink or anything, take a
cab or give your keys to a teetotaler friend who can drop you home.

Lane Cutting:

Changing lanes dangerously is one of the top causes of road accidents. Some of the factors
that may contribute to a driver making the decision to change lanes are blind spots and high
speeds. Due care must be exercised before switching from one lane to another. Driver’s
fatigue, overspeeding, distraction, the influence of alcohol and drugs, etc. are some reasons
behind abrupt lane cutting.
Red Light Jumping:

It is a common sight at road intersections that vehicles cross without caring for the signal
light. Red always means stop. Even if it seems like no other cars are coming, you can cause a
serious accident by jumping a red light and you will be breaking the law. Particularly jumping
red light is dangerous at intersections. If the red light jumper crosses the intersection with
greater speed to avoid crash and challan but it hampers his ability to judge the ongoing
traffic and quite often result in a crash. The main motive behind Red light jumping is saving
time and fuel. A red light jumper not only jeopardizes his life but also the safety of other
road users. This act by one driver incites other drivers to attempt it and finally causes chaos
at the crossing. This chaos at the intersection is the main cause of traffic jams. It is found
that if all the vehicles follow a signal, a lot of time can be saved by avoiding jams at
intersections.

Avoiding Safety Gears like Seat Belts and Helmets:

It is essential to wear a seat belt while driving a four-wheeler. Not only it keeps your posture
right, but also reduces the chances of injuries during a head-to-head collision. It also
increases the likelihood of survival of the drivers without having to suffer any significant
damage. Bikers must were a helmet, it prevents severe head injuries during skidding or
crash. Wearing seat belts and helmets doubles the chances of survival in a serious accident.
One should use safety gear of prescribed standards and tie them properly for optimum
safety.

Night Driving:

Driving in the daylight can be hazardous, but driving at night nearly doubles the risk of a car
accident occurring. Lack of visibility makes to see the danger at night. When driving at night
you should be alert at every moment use full lights when driving on an abandoned road or a
road without streetlights.
Rain or Wet Roads:

Rain or wet reduces friction between the road and tires of the vehicle, hence Wet roads
become slippery. Wet roads can be fatal for vehicles. While you can’t always avoid driving in
the rain, the slippery streets should be best avoided whenever possible. Also, when the
visibility is too low due to rain, you should pull over and wait until the rain subsides.

Tailgating:

Keep a safe distance from other cars so that you will have time to react to sudden turns or
uses of brakes. No matter how frustratingly slow the cars in front of you must be going,
there’s no excuse to get too close.

Wrong-Way Driving/ Improper Turns:

When people don’t get in the proper lane to make a turn, use signals properly, or follow
traffic signals, accidents happen. When driving be aware of street signs warnings, one-way
streets, or other irregularities, especially in unfamiliar areas. Abide by street signs. When
making turns, use signals properly. It is hard to predict sudden changes in direction or
speed, or sudden movement of other vehicles. You should avoid sudden braking as it is likely
to cause a crash. When entering roads, temporarily stop to look around for oncoming traffic.

Potholes, Diversions, and Road Construction:

Driving through potholes is a tedious job. Drivers run the risk of losing control or balance of
their vehicle or blowing out a tire when they drive over potholes. Due to sudden change in
the direction or change of lane or loss of balance by biker can cause a serious accident. Try
to drive around potholes to avoid damaging your car, when you can, but do not swerve into
another lane if cars are coming. It is especially important to drive slowly in these areas to
avoid even the smallest accidents from occurring.
Tire Blowouts:

Tire blowout may result in swerving off the vehicle unexpectedly. In such a situation pull
over your car in the service lane. Change the tire or call for help if you cannot change the
tire yourself safely.

Teenage Drivers:

Teens don’t have the experience to know what to do in unsafe conditions, hence they are
one of the causes of road accidents. Teens should not be allowed to drive vehicles.

Environmental Factors:

Noise, air pollution, fog, snow, heavy rainfall, wind storms, hail storms, etc. are the
conditions which can cause road accidents.

Other Factors:

Carelessness, illiteracy, crossing at wrong places moving on the carriageway, Jaywalkers on

part of Pedestrians can cause road accidents. Projecting their body outside the vehicle, by
talking to drivers, alighting and boarding vehicle from the wrong side traveling on
footboards, catching a running bus, etc. on part of passengers can cause road accidents.
Failure of brakes or steering, tire burst, insufficient headlights, overloading, projecting loads
of vehicles can cause road accidents. Damaged and eroded roads, merging of rural roads
with highways, diversions, illegal speed breakers, etc. are some other causes of road
accidents.

Conclusion:

From the above explanation, we can conclude that the main reason for road accidents is
human error. All these reasons might sound very basic, but they are the significant reasons
behind accidents on roads. An accident can bring sufferings to the victim and his family.
Thus due care is to be taken to avoid road accidents.

Pattern Injuries to Pedestrians in Road Accident

 Post authorBy Hemant More

 Post dateJuly 2, 2022
 No Commentson Pattern Injuries to Pedestrians in Road Accident
Law > Medical Jurisprudence > Law and Medicine > Pattern Injuries to Pedestrians in Road Accident

A traffic or road accident is defined as an accident involving at least one vehicle on a road
open to public traffic in which at least one person is injured or killed. The main cause of
accidents and crashes are due to human errors. Most of the road users are quite well aware
of the general rules and safety measures while using roads but it is only the laxity on part of
road users, which cause accidents and crashes. In this article, we shall study medico-legal
aspect of road accident. In this article we shall discuss impact injuries and secondary injuries
caused to pedestrian due to road accident.

The main causes for road accidents are:

1. Over-speeding and lane cutting

2. Distraction during driving
3. Drunken driving
4. Jumping red signal
5. Tailgating
6. Wrong lane driving
7. Potholes and damaged roads
8. Poor maintenance of vehicles
9. Large numbers and unruly pedestrians and animals
10. Poor lightings on roads

The road traffic injuries may be sustained to:

 Pedestrians
 Cyclists/ Motor cyclists
 Occupants of a vehicle

Pattern Injuries to Pedestrians:

In case of pedestrians following injuries are often seen:

Primary Impact Injuries:

These are the injuries caused by vehicle when it first struck and hit the person whether
crossing the road from one side to the other side or walking with or against the traffic. The
importance of primary impact injury is that the body of victim may bear design / pattern of
the part of vehicle in form of imprint abrasion pattern bruised. Bumper, wing, headlights,
mirrors, grill, headlights, radiator, door handles may cause primary impact injuries.

Projections of vehicle may cause specific injuries like fracture of tibia & fibula of one or both
the legs. In case of children the fracture will be in femur. Height of the victim determines
site of injury. The impact depends on the speed and weight of the vehicle.

The body part which bears the injury depends upon the position of the person such as:

1. Was the pedestrian struck by the front of Vehicle?

2. Was the pedestrian struck by the side of Vehicle?
3. Was the pedestrian standing on road?
4. Was the pedestrian walking on road?
5. Was the pedestrian lying on road?

The findings of primary impact injury are important to find out the relative position of
pedestrian and vehicle and kind of vehicle involved in the Incident.
Impact Against Bumper (Bumper Injuries):

Injuries at the site of bumper impact, in the form of abrasion, contusion, laceration, internal
hemorrhage in the calves etc. Most characteristic fracture due to bumper fractures are
fracture of the tibia. The fracture fragments are wedge shaped and is displaced forwards.
The base of the wedge indicates the site of the impact, the apex points in the direction in
which the vehicle was travelling. Rarely, fibula also may get fractured. In children, bumper
fracture is seen in femur. When brakes are applied, the height of the bumper dips down,
thus the height of the bumper fracture is less than the height of the bumper. When
accelerator is pressed, the phenomenon is reversed.

The level of bumper injury (i.e, the height of injury from ground level) varies with height of
bumper of different vehicle. The vehicle can be identified from the height of the bumper
fracture from the ground and matching the same with the offending vehicle’s height of
bumper from the ground. Frequently Bumper injuries are at different level of the two legs or
absent on one leg, which suggest that the victim was walking or running when struck. If
bumper injuries are at the same level on both legs, then it means the person is standing.

Impact against mud guard or head lamp:

At impact against the headlamp or mudguard may result in fracture of the pelvis or fracture
dislocation of the sacroiliac joint. Injuries usually depend how the victim was positioned.
Frontal impacts may cause head injury, chest injury, fracture of ribs. Side impact causes
injuries of arms. Rear impact causes injuries to buttocks and sacroiliac joints. The fractured
portion of the vertebral column may move forward and may cause transection of the spinal
cord and thoracic aorta.

Impact when struck from front:

Injuries are virtually the same, except that the injuries are more on the frontal aspect. Intra-
abdominal injuries are seen, like linear superficial tears of the abdomen and inguinal
regions, due to over stretching of the skin. They appear dry, yellow and bloodless. Liver and
splenic injuries are common. There may be injuries to chest wall and thoracic contents.
Direct impact to thorax may cause rupture of the aorta below the arch at the level of
ligamentum arteriosum due to sudden increase in the intravascular pressure. The heart may
show bruising, laceration and rupture.

Impact when struck on one side:

The injuries are seen predominantly on one side. The opposite side receives injuries while
falling on the road.

Impact when the pedestrian walks into the side of the moving vehicle:

There may be injuries on the side of the front of face, chest and arms in the form of glancing
abrasions, patterned abrasions, crush lacerations, tear lacerations, fracture ribs with or
without lung involvement, abdominal injuries etc.

Secondary Impact Injuries:

They are caused by the second impact with the vehicle (eg: the body of thrown onto the
vehicle). They are caused when after sustaining primary impact of injury, the person may be
lifted off the ground and thrown of the vehicle. Here the person strikes to windshield or
bonnet or placed on the top of car/ vehicle. Usually, such injuries are on the opposite side of
primary impact.

Injuries are variable, depending on the area of the body involved. If the feet slide forward,
the whole body falls backwards, with a secondary impact of the head against the
windshield. If the victim falls on the hood, tangential force is directed by hood to the
buttock and thigh, causing separation of the skin and sub cutaneous tissues from the
muscle. This produces a pocket in the upper thigh and buttock, leading to collection of large
amounts of blood, which is often not visible, externally. If the feet are not firmly fixed on the
ground, the victim may be scooped up and thrown in the air and may land over the roof of
the vehicle, head hitting first, or may even land on the road behind the vehicle, where he
may be run over by other vehicles. Atlanto-occipital dislocation and partial disruption of
intervertebral discs are quite common in this situation.
Secondary and tertiary injuries:

They are caused when the body strikes the ground after the collision or striking another
stationary object or another vehicle. When the victim is thrown high up in air and strikes the
ground injuries are more severe. All kinds of injuries, including abrasions, contusions,
lacerations, fractures etc may be seen.

Sometimes the victim may be run over by the same vehicle and another vehicle. Brain
damage is frequent without any associated skull fractures. Fracture of the skull and ribs due
direct contact with a surface, and fracture of spine due to hyperflexion or extension may be
seen. In pedestrian accidents, the common cause of death is head injuries and fracture
dislocation of cervical spine.

Run-Over Injuries:

They are caused when the vehicle runs over some part of the body of the victim. In this case
the severity of injury depends on the part oof the body run over and the weight of the
vehicle.

Abrasions in the form of grazes, impact or imprint abrasions of the tire marks may be seen.
They are spread out a little due to yielding and flattening of body from pressure. Skull may
be crushed from side to side or forced open with extrusion of the brain matter. The ribs may
be fractured at multiple places. The abdomen may be ruptured with extrusion of the
contents. The whole body maybe crushed or hemisected.
Medico-Legal Aspect of Sexual Assault

 Post authorBy Hemant More

 Post dateJuly 3, 2022
 No Commentson Medico-Legal Aspect of Sexual Assault

Law > Medical Jurisprudence > Law and Medicine > Medico-Legal Aspect of Sexual Assault

A Medico-Legal Case (MLC) can be defined as a case of injury or ailment, etc., in which
investigations by the law-enforcing agencies are essential to fix the responsibility regarding
the causation of the injury or ailment. It may be a legal case requiring medical expertise
when brought by the police for examination. In this article we shall discuss medico-legal
aspect of sexual assault.

List of Medico-Legal Cases:

 All cases of injuries and burns -the circumstances of which suggest commission of an
offense by somebody. (Irrespective of suspicion of foul play)
 All vehicular, factory or other unnatural accident cases specially when there is a
likelihood of patient’s death or grievous hurt.
 Cases of suspected or evident sexual assault.
 Cases of suspected or evident criminal abortion.
 Cases of unconsciousness where its cause is not natural or not clear.
 All cases of suspected or evident poisoning or intoxication.
 Cases referred from a court or otherwise for age estimation.
 Cases brought dead with improper history creating suspicion of an offense.
 Cases of suspected self-infliction of injuries or attempted suicide.
 Any other case not falling under the above categories but has legal implications

Medical professionals are often unsure of the course of action in medico-legal cases. Thus,
they are rather reluctant to attend to cases of accident for fear of being involved in
unnecessary litigation later on. Even in cases of serious accidents, medical professionals
hesitate to offer help, sometimes resulting in patient’s death. The first question that arises
in such cases is whether any medical man can be forced to accept an accident victim. The
answer to this till some time back was very clear. The doctor could choose patients
according to his own will.

In Parmananda Katara Vs Union of India, AIR 1989 SC 2039 case, the apex court held that
every doctor is bound to provide medical aid to the victims irrespective of the cause of
injury; he cannot take any excuse of allowing law to take its course. Hence, if now a doctor
refuses treatment, in case of emergency, he/she could be sued under the law. Once the
doctor accepts the case and starts treatment, then the doctor-patient relationship is
established.

The doctor or hospital is required to examine a victim of rape if she reports to the hospital
directly, and voluntarily, without a police requisition.
In State of Karnataka v. Manjanna, 2000 (3) SCR 1007 case, the Supreme Court recognized
that the rape victim’s need for a medical examination constituted a “medicolegal
emergency”. Second, it was also the right of the victim of rape to approach medical services
first before legally registering a complaint in a police station. The hospital was obliged to
examine her right away; they could always subsequently initiate a police complaint on the
request of the victim. The judgment also recognizes the three ways by which a hospital may
receive a victim of rape: voluntary reporting by the victim; reporting on requisition by the
police, and reporting on requisition by the Court.

Medico-Legal Aspect of Sexual Assault:

Section 375 of the Indian Penal Code defines the term “Rape” as follows:

A man is said to commit “rape” who, except in the case hereinafter excepted, has sexual
intercourse with a woman under circumstances falling under any of the six following
descriptions:

(First) — Against her will.

(Secondly) —Without her consent.

(Thirdly) — With her consent, when her consent has been obtained by putting her or any
person in whom she is interested in fear of death or of hurt.

(Fourthly) —With her consent, when the man knows that he is not her husband, and that
her consent is given because she believes that he is another man to whom she is or believes
herself to be law¬fully married.

(Fifthly) — With her consent, when, at the time of giving such consent, by reason of
unsoundness of mind or intoxication or the administration by him personally or through
another of any stupe¬fying or unwholesome substance, she is unable to understand the
nature and consequences of that to which she gives consent.

(Sixthly) — With or without her consent, when she is under sixteen years of age.

Explanation: Penetration is sufficient to constitute the sexual intercourse necessary to the

offence of rape.

Exception: Sexual intercourse by a man with his own wife, the wife not being under fifteen
years of age, is not rape.

Object of Rape Evaluation Test:

Victims of alleged Sexual offences like rape may be brought for the medical examination by
police, or by order of a court, or the victim may come on their own. In the event the victim
comes directly, the police will be informed and necessary action will be taken to register a
case. The objects of medical examination are as follows:

1. Medical assessment and treatment of injuries and assessment, treatment, and

prevention of pregnancy and Sexually transmitted diseases (STDs)
2. Collection of forensic evidence;
3. Psychological evaluation;
4. Psychological support;
5. Prepare reports required under the law.

The principal features of the examination are:

1. Primary data;
2. Physical Examination and mental condition;
3. Signs of struggle on clothes and body;
4. Local examination of the genitals.

Medico Legal Aspect of Sexual Assault with Reference to Victim:

Section 53(5) of the CrPC talks about examination of a female victim, which should be done
by or under the supervision of a female doctor.
Section 164(A) CrPC explains the legal requirements for medical examination of a victim of
rape. One of the main elements of this is that the consent of the victim is mandatory and
should be part of the report.

The Section provides for a medical examination of the victim of rape by a registered medical
practitioner. It also provides that when no woman doctor is available, there is no bar against
a male doctor carrying out the examination, if the victim consents. Though getting the
examination done by a woman doctor is ideal, the law does not mandate it, keeping in mind
that a medical examination should not be postponed because of an extreme situation such
as the want of a female doctor.

The same section mandates that a medical examination must be carried out within 24 hours
of the police receiving information, thus recognizing this as a medico legal emergency and
putting a timeframe for the investigating officer.

The report shall state precisely the reasons for each conclusion arrived at. The exact time of
commencement and completion of the examination shall also be noted in the report. The
registered medical practitioner shall, without delay, forward the report to the investigating
officer, who shall forward it to the Magistrate referred to in section 173 of Cr. P. C. as part of
the documents referred to in clause (a) of sub-section (5) of that section.

Medico Legal Aspect of Sexual Assault with Reference to Accused:

Section 53A of the CrPC provides for a detailed medical examination of a person accused of
an offence of rape or an attempt to commit rape. A detailed medical examination is to be
carried out by a registered medical practitioner (only allopathic doctors registered under
the MCI) employed in a hospital run by government or local authority – and in the absence
of such a practitioner within the radius of 16 km from the place where the offence has been
committed, by any registered medical practitioner acting on the request of a police officer
not below the rank of a sub inspector.
The medical examination should be carried out without any delay and a “reasoned” report
be prepared recording the name and address of the accused, the person by whom he was
brought, the age of the accused, marks of injury if any, a description of materials collected
from the accused for DNA profiling, other material particulars in reasonable detail, and the
exact time of commencement and completion of examination. The report should be
forwarded without any delay to the investigating officer who in turn shall forward it to the
magistrate concerned.

The report shall state precisely the reasons for each conclusion arrived at. The exact time of
commencement and completion of the examination shall also be noted in the report. The
registered medical practitioner shall, without delay, forward the report to the investigating
officer, who shall forward it to the Magistrate referred to in section 173 of Cr. P. C. as part of
the documents referred to in clause (a) of sub-section (5) of that section.

Where the accused in a case of sexual offence in police custody is brought for medical
examination, consent is not required. Samples may be collected and handed over to the
police for forensic examination.

SAFE Kit:

The kit was developed in Chicago in the mid-1970s by Louis Vittulo, in order to provide a
more uniform protocol for evidence collection after sexual assaults. For years, the
standardized tool was referred to as a Vitullo kit. Today it is colloquially referred to as a rape
test kit or a rape kit, which is used interchangeably to refer to the specific evidence that is
obtained through the use of the rape kit. Other terms and abbreviations used are sexual
assault kit (SAK), a sexual assault forensic evidence kit (SAFE), sexual assault evidence
collection kit (SAECK) and PERK (Physical Examination Recovery Kit).

A SAFE kit consists of small boxes, swabs, microscope slides, sterile containers, and plastic
bags for collecting and storing evidence such as clothing fibers, hairs, saliva, blood, semen or
body fluid from lips, cheeks, thighs, and vagina.

The kit is useful for investigations conducted after an alleged sexual assault, and can be used
in evidence to punish the assailant. It is equally useful to exonerate persons who have been
falsely accused of sexual assault.

In Delhi Commission of Women v. Delhi Police, W.P. (CRL) 696/2008 case, the Court
mandated certain changes in the police system, health services, child welfare committees,
legal services and support services in order to give justice to victims of rape. The court
pronounced that a SAFE Kit (Sexual Assault Forensic Evidence collection kit) be used by all
medical personnel for gathering and preserving physical evidence following sexual assault.
Court issued guidelines to police, medical examiners, courts, and prosecution. Click here for
guidelines
Guidelines for attending alleged victim of sexual offence

1. The date and time of arrival of the victim must be mentioned, both in the case sheet
and the MLC Register. The duplicate copy of case sheet and Medicolegal Report shall
be preserved for future reference.
2. The date and time of examination will be mentioned in the case sheet.
3. Case sheet will be initiated, noting personal particulars of the victim, along with date
and the time of reporting.
4. MLC will be initiated after filling the MLC Register available at examination facility.
5. The alleged victim will be admitted if the medical condition is serious.
6. The police will be informed telephonically followed by in writing after filling up the
MLC Register.
7. The Senior Registrar / Station HQ will be informed.
8. At least two identification marks of the victim will be mentioned in the case sheet as
well as in MLC register.
9. Report to the police will be given by name of the victim or as an unknown case (If
name of the victim is not known). Care must be taken to preserve the confidentiality
of the victim from others not related with the case.
10. Police will register a case under the relevant section of the IPC.
11. The police may take the victim and the accused for medical examination at a hospital
which is authorized to carry out medicolegal work.
12. Neither the victim nor accused in cases of sexual offences should be permitted to
wash or take a bath till the medical examination is completed.
13. The proforma for recording medical examination of alleged rape victim and the
accused are enclosed as in prescribed format respectively.
14. Consent of the victim must be obtained before starting the examination. The steps of
examination and their purpose should be explained to the victim in a language she
understands. The examination is to be carried out in the presence of a female
attendant.
15. All injuries present on the body will be recorded. Line diagrams depicting the front
and back of the body may be used for a better description of location of the injuries.
16. If the clothes are the same as those worn during the occurrence of alleged sexual
offence, they should be carefully examined for the presence of blood, seminal stains,
mud etc.
17. If there are any marks of suspicious stains, the clothes should be preserved with a
view to forwarding them to forensic laboratory in prescribed format.
18. If there are foreign hairs, fibres, debris under the nails etc, they must be carefully
preserved and sent to experts of forensic laboratory for comparison with those
found on the accused. Specimens should include vaginal swab, preferably from the
posterior fornix.
19. Care must be taken to preserve various samples of medicolegal importance for their
submission to respective police authority.
20. In case the victim reports herself directly to the hospital after the alleged crime, she
should not be sent to the police station for legal formalities; instead the police will
be called to the hospital for the necessary requirements.

Other Legal provisions Associated with Sexual Assault:

  U/s 228A of Indian Penal Code, no person can disclose the name of the rape victim
and if anybody discloses the name, he shall be punished with either description for a
term which may extend to two years and shall also be liable for fine.
 U/s 114-A of Indian Evidence Act, presumption can be made as to the absence of
consent in certain prosecutions for rape. Whenever the person of a female victim is
to be examined under section 53 [5] of Criminal Procedure Code (Cr. P. C), the
examination shall be made only by, or under the supervision of, a female registered
medical practitioner.
 U/s 327(2) of Code of Criminal Procedure, there should be in camera trial for all rape
victims.

Conclusion:

Medico legal evidence has been considered an important component in the prosecution of
crimes, especially those related to sexual violence. The courts heavily rely upon it. However,
it is important to understand that forensic science itself is a new and emerging discipline. No
forensic method has rigorously been able to demonstrate a definitive connection between a
specific individual and a sample or source. So special precaution should be taken and care,
emphasis should be laid on section 53 CrPC and 164A CrPC

Human Experimentation with Drugs

 Post authorBy Hemant More

 Post dateJuly 3, 2022
 No Commentson Human Experimentation with Drugs

Law > Medical Jurisprudence > Law and Medicine > Medico-Legal Aspect of Human
Experimentation with Drugs

Human experimentation can be broadly defined as anything done to an individual to learn

how it will affect him. The main objective of human experimentation with drugs is the
acquisition of new scientific knowledge rather than therapy. Human experimentation
becomes most critical in the field of medicine, where the relationship between the
experimenter and his subject is on a direct individual basis and the experiment may affect
the subject’s health or life. Medical experimentation is therefore of vital interest to law and
society. The traditional physician regarded his patient primarily as a subject for treatment
rather than for experimentation. The traditional doctor-patient relationship gets affected by
the pressures of experimentation so that now the physician is also an investigator, and the
patient is also a subject.

Clinical Trials:

A clinical trial is a systematic study to generate data for discovering or verifying the clinical
and pharmacological profile (including pharmacodynamic and pharmacokinetic) or adverse
effects of a new drug on humans. Clinical trial is the only way of establishing the safety and
efficacy of any drug before its introduction in the market for human use and is preceded by
animal trials where the efficacy and side effects are observed in animals and an estimated
drug dose is established.

Requirements of Clinical Trials:

 Fully informed consent of all participants

 Full information to be given about the experiment, including its benefits and risks
 Attentions are to be drawn to possible alternatives
 If clinical trial involves a pregnant woman, extra care and protective measures must
be taken

Need of Clinical Trials:

 For finding out bioequivalence data volunteer subjects, generally healthy individuals
but occasionally in patients are used.
 For testing a drug usually Serum/plasma samples are obtained at regular intervals
and assayed for parent drug concentration.
 But these alone neither feasible nor possible to compare the two products of various
means of use for instance if drug is to be consumed by inhaling etc.
 Thus testing will be conducted to clinical trials at several different doses to derive
expected results.

Phases of Clinical Trial:

There are 4 phases of biomedical clinical trials:

 Phase I studies usually test new drugs for the first time in a small group of people (20
– 80) to evaluate a safe dosage range and identify side effects.
 Phase II studies test treatments that have been found to be safe in phase I but now
need a larger group of human subjects (100 – 300) to monitor for any adverse
effects.
 Phase III studies are conducted on larger populations (3000) and in different regions
and countries, and are often the step right before a new treatment is approved.
 Phase IV studies take place after country approval and there is a need for further
testing in a wide population over a longer timeframe.

Participating in Clinical Trials:

A clinical study is conducted according to a research plan known as the protocol. The
protocol is designed to answer specific research questions and safeguard the health of
participants. It contains the following information:

 The reason for conducting the study

 Who may participate in the study (the eligibility criteria)
 The number of participants needed
  The schedule of tests, procedures, or drugs and their dosages
 The length of the study
 What information will be gathered about the participants

Concerns with Clinical Trials in India:

 The big problem plaguing clinical research is an over-representation of low-income

groups among trial subjects.
 Sometimes Clinical research organizations (CROs) recruit them selectively, exploiting
financial need and medical ignorance.
 Because these subjects are well-paid, and get no therapeutic benefit, their only
reward from the trial is financial.
 Such deception is a risk not only to volunteer health but also to society, because it
can throw off the trial’s results.
 Due to this unethical practices unsafe drugs can make their way into the market and
safe drugs can get rejected.
 Selectiveness in recruiting subjects for clinical trials leads to human rights violations
and to bad science.

Functions of Ethics Committee in Clinical Trials:

According to the Drugs and Cosmetics rules, 1945. an Ethics Committee is a committee
comprising of medical, scientific, non-medical and non-scientific members, whose
responsibility is to ensure the protection of the rights, safety and well-being of human
subjects involved in a clinical trial and it shall be responsible for reviewing and approving the
protocol, the suitability of the investigators, facilities, methods and adequacy of information
to be used for obtaining and documenting informed consent of the study subjects and
adequacy of confidentiality safeguards. In the case of any serious adverse event occurring to
the clinical trial subjects during the clinical trial, the Ethics Committee shall analyze and
forward its opinion as per procedure specified under APPENDIX XII of Schedule Y.

If the Ethics Committee fails to comply with any of the conditions of registration, the
Licensing Authority may, after giving an opportunity to show cause why such an order
should not be passed, by an order in writing stating the reasons therefor, suspend or cancel
the registration of the Ethics Committee for such period as considered necessary.

Nuremberg Code:

A major issue at Nuremberg was defining the criteria for ethical human experimentation.
Consequently, the Articles of the Nuremberg Tribunal developed as the first formal attempt
to create a legal framework governing human experimentation. The Nuremberg Code aimed
to protect human subjects from enduring the kind of cruelty and exploitation the prisoners
endured at concentration camps. The 10 Articles provide:

1. The voluntary consent of the human subject is absolutely essential. This means that
the person involved should have legal capacity to give consent; should be so situated
as to be able to exercise free power of choice, without the intervention of any
 element of force, fraud, deceit, duress, overreaching, or other ulterior form of
constraint or coercion; and should have sufficient knowledge and comprehension of
the elements of the subject matter involved as to enable him to make an
understanding and enlightened decision. This latter element requires that before the
acceptance of an affirmative decision by the experimental subject there should be
made known to him the nature, duration, and purpose of the experiment; the
method and means by which it is to be conducted; all inconveniences and hazards to
be expected; and the effects upon his health or person which may possibly come
from his participation in the experiment. The duty and responsibility for ascertaining
the quality of the consent rests upon each individual who initiates, directs, or
engages in the experiment. It is a personal duty and responsibility which may not be
delegated to another with impunity.
2. The experiment should be such as to yield fruitful results for the good of society,
unprocurable by other methods or means of study, and not random and unnecessary
in nature.
3. The experiment should be so designed and based on results of animal
experimentation and a knowledge of the natural history of the disease or other
problems under study that the anticipated results will justify the performance of the
experiment.
4. The experiment should be so conducted as to avoid all unnecessary physical and
mental suffering and injury.
5. No experiment should be conducted where there is an a priori reason to believe that
death or disabling injury will occur; except, perhaps, in those experiments where the
experimental physicians also serve as subjects.
6. The degree of risk to be taken should never exceed that determined by the
humanitarian importance of the problem to be solved by the experiment.
7. Proper preparations should be made and adequate facilities provided to protect the
experimental subject against even remote possibilities of injury, disability or death.
8. The experiment should be conducted only by scientifically qualified persons. The
highest degree of skill and care should be required through all stages of the
experiment of those who conduct or engage in the experiment.
9. During the course of the experiment the human subject should be at liberty to bring
the experiment to an end if he has reached the physical or mental state where
continuation of the experiment seems to him to be impossible.
10. During the course of the experiment the scientist in charge must be prepared to
terminate the experiment at any stage, if he has probable cause to believe, in the
exercise of the good faith, superior skill, and careful judgment required of him, that a
continuation of the experiment is likely to result in injury, disability, or death to the
experimental subject.

Helsinki Declaration:

The concepts of Nuremberg were re-evaluated at the meeting of the World Medical
Association in Helsinki in Finland, in June of 1964, and were incorporated into the Code of
Ethics on Human Experimentation of the World Medical Association. Helsinki declaration of
1964 serves as Bible for all doctors doing biomedical research involving human participants.
It is a set of ethical principles relating to human experimentation developed for the medical
community by the World Medical Association in 1964, at Helsinki in Finland. It is very
important and best-known policy statement. The first version was adopted in 1964 and has
been amended seven times since, most recently at the General Assembly in October 2013.
The current (2013) version is the only official one; all previous versions* have been replaced
and should not be used or cited except for historical purposes.

The fundamental principle underlying the declaration is respect for individual, his right to
self-determination and his right to make an informed decision as regard s to his
participation in research, both initially and during the course of research.

Medical research involving human subjects must conform to generally accepted scientific
principles and must be based on a thorough knowledge of the scientific literature, other
relevant sources of information, and adequate laboratory and animal experimentation.
Medical research involving human subjects must be conducted only on individuals with
appropriate ethics and scientific education, training and qualifications. Appropriate
compensation and treatment for subjects who are harmed as a result of participating in
research must be ensured.

Based upon those underlying concepts the final Code (64th WMA General Assembly,
Fortaleza, Brazil, October 2013) embodied the following basic principles:

Preamble

1. The World Medical Association (WMA) has developed the Declaration of Helsinki as
a statement of ethical principles for medical research involving human subjects,
including research on identifiable human material and data. The Declaration is
intended to be read as a whole and each of its constituent paragraphs should be
applied with consideration of all other relevant paragraphs.
2. Consistent with the mandate of the WMA, the Declaration is addressed primarily to
physicians. The WMA encourages others who are involved in medical research
involving human subjects to adopt these principles.

General Principles

 The Declaration of Geneva of the WMA binds the physician with the words, “The
health of my patient will be my first consideration,” and the International Code of
Medical Ethics declares that, “A physician shall act in the patient’s best interest when
providing medical care.”
 It is the duty of the physician to promote and safeguard the health, well-being and
rights of patients, including those who are involved in medical research. The
physician’s knowledge and conscience are dedicated to the fulfilment of this duty.
 Medical progress is based on research that ultimately must include studies involving
human subjects.
 The primary purpose of medical research involving human subjects is to understand
the causes, development and effects of diseases and improve preventive, diagnostic
and therapeutic interventions (methods, procedures and treatments). Even the best
 proven interventions must be evaluated continually through research for their
safety, effectiveness, efficiency, accessibility and quality.
 Medical research is subject to ethical standards that promote and ensure respect for
all human subjects and protect their health and rights.
 While the primary purpose of medical research is to generate new knowledge, this
goal can never take precedence over the rights and interests of individual research
subjects.
 It is the duty of physicians who are involved in medical research to protect the life,
health, dignity, integrity, right to self-determination, privacy, and confidentiality of
personal information of research subjects. The responsibility for the protection of
research subjects must always rest with the physician or other health care
professionals and never with the research subjects, even though they have given
consent.
 Physicians must consider the ethical, legal and regulatory norms and standards for
research involving human subjects in their own countries as well as applicable
international norms and standards. No national or international ethical, legal or
regulatory requirement should reduce or eliminate any of the protections for
research subjects set forth in this Declaration.
 Medical research should be conducted in a manner that minimises possible harm to
the environment.
 Medical research involving human subjects must be conducted only by individuals
with the appropriate ethics and scientific education, training and qualifications.
Research on patients or healthy volunteers requires the supervision of a competent
and appropriately qualified physician or other health care professional.
 Groups that are underrepresented in medical research should be provided
appropriate access to participation in research.
 Physicians who combine medical research with medical care should involve their
patients in research only to the extent that this is justified by its potential preventive,
diagnostic or therapeutic value and if the physician has good reason to believe that
participation in the research study will not adversely affect the health of the patients
who serve as research subjects.
 Appropriate compensation and treatment for subjects who are harmed as a result of
participating in research must be ensured.

Risks, Burdens and Benefits

 In medical practice and in medical research, most interventions involve risks and
burdens.
 Medical research involving human subjects may only be conducted if the importance
of the objective outweighs the risks and burdens to the research subjects.
 All medical research involving human subjects must be preceded by careful
assessment of predictable risks and burdens to the individuals and groups involved
in the research in comparison with foreseeable benefits to them and to other
individuals or groups affected by the condition under investigation. Measures to
minimise the risks must be implemented. The risks must be continuously monitored,
assessed and documented by the researcher.
  Physicians may not be involved in a research study involving human subjects unless
they are confident that the risks have been adequately assessed and can be
satisfactorily managed. When the risks are found to outweigh the potential benefits
or when there is conclusive proof of definitive outcomes, physicians must assess
whether to continue, modify or immediately stop the study.

Vulnerable Groups and Individuals

 Some groups and individuals are particularly vulnerable and may have an increased
likelihood of being wronged or of incurring additional harm. All vulnerable groups
and individuals should receive specifically considered protection.
 Medical research with a vulnerable group is only justified if the research is
responsive to the health needs or priorities of this group and the research cannot be
carried out in a non-vulnerable group. In addition, this group should stand to benefit
from the knowledge, practices or interventions that result from the research.

Scientific Requirements and Research Protocols

 Medical research involving human subjects must conform to generally accepted

scientific principles, be based on a thorough knowledge of the scientific literature,
other relevant sources of information, and adequate laboratory and, as appropriate,
animal experimentation. The welfare of animals used for research must be
respected.
 The design and performance of each research study involving human subjects must
be clearly described and justified in a research protocol. The protocol should contain
a statement of the ethical considerations involved and should indicate how the
principles in this Declaration have been addressed. The protocol should include
information regarding funding, sponsors, institutional affiliations, potential conflicts
of interest, incentives for subjects and information regarding provisions for treating
and/or compensating subjects who are harmed as a consequence of participation in
the research study. In clinical trials, the protocol must also describe appropriate
arrangements for post-trial provisions.

Research Ethics Committees

 The research protocol must be submitted for consideration, comment, guidance and
approval to the concerned research ethics committee before the study begins. This
committee must be transparent in its functioning, must be independent of the
researcher, the sponsor and any other undue influence and must be duly qualified. It
must take into consideration the laws and regulations of the country or countries in
which the research is to be performed as well as applicable international norms and
standards but these must not be allowed to reduce or eliminate any of the
protections for research subjects set forth in this Declaration. The committee must
have the right to monitor ongoing studies. The researcher must provide monitoring
information to the committee, especially information about any serious adverse
events. No amendment to the protocol may be made without consideration and
approval by the committee. After the end of the study, the researchers must submit
 a final report to the committee containing a summary of the study’s findings and
conclusions.

Privacy and Confidentiality

 Every precaution must be taken to protect the privacy of research subjects and the
confidentiality of their personal information.

Informed Consent

 Participation by individuals capable of giving informed consent as subjects in medical

research must be voluntary. Although it may be appropriate to consult family
members or community leaders, no individual capable of giving informed consent
may be enrolled in a research study unless he or she freely agrees.
 In medical research involving human subjects capable of giving informed consent,
each potential subject must be adequately informed of the aims, methods, sources
of funding, any possible conflicts of interest, institutional affiliations of the
researcher, the anticipated benefits and potential risks of the study and the
discomfort it may entail, post-study provisions and any other relevant aspects of the
study. The potential subject must be informed of the right to refuse to participate in
the study or to withdraw consent to participate at any time without reprisal. Special
attention should be given to the specific information needs of individual potential
subjects as well as to the methods used to deliver the information. After ensuring
that the potential subject has understood the information, the physician or another
appropriately qualified individual must then seek the potential subject’s freely-given
informed consent, preferably in writing. If the consent cannot be expressed in
writing, the non-written consent must be formally documented and witnessed. All
medical research subjects should be given the option of being informed about the
general outcome and results of the study.
 When seeking informed consent for participation in a research study the physician
must be particularly cautious if the potential subject is in a dependent relationship
with the physician or may consent under duress. In such situations the informed
consent must be sought by an appropriately qualified individual who is completely
independent of this relationship.
 For a potential research subject who is incapable of giving informed consent, the
physician must seek informed consent from the legally authorised representative.
These individuals must not be included in a research study that has no likelihood of
benefit for them unless it is intended to promote the health of the group
represented by the potential subject, the research cannot instead be performed with
persons capable of providing informed consent, and the research entails only
minimal risk and minimal burden.
 When a potential research subject who is deemed incapable of giving informed
consent is able to give assent to decisions about participation in research, the
physician must seek that assent in addition to the consent of the legally authorised
representative. The potential subject’s dissent should be respected.
 Research involving subjects who are physically or mentally incapable of giving
consent, for example, unconscious patients, may be done only if the physical or
 mental condition that prevents giving informed consent is a necessary characteristic
of the research group. In such circumstances the physician must seek informed
consent from the legally authorised representative. If no such representative is
available and if the research cannot be delayed, the study may proceed without
informed consent provided that the specific reasons for involving subjects with a
condition that renders them unable to give informed consent have been stated in
the research protocol and the study has been approved by a research ethics
committee. Consent to remain in the research must be obtained as soon as possible
from the subject or a legally authorised representative.
 The physician must fully inform the patient which aspects of their care are related to
the research. The refusal of a patient to participate in a study or the patient’s
decision to withdraw from the study must never adversely affect the patient-
physician relationship.
 For medical research using identifiable human material or data, such as research on
material or data contained in biobanks or similar repositories, physicians must seek
informed consent for its collection, storage and/or reuse. There may be exceptional
situations where consent would be impossible or impracticable to obtain for such
research. In such situations the research may be done only after consideration and
approval of a research ethics committee.

Use of Placebo

 The benefits, risks, burdens and effectiveness of a new intervention must be tested
against those of the best proven intervention(s), except in the following
circumstances: Where no proven intervention exists, the use of placebo, or no
intervention, is acceptable; or Where for compelling and scientifically sound
methodological reasons the use of any intervention less effective than the best
proven one, the use of placebo, or no intervention is necessary to determine the
efficacy or safety of an intervention and the patients who receive any intervention
less effective than the best proven one, placebo, or no intervention will not be
subject to additional risks of serious or irreversible harm as a result of not receiving
the best proven intervention. Extreme care must be taken to avoid abuse of this
option.

Post-Trial Provisions

 In advance of a clinical trial, sponsors, researchers and host country governments

should make provisions for post-trial access for all participants who still need an
intervention identified as beneficial in the trial. This information must also be
disclosed to participants during the informed consent process.

Research Registration and Publication and Dissemination of Results

 Every research study involving human subjects must be registered in a publicly

accessible database before recruitment of the first subject.
 Researchers, authors, sponsors, editors and publishers all have ethical obligations
with regard to the publication and dissemination of the results of research.
 Researchers have a duty to make publicly available the results of their research on
human subjects and are accountable for the completeness and accuracy of their
reports. All parties should adhere to accepted guidelines for ethical reporting.
Negative and inconclusive as well as positive results must be published or otherwise
made publicly available. Sources of funding, institutional affiliations and conflicts of
interest must be declared in the publication. Reports of research not in accordance
with the principles of this Declaration should not be accepted for publication.

Unproven Interventions in Clinical Practice

 In the treatment of an individual patient, where proven interventions do not exist or

other known interventions have been ineffective, the physician, after seeking expert
advice, with informed consent from the patient or a legally authorized
representative, may use an unproven intervention if in the physician’s judgement it
offers hope of saving life, re-establishing health or alleviating suffering. This
intervention should subsequently be made the object of research, designed to
evaluate its safety and efficacy. In all cases, new information must be recorded and,
where appropriate, made publicly available.
 QUESTIONS AND ANSWERS

Law and Medicine Questions 1 to 20 (3 Marks)

 Post authorBy Hemant More

 Post dateMay 21, 2022
 No Commentson Law and Medicine Questions 1 to 20 (3 Marks)

Law > Medical Jurisprudence > Duties of Medical Practitioner

Q1A. Any two medical specialists (Write any Two)

 Pediatrician: Pediatrician is a medical doctor who manages the physical, behavioral,

and mental care for children from birth until age 18. A pediatrician is trained to
diagnose and treat a broad range of childhood illnesses, from minor health problems
to serious diseases. They focus on the prevention, detection and management of
physical, behavioral, developmental and social problems that affect children. They
work to diagnose and treat infections, injuries, and many types of organic disease
and dysfunction and bring about improvement in the life of children with chronic
problems.
 Cardiologist: Cardiologists are qualified to treat heart attacks, heart failure, heart
valve disease, arrhythmia, and high blood pressure. He may collaborate with cardiac
surgeons to decide the course of treatment for his patients. Cardiology is a specialty,
which has many subspecialties like interventional cardiology, nuclear cardiology,
electro physiology, or echocardiography, which help in making diagnostic studies.
 Gynecologist: A gynecologist is a doctor who specializes in female reproductive
health. They diagnose and treat issues related to the female reproductive tract. This
includes the uterus, fallopian tubes, and ovaries and breasts. They diagnose and
treat reproductive system disorders such as endometriosis, infertility, ovarian cysts,
and pelvic pain. They may also care for people with ovarian, cervical, and other
reproductive cancers.
 Orthopedic Surgeon: An orthopedic surgeon is qualified to diagnose orthopedic
problems, perform or prescribe treatments, and assist with rehabilitation. They also
help to develop long-term strategies to treat illnesses, disorders, and issues relating
 to bones, joints, ligaments, tendons, and muscles. These specialists help treat broken
bones, joint problems, like arthritis, and degenerative conditions, like osteoporosis.
In addition orthopedic doctors treat sports injuries, infections or congenital
conditions related to, and tumors in the bones.

Q1B. Any two varieties of medical profession (Write any Two)

1. Ayurveda

Ayurveda often referred as “the mother of all healing”, is an ancient Indian system of
healing. It is 5000 to 10000 years old. Reference of this system can be seen in the Rigveda
and the Atharva Veda. “Ayur” means life and veda means “knowledge”, thus “Ayurveda”
means knowledge of life. The medicines are mainly plant based.

Diagnosis in Ayurveda takes in the form of general physical examination, involving

examination of the pulse, tongue, eyes, vein sans faeces. Regulation of diet as a therapy
plays an important role in Ayurvedic treatment.

Major books on this system are Charak Sanhita and Sushruta Sanhita. This system has
holistic approach of treating the patient. “Charak Sanhita” is a massive compilation
containing several chapters on therapeutic and internal medicine. It contains reference to
more than six hundred types of medications of plant, animal, and mineral origin. “Sushrut
Sanhita” is an ancient scholarly work dedicated to surgery. In the whole world this is the
oldest compilation on surgery. The book is written in the sixth century B.C. by an ancient
Ayurvedic scholar “Sushruta”. The book contains descriptions of surgical procedures which
are relevant even today.
Doctrine of Ayurveda:

Body is made up of Pancha Mahabhootas: Prithvi (earth), Jal (water), Agni (fire), Vayu (air)
and Akash (ether). There are three doshas in the body: Tridosha: The Vata (ether + air), Pitta
(fire) and Kapha (earth + water) and Trigunas: the Satva, Rajas and Tamas, which are the
psychological properties

Any imbalance in above factors due to internal and external factors causes disease and
restoring equilibrium through various techniques, procedures, regimes, diet and medicine
constitute treatment. Over the years, Kshar Sutra and Panchakarma therapies of Ayurveda
have become very popular among the public.

2) Homeopathy:

The systematic foundation of Homeopathic techniques was made by German physician Dr,
Samuel Hahnemann. The word homeopathy is derived from two greek words, ‘homois’
means similar and ‘pathos’ means sufferings. Homeopathy is based on following three
principles:

 The Law of Similars: Main principle is Similia Similibus Curantur meaning likes are
cure by likes or likes be treated by likes.
  The Law of Minimum Dosage: In Homeopathy patient is given minimum dose so that
toxic effect of dose can be eliminated. The dose is to stimulate internal immune
system.
 The Law of Single Remedy: Homeopathy will try to treat patient by using single
remedy, which is the most similar to the symptoms shown by the patient.

Homeopathy adopts holistic approach towards the patient. Hence Homeopathy may give
two different medicines to two different patients suffering from the same problem.
Homeopathy uses animal, plant, mineral and synthetic substances in the preparation of
medicines.

3) Allopathy:

The system of medical practice which treats disease by the use of remedies which produce
effects different from those produced by the disease under treatment. The term “allopathy”
was coined in 1842 by C.F.S. Hahnemann to designate the usual practice of medicine
(allopathy) as opposed to homeopathy, the system of therapy that he founded based on the
concept that disease can be treated with drugs (in minute doses) thought capable of
producing the same symptoms in healthy people as the disease itself.

Allopathy is also known as Biomedicine or Western Medicine. Treatment is done by

medication, surgery, radiation, or and other therapies and procedures. The criticism to the
system is that allopathic medicines like pills and injection do not cure disease, they merely
mask the symptoms of disease.

Doctrine of Allopathy

It believes that germs, bacteria, and viruses that causes disease are destroyed when drugs
and chemical agents are administered in the patient. Modern diagnostic methods like X-
rays, sonography, ECG, instruments and techniques like use of radioisotopes are used.
Millions of dollars are spent annually on research and development of allopathic drugs.
Main drugs used include, antipyretics, antibiotics, antifungal, antibacterial, antihistamine,
antifertility, narcotics, sulpha drugs, etc. Allopathy has had the most evidence-based
scientific research, data collection, and drug testing. It’s also the most regulated by a neutral
party like the Food and Drug Administration (FDA) or the Indian Medical Association.

4) Siddha Therapy:

It is 5000 year old system of medicines. It is based on the similar principles of Ayurveda. The
word “siddha” means “achievement” and practitioner of this system of treatment were
called “Siddhars”. This system is said to be developed by many Siddhars. Agatsya was the
first Siddhar. It is mostly practiced in South India, particularly in Tamil Nadu. April 14 is
celebrated as World Siddha Day.

This system treats the individual as a microcosm of the universe. It believes that the human
body is made up of five tatvas or elements namely: earth, water, air, fire, and space. It
considers food as basic building block of human body, which gets processed into humors,
tissues and waste matter. The equilibrium of humors contribute to the health of a person
and its imbalance or disturbance leads to disease. It puts emphasis on the body, mind, and
spirit and work for harmony of the human body. It is particularly effective in allergy, skin
problems, arthritis, and general debility.

The Siddha system of Medicine emphasizes on the patient, environment, age, sex, race,
habits, mental frame work, habitat, diet, appetite, physical condition, physiological
constitution of the diseases for its treatment which is individualistic in nature Diagnosis of
diseases are done through examination of pulse, urine, stool, eyes, skin, study of voice,
colour of body, tongue and status of the digestion of individual patients.

5) Yoga:

Derived from the Sanskrit word ‘yuj’ which means ‘to unite or integrate’, yoga is a 5,000-
year-old Indian body of knowledge. Yoga is all about harmonizing the body with the mind
and breath through the means of various breathing exercises, yoga poses (asanas),
mudras (hand positions) and meditation (dhyana).

There are eight limbs of yoga namely, Yam, Niyam, Asana, Pranayama, Pratyahara, Dhara,
Dhyana, Samadhi. Maharishi Patanjali who is regarded as the Father of Yoga, compiled in
his book called “Patanjali Yog Sutra”. Most of the Asnas work on the principle of stretching
a body. June, 21 every year is celebrated as the International Yoga day
Yoga is an Art and Science of healthy living. It is a spiritual discipline based on an extremely
subtle science, which focuses on bringing harmony between mind and body. The holistic
approach of Yoga is well established and it brings harmony in all walks of life and thus,
known for disease prevention, promotion of health and management of many lifestyle –
related disorders. Today, Yoga is popular across the globe, not just because of its efficacy in
the management of some diseases, but also of its strength in providing relief to the
practitioner, from mental and emotional distress and providing a feeling of well-being.
Hence, now-a-days Yoga is being practiced as part of healthy life style across the globe.

Q2. Informed consent:

Informed consent is defined as voluntary acceptance by a competent patient of a plan for

medical care after physician adequately discloses the proposed plan, its risks and benefits,
and alternative approaches. This requires a process of effective communication and
education between the physician and patient. Informed consent is a process with the
elements of autonomous authorization, free from coercion or manipulation, decision-
making capacity, disclosures to the patients, and comprehension.

There are four major components of informed consent:

1. That the patient has the capacity to make the decision.

2. The medical provider discloses information on the treatment, test, or procedure in
question. This includes explaining the expected benefits and risks, as well as the
probability of these benefits and risks occurring.
3. The patient must comprehend the information told to them.
 4. The patient must voluntarily give their consent, without any coercion from the
healthcare professional.

The informed consent may be express or implied. Before the procedure, the patient /
patient’s next keen has to complete and sign a consent form. This form is a legal document
that shows their participation in the decision and your agreement to have the procedure
done. In emergencies, when a decision must be made urgently, the patient is not able to
participate in decision making, and the patient’s next keen is not available, physicians may
initiate treatment without prior informed consent. In such situations, the physician should
inform the patient/the next keen at the earliest opportunity and obtain consent for ongoing
treatment in keeping with these guidelines.

Q3. Privileged Communication

A privileged communication is a conversation between two parties that is legally classified

as a private discussion. This discussion is legally protected, and so cannot be disclosed to
third parties. The concept is most commonly associated with a discussion between a doctor
and a patient. It is called so because whatever information that is disclosed in this kind of
setting is protected i.e., the courts cannot force the individual to disclose the details of such
communication.

Sections 122 to 129 of the Indian Evidence Act, 1872 contain provisions related to privileged
communication. These provisions deal with what is called absolute privilege, and apply only
to the specific instances covered by the sections. Communication between a doctor and his
patient does not enjoy absolute privilege, but can be said to have relative privilege. The
communication between a doctor and his patient can be communicated to other only in
bona fide manner and abiding the rules of confidentiality and exceptions to it.

If doctor is sued for medical negligence by the patient, then the doctor may disclose
information to the Court similarly if a doctor sues patient for non-payment of fees, the
patient can disclose information to the Court. If Court orders to produce medical reports
containing confidential information, then the doctor is supposed to submit it to the Court.

In Mr. X v. Hospital Z, AIR 1999 SC 495 case, the apex court when commenting on infectious
diseases held that in special circumstances, public interest would override the duty of
confidentiality, as where there is an immediate or future health risk to the community or to
a specific person.

Q4. Res ipsa loquitur

Res ipsa loquitur is a Latin maxim whose meaning is “the thing tells its own story”. It is
important on the part of the plaintiff that he/she did not contribute to the cause. In general,
it is the plaintiff’s responsibility to produce necessary evidence against the defendant to
have the judgment in his favour. The legal doctrine of res ipsa loquitur relieves a plaintiff of
his burden of proving any specific act of negligence on the part of the defendant.
The doctrine of Res Ipsa Loquitur has three elements:
 1. the injury that had occurred under the circumstances must be explicit and can only
occur due to someone’s negligence and it cannot occur in the ordinary situations.
2. the injury caused by the defendant to the plaintiff must have been done with the use
of some instrument which was exclusively under the control of the defendant.
3. the injury caused to the plaintiff must be under the scope of the defendant’s duty
and it must not be due to the voluntary act or the contribution from the plaintiff’s
side.

The first condition of doctrine is technical in nature and is difficult to prove plaintiff being
the layman in respect to medical science cannot prove the medical negligence based on
his/her common knowledge.

In Jaspal Singh v. Post Graduate Institute of Medical Education and Research 2000 (2) CPR
300 case, the patient, blood group was A+ was give n B+ blood on two different fays, and he
died soon thereafter. Here medical negligence is clearly seen and in such case the maxim
“Res ipsa loquitur” is applicable.

Q5. Right to health under Constitution of India

According to Article 21 of the Constitution of India “no person shall be deprived of his/her
life or personal liberty except according to the procedure established by law. Right to life
under Article 21 of the Constitution has been generously deciphered to mean something
more than only human presence and incorporates the right to live with nobility and
conventionality. The use of word ‘Life’ in Article 21 of the Constitution has a lot more
extensive importance which includes human nobility, the right to livelihood, right to health,
right to pollution free air, and so forth.

In the State of Punjab v. M.S. Chawla, it has been held that-the right to life ensured under
Article 21 incorporates inside its ambit the right to health and clinical consideration.

The Supreme Court in Vincent v. Union of India, held that a healthy body is the very
establishment of all human activities. Article 47, a Directive Principle of State Policy in such
manner lays pressure on the improvement of general health and denial of medications
harmful to health as one of the essential obligations of the state.

Right to health should be considered with the right to medical care and the right to clean
and pollution free environment.

Q6. Right to self determination

Article 21 of the Constitution is the basis of right of self-determination of patient. An adult

patient who suffers from no mental incapacity has an absolute right to choose whether to
consent to medical treatment. The protection of patient self-determination entails the
following elements: (a) recognition of, and respect for, the patient’s right to decide what
treatment to have or not to have; (b) provision of an enabling climate for the patient to
make self-determined choices (ensuring effective communication and building trust); and (c)
having regard for the context (social, cultural, emotional, etc.) in which the patient has to
make his or her decision. The right of self-determination of the patient ought to be
respected.
Two conditions are ordinarily required before applying the right of self determination. The
individual has to have the relevant internal capacities for self-government and has to be free
from external constraints. In a medical context, a decision is ordinarily regarded as
autonomous where the individual has the capacity to make the relevant decision, has
sufficient information to make the decision and does so voluntarily.

Where patients lack the capacity to make a decision, it follows necessarily that decisions
must be made on their behalf. Very young children ordinarily have the majority of decisions
made by parents and guardians. Where adults lack capacity, health care decisions are
ordinarily made by the health professional in overall charge of their care, although adults
can appoint someone to make decisions on their behalf.

Q7. Duties of medical practitioner

Chapter I of the Code of Ethics Regulation Rules, 2002 gives general responsibilities of the
Medical Practitioner.

1. A physician shall uphold the dignity and honour of his profession.

2. The Principal objective of the medical profession is to render service to humanity
with full respect for the dignity of profession and man.
3. Physicians should try continuously to improve medical knowledge and skills and
should make available to their patients and colleagues the benefits of their
professional attainments.
4. The physician should practice methods of healing founded on scientific basis and
should not associate professionally with anyone who violates this principle.
5. he should be modest, sober, patient, prompt in discharging his duty without anxiety;
conducting himself with propriety in his profession and in all the actions of his life.
6. Every physician shall maintain the medical records pertaining to his / her indoor
patients for a period of 3 years from the date of commencement of the treatment in
a standard proforma laid down by the Medical Council of India and attached as
Appendix 3
7. No person other than a doctor having qualification recognised by Medical Council of
India and registered with Medical Council of India/State Medical Council (s) is
allowed to practice Modern system of Medicine or Surgery.
8. Physicians should merit the confidence of patients entrusted to their care, rendering
to each a full measure of service and devotion.

Q8. Kinds of disaster:

A disaster is an unexpected accident that can inflict significant damage and maybe death. A
disaster is defined as a disruption on a massive scale, either natural or man-made, occurring
in short or long periods. Disasters can lead to human, material, economic or environmental
hardships, which can be beyond the bearable capacity of the affected society. There are two
kinds of disasters:
  Natural Disaster: A natural disaster is described as a major event caused by Earth’s
natural processes that result in significant environmental harm and loss of
life. Natural disasters are dictated by natural forces that people have little to no
influence over. These are the disasters people learn to prepare for and survive
because very little can be done to prevent them. Examples are earthquakes,
tsunamis, tornados, cyclones, floods, avalanches, landslides, draughts, forest fires.
 Man-made Disaster: Man-made disasters have an element of human intent,
negligence, or error involving a failure of a man-made system. Man-made disasters
are difficult to predict, however they are preventable. With a little vigilance, they
shouldn’t occur in the first place. Examples: gas leaks, oil spills, nuclear meltdowns,
and industrial fires due to human error.

Q9. Medical negligence

A tort is a residuary civil wrong. Duties in tort are fixed by the law and such duties are owed
in rem or to the people at large generally. Such wrongs can be remedied by filing for
unliquidated damages. Negligence is a tort. A negligence is the omission to do something
which a reasonable man, guided by those considerations which ordinarily regulate the
conduct of human affairs, would do or doing something which a prudent and reasonable
man would not do.

Medical Negligence basically is the misconduct by a medical practitioner or doctor by not

providing enough care resulting in breach of their duties and harming the patients which are
their consumers. Medical negligence has caused many deaths as well as adverse results to
the patient’s health. Some examples of medical negligence are as follows:

 improper administration of medicines.

 performing the wrong or inappropriate type of surgery.
 not giving proper medical advice.
 leaving any foreign object in the body of the patient such as a sponge or bandage,
etc. after the surgery.

Q10. Medical negligence and consumer protection Act any two case

Consumer Protection (Mediation) Rules 2020 dictates under Rule (4) that matters relating to
proceedings in respect of medical negligence resulting in grievous injury or death should not
be referred to the mediation cell. This is because medical negligence comes under the ambit
of the Consumer Protection Act.

In Indian Medical Association v V.P Shantha, 1995 (6) SCC 651 case, the Supreme Court
bought medical profession within the ambit of the Consumer Protection act, 1986. The apex
court said the relationship between patient and medical professional is contractual. A
Consumer who has been offered a service has the right to approach court if there is
sufficient evidence that there was breach of duty, medical negligence, a consumer has the
right to move to the consumer dispute redressal forum.
In Poonam Verma v. Ashwin Patel 1996 (4) SCC case, Pramod Verma, husband of the
appellant, Mrs. Poonam Verma fell ill and complained of fever and so, Ashwin Patel, who
was an authorized Homeopathic kept him under mediation and gave him some allopathic
medicines for viral fever for two days. But even after these medications the condition of
Ashwin Patel didn’t improve so Ashwin Patel shifted the medications from viral fever to
Typhoid Fever because according to Ashwin Patel these two diseases were prevalent in the
locality. But even then the condition of Pramod Verma deteriorated and so Ashwin Patel
asked the appellant to shift Pramod Verma to Sanjeevani Maternity and General Nursing
Home under Dr. Rajeev Warty. Then Pramod Verma was shifted to Hinduja Hospital in an
unconscious state where, after four and a half-hour of admission, he died. The Appellant
therefore filed a petition before the National Consumer Disputes Redressal Commission,
New Delhi. The issue was whether there was a breach of duty of care by Ashwin Patel in the
treatment of Pramod Verma and whether this will amount to actionable negligence. The
honourable Court found Ashwin Patel guilty for negligence and was made to pay
compensation.

Q11. Define Magic Remedy under DMR(OA) Act, 1954

According to Section 2(c) of theDrugs and Magic Remedies (Objectionable Advertisements)

Act, 1954, magic remedy‟ includes a talisman, mantra, kavacha, and any other charm of any
kind which is alleged to possess miraculous powers for or in the diagnosis, cure, mitigation,
treatment or prevention of any disease in human beings or animals or for affecting or
influencing in any way the structure or any organic function of the body of human beings or
animals.

Q12. Give two Examples of Medico Legal Case

All cases of accidents, burns, assaults, alleged suicide or homicide, poisoning, road traffic
accident, rape, drowning, etc shall be registered as medico legal cases (MLC).

1. Road Accident:

A traffic or road accident is defined as an accident involving at least one vehicle on a road
open to public traffic in which at least one person is injured or killed. The main cause of
accidents and crashes are due to human errors. Most of the road users are quite well aware
of the general rules and safety measures while using roads but it is only the laxity on part of
road users, which cause accidents and crashes.

The Investigation of the accident must be done as soon as possible after it occurs because it
helps in observing the conditions as they were at the time of the accident. Investigation
officer may take help from an automobile expert and a medical expert. Establishment of
facts includes visiting site of accident, examination of mechanical damages. If the driver of
the vehicle is survived, his medical examination is mandatory. It should be ascertained if he
was under the influence of alcohol or drugs at the time of accident. Medical examination of
the victims must be conducted immediately. Medical examination includes noting of injuries
suffered, place, angle, extent, and depth of injury. It also includes noting of blood stains on
body, tears, grease marks, mud and soil stains, etc.
In case of accidental death, an autopsy (post mortem) is often performed to ascertain the
cause of death. An autopsy or post-mortem is a surgical procedure involving a thorough
examination of the corpse by dissection to determine the cause and manner of death. The
procedure is performed by specialist pathologists.

2) Rape:

Section 375 of IPC defines the term “Rape”.

A man is said to commit “rape” who, except in the case hereinafter excepted, has sexual
intercourse with a woman under circumstances falling under any of the six following de-
scriptions:—

(First) — Against her will.

(Secondly) —Without her consent.

(Thirdly) — With her consent, when her consent has been obtained by putting her or any
person in whom she is interested in fear of death or of hurt.

(Fourthly) —With her consent, when the man knows that he is not her husband, and that
her consent is given because she believes that he is another man to whom she is or believes
herself to be lawfully married.

(Fifthly) — With her consent, when, at the time of giving such consent, by reason of
unsoundness of mind or intoxication or the administration by him personally or through
another of any stupefying or unwholesome substance, she is unable to understand the
nature and consequences of that to which she gives consent.

(Sixthly) — With or without her consent, when she is under sixteen years of age.

Explanation: Penetration is sufficient to constitute the sexual intercourse necessary to the

offence of rape.

Exception: Sexual intercourse by a man with his own wife, the wife not being under fifteen
years of age, is not rape.

Section 53(5) of the CrPC talks about examination of a female victim, which should be done
by or under the supervision of a female doctor. Section 53A of the CrPC provides for a
detailed medical examination of a person accused of an offence of rape or an attempt to
commit rape.

A detailed medical examination is to be carried out by a registered medical practitioner

employed in a hospital run by government or local authority without delay. A “reasoned”
report be prepared recording the name and address of the accused, the person by whom he
was brought, the age of the accused, marks of injury if any, a description of materials
collected from the accused for DNA profiling, etc.
Section 164(A) CrPC explains the legal requirements for medical examination of a victim of
rape. One of the main elements of this is that the consent of the victim is mandatory and
should be part of the report. It provides for a medical examination of the victim of rape by a
registered medical practitioner preferably woman within 24 hours of incidence of assault.

Q13. Write Short Note – Female Foeticide

Female foeticide is the procedure of abortion to terminate a female foetus from the womb
of the mother before taking birth after the sex recognition tests like an ultrasound scan. The
census figures not only indicate the imbalance in the sex ratio, but it also indicates, the
casual approach of society to all women. It is the cruellest on the part of society not to allow
a female child to be born.

Major Reasons for Female Foeticide:

 Patrilineal line of succession

 Dowry system, violence against women
 Low status of women
 Preference for son due to financial security
 Small family norm
 Religious and social taboos
 Misuse of diagnostic techniques.

Impact of Female Foeticide:

 The sex ratio denotes the ratio of females to males in a specific region. As per the
decennial Indian census, the Sex Ratio of India is 107.48. It means 107.48 males per
100 females in 2019.
 It increases number of crimes against women

Q14. Define Donor under TOHO Act 1994.

Section 2(f) of the Transplantation of Human Organs and Tissues (TOHO) Act, 1994, defines
donor as ““donor” means any person, not less than eighteen years of age, who voluntarily
authorises the removal of any of his human organs for therapeutic purposes under sub-
section (1) or sub-section (2) of section 3 of the Act”.

Q15. What is meant by “privileged communication‟?

A privileged communication is a conversation between two parties that is legally classified

as a private discussion. This discussion is legally protected, and so cannot be disclosed to
third parties. The concept is most commonly associated with a discussion between a doctor
and a patient. It is called so because whatever information that is disclosed in this kind of
setting is protected i.e., the courts cannot force the individual to disclose the details of such
communication.
Sections 122 to 129 of the Indian Evidence Act, 1872 contain provisions related to privileged
communication. These provisions deal with what is called absolute privilege, and apply only
to the specific instances covered by the sections. Communication between a doctor and his
patient does not enjoy absolute privilege, but can be said to have relative privilege. The
communication between a doctor and his patient can be communicated to other only in
bona fide manner and abiding the rules of confidentiality and exceptions to it.

If doctor is sued for medical negligence by the patient, then the doctor may disclose
information to the Court similarly if a doctor sues patient for non-payment of fees, the
doctor can disclose information to the Court. If Court orders to produce medical reports
containing confidential information, then the doctor is supposed to submit it to the Court.

16. What is meant by a patient’s rights to self-determination?

Article 21 of the Constitution is the basis of right of self-determination of patient. An adult

patient who suffers from no mental incapacity has an absolute right to choose whether to
consent to medical treatment. The protection of patient self-determination entails the
following elements: (a) recognition of, and respect for, the patient’s right to decide what
treatment to have or not to have; (b) provision of an enabling climate for the patient to
make self-determined choices (ensuring effective communication and building trust); and (c)
having regard for the context (social, cultural, emotional, etc.) in which the patient has to
make his or her decision. The right of self-determination of the patient ought to be
respected.
Two conditions are ordinarily required before applying the right of self determination. The
individual has to have the relevant internal capacities for self-government and has to be free
from external constraints. In a medical context, a decision is ordinarily regarded as
autonomous where the individual has the capacity to make the relevant decision, has
sufficient information to make the decision and does so voluntarily.

Where patients lack the capacity to make a decision, it follows necessarily that decisions
must be made on their behalf. Very young children ordinarily have the majority of decisions
made by parents and guardians. Where adults lack capacity, health care decisions are
ordinarily made by the health professional in overall charge of their care, although adults
can appoint someone to make decisions on their behalf.

Q17. Define “Genetic Counselling Centre‟ according to PCPNDT Act, 1994

According to Section 2(c) of the the Pre-conception and Pre-natal Diagnostic Techniques
(Prohibition of Sex Selection) Act, 1994, “Genetic Counselling Centre” means an institute,
hospital, nursing home or any place, by whatever name called, which provides for genetic
counselling to patients.

Q18. State any three important provisions of Helsinki Declaration with respect to human
experimentation of drugs.

Medical research in humans depends on important ethical considerations to ensure the

protection of the research subjects. The Helsinki Declaration is a statement outlining the
ethical principles for medical research involving human subjects that was initially adopted
by the 18th Assembly of the World Medical Association in Helsinki, Finland in June 1964. It
was developed from 10 principles first stated in 1947 in the Nuremberg Code and further
incorporated elements from the Declaration of Geneva (made in 1948), a statement of the
ethical duties of physicians.

1. “The health of my patient will be my first consideration,” and the International Code
of Medical Ethics declares that, “A physician shall act in the patient’s best interest
when providing medical care.”
2. It is the duty of the physician to promote and safeguard the health, well-being and
rights of patients, including those who are involved in medical research. The
physician’s knowledge and conscience are dedicated to the fulfilment of this duty.
3. he primary purpose of medical research involving human subjects is to understand
the causes, development and effects of diseases and improve preventive, diagnostic
and therapeutic interventions (methods, procedures and treatments). Even the best
proven interventions must be evaluated continually through research for their
safety, effectiveness, efficiency, accessibility and quality.
4. Medical research is subject to ethical standards that promote and ensure respect for
all human subjects and protect their health and rights.
5. While the primary purpose of medical research is to generate new knowledge, this
goal can never take precedence over the rights and interests of individual research
subjects.

Q19. What is the difference between ECG and EEG?

An electrocardiogram (ECG or EKG) is a medical test that detects heart problems by

measuring the electrical activity generated by the heart as it contracts. Each beat of the
heart is triggered by an electrical impulse generated from special cells in upper right
chamber of heart. An electrocardiogram is a painless, non-invasive way to help diagnose
many common heart problems in people of all ages. It is used to determine or detect:

 Abnormal heart rhythm (arrhythmias)

 If blocked or narrowed arteries in your heart (coronary artery disease) are causing
chest pain or a heart attack
 Whether you have had a previous heart attack
 How well certain heart disease treatments, such as a pacemaker, are working

An electroencephalogram (EEG) is a test that detects electrical activity in human brain using
small, metal discs (electrodes) attached to his scalp. The brain cells communicate via
electrical impulses and are active all the time, even when asleep. This activity shows up as
wavy lines on an EEG recording. An EEG is one of the main diagnostic tests for epilepsy.
An EEG can also play a role in diagnosing other brain disorders.

Q20. Write Short Note – Brain Stem Death

Brain stem is the “stalk of the brain” which connects the spinal cord to various parts of the
brain. It sends messages to the rest of your body to regulate balance, breathing, heart rate
and more. It is very vital part of the body. Section 2(d) of the Transplantation of Human
Organs and Tissues Act, 1994, defines brainstem death as ““brain-stem death” means the
stage at which all functions of the brain-stem have permanently and irreversibly ceased and
is so certified under sub-section (6) of section 3 of the Act.”

Identification of brain stem death carries important prognosis for the survival of the patient,
because the heart may keep on beating for few days after brain stem death, or even for
weeks if the patient is in the Intensive Care Unit of hospital with all forms of medical and
cardiac support. The person cannot perform fundamental work of an organism. The person
is practically dead but may have heart beat and such person may still able to breathe. Such
brain stem death must be certified by a Board of Medical Expert referred to in Section 3(6)
of the Act. The Board should contain

 the registered medical practitioner in charge of the hospital in which brain-stem

death has occurred;
 an independent registered medical practitioner, being a specialist, to be nominated
by the registered medical practitioner specified in clause (i), from the panel of names
approved by the Appropriate Authority;
 a neurologist or a neurosurgeon to be nominated by the registered medical
practitioner specified in clause (i), from the panel of names approved by the
Appropriate Authority: Provided that where a neurologist or a neurosurgeon is not
available, the registered medical practitioner may nominate an independent
registered medical practitioner, being a surgeon or a physician and an anaesthetist
or intensivist subject to the condition that they are not members of the
transplantation team for the concerned recipient and to such conditions as may be
prescribed;
 the registered medical practitioner treating the person whose brain-stem death has
occurred

Law and Medicine Questions 21 to 40 (3 Marks)

 Post authorBy Hemant More

 Post dateMay 22, 2022
 1 Commenton Law and Medicine Questions 21 to 40 (3 Marks)

Law > Medical Jurisprudence > Duties of Medical Practitioner

Q21. Quote the purpose of Pre-Natal Diagnostic Techniques (Regulation and Prevention of
Misuse) Act, 1994.

The purpose of the Pre-Natal Diagnostic Techniques (Regulation and Prevention of Misuse)
Act, 1994 are as follows:

 To prevent misuse of Pre-conception and Pre-natal Diagnostic Techniques for sex

determination leading to female feticide and arrest the declining sex ratio in India.
 To ensure the implementation of all promotional schemes for girl children at the
district level.
 To Monitor and evaluate the implementation of the PCPNDT Act through community
participation.
 To ensure accountability of implementing agencies through monitoring
implementation of the Act through community participation.
 To track pregnancies, MTPs, and birth registration with the help of Anganwadi
workers, ASHAs.
 To identify violators of the Act through conducting detailed audits of form ‘F’ filled in
for the pregnant women in the clinics.
 To develop a national, state, and district annual Plan.

Q22. An octogenarian couple have made a petition to Government for granting them
permission for active euthanasia. Quote landmark Indian case dealing with euthanasia
and legal status of euthanasia in India.

An octogenarian couple means that both the husband and wife are of age between 80 and
89. Euthanasia is described as the deliberate and intentional killing of a person for the
benefit of that person in order to relieve him from pain and suffering. The term ‘Euthanasia’
is derived from the Greek words which literally means “good death” (Eu= Good;
Thanatos=Death). Euthanasia is defined as the act of bringing the death of a person (patient)
for the purpose of relieving the patient’s intolerable and incurable suffering. Typically, the
physician’s motive is merciful and intended to end suffering. In voluntary euthanasia, a
consent from the patient is taken. In non-voluntary euthanasia, the consent of patient is
unavailable due to some reason.
In active euthanasia, the death of patient is brought directly by giving him a lethal dose of
poisonous drug. In passive euthanasia, the life supporting system to the patient is
discontinued and ultimately patient dies. In Aruna Shanbaug v. Union of India, the Supreme
Court opposed active euthanasia but has given nod to passive euthanasia. The apex court
also observed that right to life does not include right to die. Thus the request of the couple
of active euthanasia is not permitted under the light of Supreme Court decision.

Q23. What are the tests conducted by doctors to prove sexual offences?
Section 53(5) of the CrPC talks about examination of a female victim, which should be done
by or under the supervision of a female doctor. Section 164(A) CrPC explains the legal
requirements for medical examination of a victim of rape. One of the main elements of this
is that the consent of the victim is mandatory and should be part of the report. It provides
for a medical examination of the victim of rape by a registered medical practitioner. It also
provides that when no woman doctor is available, there is no bar against a male doctor
carrying out the examination, if the victim consents. Though getting the examination done
by a woman doctor is ideal, the law does not mandate it, keeping in mind that a medical
examination should not be postponed because of an extreme situation such as the want of a
female doctor. The same section mandates that a medical examination must be carried out
within 24 hours of the police receiving information, thus recognising this as a medico legal
emergency and putting a timeframe for the investigating officer.

A SAFE kit developed in Chicago in the mid-1970s by Louis Vittulo, consists of small boxes,
swabs, microscope slides, sterile containers, and plastic bags for collecting and storing
evidence such as clothing fibers, hairs, saliva, blood, semen or body fluid from lips, cheeks,
thighs, and vagina.

Q24. Give any three functions / activities of Red Cross.

The main functions of the Red Cross are:

 To extend relief and help to the victims of any calamity – fire, flood, famine,
earthquakes, etc
 To procure and supply blood for the victims of war and other calamities
 To extend all possible first-aid in an accident
 To educate people in accident prevention
 To arrange for ambulance service in all emergencies
 To look after maternal and child welfare centres
 Train midwives.

Q25. What do you mean by “Golden Hour”?

A traffic or road accident is defined as an accident involving at least one vehicle on a road
open to public traffic in which at least one person is injured or killed. The main cause of
accidents and crashes are due to human errors.

The ‘Golden Hour’ is the first hour after the Trauma. If proper and timely first aid is given,
road accident victims have a higher chance of survival. Prompt action may also reduce the
severity of the injuries. Many deaths and impact of injuries can be prevented with First Aid if
causalities are treated immediately. One of the misconceptions about road accidents death
is that most of them happen due to sever injury and loss of blood. But reality is that most
common cause of death in road accidents due to loss of oxygen supply. Normally it takes
less than four minutes for a blocked airway to cause death. It is said that these four minutes
are crucial. It is not always possible that proper medical care reaches the victim within an
hour. In that case the passer-by, onlookers and other people involved can provide the first
aid to serious victims.

Q26. A Doctor was negligent while operating his patient for transplantation of kidney. As
an Advocate of your client, how you will prove Doctor’s negligence when you have
approached Consumer Commission under Consumer Protection Act, 1986?

Medical Negligence basically is the misconduct by a medical practitioner or doctor by not

providing enough care resulting in breach of their duties and harming the patients which are
their consumers. Medical negligence has caused many deaths as well as adverse results to
the patient’s health. Some examples of medical negligence are as follows:

 improper administration of medicines.

 performing the wrong or inappropriate type of surgery.
 not giving proper medical advice.
 leaving any foreign object in the body of the patient such as a sponge or bandage,
etc. after the surgery.

In law, a patient must establish three elements in order to succeed in an action for medical
negligence, which are as follows:

1. That the medical practitioner owed the patient a duty of care.

2. That the medical practitioner was in breach of that duty.
3. That the patient suffered injury / damages as a result of the breach

Q 27. What do you mean by “informed consent”?

Informed consent is defined as voluntary acceptance by a competent patient of a plan for

medical care after physician adequately discloses the proposed plan, its risks and benefits,
and alternative approaches. This requires a process of effective communication and
education between the physician and patient. Informed consent is a process with the
elements of autonomous authorization, free from coercion or manipulation, decision-
making capacity, disclosures to the patients, and comprehension.

There are four major components of informed consent:

1. That the patient has the capacity to make the decision.

2. The medical provider discloses information on the treatment, test, or procedure in
question. This includes explaining the expected benefits and risks, as well as the
probability of these benefits and risks occurring.
3. The patient must comprehend the information told to them.
 4. The patient must voluntarily give their consent, without any coercion from the
healthcare professional.

The informed consent may be express or implied. Before the procedure, the patient /
patient’s next keen has to complete and sign a consent form. This form is a legal document
that shows their participation in the decision and your agreement to have the procedure
done. In emergencies, when a decision must be made urgently, the patient is not able to
participate in decision making, and the patient’s next keen is not available, physicians may
initiate treatment without prior informed consent. In such situations, the physician should
inform the patient/the next keen at the earliest opportunity and obtain consent for ongoing
treatment in keeping with these guidelines.

Q28. Quote any three principles to be followed by Health Workers.

The Hippocratic Oath is a sworn agreement made by physicians when they become doctors.
It isn’t a law, but rather is a guiding principle for doctors. It was written by the Greek
physician Hippocrates. It has been rewritten multiple times. Some use the original Greek
oath, while others use the Declaration of Geneva or the Oath of Maimonides, both of which
reference the original. Whichever version is used, virtually all medical schools use an oath of
some kind.

 The oath begins with an agreement by practitioners to openly share knowledge with
the physicians that follow them, for the sake of the profession.
 Next it swears that treatments will be used for the benefit of the ill and not for harm.
That’s the ‘do no harm’ part.
 Next, the oath says that doctors will allow specialists to complete surgeries, being
aware of their own limits, and that they will not use their position to complete sexual
acts or otherwise take advantage of their patients.
 Finally, the oath talks about doctor-patient confidentiality, requiring that doctors do
not reveal details of their meetings, conditions, or treatments.

Q29. Discuss in short any two varieties of Medical Profession in India. (Any Two)

1. Ayurveda

Ayurveda often referred as “the mother of all healing”, is an ancient Indian system of
healing. It is 5000 to 10000 years old. Reference of this system can be seen in the Rigveda
and the Atharva Veda. “Ayur” means life and veda means “knowledge”, thus “Ayurveda”
means knowledge of life. The medicines are mainly plant based.

Diagnosis in Ayurveda takes in the form of general physical examination, involving

examination of the pulse, tongue, eyes, vein sans faeces. Regulation of diet as a therapy
plays an important role in Ayurvedic treatment.

Major books on this system are Charak Sanhita and Sushruta Sanhita. This system has
holistic approach of treating the patient. “Charak Sanhita” is a massive compilation
containing several chapters on therapeutic and internal medicine. It contains reference to
more than six hundred types of medications of plant, animal, and mineral origin. “Sushrut
Sanhita” is an ancient scholarly work dedicated to surgery. In the whole world this is the
oldest compilation on surgery. The book is written in the sixth century B.C. by an ancient
Ayurvedic scholar “Sushruta”. The book contains descriptions of surgical procedures which
are relevant even today.
Doctrine of Ayurveda:

Body is made up of Pancha Mahabhootas: Prithvi (earth), Jal (water), Agni (fire), Vayu (air)
and Akash (ether). There are three doshas in the body: Tridosha: The Vata (ether + air), Pitta
(fire) and Kapha (earth + water) and Trigunas: the Satva, Rajas and Tamas, which are the
psychological properties

Any imbalance in above factors due to internal and external factors causes disease and
restoring equilibrium through various techniques, procedures, regimes, diet and medicine
constitute treatment. Over the years, Kshar Sutra and Panchakarma therapies of Ayurveda
have become very popular among the public.

2) Homeopathy:

The systematic foundation of Homeopathic techniques was made by German physician Dr,
Samuel Hahnemann. The word homeopathy is derived from two greek words, ‘homois’
means similar and ‘pathos’ means sufferings. Homeopathy is based on following three
principles:

 The Law of Similars: Main principle is Similia Similibus Curantur meaning likes are
cure by likes or likes be treated by likes.
 The Law of Minimum Dosage: In Homeopathy patient is given minimum dose so that
toxic effect of dose can be eliminated. The dose is to stimulate internal immune
system.
 The Law of Single Remedy: Homeopathy will try to treat patient by using single
remedy, which is the most similar to the symptoms shown by the patient.

Homeopathy adopts holistic approach towards the patient. Hence Homeopathy may give
two different medicines to two different patients suffering from the same problem.
Homeopathy uses animal, plant, mineral and synthetic substances in the preparation of
medicines.

3) Allopathy:

The system of medical practice which treats disease by the use of remedies which produce
effects different from those produced by the disease under treatment. The term “allopathy”
was coined in 1842 by C.F.S. Hahnemann to designate the usual practice of medicine
(allopathy) as opposed to homeopathy, the system of therapy that he founded based on the
concept that disease can be treated with drugs (in minute doses) thought capable of
producing the same symptoms in healthy people as the disease itself.
Allopathy is also known as Biomedicine or Western Medicine. Treatment is done by
medication, surgery, radiation, or and other therapies and procedures. The criticism to the
system is that allopathic medicines like pills and injection do not cure disease, they merely
mask the symptoms of disease.

Doctrine of Allopathy

It believes that germs, bacteria, and viruses that causes disease are destroyed when drugs
and chemical agents are administered in the patient. Modern diagnostic methods like X-
rays, sonography, ECG, instruments and techniques like use of radioisotopes are used.
Millions of dollars are spent annually on research and development of allopathic drugs.
Main drugs used include, antipyretics, antibiotics, antifungal, antibacterial, antihistamine,
antifertility, narcotics, sulpha drugs, etc. Allopathy has had the most evidence-based
scientific research, data collection, and drug testing. It’s also the most regulated by a neutral
party like the Food and Drug Administration (FDA) or the Indian Medical Association.

4) Siddha Therapy:

It is 5000 year old system of medicines. It is based on the similar principles of Ayurveda. The
word “siddha” means “achievement” and practitioner of this system of treatment were
called “Siddhars”. This system is said to be developed by many Siddhars. Agatsya was the
first Siddhar. It is mostly practiced in South India, particularly in Tamil Nadu. April 14 is
celebrated as World Siddha Day.

This system treats the individual as a microcosm of the universe. It believes that the human
body is made up of five tatvas or elements namely: earth, water, air, fire, and space. It
considers food as basic building block of human body, which gets processed into humors,
tissues and waste matter. The equilibrium of humors contribute to the health of a person
and its imbalance or disturbance leads to disease. It puts emphasis on the body, mind, and
spirit and work for harmony of the human body. It is particularly effective in allergy, skin
problems, arthritis, and general debility.

The Siddha system of Medicine emphasizes on the patient, environment, age, sex, race,
habits, mental frame work, habitat, diet, appetite, physical condition, physiological
constitution of the diseases for its treatment which is individualistic in nature Diagnosis of
diseases are done through examination of pulse, urine, stool, eyes, skin, study of voice,
colour of body, tongue and status of the digestion of individual patients.

5) Yoga:

Derived from the Sanskrit word ‘yuj’ which means ‘to unite or integrate’, yoga is a 5,000-
year-old Indian body of knowledge. Yoga is all about harmonizing the body with the mind
and breath through the means of various breathing exercises, yoga poses (asanas),
mudras (hand positions) and meditation (dhyana).

There are eight limbs of yoga namely, Yam, Niyam, Asana, Pranayama, Pratyahara, Dhara,
Dhyana, Samadhi. Maharishi Patanjali who is regarded as the Father of Yoga, compiled in
his book called “Patanjali Yog Sutra”. Most of the Asnas work on the principle of stretching
a body. June, 21 every year is celebrated as the International Yoga day
Yoga is an Art and Science of healthy living. It is a spiritual discipline based on an extremely
subtle science, which focuses on bringing harmony between mind and body. The holistic
approach of Yoga is well established and it brings harmony in all walks of life and thus,
known for disease prevention, promotion of health and management of many lifestyle –
related disorders. Today, Yoga is popular across the globe, not just because of its efficacy in
the management of some diseases, but also of its strength in providing relief to the
practitioner, from mental and emotional distress and providing a feeling of well-being.
Hence, now-a-days Yoga is being practiced as part of healthy life style across the globe.

Q30. What is the ratio decidendi in Indian Medical Council V/s V.P. Shanta AIR 1996 SC
550.

Indian Medical Council v. V.P. Shanta AIR 1996 SC 550:

Issues:

 Whether a medical practitioner, hospital, or nursing home can be regarded as

rendering service under Section 2(1)(o) of the Consumer Protection Act, 1986?
 Under what circumstances can the service render at a hospital/nursing be regarded
as service under Section 2(1)(o) of the Consumer Protection Act, 1986?

The ratio decendi of the case is medical negligence. Medical negligence is basically the
misconduct by medical practitioner by not providing enough care resulting in breach of their
duties and harming the patients which are consumers. They also argued whether this was
the case of negligence in Torts or IPC, later on it was decided that any negligence in medical
field would be determined under CPA, 1986. The Supreme court also stated that a medical
practitioner, nursing home or a hospital can be regarded as rendering service under CPA,
1986.

As a result of this judgement, medical profession has been brought under the Section 2(1)
(0) of CPA , 1986 and also , it has included the following categories of doctors/hospitals
under this Section:

 All medical / dental practitioners doing independent medical / dental practice unless
rendering only free service.
 All hospitals having free as well as paying patients and all the paying free category
patients receiving treatment in such hospitals.
 Medical / Dental practitioners and hospitals paid by an insurance firm for the
treatment of a client or an employment for that of an employee.

Q31 Role and functions of the proposed national medical commission

The Role of the National Medical Commission are

 To improve access to quality and affordable medical education,

  To ensure availability of adequate and high-quality medical professionals in all parts
of the country;
 To promote equitable and universal healthcare that encourages community health
perspective and makes services of medical professionals access to all the citizens;
 To encourages medical professionals to adopt latest medical research in their work
and to contribute to research;
 To objectively assess medical institutions periodically in a transparent manner;
 To maintain a medical register for India;
 To enforce high ethical standards in all aspects of medical services;
 To have an effective grievance redressal mechanism.

Functions of the National Medical Commission:

 lay down policies for maintaining a high quality and high standards in medical
education and make necessary regulations in this behalf;
 lay down policies for regulating medical institutions, medical researches and medical
professionals and make necessary regulations in this behalf;
 assess the requirements in healthcare, including human resources for health and
healthcare infrastructure and develop a road map for meeting such requirements;
 promote, co-ordinate and frame guidelines and lay down policies by making
necessary regulations for the proper functioning of the Commission, the
Autonomous Boards and the State Medical Councils;
 ensure co-ordination among the Autonomous Boards;
 take such measures, as may be necessary, to ensure compliance by the State
Medical Councils of the guidelines framed and regulations made under this Act for
their effective functioning under this Act;
 exercise appellate jurisdiction with respect to the decisions of the Autonomous
Boards;
 lay down policies and codes to ensure observance of professional ethics in medical
profession and to promote ethical conduct during the provision of care by medical
practitioners;
 frame guidelines for determination of fees and all other charges in respect of fifty
per cent. of seats in private medical institutions and deemed to be universities which
are governed under the provisions of this Act;
 exercise such other powers and perform such other functions as may be prescribed.

Q32. Privileged communication in medical cases

A privileged communication is a conversation between two parties that is legally classified

as a private discussion. This discussion is legally protected, and so cannot be disclosed to
third parties. The concept is most commonly associated with a discussion between a doctor
and a patient. It is called so because whatever information that is disclosed in this kind of
setting is protected i.e., the courts cannot force the individual to disclose the details of such
communication.

Sections 122 to 129 of the Indian Evidence Act, 1872 contain provisions related to privileged
communication. These provisions deal with what is called absolute privilege, and apply only
to the specific instances covered by the sections. Communication between a doctor and his
patient does not enjoy absolute privilege, but can be said to have relative privilege. The
communication between a doctor and his patient can be communicated to other only in
bona fide manner and abiding the rules of confidentiality and exceptions to it.

If doctor is sued for medical negligence by the patient, then the doctor may disclose
information to the Court similarly if a doctor sues patient for non-payment of fees, the
doctor can disclose information to the Court. If Court orders to produce medical reports
containing confidential information, then the doctor is supposed to submit it to the Court.

Q33. Civil and criminal negligence in medico-legal cases:

Medical Negligence basically is the misconduct by a medical practitioner or doctor by not

providing enough care resulting in breach of their duties and harming the patients which are
their consumers. Medical negligence has caused many deaths as well as adverse results to
the patient’s health. Some examples of medical negligence are as follows:

 improper administration of medicines.

 performing the wrong or inappropriate type of surgery.
 not giving proper medical advice.
 leaving any foreign object in the body of the patient such as a sponge or bandage,
etc. after the surgery.

Negligence is a tort. The concept of mens rea is not applicable in torts. If doctor’s rash or
negligent act endangers human life or personal safety of his patient, he can be tried for
criminal liability.

Civil Liability, i.e., monetary compensation can be imposed under the general law by
pursuing a remedy before appropriate Civil Court or Consumer forums. There are various
degrees of negligence and a very high degree of Gross Negligence is required to be proved
beyond reasonable doubt for certain acts to be made punishable under the provisions of
Criminal Law. As per existing Laws, cases for medical negligence caused by Doctors can be
filed under following enactments at the option of the Patients:

 A complaint for deficiency of service can be filed before the Consumer Forum under
the Consumer Protection Act, 1986.
 A Civil Suit for the Recovery of Damages in the appropriate Civil Court.
 A complaint under Section 304–A of the Indian Penal Code, 1860 in the appropriate
Criminal Court.
 A complaint to the Medical Council of India or The State Medical Council for de
registration of a Doctor on account of negligence.

Q34. Determination of brain stem death under the transplantation of human organs act,
1994.

Brain stem is the “stalk of the brain” which connects the spinal cord to various parts of the
brain. It sends messages to the rest of your body to regulate balance, breathing, heart rate
and more. It is very vital part of the body. Section 2(d) of the Transplantation of Human
Organs and Tissues Act, 1994, defines brainstem death as ““brain-stem death” means the
stage at which all functions of the brain-stem have permanently and irreversibly ceased and
is so certified under sub-section (6) of section 3 of the Act.”

Identification of brain stem death carries important prognosis for the survival of the patient,
because the heart may keep on beating for few days after brain stem death, or even for
weeks if the patient is in the Intensive Care Unit of hospital with all forms of medical and
cardiac support. The person cannot perform fundamental work of an organism. The person
is practically dead but may have heart beat and such person may still able to breathe. Such
brain stem death must be certified by a Board of Medical Expert referred to in Section 3(6)
of the Act. The Board should contain

 the registered medical practitioner in charge of the hospital in which brain-stem

death has occurred;
 an independent registered medical practitioner, being a specialist, to be nominated
by the registered medical practitioner specified in clause (i), from the panel of names
approved by the Appropriate Authority;
 a neurologist or a neurosurgeon to be nominated by the registered medical
practitioner specified in clause (i), from the panel of names approved by the
Appropriate Authority: Provided that where a neurologist or a neurosurgeon is not
available, the registered medical practitioner may nominate an independent
registered medical practitioner, being a surgeon or a physician and an anaesthetist
or intensivist subject to the condition that they are not members of the
transplantation team for the concerned recipient and to such conditions as may be
prescribed;
 the registered medical practitioner treating the person whose brain-stem death has
occurred.

Q35. Disaster management preparedness in case of industrial disasters

A disaster is a catastrophic situation in which suddenly, people are plunged into

helplessness and suffering and, as a result, need protection, clothing, shelter, medical and
social care and other necessities of life. The Disaster Management Plan is aimed to ensure
safety of life, protection of Environment, protection of installation, restoration of production
and salvage operations in this same order of priorities.

The disaster management preparedness plan in case of industrial disasters is given as

follows:

 To constitute Disaster Management Committee under senior officer not below the
rank of General Manager
 To identify potential hazards areas in the layout map
 To use model to predict hazards impact in the surrounding areas in form of pool-fire
or gas leakage
 To predict degree of burns and distance of the risk zone by using model
 To evacuate the area within risk zone
  To localize the emergency and if possible, eliminate it
 To minimize the effects of accidents on people and property
 To take remedial measures in the quickest possible time to contain the incident and
control it with minimum damage
 To mobilize the internal resource and utilize them in the most effective way
 To get help from the local community and government official to supplement
internal manpower and resources
 To minimize the damage in other sections
 To keep the required emergency equipment in stock at right places and ensure that
they are in working condition
 To keep the concerned personnel fully trained in the use of emergency equipment
 To give immediate warning to the surrounding localities in case of emergency
situation arising
 To mobilize transport and medical treatment of the injured
 To educate the public in the surrounding village regarding hazards
 To arrange treatment of causalities
 To safe guard the people
 To identify the causalities and communicate to persons known to them • To render
necessary help to concerned
 To rehabilitate area affected
 To provide information to media and government agencies

Q36. Medical malpractices

Chapter 6 of the Code of Ethics Regulations, 2002 contains a list of acts and practices which
are regarded as unethical practices or medical malpractices on the part of physicians. Some
of the unethical practices are:

 All forms of advertisements by doctors are banned. To advertise in any manner to

invite attention of general public to him or to his professional position, skill,
qualifications, achievements, attainments or honours is medical malpractice.
 A physician giving to any person any approval, recommendation, endorsement,
certificate, report or statement with respect to any drug, medicine, surgical article,
for use in connection with his name, signature, photograph in any form for
advertisement is a medical malpractice.
 A physician opening and running a shop for medicine or medical surgical appliances
is a medical malpractice.
 The physician cannot aid or abet torture or be a party to infliction of mental or
physical trauma or concealment of torture inflicted by some other person or agency
in clear violation of human right.

Q37. Medico-legal aspects of sexual assault cases

Section 53(5) of the CrPC talks about examination of a female victim, which should be done
by or under the supervision of a female doctor. Section 53A of the CrPC provides for a
detailed medical examination of a person accused of an offence of rape or an attempt to
commit rape.
A detailed medical examination is to be carried out by a registered medical practitioner
employed in a hospital run by government or local authority without delay. A “reasoned”
report be prepared recording the name and address of the accused, the person by whom he
was brought, the age of the accused, marks of injury if any, a description of materials
collected from the accused for DNA profiling, etc.

Section 164(A) CrPC explains the legal requirements for medical examination of a victim of
rape. One of the main elements of this is that the consent of the victim is mandatory and
should be part of the report. It provides for a medical examination of the victim of rape by a
registered medical practitioner preferably woman within 24 hours of incidence of assault.

Q38. Doctor-patient contractual relationship

Following are the essentials of any contract:

 Proposal and Acceptance: Patient goes to doctor, seeking treatment for illness
(Proposal). Doctor gives him an appointment and accepts him as a patient
(Acceptance)
 Competencies of the Parties: According to the Contract Act, contracting parties
should be major, and of sound mind. If patient is minor, the doctor is entering in
contract with parents or guardians of minor.
 Free Consent: Here parties agree on the same thing in the same sense and the
consent is not caused by coercion or undue influence or fraud or misrepresentation
or mistake.
 Lawful Consideration and Object: In Doctor-Patient contract both the consideration
and object are lawful. There is no unlawful in the treatment of a patient.
 The agreement should not be expressly prohibited by Ss. 27 to 30 of the Indian
Contract Act: The Contract between patient and Doctor is not prohibited by these
provisions.

Thus, all the requirements of valid contract are satisfied. This explains Doctor-Patient
Contractual Relationship.

Case Laws: Everett v. Griffiths, Morris v. Winsburry White, Edwards v. Mullan.

Q39. Clinical trials on prisoners

Clinical trials are a type of research that studies new tests and treatments and evaluates
their effects on human health outcomes. People volunteer to take part in clinical trials to
test medical interventions including drugs, cells and other biological products, surgical
procedures, radiological procedures, devices, behavioural treatments and preventive care.

Every clinical trial requires, inter alia, the following:

 Fully informed consent of participants;

 Full information to be given about the experiment, including its benefits and risks;
 Attention is to be drawn to possible alternatives
  If the clinical trial involves a pregnant woman, extra care and protection to be taken
safeguarding the woman and the child.

But these principles were violated during World War II in Germany. It was found that
thousands of experiments were conducted at random, mostly by unqualified persons, under
revolting physical conditions. No adequate scientific reason was given for causin
unnecessary suffering, injury and agony to the subjects, who went through torture, extreme
pain and permanent injuries. The inmates of the German concentration camps used in such
experiments were prisoners of war or civilians who were imprisoned and forced to submit
to human torture and barbaric experiments. There was no free consent from subjects. After
end of the war, allied powers conducted series of trials in the city of Nuremberg.

Q40. Civil and criminal liability of doctors

Civil Liability:

Civil liability for negligence occurs when a person is said to omit to do something which a
reasonable man would do when he is guided by the factors which originally regulate human
conduct or when he does something which a prudent and a reasonable man would not do.
The most common and potent basis of civil liability for medical practitioner cases is
negligence. Thus, where a health care provider administers treatment to a patient
negligently and injury is caused to the patient, he may sue for medical negligence against
the medical practitioner for the injury suffered.

In law, a patient must establish three elements in order to succeed in an action for medical
negligence, which are as follows:

1. That the medical practitioner owed the patient a duty of care.

2. That the medical practitioner was in breach of that duty.
3. That the patient suffered injury / damages as a result of the breach.

A complaint for deficiency of service can be filed before the Consumer Forum under the
Consumer Protection Act, 1986 and a Civil Suit for the Recovery of Damages in the
appropriate Civil Court. A monetary compensation can be imposed under the general law by
pursuing a remedy before appropriate Civil Court or Consumer forums.

In Jaspal Singh v. Post Graduate Institute of Medical Education and Research 2000 (2) CPR
300 case, the patient, blood group was A+ was give n B+ blood on two different fays, and he
died soon thereafter. Here medical negligence is clearly seen and in such case the maxim
“Res ipsa loquitur” is applicable. The respondent was convicted of negligence.

Criminal Liability:

There are various degrees of negligence and a very high degree of Gross Negligence is
required to be proved beyond reasonable doubt for certain acts to be made punishable
under the provisions of Criminal Law. A complaint under Section 304–A of the Indian Penal
Code, 1860 in the appropriate Criminal Court or a complaint to the Medical Council of India
or The State Medical Council for de registration of the doctor on account of negligence can
be made.
Provisions of Section 304A of the Indian Penal Code, 1860, are general in nature and do not
provide specifically for “medical negligence.” Similarly, other general provisions of IPC, such
as Section 337 (causing hurt) and 338 (causing grievous hurt), are also often deployed in
relation to medical negligence cases.

Law and Medicine Questions 41 to 60 (3 Marks)

 Post authorBy Hemant More

 Post dateMay 23, 2022
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Law > Medical Jurisprudence > Law and Medicine Questions 41 to 60

Q41. Medico-legal aspects of road accident cases.

A traffic or road accident is defined as an accident involving at least one vehicle on a road
open to public traffic in which at least one person is injured or killed. The main cause of
accidents and crashes are due to human errors. Most of the road users are quite well aware
of the general rules and safety measures while using roads but it is only the laxity on part of
road users, which cause accidents and crashes.

The Investigation of the accident must be done as soon as possible after it occurs because it
helps in observing the conditions as they were at the time of the accident. Investigation
officer may take help from an automobile expert and a medical expert. Establishment of
facts includes visiting site of accident, examination of mechanical damages. If the driver of
the vehicle is survived, his medical examination is mandatory. It should be ascertained if he
was under the influence of alcohol or drugs at the time of accident. Medical examination of
the victims must be conducted immediately. Medical examination includes noting of injuries
suffered, place, angle, extent, and depth of injury. It also includes noting of blood stains on
body, tears, grease marks, mud and soil stains, etc.
In case of accidental death, an autopsy (post mortem) is often performed to ascertain the
cause of death. An autopsy or post-mortem is a surgical procedure involving a thorough
examination of the corpse by dissection to determine the cause and manner of death. The
procedure is performed by specialist pathologists.

Q42. Legal issues faced by victims of Bhopal Gas leak tragedy

The Bhopal gas tragedy occurred in 1984 at Bhopal. On Dec. 3, a dangerous chemical
reaction occurred in the plant. As a result, water entered into the tank containing
methyl isocyanate gas. This resulted in the increase of temperature and pressure inside the
tank. This led to the release of methyl isocyanate gas from the tank. The gas spread within
the radius of eight kilometres. The gas caused coughing, breathlessness, stomach pain,
burning in the respiratory tract. By the morning, thousand of people had died. Many people
who survived this disaster, suffered from various diseases for the rest of their lives. People
still suffer from cancer, tuberculosis, gynaecological disorders, etc. as the result of the
inhalation of the gas.

In the February of 1985, the Indian Government filed a case in the U.S Court for a claim of
$3.3 billons against the Union Carbide Corporation. But by 1986 all of these litigations in the
U.S District were transferred to India on the grounds of forum non-convenient. It means
that the case should be transferred to a more convenient forum so that the trial proceeds
smoothly. Meanwhile in March 1985, the Bhopal Gas Leak Disaster (Processing of Claims)
Act was passed which empowered the Central Government to become the sole
representative of all the victims in all kinds of litigations so that interests of the victims of
the disaster are fully protected and the claims for compensation are pursued speedily. In the
year 1987, cases were filed in the Bhopal District Court which ordered the Union Carbide
Corporation to pay 350 crores as interim compensation. Ultimately company appealed in
the Supreme Court and company agreed to pay compensation of 470 million dollars.

Apart from these civil proceedings, criminal proceedings were also initiated before the Chief
Judicial Magistrate in Bhopal. The proceedings were initiated under Section 304 A, and
Sections 336, 337, and 338 read with Section 35 of the Indian Penal Code. Section 304 A
deals with causing death by negligence. Sections 336, 337 and Section 338 deal with the
offences of endangering life and personal safety of others. This is read along with Section 35
which deals with the aspect of common intention.

Q43. Role and functions of Indian medical council

Role and functions of Indian medical council are as follows:

 To lay down policies for maintaining a high quality and high standards in medical
education and make necessary regulations in this behalf;
 To lay down policies for regulating medical institutions, medical researches and
medical professionals and make necessary regulations in this behalf;
 To assess the requirements in healthcare, including human resources for health and
healthcare infrastructure and develop a road map for meeting such requirements;
  To promote, co-ordinate and frame guidelines and lay down policies by making
necessary regulations for the proper functioning of the Commission, the
Autonomous Boards and the State Medical Councils;
 To ensure co-ordination among the Autonomous Boards;
 To take such measures, as may be necessary, to ensure compliance by the State
Medical Councils of the guidelines framed and regulations made under this Act for
their effective functioning under this Act;
 To exercise appellate jurisdiction with respect to the decisions of the Autonomous
Boards;
 To lay down policies and codes to ensure observance of professional ethics in
medical profession and to promote ethical conduct during the provision of care by
medical practitioners;
 To frame guidelines for determination of fees and all other charges in respect of fifty
per cent. of seats in private medical institutions and deemed to be universities which
are governed under the provisions of this Act;
 To exercise such other powers and perform such other functions as may be
prescribed.

Q44. Euthanasia

Euthanasia is described as the deliberate and intentional killing of a person for the benefit of
that person in order to relieve him from pain and suffering. The term ‘Euthanasia’ is derived
from the Greek words which literally means “good death” (Eu= Good; Thanatos=Death).
Euthanasia is defined as the act of bringing the death of a person (patient) for the purpose
of relieving the patient’s intolerable and incurable suffering. Typically, the physician’s
motive is merciful and intended to end suffering. In voluntary euthanasia, a consent from
the patient is taken. In non-voluntary euthanasia, the consent of patient is unavailable due
to some reason.

In active euthanasia, the death of patient is brought directly by giving him a lethal dose of
poisonous drug. In passive euthanasia, the life supporting system to the patient is
discontinued and ultimately patient dies. In Aruna Shanbaug v. Union of India, the Supreme
Court opposed active euthanasia but has given nod to passive euthanasia. The apex court
also observed that right to life does not include right to die.

Q45. Right to health under the constitution of India

According to Article 21 of the Constitution of India “no person shall be deprived of his/her
life or personal liberty except according to the procedure established by law. Right to life
under Article 21 of the Constitution has been generously deciphered to mean something
more than only human presence and incorporates the right to live with nobility and
conventionality. The use of word ‘Life’ in Article 21 of the Constitution has a lot more
extensive importance which includes human nobility, the right to livelihood, right to health,
right to pollution free air, and so forth.

In the State of Punjab v. M.S. Chawla, it has been held that-the right to life ensured under
Article 21 incorporates inside its ambit the right to health and clinical consideration.
The Supreme Court in Vincent v. Union of India, held that a healthy body is the very
establishment of all human activities. Article 47, a Directive Principle of State Policy in such
manner lays pressure on the improvement of general health and denial of medications
harmful to health as one of the essential obligations of the state.

Right to health should be considered with the right to medical care and the right to clean
and pollution free environment.

Q46. Doctor patient confidentiality

If patient want to get a good treatment from a doctor he is expected to disclose all the
details of his illness. Such information may be private and of personal nature and patient
may like to disclose it to doctor only and not to others even not to relatives or friends. Now
there is obligation on doctor not to disclose such information without obtaining prior
permission from the patient. This expectation in medical field is called confidentiality in
medical practice. If doctor fails to comply, the patient may ask for compensation on plea of
breach of confidentiality. If assurance of confidentiality was not available, a patient
hesitates to confide in his doctor, who in turn would not be able to give the best diagnosis
or treatment.

A privileged communication is a conversation between two parties that is legally classified

as a private discussion. This discussion is legally protected, and so cannot be disclosed to
third parties. Sections 122 to 129 of the Indian Evidence Act, 1872 contain provisions related
to privileged communication.

Sometimes public interest overrides the concept of confidentiality. If a patient is suffering

from contagious disease and it is harmful to society as a whole. In such case the doctor has a
duty to inform about the disease to health authorities in public interest.

In Mr. X v. Hospital Z, AIR 1999 SC 495 case, the apex court when commenting on infectious
diseases held that in special circumstances, public interest would override the duty of
confidentiality, as where there is an immediate or future health risk to the community or to
a specific person.

Q47. Role and functions of ethics committee in clinical trials

According to the Drugs and Cosmetics rules, 1945. an Ethics Committee is a committee
comprising of medical, scientific, non-medical and non-scientific members, whose
responsibility is to ensure the protection of the rights, safety and well-being of human
subjects involved in a clinical trial and it shall be responsible for reviewing and approving the
protocol, the suitability of the investigators, facilities, methods and adequacy of information
to be used for obtaining and documenting informed consent of the study subjects and
adequacy of confidentiality safeguards. In the case of any serious adverse event occurring to
the clinical trial subjects during the clinical trial, the Ethics Committee shall analyse and
forward its opinion as per procedure specified under APPENDIX XII of Schedule Y.
If the Ethics Committee fails to comply with any of the conditions of registration, the
Licensing Authority may, after giving an opportunity to show cause why such an order
should not be passed, by an order in writing stating the reasons therefor, suspend or cancel
the registration of the Ethics Committee for such period as considered necessary.

Q48. Female foeticide

Female foeticide is the procedure of abortion to terminate a female foetus from the womb
of the mother before taking birth after the sex recognition tests like an ultrasound scan. The
census figures not only indicate the imbalance in the sex ratio, but it also indicates, the
casual approach of society to all women. It is the cruellest on the part of society not to allow
a female child to be born.

Major Reasons for Female Foeticide:

 Patrilineal line of succession

 Dowry system, violence against women
 Low status of women
 Preference for son due to financial security
 Small family norm
 Religious and social taboos
 Misuse of diagnostic techniques.

Impact of Female Foeticide:

 The sex ratio denotes the ratio of females to males in a specific region. As per the
decennial Indian census, the Sex Ratio of India is 107.48. It means 107.48 males per
100 females in 2019.
 It increases number of crimes against women

Q49. Object of transplantation of human organs act, 1994

The objects of the Transplantation of Human Organs and Tissues (TOHO) Act, 1994 are as
follows:

 To provide for the regulation of removal, storage, and transplantation of human

organs for therapeutic purposes and for the prevention of commercial dealings in
human organs.
 To illegalize the buying and selling of human organs and makes cash-for-kidney
transactions a criminal offence.
 To establish an institutional structure to authorize and regulate human organ
transplants and to register and regulate, through regular checks, hospitals that are
permitted to perform transplants.

Q50. Brain stem death

Brain stem is the “stalk of the brain” which connects the spinal cord to various parts of the
brain. It sends messages to the rest of your body to regulate balance, breathing, heart rate
and more. It is very vital part of the body. Section 2(d) of the Transplantation of Human
Organs and Tissues Act, 1994, defines brainstem death as ““brain-stem death” means the
stage at which all functions of the brain-stem have permanently and irreversibly ceased and
is so certified under sub-section (6) of section 3 of the Act.”

Identification of brain stem death carries important prognosis for the survival of the patient,
because the heart may keep on beating for few days after brain stem death, or even for
weeks if the patient is in the Intensive Care Unit of hospital with all forms of medical and
cardiac support. The person cannot perform fundamental work of an organism. The person
is practically dead but may have heart beat and such person may still able to breathe. Such
brain stem death must be certified by a Board of Medical Expert referred to in Section 3(6)
of the Act. The Board should contain

 the registered medical practitioner in charge of the hospital in which brain-stem

death has occurred;
 an independent registered medical practitioner, being a specialist, to be nominated
by the registered medical practitioner specified in clause (i), from the panel of names
approved by the Appropriate Authority;
 a neurologist or a neurosurgeon to be nominated by the registered medical
practitioner specified in clause (i), from the panel of names approved by the
Appropriate Authority: Provided that where a neurologist or a neurosurgeon is not
available, the registered medical practitioner may nominate an independent
registered medical practitioner, being a surgeon or a physician and an anaesthetist
or intensivist subject to the condition that they are not members of the
transplantation team for the concerned recipient and to such conditions as may be
prescribed;
 the registered medical practitioner treating the person whose brain-stem death has
occurred.

Q51. Right of self determination

Article 21 of the Constitution is the basis of right of self-determination of patient. An adult

patient who suffers from no mental incapacity has an absolute right to choose whether to
consent to medical treatment. The protection of patient self-determination entails the
following elements: (a) recognition of, and respect for, the patient’s right to decide what
treatment to have or not to have; (b) provision of an enabling climate for the patient to
make self-determined choices (ensuring effective communication and building trust); and (c)
having regard for the context (social, cultural, emotional, etc.) in which the patient has to
make his or her decision. The right of self-determination of the patient ought to be
respected.

Two conditions are ordinarily required before applying the right of self determination. The
individual has to have the relevant internal capacities for self-government and has to be free
from external constraints. In a medical context, a decision is ordinarily regarded as
autonomous where the individual has the capacity to make the relevant decision, has
sufficient information to make the decision and does so voluntarily.

Where patients lack the capacity to make a decision, it follows necessarily that decisions
must be made on their behalf. Very young children ordinarily have the majority of decisions
made by parents and guardians. Where adults lack capacity, health care decisions are
ordinarily made by the health professional in overall charge of their care, although adults
can appoint someone to make decisions on their behalf.

Q52. Disaster management plan

An ideal disaster management plan involves the following:

 Initial alert: All persons in danger must be alerted in a manner that is simple and
concise and yet audible and loud enough to reach every nook and corner of that
place. Bells, sirens, public address system can be used for the same. Necessary dos
and don’ts to be conveyed to affected people.
 Quick intimation to agencies providing assistance: Fire brigades, hospitals, medical,
paramedical staff should be intimated at the earliest and ask them to be ready for
any eventuality and load.
 Code alert: Different coloured flags are used on sea shore to show danger level of
cyclones.
 Rehearsal and mock drill: Rehearsal and mock drill should be performed when
situation is normal this helps working effectively during actual crisis.
 Common nucleus: There should be central control room to coordinate the activities
and administration during crisis.
 Accurate Information: It should be made available on timely basis through media.

Q53. Medical record

The term medical records refer to the systematic documentation of a patient’s medical
history, treatment and care maintained by a doctor or a hospital or similar other institution.
Nowadays these reports are maintained in electronic form and called Electronic Medical
Record (EMR). These records serve two purposes.

 It documents entire medical history of patients including physical examination and

the investigations done, diagnosis and treatment given to the patient.
 This information is important when the patient visits the doctor again for same
disease or for routine check-up.

Utmost confidence is to be observed by the medical practitioner in maintaining such

records, as they often contain sensitive medical information of the patient. Medical
professionals are bound to maintain such records. If a physician does not maintain record of
his individual patients for three years it is professional misconduct and punishable. Only
Court can ask for medical reports from the doctor during a trial involving medical reference
to the matter.
Q54. Medical certificate

A Medical Certificate is a written statement from a doctor or a qualified health professional

who attests to the result of the medical examination of a patient. This written statement is
required for many purposes but is most widely used as for sick leave, where it states that an
employee is unfit for work due to health concerns or for fitness that, the person to whom
certificate is given is fit. Medical certificates might also be required to access certain health
benefits that are provided by an employer. Medical certificates are also used by students,
excusing them from attending school for reasons of illness. Medical Certificates are very
personal documents; hence it must respect a patient’s right to confidentiality. This means
that the patients’ consent is required for sharing sensitive medical information.

Issuing medical certificates is integral responsibility of medical practitioner. He has right to

issue medical certificates required

 by employers, schools, colleges, etc.

 to obtain passport or driving license
 under Factories Act, Vaccination Act, etc.
 to fulfil statutory requirements.

Regulation 7.7 of the Code of Ethics Regulation, 2002, states that registered medical
practitioners are in certain cases bound by law to give, or may from time to time be called
upon or requested to give certificates, notification, reports and other documents of similar
character signed by them in their professional capacity for subsequent use in the courts or
for administrative purposes etc.

Medical practitioner is supposed to maintain record of the medical certificates issued by

him, giving full details of the certificate. It is found that some medical practitioners issue
false medical certificate.

Q55. Who can give consent for the donation of a human organ?

Organ donation is basically giving or gifting organ in order to help someone who needs
organ transplant to be operated, it could be near relative or any other person.

According to Section 2(f), “donor” means any person, not less than eighteen years of age,
who voluntarily authorises the removal of any of his human organs for therapeutic purposes
under sub-section (1) or sub-section (2) of section 3 of the Act”. Under the virtue of Section
3 of the Act, Donor would fall under the following two categories;

 Living Donor: any person not less than 18 years of age, who voluntarily authorizes
the removal of any of his organ and/or tissue, during his or her lifetime solely for
therapeutic purposes.
 Deceased Donor: Anyone, regardless of age, race or gender can become a donor of
any organ and/or tissue after his/her death (Brainstem/Cardiac). A person who is in
lawful possession of the dead body or the free consent of ‘near relative is required
for the said purpose. If the deceased donor is under the age of 18 years, then the
 consent required from one of the parents or any near relative authorized by the
parents is necessary.

Under section 2(i) of the Act, ‘near-relative’ means spouse, children, grandchildren, brother-
sister, parents and grandparents of the patient can donate the organ after taking prior
permission from the doctor in-charge of the transplant center to donate his organ. A non-
related donor needs prior permission of Authorization Committee established by the state
under the Act in order to donate his organs.

Q56. Indian medical association V/s. V. P. Shantha

Indian Medical Association v. V.P. Shantha AIR 1996 SC 550:

Issues:

 Whether a medical practitioner, hospital, or nursing home can be regarded as

rendering service under Section 2(1)(o) of the Consumer Protection Act, 1986?
 Under what circumstances can the service render at a hospital/nursing be regarded
as service under Section 2(1)(o) of the Consumer Protection Act, 1986?

The ratio decendi of the case is medical negligence. Medical negligence is basically the
misconduct by medical practitioner by not providing enough care resulting in breach of their
duties and harming the patients which are consumers. They also argued whether this was
the case of negligence in Torts or IPC, later on it was decided that any negligence in medical
field would be determined under CPA, 1986. The Supreme court also stated that a medical
practitioner, nursing home or a hospital can be regarded as rendering service under CPA,
1986.

As a result of this judgement, medical profession has been brought under the Section 2(1)
(0) of CPA , 1986 and also , it has included the following categories of doctors/hospitals
under this Section:

 All medical / dental practitioners doing independent medical / dental practice unless
rendering only free service.
 All hospitals having free as well as paying patients and all the paying free category
patients receiving treatment in such hospitals.
 Medical / Dental practitioners and hospitals paid by an insurance firm for the
treatment of a client or an employment for that of an employee.

Q57. Ayurveda

Ayurveda often referred as “the mother of all healing”, is an ancient Indian system of
healing. It is 5000 to 10000 years old. Reference of this system can be seen in the Rigveda
and the Atharva Veda. “Ayur” means life and veda means “knowledge”, thus “Ayurveda”
means knowledge of life. The medicines are mainly plant based.
Diagnosis in Ayurveda takes in the form of general physical examination, involving
examination of the pulse, tongue, eyes, vein sans faeces. Regulation of diet as a therapy
plays an important role in Ayurvedic treatment.

Major books on this system are Charak Sanhita and Sushruta Sanhita. This system has
holistic approach of treating the patient. “Charak Sanhita” is a massive compilation
containing several chapters on therapeutic and internal medicine. It contains reference to
more than six hundred types of medications of plant, animal, and mineral origin. “Sushrut
Sanhita” is an ancient scholarly work dedicated to surgery. In the whole world this is the
oldest compilation on surgery. The book is written in the sixth century B.C. by an ancient
Ayurvedic scholar “Sushruta”. The book contains descriptions of surgical procedures which
are relevant even today.

Doctrine of Ayurveda:

Body is made up of Pancha Mahabhootas: Prithvi (earth), Jal (water), Agni (fire), Vayu (air)
and Akash (ether). There are three doshas in the body: Tridosha: The Vata (ether + air), Pitta
(fire) and Kapha (earth + water) and Trigunas: the Satva, Rajas and Tamas, which are the
psychological properties

Any imbalance in above factors due to internal and external factors causes disease and
restoring equilibrium through various techniques, procedures, regimes, diet and medicine
constitute treatment. Over the years, Kshar Sutra and Panchakarma therapies of Ayurveda
have become very popular among the public.

Q58. Right of registered medical practitioners

Medical practitioner has following rights:

 Right to choose his patients

 Right to use his titles and qualifications
 Right to receive and recover fees and expenses
 Right to get appointed in Hospitals and Institution
 Right practice medicine and dispense medicine
 Right to issue medical certificates
 Right to Give Evidence
 Right to remove organs and tissues from a dead body
 Right to perform medical termination of pregnancy
 Right to disclose confidential information in exceptional circumstances
 Right to disclose and report injuries
 Right to access information
 Right not to be unfairly discriminated
 Right to have political views
 Right to refuse to conduct an unlawful bodily search or seizure

Q59. Authority under the transplantation of human organs act

The Central Government is empowered by the Act to appoint, by notification one or more
officers as the Appropriate Authority for the purposes of the Act, for each of Union
Territories. Likewise, every State must by notification, appoint one or more persons as the
Appropriate Authority of that State.

Functions of Appropriate Authority:

Section 13 of the Act gives functions of the Appropriate Authority under the TOHO Act,
1994.

 to grant registration under sub-section (1) of section 15 or renew registration under

sub-section (3) of that section;
 to suspend or cancel registration under sub-section (2) of section 16;
 to enforce such standards, as may be prescribed,— (A) for hospitals engaged in the
removal, storage or transplantation of any human organ: (B) for Tissue Banks
engaged in recovery, screening, testing, processing, storage and distribution of
tissues;
 to investigate any complaint of breach of any of the provisions of this Act or any of
the rules made thereunder and take appropriate action;
 to inspect Tissue Banks periodically;
 to inspect hospitals periodically for examination of the quality of transplantation and
the follow-up medical care to persons who have undergone transplantation and
persons from whom organs are removed; and
 to undertake such other measures as may be prescribed.

Q60. Mens rea in medical negligence

A tort is a residuary civil wrong. Duties in tort are fixed by the law and such duties are owed
in rem or to the people at large generally. Such wrongs can be remedied by filing for
unliquidated damages. Negligence is a tort. A negligence is the omission to do something
which a reasonable man, guided by those considerations which ordinarily regulate the
conduct of human affairs, would do or doing something which a prudent and reasonable
man would not do. Medical Negligence basically is the misconduct by a medical practitioner
or doctor by not providing enough care resulting in breach of their duties and harming the
patients which are their consumers. Medical negligence has caused many deaths as well as
adverse results to the patient’s health.

The concept of mens rea is not applicable in torts. If doctor’s rash or negligent act
endangers human life or personal safety of his patient, he can be tried for criminal liability.
In Jacob Mathew case the Court held that in criminal law medical professionals are placed
on a pedestal different from ordinary mortals. It was further held that to prosecute the
medical professionals for negligence under criminal law, something more than mere
negligence had to be proved. Medical professionals deal with patients and they are
expected to make the best decisions in the circumstances of the case. Sometimes, the
decision may not be correct, and that would not mean that the medical professional is guilty
of criminal negligence. Such a medical professional may be liable to pay damages but unless
negligence of a high order is shown the medical professionals should not be dragged into
criminal proceedings