-: Responsibilities of Doctor :-
Duties of RMP
(Registered Medical Practioner)
1) Duty of patient.
2) Duty to public at large & to abide by public policy.
3) Duty towards law enforcers.
4) Duty not to violate professional ethics.
5) Duty not to do anything illegal or hide illegal acts.
1) Duty of patient :
A] Standard care :
Principle of standard care/ reasonable cares taken by average person doing similar reasonable job in similar reasonable situation of similar specialty.
(1) Due care & diligence of prudent RMP.
(2) Standard suitable, equipment in good repair.
(3) Standard assistants for example compounders, assistants, nurses and ayah etc. Principle of vicarious responsibility, master responsible for servants acts, assistant is an agent of Master. Nonetheless agent can not do more then what master has delegated to him. Wherever State has prescribed qualifications for agents they must be complied with. Master is not responsible for criminal acts of their servants. But responsible for civil acts.
(4) Standard drugs-Non standard drug is a poison by definition.
(5) Standard procedure & indication for treatment and surgery.
(6) Standard premises, where required registered e.g. Nursing home, hospital must comply with all laws applicable as imposed by state under Nursing home act, shop and establishment act.
(7) Standard Proper reference to appropriate specialist for example radiologist, pathologist, pediatrician, Gynecologist, Orthopedic surgeon, etc.
(8) Standard proper record keeping for treatment given, surgery done, X-ray and pathological reports to be kept.
(9) Standard of not to experiment with patient.
(10) Anticipation of standard risks and complications and preventive actions taken time to time.
B] Right of information by patient :
Regarding natural documented complication of drug surgery, procedure, disease, investigation etc.
Regarding necessity of treatment Otherwise what will happen ?
Alternative modalities of treatment Ayurved, unani, siddha, Homeopathy, Naturopathy.
Risks of not pursuing the treatment.
Prognosis /Has patient reached to point of no return? Explain it carefully taking in to account the emotional and psychological aspect of relatives e.g Cancer patients, terminally ill.
C] Regarding authorization of treatment:
Principle of prior informed consent by patient himself or legally authorized person.
(a) Specific consent
i. Patient specific.
ii. Procedure specific.
(b) Information to patient: regarding indication, procedure, complications and prognosis.
(c) Preferably written consent is ideal.
(d) Signed by authorized person: natural parents, guardian or person above 18 years of age authorized patient.
CAUTION: AUNT OR UNCLE CAN NOT GIVE CONSENT FOR NEPHEW AND NIECE. INSANE, MINORS, DRUNKEN PERSONS CONSENT NOT VALID, NEIGHBOR’S CONSENT NOT VALID.
(e) Proper witness to attest signature of authorized consent which is signed by one or two people.
D] Right to know about expenses and its break up and duration of treatment required.
E] Guarantee of standard care service and not for the cure of disease or infirmity is held out of patients
Duty of public:
(1) Medical help when natural calamities like drought, flood earth quake occur
(2) Medical help during train accidents
(3) Compulsory notification of births, deaths, infectious diseases, food poisoning etc.
(4) Help victims of house collapse, road accidents, fire etc.
(5) Duty to attend emergency and give first aid at least
Duty towards law enforcers: Police,
(1) Inform police all cases of injury, illegal abortions, suicide, homicide, manslaughter, hurt, grievous
hurt & its natural complications like tetanus, gas gangrene, etc. Includes vehicular accidents,
fractures of bone and tooth.
(2) Inform police all cases of poisoning
(3) Inform police all cases of burns particularly importance given to female patients
(4) Call a magistrate for recording dying declaration.
(5) Inform bride burning and battered child cases.
Duty not to violate professional
Ethics important few
(1) Not to associate with unregistered medical practitioner or employ medical practitioner of other
faculty to allow him to practice what he is not qualified for.
(2) Not to advertise
(3) Not to issue false certificates & bills.
(4) Not to run a medical stores.
(5) Not to write secret formulations.
(6) Not to refuse professional service on religious grounds.
(7) Not to attend patient under the effect or alcoholic drinks.
(8) No fee sharing (Dichotomy)
(9) Not to talk Loose about colleagues.
(10) Keep information give by patient as secret, not be divulged to employer, insurance company,
parent of a major son/daughter with out consent of patient, even in court where one does so
under protest and in the interest of Justice.
Duty to avoid anything illegal or
hide illegal acts:
(1) Performing illegal abortion.
(2) Issuing death certificates where cause of death is not known.
(3) Not to inform police a case of accident, burns, poisoning suicide, hurt, grievous hurt, tetanus, gas
(4) Not to call magistrate for dying declaration.
(5) To do sex determination in state of Maharashtra and other states.
(6) Unauthorized, unnecessary, uninformed treatment and surgery or procedure.