The relationship between a patient and that of a medical practitioner is infused with trust and belief. This is the sole reason why medical practitioners are emulated to be as God’s in the eyes of the suffering patient. But such reverence comes with a massive responsibility, a responsibility that cannot neglected. Hence, a doctor is obliged and owes certain duties to his patient and a breach of any of these duties gives a cause of action for negligence against the doctor.
The doctor has an essential duty to obtain prior consent from the patient before carrying out diagnostic tests or therapeutic management. The doctor is obligated to make certain other necessary statements about the risks and damages about the problem with the patient. The services of the doctors are covered under the provisions of the Consumer Protection Act, 2019, and a patient can seek redressal of grievances from the Consumer Courts. With moving time frame case laws have become an important aspect in dealing with medical negligence cases. Further, they have shaped and created an ambit and outlook to see and govern with medical negligence.
The following case analysis explains the rule of medical negligence being laid down by the Courts-
[1] Bolam v Friern Hospital Management Committee [1957] 1 WLR 583
In this case the doctor did not give muscle-relaxant drugs nor restrained them prior to giving them electro-convulsive therapy and the patient was mentally ill, he suffered injuries during the procedure. Then the doctor was sued for being was negligent for not restraining them or giving them the drug.
The issue raised was to assess the standard of care imposed on a professional defendant where a substantial portion of professionals opposed a particular practice, while others did not.
The High Court held that the doctor had not breached his duty to the patient, and so the defendant was not liable. The professional will not be in breach of their duty of care if they acted in a manner which was in accordance with practices accepted as proper by a responsible body of other medical professionals with expertise in that particular area. If this is established, it does not matter that there are others with expertise who would disagree with the practice. They named this as the Bolam test.
Because of the nature of the relationship between a medical practitioner and a patient, it is reasonable as well as necessary for the patient to rely on the advice given by the practitioner. Thus, Bolamapplies to all the acts and omissions constituting diagnosis and consequential treatment.
[2] Jacob Mathew vs State Of Punjab & Anr on Appeal (crl.) 144-145 of 2004
The brief facts that gave rise to the issue of medical negligence are such that an empty oxygen cylinder was pulled up to the patient and no proper equipment were there to initiate a new cylinder thereby, resulting in the death of the patient. Hence, the case was registered under section 304-A and 34 of IPC. The said case reached to the Supreme Court, and therein the court using the earlier mentioned Bolam’s Test opined that –
“The only assurance which such a professional can give or can be understood to have given by implication is that he is possessed of the requisite skill in that branch of profession which he is practising and while undertaking the performance of the task entrusted to him he would be exercising his skill with reasonable competence. This is all what the person approaching the professional can expect. Judged by this standard, a professional may be held liable for negligence on one of two findings: either he was not possessed of the requisite skill which he professed to have possessed, or, he did not exercise, with reasonable competence in the given case, the skill which he did possess. The standard to be applied for judging, whether the person charged has been negligent or not, would be that of an ordinary competent person exercising ordinary skill in that profession. It is not necessary for every professional to possess the highest level of expertise in that branch which he practices.”
The court involved the government for Statutory Rules of Executive Instructions incorporating certain guidelines need to be framed and issued by the Government of India and/or the State Governments in consultation with the Medical Council of India. The court further proposed to lay down certain guidelines for the future, so that doctors are not prosecuted by criminal negligence and rashness wrongly.
A private complaint only be entertained after a prima facie evidence is produced by the complainant and in addition a review by other competent doctor to prove the ground. The judges have given a thread to Central and State government to give rules and regulations.
[3] Martin F. D’Souza vs. Mohd. Inshaf, CIVIL APPEAL NO. 3541 OF 2002
The recent judgment pronounced in Martin F. D’Souza V. Mohd. Ishfaq by the Hon’ble Supreme Court of India caters to the plight of the medical practitioners. The facts for the understanding are such that the patient was suffering from a number of anomalies, such as renal failure, urinary tract infection and also blood infection. The situation was such that the doctor was in a precarious situation whereby to save the life of the patient, it was requisite to provide the patient with a drug called Amikacin, the side effect of which caused hearing impairment to the patient.
In such a case the Hon’ble judges opined that “the appellant was faced with a situation between the devil an the deep sea”.
The Hon’ble court further opined that-
“the courts and the consumer for a are not experts in the medical sciences, and must not substitute their own views over that of specialist. It must be remembered that sometimes despite their best efforts the treatment of a doctor fails. That does not mean that the doctor or the surgeon must be held to be guilty of medical negligence, unless there is some strong evidence to suggest that he is.”
Conclusion
According to the Hon’ble Supreme Court, cases both civil and criminal as well as in Consumer forum are often filed against medical practitioners and hospitals complaining of medical negligence against doctor.
Medicine situations are unpredictable and thus no one can assure of a certain outcome in many cases. This depends upon the facts and circumstances of the case and also the interpretation of courts hearing it. During the years courts have laid down certain principals and obligations following are the two major aspects when dealing with medical negligence.
a) Judges expertise in law and not medical science. It makes it difficult for them to decide cases. Further they have to depend on the testimonies of other doctors who have the tendency to manipulate the same. The court has the obligation to take a reasonable ground and further it becomes difficult to understand the complicated medical matters.
b) The doctors who cause death due to medical negligence should certainly be penalized. The important part is every professional makes mistake in their judgement and if they are being punished then no doctor can practice his vocation with equanimity.
The courts take reasonable discretion and potential to deal with medical negligence cases in the country. But people also sometime create scenarios to add to the problems of agent of God.
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