MEDICO
LEGAL

 

 

 

 

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-:
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 servant’s 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

 

2)
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

 

3)

Duty towards law enforcers: Police,
magistrate etc.

(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.

 

4)

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.

 

5)

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

gangrene.

(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.

 

 

 

 

 

 

MEDICOLEGAL

-:Responsibilitiesof Doctor :-

Dutiesof RMP

(Registered Medical Practioner)

1)Duty of patient.

2) Duty to public at large & toabide by public policy.3) Duty towards law enforcers.4) Duty not to violate professionalethics.5) Duty not to do anything illegal orhide illegal acts.

1)Duty of patient :

 

A]Standard care :

    • Principle of standard care/ reasonablecares taken by average person doing similar reasonable job in similarreasonable situation of similar specialty.(1) Due care & diligence of prudent RMP.(2) Standard suitable, equipment in goodrepair.(3) Standard assistants for example compounders, assistants, nurses and ayahetc.Principle of vicarious responsibility,master responsible for servant’s acts,assistant is anagent ofMaster. Nonetheless agentcan not do more then what master hasdelegated to him. WhereverState has prescribed qualifications foragents they must be complied with. Masteris not responsiblefor criminal acts oftheir servants. But responsiblefor civil acts.(4) Standard drugs-Non standard drug is apoison by definition.(5) Standard procedure &indication for treatment and surgery.(6) Standard premises, where requiredregistered e.g. Nursinghome, hospital must comply  withall laws applicable as imposed by state underNursing home act, shop and establishmentact.(7) Standard Proper reference toappropriate specialist for exampleradiologist, pathologist, pediatrician, Gynecologist, Orthopedic surgeon, etc.(8) Standard proper record keeping fortreatment given, surgery done, X-ray andpathological reports tobe  kept.(9) Standard of not to experiment with patient.(10) Anticipation of standard risks andcomplications and preventive actions takentime to time.

B]Right of information by patient :

    • Regarding natural documentedcomplication of drug surgery, procedure,disease, investigation etc.

    • Regarding necessity oftreatment Otherwise what will happen ?

    • Alternative modalities of treatmentAyurved, unani, siddha, Homeopathy,Naturopathy.

    • Risks of not pursuing the treatment.

    • Prognosis /Haspatient reached to point of no return? Explain itcarefully taking in to account theemotional and psychological aspect ofrelatives e.g Cancer patients, terminallyill.

C]Regarding authorization of treatment:

    • Principle of priorinformed consent by  patient himself or legallyauthorized person.(a)Specific consenti. Patient specific.ii. Procedure specific.(b) Information to patient:   regardingindication, procedure, complications andprognosis.(c) Preferably writtenconsent is ideal.(d) Signed by authorized person: naturalparents, guardian or person above 18 yearsof age authorized patient.CAUTION: AUNT OR UNCLE CAN NOT GIVECONSENT FOR NEPHEW AND NIECE. INSANE, MINORS, DRUNKEN PERSONS CONSENT NOT VALID,NEIGHBOR’S CONSENT NOT VALID.(e)Proper witness to attest signature ofauthorized consent which is signed by oneor two people.

D]Right to know about expenses andits break up and duration of treatmentrequired.

E]Guarantee of standard care serviceand not for the cure of disease orinfirmity is held out ofpatients

2)Duty of public:(1) Medical help when natural calamitieslike drought, flood earth quake occur(2) Medical help duringtrain accidents(3) Compulsory notification of births,deaths, infectious diseases, foodpoisoning etc.(4) Help victims of house collapse, roadaccidents, fire etc.(5) Duty to attend emergency and givefirst aid atleast

3)Duty towards law enforcers: Police,magistrate etc.(1) Inform police all cases of injury,illegal abortions, suicide, homicide,manslaughter, hurt, grievoushurt &its natural complications like tetanus,gas gangrene, etc. Includes vehicularaccidents,fractures of bone and tooth.(2) Inform police all cases of poisoning(3) Inform police all cases of burnsparticularly importance given to femalepatients(4) Call a magistrate for recording dyingdeclaration.(5) Inform bride burning and batteredchild cases.

4)Duty not to violate professionalEthics important few(1) Not to associate with unregisteredmedical practitioner or employ medicalpractitioner of otherfaculty to allow himto 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 onreligious grounds.(7) Not to attend patient under the effector alcoholic drinks.(8) No fee sharing (Dichotomy)(9) Not to talk Loose about colleagues.(10) Keep information give by patient assecret, not be divulged to employer,insurance company,parent of a majorson/daughter with out consent of patient,even in court where one does sounder protest and in the interest ofJustice.

5)Duty to avoid anything illegal orhide illegal acts:(1) Performing illegal abortion.(2) Issuing death certificates where causeof death is not known.(3) Not to inform police a case ofaccident, burns, poisoning suicide, hurt,grievous hurt, tetanus, gasgangrene.(4) Not to call magistrate for dyingdeclaration.(5) To do sexdetermination in state of Maharashtra andother states.(6) Unauthorized, unnecessary, uninformedtreatment and surgery or procedure.