Dr. Amdekar writes about the current situation of doctors in India and how they are not only bound by morality but also by law and good doctor-patient relationship along with the patient caregiver's faith is the key to be legally safe.

Moral duties of a doctor

The Hippocratic Oath developed 2500 years ago by the Greek physician laid down moral principles of conduct for doctors. WHO developed Geneva Declaration and Medical Council of India brought in an act that has been amended a few times as per the need with changing medical practice scenarios. It has widened the scope of expected conduct of a doctor.

Every doctor is bound by such rules to follow medical ethics. Its main pillars are beneficence (do good), non-maleficence (do no harm), autonomy (patient’s right to make independent decisions), confidentiality (information communicated by patient is in confidence and should not be shared with others without patient’s permission), justice (equality of rights, fairness and morality). Medical Council Registration is an agreement to follow these rules and so we are all bound by the same.

What is expected of a doctor?

Every doctor is expected to act with reasonable care and skill appropriate to the standards set up by professional bodies. The standard of care varies as per the qualifications, experience and environment in which a doctor practices. Irrespective of these variables, each doctor is expected to offer 'care always, cure if possible'. Care involves action with empathy, concern for the patient, communication, counselling and documentation besides time management, good conduct, honesty, transparency, not to hide ignorance and not to run down peers.

Evolution of legality in medical practice

Ethical standards are based on human principles of right and wrong while legal standards are based on written law. Moral principles were set up by the community and every doctor was expected to follow the same in order to offer the best to a patient. It was left to individual doctors to follow.

However with changing scenarios in medical practice, few doctors strayed away from moral principles that made the Government of India bring about the Consumer Protection Act in the year 1986. According to this act, a dissatisfied patient may complain to the consumer forum at the local level and if not satisfied with the outcome, may go to the state or further, the national level.

The Indian Medical Association protested against such an act but finally it has stayed. It became necessary only because of a few doctors not following moral principles laid down by competent medical bodies. We ourselves are responsible to bring our services into legality.

What constitutes medical negligence?

Medical negligence is a breach of legal duty to care as per the standard expected that causes harm to the patient. It could be in the form of error of a diagnosis, under or over investigations or treatment or deficiency in care. When a doctor accepts a patient, it becomes an implied undertaking to offer standard care. It is assumed that he has enough skills to handle such a patient.

Every doctor is expected to act with reasonable care and skills. An error of judgment is considered as negligence only if other professionals in the same situation would not have done the same. Only because something went wrong is not considered negligence if professional experts opine that adequate care was given to the patient. No doctor is supposed to give warranty of perfection for their skills or guarantee for a cure. If the action of the doctor is appropriate to the standard laid down by a professional body, error in diagnosis or outcome is not negligence.

Disclaimer- The views and opinions expressed in this article are those of the author's and do not necessarily reflect the official policy or position of M3 India.