IML RELEASES WHITE PAPER BASED ON FRATERNITY RECOMMENDATIONS TO ADDRESS LEGAL ISSUES IN HEALTH CARE

2nd National Convention On Medicine & Law – 2016 Concludes In New Delhi

New Delhi: A major step in bridging the lack of dialogue between the doctor community, hospitals, legal professionals, and policy makers was taken yesterday at 2^nd National Convention on Medicine & Law – 2016 organized by the Institute of Medicine & Law (IML). Subsequently a white paper recommending legal reforms in health care was released today, which will be submitted to policy makers and regulators.

The document exhaustively discusses and highlights several medico-legal issues including the need for a new law recognizing declaration or certification of Brain Stem Death as a form of death under Uniform Determination of Death Act, a law to enable doctors to refuse treatment or admission in case of 'futility of care', to legally recognize Living Wills / Advance Directives / DNR Instructions among others.

“India is witnessing a sharp rise in cases of medical negligence in courts along with cases of violence against doctors and hospitals. These indicate a systemic failure and breakdown of trust between doctors and patients. A soft regulatory framework, unrealistically high expectations of patients, and the peculiar socio-economic character of the nation further compound the issue. This does not augur well for a developing country like India and the convention hopes to bring apprise Policy makers and regulators about these contentious issues and recommend changes required in the legal and regulatory framework,” says Advocate Mahendrakumar Bajpai, keynote speaker at the 2^nd National Convention on Medicine & Law – 2016.

Dr Ravindra Pandula (Member of Parliament – Amalapuram, Andhra Pradesh), Dr V P Mishra, Chairman - Academic Council, MCI, Dr B C Gupta, Member, - National Consumer Disputes Redressal Commission, Dr B D Athani, Special Director General of Health Services – MoHFW were the Guests of Honour at the convention.

“It is inappropriate that courts are forced to find solutions to issues that should have been provided either by the policy makers or the medical fraternity. It is imperative for doctors, medical associations, and hospitals to come together to identify and discuss the legal issues relating to medicine and to find practical and legally appropriate solutions. The recommendations on transplant, HIV, dermatology, intensivists, private hospitals, public hospitals and emergency medicine are generally unanimous in their respective consensus and have been constructively conveyed through the paper,” adds Adv. Bajpai.

The convention also discussed and addressed several other pressing medico-legal matters that are either still ambiguous or have not received the deserved attention. Some of these include incentivizing organ donation with non-monetary incentives to the donor or family such as giving priority in receiving organs, to allow HIV positive couples to adopt children subject to certain conditions and due diligence performed by the authorities, framing regulations for doctors’ website and its content, and also framing of proper guidelines for tele-consultation and e-consultation among others.

“The Convention is a platform to identify the legal issues relating to medicine, discuss them threadbare, and suggest remedial measures. Into the second year, the Convention has registered a humongous increase in participation from all relevant communities compared to the previous year’s and has raised the bar in making definitive strides towards addressing the legal health care issues in India. The suggestions and actions recommended by the Convention will be conveyed appropriately to the regulators and policy makers,” concludes Adv. Bajpai.

Institute of Medicine & Law:

Institute of Medicine & Law (IML) provides education, information, and services related to medical laws. IML’s actionable content and analyses are delivered to doctors, hospitals, and lawyers on multiple platforms in real time. IML is India’s foremost authority on medical laws possessing the best resources in terms of legal professionals and experts. Its detailed knowledge bank is continuously updated with the latest developments and is optimally utilized to provide medico legal solutions to the benefit of healthcare providers. IML organized the first ever 'National Convention on Medicine & Law - 2015' (www.medicineandlawconvention.com), a platform to identify the legal issues relating to medicine, discuss them threadbare, and suggest remedial measures. Doctors, medical associations, hospitals, lawyers, judges, regulators, and policy makers were part of this initiative.

For further information, please visit http://medicineandlawconvention.com/

HOSPITALS CANNOT COMPEL PATIENTS TO BUY MEDICINES FROM IN-HOUSE PHARMACIES; DOCTORS REFERRING GOVT. HOSPITAL PATIENTS TO PRIVATE NURSING HOMES COULD BE PENALIZEDHOSPITALS CANNOT COMPEL PATIENTS TO BUY MEDICINES FROM IN-HOUSE PHARMACIES; DOCTORS REFERRING GOVT. HOSPITAL PATIENTS TO PRIVATE NURSING HOMES COULD BE PENALIZED

Hospitals Cannot Compel Patients To Buy Medicines From In-House Pharmacies; Doctors Referring Govt. Hospital Patients To Private Nursing Homes Could Be Penalized

Mumbai: When Shenar Rehan was refused admission to the Cantonment General Hospital, Aurangabad little did she realize that her experience, while personally traumatic would set a precedent for thousands of patients across Govt. hospitals in India. The patient, in labor then, had sought admission to the hospital, but was directed to a private nursing home. When the aggrieved patient later approached the Courts, Hon’ble Dr. S. M. Kanitkar of the National Consumer Commission taking a harsh view on the practice not only imposed a penalty of Rs. 5 lakh but also observed that the Cantonment General Hospital Board can recover this penalty from the salary of errant doctors, CEOs, and staff, as per law.

“The unambiguous observation of Hon’ble Court that the hospital staff was ‘involved in referring poor patients intentionally to the private nursing homes’ and ‘the poor patients are deprived of essential medical services clearly shows that the courts have taken judicial notice of this widespread illegality and are seeking to address it,” revealed Adv. Mahendrakumar Bajpai, keynote speaker and a leading authority on medical laws at the 8^th Annual Medical Review held at Mumbai.

The Annual Medico Legal Review, held consecutively since 2009 by Institute of Medicine & Law (IML) has been analyzing the complete medico legal environment in the country, compiling comparative statistics of medical malpractice cases, examining current trends in medical malpractice cases and underlying reasons for increasing cases of medical negligence.

“As compared to the previous years, 2015 has thrown a number of noteworthy trends and judgments. For instance, it was also observed that more and more aggrieved patients sued 'only' hospitals and notably omitted doctors. Two interesting cases bring this anomaly to fore. The first from Andhra Pradesh (Dr. M. Sarojini Devi v/s Galla Jayanthi) wherein despite directions from the court, the surgeon who had performed the surgery negligently was not made a party by the patient and the court had no other option but to hold 'only' the hospital negligent. The second case was from Delhi reported from the National Consumer Commission (Himanchal Kumari & Ors. v/s The Govt. of N.C.T. of Delhi & Ors.). The hospital alleged and admitted in the court that the oncologist was negligent and not the resident doctor and the technician who gave radiation. The court agreed with what the hospital stated and did not hold the resident doctor and the technician negligent. But the hospital 'only' was held negligent as the oncologist was not sued by the patient,” added Adv. Bajpai.

The review also reported that complaints by patients forced to buy medicines from in-house pharmacies of hospitals were on the rise and that allegations related to delayed and improper diagnosis doubled as compared to the previous year. Filing of an unusually large number of cases of negligence against surgeons going on planned leave or absences immediately after a surgery were also observed.

In addition, in the year under review, Indian Courts continued with the trend of giving benefit of doubt to doctors; not questioning the correctness of medical records, except in cases of gross fabrications; and, courts continuing to hold that a wrong method or decision by a doctor does not necessarily constitute negligence. During emergencies courts were observed to be even more accommodating by overlooking and condoning deviation from standard protocol.

In 2015, the Courts also held that a doctor relying on a wrong investigation report of another qualified radiologist, sonologist or pathologist and acting accordingly is not negligent. It also deplored appeals in trivial cases and penalized appellants. “On the whole, the year was good as well as bad for doctors. The courts are hesitant in holding the healthcare providers negligent and are seeking more clear and convincing evidence from the patients. But once convinced that the doctor or the hospital has been negligent then the penalty that follows is heavy.”

Annual Medico Legal Review 2016 was presented by Supreme Court Advocate, Mahendrakumar Bajpai and chaired by Mr. Mayank Kshirsagar, Adv. Supreme Court, Dr. Atul Shah, Hon. Sec., Association of Plastic Surgeons of India and Dr. Mahesh Baldwa, Sr. Pediatrician & Medico Legal expert. The review in Mumbai will be followed by reviews in Kolkata, Hyderabad, Chennai and Bangalore. Participation in this event is by invitation only with about 80 - 100 invitees in each city. The attendees would also include Ministry Officials, Regulators, MCI Office Bearers, Judges of the National / State Consumer Commission, and press.

“Law is dynamic. Every single judgment passed each day has the potential to amend the existing laws. While these changes impact everyone, it has a wider implication for doctors. With the exponential rise in medico legal cases and ignorance not being a valid defense, it becomes imperative upon doctors to be abreast of changes in medical laws and take appropriate precautions,” concludes Adv. Bajpai.

About Institute of Medicine & Law:

Institute of Medicine & Law (IML) provides education, information, and services related to medical laws. IML’s actionable content and analyses are delivered to doctors, hospitals, and lawyers on multiple platforms in real time.

IML is India’s foremost authority on medical laws possessing the best resources in terms of legal professionals and experts. Its detailed knowledge bank is continuously updated with the latest developments and is optimally utilized to provide medico legal solutions to the benefit of healthcare providers.

IML organized the first ever 'National Convention on Medicine & Law - 2015' (www.medicineandlawconvention.com), a platform to identify the legal issues relating to medicine, discuss them threadbare, and suggest remedial measures. Doctors, medical associations, hospitals, lawyers, judges, regulators, and policy makers were part of this initiative.

IML has been conducting an annual exercise of drafting and adopting a ‘SOP on Patients Consent’ (www.patientsconsent.com) together with major national medical associations like IMA, ASI, FOGSI, API, IOA, IRIA, AIOS, ISA, ISCCM, and CSI among others. This SOP is today accepted as a standard, comprehensive, and legally compliant document on patients consent in India.