LEGAL CHALLENGES IN HEALTHCARE AND MEDICAL MALPRACTICE

INTRODUCTION

The last century has seen rapid advancements in medicine, which have altered the practice of medicine. It is now possible to diagnose diseases faster and more accurately using advanced diagnostic techniques. Refined drugs with more focused activities and fewer adverse effects have increased the effectiveness of medical therapy. Surgical treatment has moved towards less invasive modes of management with lesser morbidity and faster recovery. 

Amid all these changes, India’s medical industry is at a crossroads and faces numerous ethical and legal difficulties in its daily operations. The medical community is becoming more and more reliant on technology, and doctors’ decisions are frequently influenced by market factors. The fundamental principles of medicine demand that the practitioner put the patient’s best interests ahead of all else.

The important considerations of autonomy, secrecy, fairness, beneficence, and non-maleficence should work as a springboard for the doctor’s everyday decision-making. These choices could be as straightforward as selecting the best antibiotic for an infection or selecting the best treatment for hypertension or hypercholesterolemia. It gets more difficult when there are significant ethical questions raised by assisted reproduction, genetic testing, clinical trials, organ transplantation, or end-of-life decisions.

For all of the aforementioned circumstances, the ethical standards are still the same. The Indian Medical Council (Professional Conduct, Etiquette, and Ethics) Regulations, 2002’s ethical requirements for medical practice are designed to raise the bar for all Indian-certified medical professionals.

WHAT IS TERMED MEDICAL MALPRACTICE?

A hospital, doctor, or other healthcare professional should uphold a certain level of care. Even if not all harms a patient experiences are the expert’s fault, they are nonetheless held legally accountable if the patient experiences harm or injury because the healthcare professional failed to provide the level of care that is normally expected in such circumstances.

If the healthcare provider fails to carry out such anticipated care, then it is termed as medical malpractice. A number of factors are involved in this scenario, which are listed below:

• Inadequate standard of care: Healthcare professionals are required by law to uphold certain standards or face charges of negligence.
• Any injury as a result of negligence: If there is no harm or injury but the patient believes the practitioner was careless, then there is no basis for a claim. The patient has to prove that negligence resulted in harm or injury and that it would not have occurred in the absence of negligence.
• The harm must have serious repercussions: The patient must demonstrate that the hurt or injury brought on by the medical negligence resulted in significant loss.

Some examples of cases of malpractice, where error or negligence on the part of the medical practitioner or healthcare provider, can lead to lawsuits are:

• misdiagnosis or failure to diagnose
• unnecessary or incorrect surgery
• premature discharge
• failure to request necessary tests or take action based on results
• not following up
• prescribing the wrong dosage or the wrong medication
• leaving things inside the patient’s body after surgery
• working on the incorrect bodily part
• After surgery, the patient still feels agony.
• potentially fatal infections acquired in the hospital
• Pressure ulcers, or bedsores.

WHAT ARE THE LEGAL ISSUES IN HEALTHCARE AND MEDICAL FIELD?

Medical negligence, informed consent, and confidentiality are the three significant legal concerns in the healthcare system. Here are a few legal concerns that frequently have an impact on the healthcare system:

• Antitrust issues and ACOs: Accountable treatment Organizations (ACOs) are networks of physicians, hospitals, and other healthcare professionals who work together voluntarily to deliver patients with well-coordinated, high-quality treatment. The most well-known of the numerous schemes proposed under the healthcare legislation that seek to improve healthcare quality and reduce costs is the accountable care organization program. The ACOs mandate close collaboration between healthcare providers to achieve coordinated care, lower costs, and higher quality.
• False claims and whistle-blower suits: The National Health Service (NHS) method for identifying medical fraud and abuse committed by dishonest doctors, healthcare professionals, and suppliers is being discussed here. Typically, a country’s government lacks the manpower to efficiently identify the massive amount of claims made to the controlling healthcare agencies. According to whistleblower cases, there are numerous ways for healthcare providers and suppliers to scam the government. They can help national governments recover money that was paid out due to deceptive claims. As a result, they are crucial in the battle against healthcare fraud.
• Healthcare system malpractice and tort reform:Governments’ efforts to curtail medical misconduct and implementation of tort reform are primarily motivated by a desire to save money on unneeded medical treatments. These measures have the potential to lower global malpractice risk in addition to lowering overall healthcare expenditures.

Health care has undergone a significant transition in India, where its profitability has attracted investors from a wide range of backgrounds who are motivated by financial gain. There is also a claim that contemporary medicine is growing more impersonal, and that as our reliance on technology grows, so does the cost of care. It is an undeniable fact that people are becoming increasingly dissatisfied and have higher expectations of doctors, which is increasing the likelihood of legal action.

After conducting the appropriate investigations, the Medical Council of India has a redress system that can sanction the negligent physician. The Supreme Court has provided guidelines for the criminal charge of a doctor for negligence, which has helped to reduce the needless harassment of doctors who are unjustly accused in criminal negligence cases.

Doctors will benefit from the recent Supreme Court recommendations because they won’t be drawn into needless litigation. The rules call for a stricter examination by the Consumer Courts before moving forward with patient-filed claims of medical malpractice. However, it should be highlighted that the courts frequently rule in favor of patients who have suffered as a result of doctors’ negligence. This was recently reaffirmed in a Supreme Court judgment that upheld the State Commission’s conclusion and awarded even larger damages.

The continued education of medical physicians in medical law is essential today. In their day-to-day practice, doctors are required by law to abide by all applicable ethical and legal requirements. Even though the doctor treats the patient in good faith to lessen pain, ignorance of the law and its implications will be to the doctor’s detriment. Even well-intentioned activities could not pass legal muster. It is no more a matter of choice, but rather a context-driven legal duty and necessity for doctors to be knowledgeable with the fundamental legal concerns involved in medical practice as a result of the rising number of claims brought by unhappy patients seeking legal redress from doctors and medical establishments.

CASE LAWS RELATED TO LEGAL ISSUES IN HEALTHCARE AND MEDICAL MALPRACTICE:

• Krishan Rao v Nikhil Super Speciality Hospital, (2010) 5 SCC 513

A complaint was made against the hospital by Krishna Rao, a malaria department officer, for improperly overseeing his wife’s care. Instead of treating her for malaria fever, the hospital treated her for typhoid and gave her typhoid medication. The complainant’s wife reported experiencing breathing issues. The complainant also informed the authorities that the patient was receiving artificial oxygen.

Artificial oxygen was not required at that point, according to the complainant, but it was still administered without first determining the patient’s true need.  Typhoid treatment involves taking medications that are tailored to the condition’s specific causes and effects. When fulfilling their only obligation to their patient, they acted quite negligently.

Rao received compensation of Rs. 2 lakhs when the verdict was rendered. Res Ipsa Loquitor, which translates to “the thing speaks for itself,” was the guiding principle in this situation. Therefore, the plaintiff received the Compensation.

• State of Haryana and Others v. Smt. Santra, (2000) 5 SCC 182

A poor laborer Smt. Santra, who already had seven children, underwent sterilization as part of a government initiative to prevent more pregnancies. After the sterilization was completed, Smt. Santra received a certificate from authorized government medical officials attesting to the sterilization’s success and her inability to conceive again. She eventually got pregnant after that and gave birth to a girl.

Both the district court and the lower appellate court determined that the incompleteness of the procedure performed showed the doctor’s negligence, and they both ordered payment of 54,000 rupees in compensation plus 12% interest from the date the civil suit was filed until the compensation was paid.

• Spring Meadows Hospital v. Harjot Ahluwalia, 1997 Civil Appeal No 7708

In this instance, the court ruled that when parents moved a young kid to a private hospital to be treated by doctors. Then, by the Consumer Protection Act, not only the child but also his parents are recognized as consumers. A parent may therefore request compensation under the Consumer Protection Act. As a result, the court made a decision that was favorable to both the kid’s parents and the child who benefited from the service.

The hospital contended that proper care had indeed been given and that it was thus not allowed to compensate the parents for their mental anguish. They argued that the parents would not fall within the Consumer Protection Act’s definition of a consumer. The court correctly noted that this argument was untrue because parents are included in the act’s definition of a customer.

• Kunal Saha Vs AMRI(Advanced Medical Research Institute) SSC 384 (2014)

Famously known as the “Anuradha Saha Case,” this complaint was brought in 1998 against the Kolkata-based AMRI Hospital and three doctors, Dr. Sukumar Mukherjee, Baidyanath Halder, and Balram Prasad, alleging medical malpractice. In plain English, the wife had a drug allergy, and the doctors’ carelessness in administering medication caused the patient’s condition to worsen further and ultimately result in death. In a nutshell, these are the events that led up to the Supreme Court’s final decision in this case, which awarded the husband 6.08 crore in damages for the death of his wife on October 24, 2013.

CONCLUSION

Medico-legal cases have to be dealt with property, following the latest prevailing guidelines. If sufficient caution, due care, and attention are used when handling them, these cases pose no problem, even if the appropriate guidelines or procedures are not followed or are unavailable. To see such cases handled effectively, all that is required is proper documentation, timely information, a methodical and thorough review involving all pertinent investigations and referrals, etc.