INTRODUCTION

The industrial revolution and the development in the international trade and commerce
has led to the vast expansion of business and trade, as a result of which a variety of consumer
goods have appeared in the market to cater to the needs of the consumers and a host of
services have been made available to the consumers like insurance, transport, electricity,
housing, entertainment, finance and banking. A well organised sector of manufacturers and
traders with better knowledge of markets has come into existence, thereby affecting the
relationship between the traders and the consumers making the principle of consumer
sovereignty almost in applicable. The advertisements of goods and services in television,
newspapers and magazines influence the demand for the same by the consumers though there
may be manufacturing defects or imperfections or short comings in the quality, quantity and
the purity of the goods or there maybe deficiency in the services rendered. In addition, the
production of the same item by many firms has led the consumers, who have little time to
make a selection, to think before they can purchase the best. For the welfare of the public, the
glut of adulterated and sub-standard articles in the market have to be checked.

Safe nursing practice includes an understanding of the legal boundaries in which

nurses must function. An understanding of the implications of the law supports critical
thinking on the nurses part. Laws are changing constantly to reflect changes in society,
changes in the delivery of health care and advancement in medical technology.

The role of nurses and the ethical dilemmas associated with client care have increased
and often becomes legal issues. The community is now better aware than in the past about
their rights in health care. The Consumer Protection Act (CPA) was passed by the
government of India in 1986 to protect the interest of the consumer. Consumer means any
person who buys any goods against consideration is a consumer. In health care delivery,
patient is a consumer.

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THE CONSUMER PROTECTION ACT, 1986
On 24th December an act was formed named consumer protection act for tackling the
problems.
Statement of the act
[24th December, 198"6)
“An Act to provide for better protection of the interests of consumers and for that purpose
to make provision for the establishment of consumer councils and other authorities for the
settlement of consumers' disputes and for matters connected therewith”

STATEMENT OF OBJECTS AND REASONS

The Consumer Protection Bill, 1986 seeks to provide for better protection of the
interests of consumers and for the purpose, to make provision for the establishment of
Consumer councils and other authorities for the settlement of consumer disputes and for
matter connected therewith.
It seeks, inter alia, to promote and protect the rights of consumers such as-
(a) The right to be protected against marketing of goods which are hazardous to life and
property
(b) The right to be informed about the quality, quantity, potency, purity, standard and
price of goods to protect the consumer against unfair trade practices.
(c) The right to be assured, wherever possible, access to an authority of goods at
competitive prices.
(d) The right to be heard and to be assured that consumer’s interests will receive due
consideration at appropriate forums.
(e) The right to seek redressal against unfair trade practices or unscrupulous exploitation
Of consumers
(f) Right to consumer education.

These objects are sought to be promoted and protected by the Consumer Protection
Council to be established at the Central and State level.
To provide speedy and simple redressal to consumer disputes, a quasi-judicial
machinery is sought to be setup at the district, State and Central levels. These quasi-judicial
bodies will observe the principles of natural justice and have been empowered to give relief
of a specific nature and to award, wherever appropriate, compensation to consumers.
Penalties for non-compliance of the orders given by the quasi-judicial bodies have also been
provided.

CONSUMER PROTECTION COUNCIL

Consumer Protection Councils are established at the national, state and district level to
increase consumer awareness.

THE CENTRAL CONSUMER PROTECTION COUNCIL

It is established by the Central Government which consists of the following members:

• The Minister of Consumer Affairs, – Chairman

• Such number of other official or non-official members representing such interests as

may be prescribed.

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STATE CONSUMER PROTECTION COUNCIL

It is established by the State Government which consists of the following members:

• The Minister in charge of consumer affairs in the State Government – Chairman.

• Such number of other official or non-official members representing such interests as
may be prescribed by the State Government.
• Such number of other official or non-official members, not exceeding ten, as may be
nominated by the Central Government.

The State Council is required to meet as and when necessary but not less than two meetings
every year.

CONSUMER DISPUTES REDRESSAL AGENCIES

• District Consumer Disputes Redressal Forum (DCDRF) : Also known as

“District Forum” was established by the State Government in each district of the
state. The State Government may establish more than one district forum in a district.
It is a district level court that deals with cases valuing up to rs 2 million.
• State consumer disputes redressal commission (SCDRC): Also known as the “
state commission” established by the state government in the state. It is a state level
court that takes up cases valuing less than Rs 10 million.
• National Consumer Disputes Redressal Commission (NCDRC): Established by
the Central Government. It is a national level court that works for the whole country
and deals with amount more than ₹10 million.

OBJECTIVES

Objectives of Central Council

The objectives of the Central Council is to promote and protect the rights of the consumers
such as:-

1. The right to be protected against the marketing of goods and services which are
hazardous to life and property.
2. The right to be informed about the quality, quantity, potency, purity, standard and
price of goods or services, as the case may be so as to protect the consumer against
unfair trade practices.
3. The right to be assured, wherever possible, access to a variety of goods and services at
competitive prices.
4. The right to be heard and to be assured that consumer's interests will receive due
consideration at appropriate forums.
5. The right to seek redressal against unfair trade practices or restrictive trade practices
or unscrupulous exploitation of consumers; and
6. The right to consumer education.
7. The right against consumer exploitation.

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ACT 68 OF 1986
The Consumer Protection Bill, 1986 was passed by both the Houses of Parliament and
it received the assent of the President on 24th December, 1986. It came on the Statutes Book
as the Consumer Protection Act, 1986 (68 of 1986).

THE CONSUMER PROTECTION ACT, 1986

Though consumer is the purpose and most powerful motivating force of production, yet
at the same time consumer is equally vulnerable segment of the whole marketing system.
Attempts have been made to guard the interest of the consumer in a sporadic way till 1986,
when Government of India enacted a comprehensive legislation-Consumer Protection Act, to
safe guard the interest of the consumer then ever before. The Consumer Protection Act, 1986,
applies to all goods and services, excluding goods for resale or for commercial purpose and
services rendered free of charge and under a contract for personal service. The provisions of
the Act are compensatory in nature. It covers public, private, joint and cooperative sectors.

The Act enshrines the rights of the consumer such as right to safety, right to be
informed, right to be heard, and right to choose, right to seek redressal and right to consumer
education.

Consumer:

A consumer is any person who buys any goods for a consideration and user of
such goods where the use is with the approval of buyer, any person who hires/avails of any
service for a consideration and any beneficiary of such services, where such services are
availed of with the approval of the person hiring the service. The consumer need not have
made full payment.

Goods:

Goods mean any movable property and also include shares, but do not include
any auctionable claims.

Service:

Service of any description such as banking, insurance, transport, processing,

housing construction, supply of electrical energy, entertainment, board or lodging.

Nature of complaint:

• Any unfair trade practice or restrictive trade practice adopted ;by the trader
• Defective goods
• Deficiency in service
• Excess price charged ;by the trader
• Unlawful goods sale, which is hazardous to life and safety when used

Consumer Courts:

A three-tier-system

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 1. National Consumer Dispute Redressal Commission: claims above Rs. 20 lakh
2. Consumer Dispute Redressal Commission or State Commission: Claims from
Rs 5 to 20 lakh.
3. Consumer Dispute Redressal Forum or District Forum: Claims upto Rs 5 Lakh

Complaint:

A complaint, hand written or typed, can be filed by a consumer, a registered consumer

organisation, central or state Government and one or more consumers, where there are
numerous consumers having the same interest.No stamp or court fee is needed. The nature of
complaint must be clearly mentioned as well as the relief sought by the consumer. It must be
in quadruplicate in district forum or state commission. Else, additional copies are required to
be filed.

Grant of relief:

• Repair of defective goods

• Replacement of defective goods
• Refund of the price paid for the defective goods or service
• Removal of deficiency in service
• Refund of extra money charged
• Withdrawal of goods hazardous to life and safety
• Compensation for the loss or injury suffered by the consumer due to negligence of
the opposite party
• Adequate cost of filing and pursuing the complaint

Normally, complaints should be decided within 90 days from the date of notice
issued to the opposite party. Where a sample of any goods is required to be tested, a
complaint is required to be disposed of within 150 days; it may take more time due to
practical problems.

LIST OF AMENDING ACTS

a. The Consumer Protection (Amendment) Act, 1991 (34 of 1991)
Restrictions on disclosure of information
(1) Subject to the following provisions of this section, a person shall be guilty
of an offence if he discloses any information —
(a) which was obtained by him in consequence of its being given to
any person in compliance with any requirement imposed by
safety regulations or regulations.
(b) which consists in a secret manufacturing process or a trade secret
and was obtained by him in consequence of the inclusion of the
information
(c) which was obtained by him in consequence of the exercise by the
Board of the power.
(d) which was obtained by the Board in consequence of the exercise
by any person of any power
(e) which was disclosed to or through him .

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b. The Consumer Protection (Amendment) Act, 1993 (50 of 1993).
• Under this act appropriate laboratory means a laboratory or organization
recognized by the central Government and State Government.
• The customer can complain if:
❖ An unfair trade practice or a restrictive trade practice has been
adopted by the trader.
❖ Selling of goods which are hazardous to life and safety when used
for public
❖ Unfair trade practice means a trade practice for the purpose of
promoting the sale, use or supply of any goods or for the provision
of any services, adopts any unfair method like the practice of
making statement ehether in writing or promotion
c. The Consumer Protection (Amendment) Act, 2002 (62 of 2002).
• It was formed on 17th December 2002.
• The consumer can complain if:
❖ Goods which will be hazardous to life and safety when used are being
offered for sale to the public
❖if the trader could have known with due diligence that the goods so
offered are unsafe to the public
❖ services which are hazardous or likely to be hazardous to life and safety
of the public when used, are being offered by the service provider
which such person could have known with due diligence to be injurious
to life and safety.
• The State Government shall establish for every district by notification a council
to be known as the District Consumer Protection Council with effect from such
date as it may specify in such notification.
• The District Consumer Protection Council (hereinafter referred to as the District
Council) shall consist of the following members, namely:-
❖ The Collector of the district shall be its Chairman.
❖ Two other members one of whom shall be a woman, who shall have the
following qualifications, namely:-
▪ be not less than thirty-five years of age,
▪ possess a bachelor’s degree from a recognised university,
▪ be persons of ability, integrity and standing, and have
adequate knowledge and experience of at least ten years in
dealing with problems relating to economics, law, commerce,
accountancy, industry, public affairs or administration:
• Provided that a person shall be disqualified for appointment as a member if he
❖ has been convicted and sentenced to imprisonment for an offence, which,
in the opinion of the State Government involves moral turpitude
❖ is an undischarged insolvent
❖ is of unsound mind and stands so declared by a competent court; or
❖ has been removed or dismissed from the service of the Government or a
body corporate owned or controlled by the Government; or

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 ❖ has, in the opinion of the State Government, such financial or other
interest as is likely to affect prejudicially the discharge by him of his
functions as a member; or
❖ has such other disqualification as may be prescribed by the State
Government,";
• Every member of the District Forum shall hold office for a term of five years or
upto the age of sixty-five years, whichever is earlier.
• The District Council shall meet as and when necessary but not less than two
meetings shall be held every year.

CONSUMER PROTECTION ACT IN NURSING PRACTICE

It has been enacted by Parliament in the Thirty-seventh Year of the Republic of India
as follows:-
Safe Nursing Practice includes an understanding of the legal boundaries in which
nurses must function. An understanding of the implication of the law supports critical
thinking on the Nurses part. Laws are changing constantly to reflect changes in society,
changes in the delivery of health care and advancement in medical technology.
The role of the Nurses and the ethical dilemmas associated with client care have
increased and often becomes legal issues. The community is now better aware than in the past
about their rights in health care. The Consumer Protection Act (CPA) was passed by the
Government of India in 1986 to protect the interests of the consumer. Consumer means any
person who buys any goods against consideration is a consumer. Similarly any person who
hires services against consideration is also a consumer. In health care delivery, patient is a
consumer. Government institutions do not come under the preview of CPA because the
consumers pay only nominal amount of registration charges, so cannot fall within the ambit

ORGANISATION OF CONSUMER PROTECTION COUNCIL

This is a central protection council and consists of the following members:

1. The minister in charge of the consumer affairs in the central government who shall be its
chairman.
2. Officials and non-official members representing such interests as may be prescribed.

The Central government is legal authority in three ways:

(a) Through the Government Service Conduct Rules
(b) Through the Indian Nursing Council Act
(c) Through British laws which continue to remain in effect even after independence.

The Central Council meets once a year.

Objectives of the Council

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 • The right to be protected against the marketing of goods and services, which are
hazardous to life and property.
• The right to be informed about the quality, quantity, potency, purity, standard and
price of goods (or consumer against, as the case may be) so as to protect the consumer
against unfair trade practices.
• The right to be assured, wherever possible, access to a variety of goods (and services)
at competitive prices.
• The right to be heard and to be assured that consumer’s interests will receive due
consideration at appropriate fora.
• The right to seek redress against unfair trade practices (for restrictive trade practices)
or unscrupulous exploitation of consumers.

NEGLIGENCE
Negligence is the conduct that falls below the standard of care. The standard of care
is established by the law for the protection of consumers against and unreasonable practices
which create risk or harm. Professionals such as Nurses, doctors having special skills and
knowledge. Nursing Practice act describe and define the legal boundaries of nursing practice
within each state. The responsibilities of the Indian Nursing Council, State Council and
University to regulate the standard of the Nursing.

Common Sources of Negligence

Nurses should be aware of the common negligent acts that have resulted in lawsuits
against hospital and nurses. The commonly occurring examples are outlined below:
• Medication errors that result in injury to client
• Intravenous therapy errors resulting is infiltration or phlebitis.
• Burn to clients caused by equipment, bathing, or spill of hot liquids and food
• Falls resulting in injury to client
• Failure to use aseptic technique where required.
• Errors in sponge, instruments, or needle count in surgical cases.
• Failure to give a report, or giving an incomplete report, to an oncoming shift.
• Failure to adequately monitor a client’s condition.
• Failure to notify a physician of a significant change in a client’s status.

With advancement in nursing profession, nurses are in a position to take

independent decision, this increases their responsibility and commitment. In
previous years, the consumers were hardly moving court cases against nurses, but
now, due to commercialisation of the nursing profession, there has been
mushrooming of nursing schools / colleges. The product coming out is far below
the standards. Graduates from these institutions are not up to the mark; nurses
from these institutions have not developed the right attitude towards their
profession. Carelessness or negligence on the part of nurses is not uncommon.
This is very unfortunate as professional nurses used to have more responsibility
and commitment. The time is not far when cases of negligence or carelessness will
be filed against nurses and heavy damages could be awarded against the nurse.

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 Nurses have to abide by the laws related to :
• Informed consent for operation / invasive procedure
• Correct identity medication and drugs
• Medico legal records
• Records of observation documentation should be accurate, complete, do not cross
the line if some error has occurred
• Care of valuables and money
• Death and dying
• Birth & death certificate
• Resuscitation
• Organ donation
• Autopsy
• Will - the nurse may be asked to witness a will
• Good Samaritan law assisting in an emergency and render reasonable care under
such circumstances.

RECOMMENDATIONS
• Health education and awareness programme for people should be conducted
through media so that common man should be educated regarding intricacies
of human body, disease and treatment. This will help in reducing the litigation
cases against medical practitioners.
• The limit of penalty imposed on opposite party, if the complaint made against
nursing practitioners is found to be frivolous or vexations (as per the
amendment in section 26 of the CPA in 1993) should exceed from present Rs.
10,000/- to Rs. 50,000/- so that frivolous complaints will be reduced.
• The nurses must not indulge in malpractices.
• A nurse has right to refuse to assist any medical practitioner if he /she indulges
in malpractice.
• To prevent unnecessary defamation of the health care practitioners in society,
a blanket ban should be placed on print media as well as on electronic media,
so that the name of the health care practitioners and hospital on whom
allegations are made regarding Nursing and Medical negligence should not be
exposed till he /she is found guilty and is convicted by the court of law.

PREVENTION OF ERROR
Several suggestions are made for reducing error. Leaper suggests that many health
care delivery systems, especially in hospital could be redesigned to significantly reduce the
likelihood of error.

• Reduced reliance on memory by using checklists protocols and computerised

decision aids for prescription writing.
• Improved information access with availability of computerised medical record at
bedside.

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 • Error proofing - use of forcing function in computer programmes so that a physician
cannot enter an overdose or prescribe a medication to which the patient is allergic.
• Standardisation of drug doses and time of administration, of information displays,
equipment and supplies location in hospital.
• Training of doctors, nursing and other staff in safe practice.
For the individual nurses following strategies appear prudent.
• Read prescription care- fully. Physician’s prescriptions are at times illegible and lead
to litigation and medication errors.
• Medication errors occur due to mistakes (knowledge- based or rule-based) and slips of
action and lapses of memory. Focus on the task at hand. Knowledgeable and
experienced nurses can easily identify the mistakes.
• Be careful while administering drugs / doses. Doctor should avoid trailing zeros e.g.
10.0 mg which may be read 100 mg.
• Beware of high-risk situations e.g. elderly patients on multiple drugs.
• Review basic drug-related information from approved standard textbook.
• Avoid use of a drug for unproved unlabelled indications especially where risk of drug
use is higher than expected benefits.
• Communicate effectively when patients, families, pharmacists question prescriptions.

PATIENT’S RIGHTS
Patient rights are those rule of conduct between patients and medical caregivers as
well as the institutions ad people that support them.
Formalized in 1948, the Universal Declaration of Human Rights recognizes “the
inherent dignity” and the “equal and unalienable rights of all members of the human family”.
And it is on the basis of this concept of the person, and the fundamental dignity and equality
of all human beings, that the notion of patient rights was developed. In other words, what is
owed to the patient as a human being, by physicians and by the state, took shape in large part
thanks to this understanding of the basic rights of the person.

Patients' rights vary in different countries and in different jurisdictions, often

depending upon prevailing cultural and social norms. Different models of the patient-
physician relationship—which can also represent the citizen-state relationship—have been
developed, and these have informed the particular rights to which patients are entitled.

THE AIM OF THE ACT

This Act aims to establish the rights of every person when requests medical care or who
isin receipt of medical care, and to protect his dignity and privacy.

Definitions

In this Act –

• Hospital– is defined as in Clause 24 of the Public Health Ordinance, 1940.

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 • Ethics Committee – is a committee established under Clause 24 of this Act.
• Emergency Department – a place intended for the provision of emergency medical
care, manned by at least one physician, and recognized by the Director-General as an
Emergency Dept. for the purposes of this Act.
• Medical care or Medical treatment – includes medical diagnostic procedures,
preventive medical care, psychological care, and nursing.
• Medical facility – hospital or clinic.
• Patient – a sick person or any person requesting or receiving medical care.
• Clinician – a physician, dentist, intern, nurse, midwife, psychologist, or any other
professional recognized by the Director-General, and so published in the Official
Gazette, as a health care clinician.
• Medical information – information that refers directly to a patient’s state of physical
or mental health, or to the medical treatment of it.
• Midwife – a person licensed to practice midwifery by the Midwifery Ordinance.
• The Director-General – the Director-General of the Ministry of Health.
• Director of a medical facility – includes an acting director.
• Medical emergency – a situation threatening immediate danger to life or severe,
irreversible disability, if medical care is not given urgently
• Clinic – as defined in Clause 34 of the Public Health Ordinance, 1940, in which
medical care is given by at least five clinicians.
• Intern – as defined in Chapter B.1 of the Physicians Ordinance (New Version), 1976.
• Grave danger – a situation threatening danger to life or severe, irreversible disability,
if medical care is not given.
• Social worker – as defined in the Social Workers Act, 1996.
• Psychologist – a person registered in the Register of Psychologists in accordance with
the Psychologists Act of 1977.
• Sick Fund - as defined in National Health Insurance Act, 1994.
• Physician – a person licensed to practice medicine under the Physicians Ordinance
1976;
• Dentist – a person licensed to practice dentistry under the Dentists Ordinance 1979;
• Medical records – information in accordance with Clause 17 of this Act, recorded in
writing or by photocopying, or in any other way, including the patient’s personal
medical records, containing medical documents concerning him
• The Minister – the Minister of Health.

RIGHTS

• The Right to Medical Care

❖ Every person in need of medical care is entitled to receive it in accordance

with all laws and regulations and the conditions and arrangements obtaining
at any given time in health care system.
❖ In a medical emergency, a person is entitled to receive emergency medical
care unconditionally.

• Prohibition of Discrimination

No medical facility or clinician shall discriminate between patients on grounds

of religion, race, sex, nationality, country of birth, or other such grounds.
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• Proper Medical Care

A patient shall be entitled to proper medical care, having regard both to its
professionalism and quality, and to the personal relations incorporated in it.

• Information on Clinician Identity

A patient is entitled to be informed of the identity and position of every person

treating him.

The Director-General shall issue directions as to the way clinicians and every
worker in a medical facility shall be identified.

• A Second Opinion

The patient is entitled to obtain, at his own initiative, a second opinion as to

his medical care; the clinician and the medical facility shall give the patient all the
assistance he requires to fulfil this right.

• Right to Continuity of Proper Care

Should a patient have transferred from one clinician facility to another, he

shall be entitled, at his request, to the cooperation of ensure proper continuity of care.

• Receiving Visitors

A patient hospitalized in a medical facility is entitled to receive visitors at the

times, and according to the arrangements, determined by the facility director.

• Maintaining the Dignity and Privacy of the Patient

❖ The clinician, all those working under his direction, and all other workers in
the medical facility, shall maintain the dignity and privacy of the patient at all
stages of his treatment.
❖ The facility director shall issue directions for maintaining the dignity and
privacy of patients in his facility.

• Medical Care in Medical Emergencies or in Situations of Grave Danger

❖ Should a clinician or a medical facility be requested to give medical treatment

to a person in circumstances indicating, prima facie, a medical emergency or
grave danger, the clinician shall examine and treat the person to the best of his
ability.
❖ Should the clinician or medical facility be unable to provide treatment to the
patient, they shall, to the best of their ability, refer him to a place where he
can receive appropriate treatment.
❖ The facility director shall make appropriate arrangements for the
implementation of the provisions of this clause.

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 • Medical Examination in Emergency Dept.

❖ All patients applying to an Emergency Dept. are entitled to medical

examination by a physician.
❖ Should the examining physician find that the patient requires urgent medical
treatment, he shall give the patient that treatment; however, if the patient
requires treatment that cannot be given at that place, the Emergency Dept.
physician shall refer the patient to an appropriate medical facility, and shall
ensure, to the best of his ability, that the patient is transferred to that facility.
❖ The director of a medical facility containing an Emergency Dept. shall make
appropriate arrangements for the implementation of the provisions of this
Clause.

• Informed Consent to Medical Care

❖ No medical care shall be given unless and until the patient has given his informed
consent to it, in accordance with the provisions of this chapter.
❖ In order to obtain informed consent, the clinician shall supply the patient medical
information to a reasonable extent, such as to enable the patient to decide whether to
agree to the treatment proposed; for this purpose, "medical information” includes:

➢ The diagnosis of the patient's medical condition and its prognosis;

➢ A description of the essence, course, goal, anticipated benefit, and likelihood of
success of the treatment proposed;
➢ The risks entailed in the proposed treatment, including side effects, pain, and
discomfort;
➢ The likelihood of success and the risks of alternative forms of treatment, and of non-
treatment;
➢ Where the treatment is innovatory, the patient shall be so informed.

❖ The clinician shall furnish the medical information to the patient at the earliest
possible stage and in a manner that maximizes the ability of the patient to understand
the information and to make a free and independent choice.
❖ The provisions of Sub-Clause 13(b) notwithstanding, the clinician may withhold
medical information from the patient concerning his medical condition if an Ethics
Committee has confirmed that giving this information is likely to cause severe harm
to the patient’s mental or physical health.

The Way in which Informed Consent May Be Given

❖ Informed consent may be given verbally, in writing, or demonstrated by the patient’s

behaviour.
❖ Informed consent to one of the treatments enumerated in the Supplement to this Act
shall be given by means of a written document that shall include a summary of the
explanation given the patient.
❖ Should a patient require one of the treatments enumerated in the Supplement to this
Act and be unable to give his informed consent in writing, his shall give his consent
before two witnesses, provided that the consent and the evidence of the witnesses be
put in writing as soon as possible aft.

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 ❖ In a medical emergency, informed consent to one of the treatments enumerated in the
Supplement to this Act may be given verbally, provided that the consent be put into
writing as soon as possible afterwards.

Medical Care without Consent

The provisions of Clause 13 notwithstanding –

❖ A clinician may give medical treatment that is not one of the treatments enumerated in
the Supplement to this Act without the informed consent of the patient, if all the
following conditions are met:

➢ The patient’s physical or mental state does not permit obtaining his informed
consent;
➢ The clinician has not been made aware that the patient of his legal guardian
objects to his receiving medical treatment;
➢ It is impossible to obtain the consent of the patient’s representative, should
such a representative have been appointed under Clause 16 of this Act, or of
thepatient’s legal guardian, where the patient is a minor or an incapacitated
person.

❖ Should the patient be deemed to be in grave danger but reject medical treatment,
which in the circumstances must be given soon, the clinician may perform the
treatment against the patient’s will, if an Ethics Committee has confirmed that all the
following conditions obtain:

➢ The patient has received information as required to make an informed choice;

➢ The treatment is anticipated to significantly improve the patient’s medical
condition;
➢ There are reasonable grounds to suppose that, after receiving treatment,
thepatient will give his retroactive consent.

❖ In a medical emergency a clinician may give urgent medical treatment without the
patient’s informed consent if, because of the emergency circumstances, including the
patient’s physical or mental state, it is not possible to obtain his informed consent; a
treatment cited in the Supplement to this Act shall be given with the consent of three
physicians, unless the emergency circumstances do not permit this.

Appointment of a Patient’s Representative

❖ A patient may appoint an official representative who shall have the authority to
consent in his place to medical treatment; the power of attorney shall detail the
circumstances and conditions in which the representative shall have the authority to
consent in place of the patient to medical treatment.
❖ The Minister may issue directions as to the manner in which a power of attorney may
be given under this Clause.

• The Patient's Right to Medical Information

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 ❖ The patient shall be entitled to obtain from the clinician or the medical
facility medical information concerning himself, including a copy of his
medical records.
❖ A member of a clinical team may pass on to the patient medical information
from within his own specialization only and in coordination with the head of
the team.
❖ The provisions of Sub-Clauses 18(a) and 18(b) notwithstanding, a clinician
may decline to pass on to the patient part or all of the medical information
concerning him, if the information is liable to cause serious harm to the
patient's physical or mental health or endanger his life; should a clinician
decide not to pass certain information to the patient, as aforesaid in this sub-
clause, he shall immediately so inform the Ethics Committee and shall
submit to it the withheld information and his arguments for withholding it.
❖ The Ethics Committee may endorse, rescind, or modify the clinician's
decision.
❖ Before issuing its decision, the Ethics Committee may hear the patient or any
other person.

Maintaining Medical Confidentiality

❖ A clinician or any worker in a medical facility shall not disclose any information
regarding a patient, which is brought to their knowledge in the course of their duties
or their work.
❖ The clinician and, in a medical facility, the director of the facility shall make
arrangements to ensure that workers under their direction shall not disclose any
matters brought to their knowledge in the course of their duties or their work.

Disclosing Medical Data to a Third Person

A clinician or medical facility may pass on medical information to a third person in any of
the following cases:

❖ The patient has consented to the disclosure of the medical information.

❖ The clinician or medical facility are legally obliged to pass on the information;
❖ The disclosure is for the purpose of the patient’s treatment by anotherclinician;
❖ Under the provisions of Sub-Clause 18(c) the medical information has not been
passed on to the patient and an Ethics Committee has approved its disclosure to a
third person;

THE TEN RIGHTS OF MEDICATION ADMINISTRATION

1. Right Patient regarding to the right patient to be administered a medication.

2. Right Medication regarding to the right medication to be administered to a patient.

3. Right Dosage right and enough dose.

4. Right Route medication should take on its real time matter of way. (If must to be taken
oral, it should be taken orally.)

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5. Right Time should be according on right time. (If it should be taken by 7 in the morning in
should be taken on 7 in the morning.)

6. Right Documentation right input of information, data, and details.

7. Right Client Education right health teaching.

8. Right to Refuse right to reject medication.

9. Right Assessment right to determine real illness. (Examination)

10. Right Evaluation right examination and right judgment. (Finalizedexamination)

PATIENT RIGHTS AND RESPONSIBILITIES

As a patient, you have the right to:
1. Receive considerate, compassionate and respectful care in a safe and secure environment
free from all forms of abuse, harassment, neglect and mistreatment.
2. Be treated with respect and regard for privacy, individuality, personal values, and beliefs,
spiritual and cultural traditions.
3. Be informed of your rights and the policies regarding them both verbally and in writing in
a manner in which you or your representative understands.
4. Personal privacy and confidentiality. Consultation, examination, treatment and case
discussion are confidential and will be conducted discreetly.
5. Receive timely and qualified care in a setting appropriate to health care needs.
6. Receive referrals to staff and services in a timely manner consistent with quality
professional practice.
7. Access protective and advocacy services in cases of abuse or neglect.
8. Know the professional status of the person(s) directing and/or providing care and those
giving medical advice after hours.
9. Participate in decisions affecting your care and treatment according to your desires, needs,
and understanding including the choice to have family and friends participate in the
process.
10. Receive information regarding your health status, diagnosis, prognosis, the course of
treatment, the benefits and risks of treatment, and the prospects for good health in terms
you can understand.
11. Refuse care, treatment and services, to the extent permitted by law. You will be fully
informed of possible consequences of such refusal.
12. Submit an Advanced Directive and appoint someone to make health care decisions for
you if you are unable to. If you do not have an Advance Directive, we can provide you
with information and help you complete one. All patients' rights apply to the person
whom you elect.
13. Express satisfaction regarding services rendered and to comment and make suggestions
for improvement of the quality of care and services.
14. File a complaint and to receive a response in a timely manner without fear of
discrimination.
15. Access your medical records, approve and refuse the release of your medical records.
Records are maintained private and confidential in a safe and secure environment.
16. Know, in advance of services, the cost of services and any applicable payment policy.

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17. Agree or refuse to participate in research/experimental activities.
18. Change your Primary Care or Dental providers if other qualified practitioners are
available.

As a patient, you have the responsibility to:

1. Ask questions and actively participate in discussions and decisions regarding your health
care.
2. Provide complete and accurate information about your health and medical history,
including present condition, past illnesses, hospitalizations and medications.
3. Discuss your health care problems, concerns, and personal needs with your provider in an
honest manner and to inform the health care provider of any changes occurring in your
health.
4. Come to all appointments drug and alcohol free. Patient’s believed to be under the
influence will be asked to leave.
5. Cooperate with all health care personnel involved in your care and to conduct yourself in a
polite and respectful manner.
6. Respect the rights of your health care provider and to exchange information in a non-
abusive manner either physically or verbally while receiving care.
7. Follow your provider's health care instructions or inform provider if you cannot or will not
follow treatment plan.
8. Accept consequences for refusing care or not following treatment plan.
9. Show consideration and respect the rights and property of all health care professionals,
employees, and other patients.
10. Make and keep all scheduled appointments. To assure that all patients are served in a
timely manner, patients are responsible for calling and changing appointments 24 hours in
advance.
11. Pay for services at the time service is provided and to provide the patient registration
office with accurate, complete, and current information pertaining to insurance coverage,
home address, telephone number, social security number, and Native American Indian
verification. You have a right to receive detailed information regarding your bill.
12. Advise your provider of all changes in decisions concerning advance directives and/or
persons designated by you to make health care decisions

RIGHTS OF SPECIAL GROUP

CHILDREN

They are abandoned. They do not get a chance to step in a school. They
are left to fend for themselves on the streets. They suffer from many forms of
violence. They do not have access to even primary healthcare. They are
subjected to cruel and inhumane treatments every day. They are children –
innocent, young and beautiful – who are deprived of their rights.

In the history of human rights, the rights of children are the most
ratified. The United Nations Convention on the Rights of the Child (UNCRC)
defines Child Rights as the minimum entitlements and freedoms that should be
afforded to every citizen below the age of 18 regardless of race, national origin,

16
colour, gender, language, religion, opinions, origin, wealth, birth status,
disability, or other characteristics.

These rights encompass freedom of children and their civil rights,

family environment, necessary healthcare and welfare, education, leisure and
cultural activities and special protection measures. The UNCRC outlines the
fundamental human rights that should be afforded to children in four broad
classifications that suitably cover all civil, political, social, economic and
cultural rights of every child:

Right to Survival:

❖ Right to be born
❖ Right to minimum standards of food, shelter and clothing
❖ Right to live with dignity
❖ Right to health care, to safe drinking water, nutritious food, a clean and
safe environment, and information to help them stay healthy

Right to Protection:

❖ Right to be protected from all sorts of violence

❖ Right to be protected from neglect
❖ Right to be protected from physical and sexual abuse
❖ Right to be protected from dangerous drugs

Right to Participation

❖ Right to freedom of opinion.

❖ Right to freedom of expression
❖ Right to freedom of association
❖ Right to information
❖ Right to participate in any decision making that involves him/her directly
or indirectly

Right to Development:
❖ Right to education
❖ Right to learn
❖ Right to relax and play
❖ Right to all forms of development – emotional, mental and physical

WOMEN
Women's rights are the rights and entitlements claimed for women and girls of many
societies worldwide, and formed the basis to the women’s in the nineteenth century
and feminist movement during the 20th century. In some countries, these rights are
institutionalized or supported by law, local custom, and behaviour, whereas in others they
may be ignored or suppressed. They differ from broader notions of human rights through

17
claims of an inherent historical and traditional bias against the exercise of rights by women
and girls, in favour of men and boys.

❖ Employment right
Employment rights for women include non-discriminatory access of women
to jobs and equal pay.
The rights of women and men to have equal pay and equal benefits for equal
work were openly denied before. . Before this, the job status of a woman changed
from permanent employee to temporary employee once she was married, thus losing
the pension benefit. Some of them even lost their jobs. Since nurses were mostly
women, this improvement of the rights of married women meant much to the nursing
profession,, married women could not work without the consent of their husbands
until a few decades ago,

❖ Right to vote
During the 19th century some women began to ask for, demand, and then
agitate and demonstrate for the right to vote - the right to participate in their
government and its law making. During the 19th century the right to vote was
gradually extended in many countries, and women started to campaign for their right
to vote. In 1893 New Zealand became the first country to give women the right to
vote on a national level. Australia gave women the right to vote in 1902, In India,
under colonial rule, universal suffrage was granted in 1935
❖ Right to education
The right to education is a universal entitlement to
[158]
education. The Convention against Discrimination in Education prohibits
discrimination in education, with discrimination being defined as "any distinction,
exclusion, limitation or preference which, being based on race, colour, sex, language,
religion, political or other opinion, national or social origin, economic condition or
birth, has the purpose or effect of nullifying or impair International Covenant on
Economic, Social and Cultural Rights. While women's right to access to academic
education is recognized as very important, it is increasingly recognized that academic
education must be supplemented with education on human rights, non-
discrimination, ethics and gender equality, in order for social advancement to be
possible.

❖ Women's rights in marriage, divorce and family law

Article 16 of the Universal Declaration of Human Rights enshrines the right of
consenting men and women to marry and found a family.
• Men and women of full age, without any limitation due to race, nationality or
religion, have the right to marry and to found a family. They are entitled to equal
rights as to marriage, during marriage and at its dissolution.
• Marriage shall be entered into only with the free and full consent of the intending
spouses.
• The family is the natural and fundamental group unit of society and is entitled to
protection by society and the State.

18
RIGHTS OF HIV/AIDS PATIENT

HIV/AIDS is one of the biggest challenges faced by India. There are about three
million people suffering from HIV/AIDS in India. The socioeconomic condition of the
country coupled with the traditional outlook and the myths associated with the things has
made it more vulnerable to the disease. Poor literacy level is one of the biggest causes of the
spread of the disease. The disease has a very serious social stigma attached with it. People
infected with HIV/AIDS are discriminated at every place and are looked upon in the society.
The major field where they feel the effects of this disease is at the workplace. The disease not
completely curable but measures can be followed to prevent it. Imparting knowledge and
creating awareness amongst the people with regard to the disease, its causes, its effects can
help in reducing it from spreading further.
❖ RIGHT TO TREATMENT
A person suffering from any ailment has the right to get treatment for his
suffering. Treatment cannot be denied to a patient on the basis of his HIV/AIDS
status. If any HIV/AIDS patient is denied treatment, it amounts to discrimination. The
Supreme Court of India has issued directions to make second-line HIV/AIDS
treatment available free of cost to all those who need it.
❖ CONFIDENTIALITY
A person who has been diagnosed with HIV/AIDS has the right to keep
his/her HIV/AIDS status confidential. Even the Courts have delivered judgments in
their favour that if they do not want to disclose their identity they can use a
pseudonym before the Courts to suppress their identity.
❖ RIGHT TO EMPLOYMENT AND RIGHT AGAINT DISCRIMINATION AT
WORKPLACE
Right against discrimination is a fundamental right possessed by a citizen of
India. No one can be discriminated on the basis of his HIV/AIDS status in India.
HIV/AIDS patients have a right of equal treatment everywhere and they cannot
denied job opportunity or discriminated in employment matters on the ground of their
HIV/AIDS

HANDICAPPED OR DISABLED
Unfortunately, persons with disabilities are routinely subjected to all forms of
discrimination, denial, and deprivation of rights with the result that they are often
marginalized and excluded and are made to live in a state of relative invisibility,
disempowerment and disarticulation. The world is home to over 600 million people with
disabilities. Over two-thirds of them live in developing countries. The adoption of the United
Nations Convention on the Rights of Persons with Disabilities
(UNCRPD) has brought about a highly significant change in the manner disability has
hitherto been construed. The said 3convention seeks to introduce a human rights based
construct of disability unlike the existing Indian law which defines disability purely on
medical terms. As stated above, the Persons with Disabilities (Equal Opportunities, protection
of Rights, and Full Participation) Act 1995 (PWD Act) adopts medical model and defines
disability as:

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(i) Blindness
(ii) Low vision
(iii) Leprosy-cured
(iv) Hearing impairment
(v) Locomotor disability
(vi) Mental retardation
(vii) Mental illness
❖ EDUCATION
• Provision for free education in an appropriate environment for Section 26every child
with a disability upto 18 years of age.
• Provision for reservation of not less than 3% seats for admission Section 39to
Government and/or Government aided educational institutions.
• Government to prepare comprehensive education schemes withprovision for
transport facilities, barrier free access to schools, Section 30supply of uniforms,
books, other materials, scholarship, etc., tochildren with disabilities.
• Provision for amanuensis for students with blindness or students Section 31with low
vision.
EMPLOYMENT/AFFIRMATIVE ACTION/SOCIAL SECURITY
• Provision for reservation in vacancies to the tune of not less than3% in Government
establishments.
• 92 Provision for reservation of not less than 3% quota for persons with Section
40disabilities in all poverty alleviation schemes.
• Provision for providing incentives to public sector and private employers Section
41to ensure that atleast 5% of their work force is composed of personswith
disabilities.
• Provision for schemes to provide aids and appliances to persons with Section
42disabilities.
• Preferential allotment of land at concessional rates in favour of personswith
disabilities for residential purpose; setting up business, setting up Section 43of
special recreation centres; establishment of special schools,establishment of research
centres; establishment of factories byentrepreneurs with disabilities.
• Provision for unemployment allowance for such persons withdisabilities who could
not be gainfully employed even after two Section 68years of their registration with a
special employment exchange.
NON-DISCRIMINATION AND BARRIER-FREE ACCESS
• Provision for special measures to adapt rail compartments, buses,vessels and aircrafts
in such a way that they become accessible to Section 44persons with disabilities,
including toilets.
• Provision to make roads and public places barrier-free including installation of
auditory signals at red lights.

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PSYCHIATRIC PATIENTS
It is the responsibility of the nurses to encourage that their actions promote the welfare
of patients. Psychiatric patients are often the least capable of protecting their own rights.
Psychiatric problemsmay cause patients to lack social skillsor may cause an inability to
make a point clearly understood because of difficulties in concentration. As a result, the
rights of psychiatric patients have always been ignored and abused for centuries.
When apsychiatric patients enter a hospital, he loses his freedom to come and go, to
schedule his activity, and to control his activities of daily living. If he is also adjudicated
incompetent, he loses his freedom to manage his financial and legal affairs and make many
important decision.
The rights of the psychiatric patients are:
• The right to wear their own clothes
• The right to keep and use their own personal possessions, including toilet articles.
• The right to keep and be allowed to spend a reasonable sum of their money for
canteen expenses and small purchases.
• The right to have access to individual storage space for their private use.
• The right to see visitors everyday.
• The right to have reasonable access to telephone both to make and to receive calls.
• The right to have ready access to letter writing materials.
• The right to mail and receive unopened correspondence.
• The right to refuse electro convulsive therapy.
• The right to manage and dispose of property.
• The rights to execute wills.
• The right to hold civil service status.
• The right to treatment in the least restrictive settings.

NURSING IMPLICATIONS FOR PROVISION OF RIGHTS.

Nursing has long espoused a philosophy that one of its important roles in the health
care system is to act as an advocate for the patients.
Discussing rights within treatment teams, including these rights in the nursing care
plan, and ensuring that methodologies for rights protection are nursing activities that fulfil the
role as patient’s advocate. One important resource that nursing should request is ongoing
legal advice and consultation in the area of patient’s rights. These are mostly prescribed and
governed by health care agency in India.
However to protect patient’s rights, the nurses should be made aware of patient’s
rights, ensure that ward procedure and policy does not violate patient’s rights, review
periodically the rights, issues of violations, and mechanisms that provide rights
accountability.

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CONCLUSION

Rules and regulations framed by statutory bodies must be strictly followed at all levels.
Nursing students, during their training period, should be made aware of the Consumer
Protection Act. Continuing nursing education programme through workshops, conferences
and in-service education courses to refresh their knowledge and also to create awareness
among nurses regarding new technologies in medical sciences, which will be beneficial for
self-development, to patient and society at large.

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Article
Journal of Consumer Policy
March 2002, Volume 25, Issue 1, pp 117-123
Developments in Consumer Protection in India

D. P. S. Verma
Abstract
This paper surveys the major developments in the field of consumer protection in India since
1984, when the statutory provisions for regulating unfair trade practices were incorporated
for the first time.
Among the developments described in the paper is the strengthening of provisions for
consumer protection through amendments to the Act regulating restrictive and monopolistic
trade practices (the MTRP Act). Public-sector undertakings and co-operative societies have
been brought within the purview of the Act, and consumers have obtained the right to
participate in inquiry proceedings before the MRTP Commission.
Consumers and their associations have been given the right to seek redress of grievances
arising out of the violation of certain pieces of legislation, including the Drugs and Cosmetics
Act. The Consumer Protection Act, 1986, was enacted in order to provide speedy and
inexpensive redress of consumers' grievances. Redress can now be sought before any
consumer court also for negligence or deficiency in medical services.
The Bureau of Indian Standards Act, 1986, has strengthened the measures for the
standardisation and quality control of manufactured goods.
A Consumer Welfare Fund has been set up to provide financial assistance to voluntary
consumer organisations and for the general development of consumer movement in the
country. A spurt in voluntary consumer organisations in different parts of the country can
also be observed.
Other developments include the establishment of a separate Department of Consumer Affairs
in the Union Government and the setting up of a Consumer Product Testing Laboratory.
Human rights in patient care: A theoretical and practical framework

23
Article

Jonathan Cohen and Tamar Ezer

Health and Human Rights 15/2

Published December 2013

Abstract
The concept of “human rights in patient care” refers to the application of human rights
principles to the context of patient care. It provides a principled alternative to the growing
discourse of “patients’ rights” that has evolved in response to widespread and severe human
rights violations in health settings. Unlike “patients’ rights,” which is rooted in a consumer
framework, this concept derives from inherent human dignity and neutrally applies universal,
legally recognized human rights principles, protecting both patients and providers and
admitting of limitations that can be justified by human rights norms. It recognizes the
interrelation between patient and provider rights, particularly in contexts where providers
face simultaneous obligations to patients and the state (“dual loyalty”) and may be pressured
to abet human rights violations.
The human rights lens provides a means to examine systemic issues and state responsibility.
Human rights principles that apply to patient care include both the right to the highest
attainable standard of health, which covers both positive and negative guarantees in respect of
health, as well as civil and political rights ranging from the patient’s right to be free from
torture and inhumane treatment to liberty and security of person. They also focus attention on
the right of socially excluded groups to be free from discrimination in the delivery of health
care. Critical rights relevant to providers include freedom of association and the enjoyment of
decent work conditions. Some, but not all, of these human rights correspond to rights that
have been articulated in “patients’ rights” charters.
Complementary to—but distinct from—bioethics, human rights in patient care carry legal
force and can be applied through judicial action. They also provide a powerful language to
articulate and mobilize around justice concerns, and to engage in advocacy through the media
and political negotiation. As “patients’ rights” movements and charters grow in popularity, it
is important to link patient rights back to human rights standards and processes that are
grounded in international law and consensus.

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BIBLIOGRAPHY
• Basavanthappa B. T, Nursing Administration, 1st ed , New Delhi: Jaypee Brother’s
Medical Publishers(p) ltd; 2000
• Gopalakrishnan, Sunderasan. Material Management, Prentice Hall of India Pvt ltd;
New Delhi: 1979
• Kulkarni G. R, Managerial Accounting for Hospitals. Mumbai: Ridhiraj Enterprise;
2003.
• Kumar R, Goel S.L, Hospital Administration and Management, 1st ed, New Delhi;
Deep and Deep publications.
• Gupta S, Kanth S, Hospital Stores Management, An Integrated Approach. 1st ed. New
Delhi: Jaypee Brothers; 2004
• www.rightsofchildren.com
• www.womens right.com

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