Ms. Atishaya Kaushal, Advocate
VIOLENCE AGAINST DOCTORS
Violence against doctors and police on streets seen in the media today, during the lockdown, is a visible protest against the government agencies, openly rejecting standard guidelines issued by the Ministry of Health & Family Welfare for COVID 19 management, that requires tests of the individuals to identify the trail of the virus and contain its stages. All such incidents are, inter alia, culpable under the Epidemic Diseases Act, 1897, Disaster Management Act, 2005 and the Indian Penal Code. To contain the coronavirus spread, and protect the medical and law enforcing warriors on the ground, the Government of India initiated an ordinance by amendment of the Epidemics Diseases Act.
The laws protecting the doctors from violence are not very old, the Medicare Service Personnel and Medicare Service Institutions (Prevention of Violence and Damage to Property) Acts passed in various states have seen minor success, but no deterrent. The first such law came into existence in Andhra Pradesh in 2007. This was followed by states such as Delhi, Haryana, Rajasthan, Tamil Nadu, Odisha, and others, making such acts for prevention of violence against doctors. In total, about 20 states of India have some kind of act for the protection of medical professionals and health-care establishments, similarly worded. But the procedure for initiation of the prosecution and conviction rates, not good.
Medical Practitioners become risk-averse not to choose severely ill cases where treatment outcomes may be poor and therefore avoid uncertain procedures that could save patients. The defensive practice relies more on diagnostic procedures from the standpoint of protecting the doctor from malpractice litigation rather than prioritizing the provision of care and recovery of the patient. But the importance of proper clinical diagnosis by the doctor himself cannot be undermined. At times, ambulance-chasing complaints are filed by the patients to make unlawful gains due to the low court fee payable under the Consumer Protection Act, 1986. But the burden of proof of negligence, carelessness, or insufficiency generally lies with the complainant. There is an attempt by relatives to allege negligence in cases of the sudden death of a patient; this leads to first investigation reports being lodged for murder, culpable homicide, and cheating many a time. The reputation of the doctor takes the toll.
Law needs to be enforced strictly along with the deployment of adequate security personnel in government hospitals to ensure a safe workplace for doctors. There are sensational news reports of death and sting operations against doctors. The media fails to understand that the practice of medicine is not a black-and-white subject. Diagnosis of a patient is essentially a hypothetico-deductive process, and with the appearance of new evidence through investigations and knowledge, the diagnosis of some of the cases continues to be questioned and refined. However, whatever the diagnosis be, there is always a risk of negative outcomes. Doctors cannot be held accountable for every death that occurs in the hospital on account of negligence. Modern medicine is reaching new frontiers, but at the same time, a negative public perception of doctors is leading to an increase in litigations. Thus, every doctor is forced to follow the cardinal principle “do not overreach,” i.e., do not treat beyond the scope of one's training and facilities to prevent both violence and litigations against themselves. Doctors ensure that valid and informed consent is taken properly. The condition of the patient has to be explained to the relatives because health-care literacy is low in the country. Media can play a positive role by allaying the fears of the public, bringing compatibility between the patients and the doctors and avoiding telecast or broadcast of a medical mishap as a hardcore crime against the society. On the contrary, effort should be made to reserve space for healthy dialogue and making good health common goals for all.
Although the Health Services Personnel and Clinical Establishments (Prohibition of Violence and Damage of Property) Bill, 2019 was conceived by the Government of India, it is hoped that the urgency to get it enacted is resumed, even as after the COVID 19 is eradicated successfully, with the flawless, self-less, and unmatched spirits of the doctors, and the purpose behind the amendment in Epidemic Diseases Act, 1897 is served.
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