2. Introduction
Definition
Objectives
Gen. Acts/legislation
applicable to Hosp.
Law of torts.
Bill of Rights
Ethical & legal
Responsibilities
3. Introduction
Society has laid down the laws of land
prescribing normative behavior of
Indv/Groups with provision of deterrent
corrective punishment for any contravention
by the society through various methods e.g.
imprisonment/fine.
Law can be divided into i)civil law is concerned
with relationship among people & the
protection of persons right . Violation may
causes harm to an indv. or property but no
threat to society & ii) criminal law includes
rules forbidding conduct that is injurious to
public order & specifies punishment to indl
who exhibits injurious conduct.
4. Criminal law is concerned with relationship
between indv. & Govt. & acts that threatens
the society & its order.
“Crime is an offense against a society that
violates a law.”
Ignorance of law offers no protection from
punishment.
Public is now becoming aware of its own
rights, obligation of Drs. & also obligation of
hospitals consequently MLC are on rise.
5. MLC : Any case of injury or ailment where
some criminality is involved is called as
MLC. Criminality in a case may be Non
Cognizable(Police has no auth to arrest
without warrant) or cognizable (police can
arrest without warrant).
Dying Declaration: It is a statement of a
person, written or oral, who is dying as a
result of some unlawful act, relating to the
material facts of cause of his death or
bearing on the circumstances.
6. Various Medico-legal issues
•Personal Injury
•Medical frauds
•Defensive medicine
•Negligence
•Professional In-competency
•Organ Transplants
•Malpractice
•Ethical issues in human
experimentation
•Sex Determination & genetic
counseling
7. Objectives
Increasing number of MLC has made it
necessary for hosp. Administrators to
understand Medico Legal issues.
To understand Medico legal issues is
necessary so as to do the right things and
protect themselves & institutes from
frivolous litigations & also do justice to
patients.
8. Hospital Administration
Has an obligation to have clear understanding
of Ethical & legal responsibilities. Mgt is
responsible for policies, for maintaining a safe
hosp., physical facilities & services, must ensure
building conforms to local by laws, safety
regulations,sanitation arrangements.
Hosp. Being an integral part of the social
system is subject to all laws of the land.
Hosp. Is responsible for safety from explosives
& inflammatory gases,chemicals, machinery,
steam damages from slippery floors etc.
9. Application of Law
Application of Laws related to hosp
working, of interest are the ones
which are concerned with Consent,
Professional secrecy, evidence,
Medical negligence, law of torts, &
organ transplant.
10. General Acts/Legislation
applicable to hosp.
Industrial dispute act 1947
Minimum wages Act1948
Employees Provident Fund Act
Payment Of Bonus Act
Payment of Gratuity act 1972
Payment of wages act 1936
ESI act 1948
11. Industrial dispute Act 1947 An Act to make
provision for the investigation and settlement
of industrial disputes, and for certain other
purposes.
Minimum Wages Act: States No.of hours of
work/overtime/working days/holidays.
Workman’s compensation Act:loss of both
hands/feet/one hand &one foot right/total
disfigurement of face constitutes 100% loss.Act
lays down the %age of loss of earning capacity.
12. Motor vehicle Act 1988: Breath analyzer
test/blood test. Police can detain a person for
alcohol test for not more than 2 hrs.
Drug and Cosmetic Act 1940:Regulates import,
manufacture, distribution & sale of drugs in
India. Insecticide, disinfectant &
contraceptives & cosmetics are included in this
Act. It lays down the drugs which can be sold
over the counter& those e.g. schedule H &L
normally would not be sold without
prescription.
13. Medical / professional Acts
Indian Medical Council Act 1933.
Indian Nursing Council Act 1947.
The Pharmacy Act 1948
Births & Deaths & Marriages
registration Act. Hosp is bound to
inform all births/deaths taking place
in a hosp.
14. Miscellaneous Acts
Applicable to Hospitals
Societies registration Act,1860: It
governs working & Mgt of institutions
est. or owned by charitable trusts.
State Public charitable Trust Acts.
Acts in relation Establishment of
Nursing homes.
15. Law of Torts
Tort is defined as “Any wrong,injury
or damage is done to the person for
which a civil suit can be brought” e.g.
wrong operation, operating without
consent, leaving instrument inside
the body,invading the right of
privacy, breach of professional
secrecy, defamation,malicious
prosecution, misrepresentation.
16. COPRA 1986
This Act came into force w.e.f.1 Sep,1987.
Provides redressal for defective goods, deficient
service, unfair trade practices.
The Consumer Protection Act, gives easy and
fast compensation to consumer grievances. It
safeguards and encourages consumers to speak
against insufficiency and flaws in goods and
services. If traders and manufacturers practice
any illegal trade, this act protects their rights as a
consumer.
17. Deficiency: Any fault, imperfection
shortcoming or inadequacy in the quality,
nature & manner of performance of a
contract , or otherwise in relation to the
service.
Service means service of any description
except free service & personal service.
A claim for compensation under COPRA
must be filed within 3Yrs.
National Forum deals cases >10 lacs, state
forum >5lacs & district forum upto 5lacs.
18. BILL OF RIGHTS
Respectful care
Complete information regarding
diagnosis,tmt,&prognosis.
Pt. Has right to information from Dr before
he gives consent.
Right to refuse ,to the extent permitted by
law & to be informed of med. Consequences.
Right to privacy, all communication & records
be treated as confidential.
Hosp must provide evaluation, service,&/or
referral as indicated by the urgency of case.
19. Relationship of hosp to other hosp where
one is being referred to.
Right to refuse to participate in research.
Right to know appointments/availability of
DR, continuity of hlth care requirements
after discharge.
Right to examine & receive explaination of
bill.
Right to Hospital rules.
20. Offences & Professional
Misconducts
Adultery/improper conduct/association with
patient.
Issuing false certificates.
Conviction by court of law for offences involving
moral factors.
Selling of schedule poisons
Performing an abortion or illegal operation/op
without consent.Disclosing patients secrets.
Issuing certificates to unqualified persons.
Advertisement of services or the institutions run by
the physicians. Use of agents.
21. Organ Transplant
There is no specific central legislation which
permits sale/purchase of organs. Indian law
is silent on trade in human organs.
Transplant of Human organs Bill1992 is
under consideration deals with various
aspects of organ transplantation.It deals with
measure to curb malpractice,punishment for
donors,doctors & even advertisement
seeking donation of organs.
22. MTP ACT 1972
Specifies conditions under which
pregnancy can be terminated., the
persons who can perform
termination & places where such
procedures can be performed. It can
be performed either in Govt. hosp or
other places approved by the Govt.
23. Current Ethical Issues
Aids
Abortions
Euthanasia
Sterilization
Adoption of children
Ethical issues & poor patients
Ethical Issue of Examination of females.
Use of new drugs on trial on patients.
24. ETHICAL ISSUES
We will have to treat every case on
its merits, if we do our best in all
honesty, we will make the decision
right. Respect for a patient is
fundamental to the Dr. pt
relationship & respect we show
reflects what we think of the patient’s
worth.
