DELIBERATING MEDICO-LEGAL Frameworkat CAHOCON 2017

DELIBERATING MEDICO-LEGAL FRAMEWORKat CAHOCON 2017

“Legal issues that affect Medicine are as important as Medical issues that have Legal implications” – resonated Air Marshal Dr. PawanKapoor, DGMS- Defence Services as he took the chair along with Dr. BishnuPanigrahi, Global Head – Medical Strategies, Fortis for the session on “Medico Legal Framework”

Keeping with the theme of the CAHOCON 2017 - “Monitor , Measure, Improve”, this session on “Medico Legal Framework” had its distinguished speakers Mr. MahandraBajpai, Mr. SiddharthLuthera and Dr. Sunil Khetrapal to speak from their vast expertise.

The session had been rightly started by Mr. MahendraBajpai, an Advocate, Supreme Court, Delhi who outlined the importance of “Learning from Mistakes”. He took the dias by storm as he nudged all the distinguished guests to introspect with two fundamental questions - “Have we learnt from our past mistakes? Have we actually made a systematic effort to Know our mistakes?”

He went on to enumerate case after case that how certain judgements like PanditParamandKatara Vs. Union of Indian (Supreme court – 28.08.1989) and Laxmi Vs Union of India (Supreme Court – 24.04.2015) has ramifications at Macro level and became a directive for delivery of Emergency care in India. He also emphasized the importance of Learning from precedence on a Micro Level from the outcome and deliberation of cases – Director, PGI Vs Meena, etc. and reiterated the importance of documenting and preserving not only Medical Records but Non-Medical Records also. He urged to all present that is time to make a collective effort to understand ramifications and remedy the various antecedents before us, as concluded his by saying - “consistent efforts must be made by all stakeholders in healthcare to ‘Measure, Monitor and Improve’ ,- to ‘discover, formulate and update’ the best practices and to draw inference from and to learn from mistakes to ensure and enhance Patient safety”

Mr. SiddharthLuthra took the stage echoing the sentiments of his previous speaker, that there must be a fundamental understanding among the Medical & Healthcare fraternity of Law as he spelt out the distinction between Civil & Criminal Law at the initiation of his talk on “Avoiding Criminal Negligence in Healthcare”

He illustrated the principles of Criminal jurisprudence in case of Medical Negligence to be based on the Bolam’s Case (Bolam Vs Friern Hospital Committee reported as [1957]2 All E.R 118) in which de-facto test is based on assessing what other doctors would have reasonably done or not done in a given situation.

He resolved that to prosecute a medical professional for negligence under criminal law, it must be shown that the accused did something or failed to do something which in the given facts and circumstances, no medical professional in his ordinary senses and prudence would have done or failed to so – as observed in the Jacob Mathew Vs State of Punjab (2005) 6 SCC 1

He brought out the relevant sections of IPC under which a doctor may be booked in a case of Medical Negligence to be Sec 87, 88, 92, 304, 324, 326, 312-316, 304-A, 337, 338 but at the same time construed that the Constitutional bench in LalitaKumari vs. Govt. of U.P (2014) 2 SCC 1, provided a safeguard making an exception to mandatory registration of FIR, and held that there can be no registration of FIR against medical practitioners without preliminary inquiry.

He dealt with the fulcrums in cases medical negligence

• Consent & High risk Consent – he maintained that the nature and extent of information to be furnished by the doctor to the patient to secure the consent should be of the extent which is accepted as normal and proper by a body of medical men skilled and experienced in the particular field.

• Medical Record - Crucial and must be cogent and accurate. Coherence of records between different specialties and groups are also of prime importance.

• Communication - he urged the fraternity to wake up and assimilate that today communication has become a prime mover for dissatisfaction and catalyst for allegations of Medical Negligence.

He concluded with advocating to the fraternity to know your Law.

Dr. Sunil Khetrapal took over torch set forth by the previous two speakers and took the dias to apprise the gathering on “Recent Updates in Hospital Laws”. He appraised us with an elaborate list of the Law’s applicable to the Healthcare Establishment and went on to point out the various Law’s that have been amended in the recent past. Those laws’s being

1. Biomedical Waste Management and Handling Rules 1998
2. AERB Guidelines
3. PCPNDT Act 1994
4. Mental Health Act 1987
5. Clinical Establishment Act 2010
6. Maternity Benefit Act 1961
7. The Registration of Births & Deaths Act 1969
8. Finance Act 1961– Finance Bill 2017
9. FRRO as per orders of Ministry of Home Affairs

Dr. Khetrapal spoke in great detail on the salient features of the amendments of each of these Law’s

The session proceeded to an engaging open forum where questions were raised and clarified and thoughts and views of eminent persons were shared.

Dr. BishnuPanigrahi rightly concluded this beautiful and informative session by voicing the thought on everyone’s mind - “We must be on-track with any Legal changes that happens because not knowing the Law is no excuse”.