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Legal Aspects of Medical Practice

Dr A Prakash
Sr Professor
Health Management
NAIR

CONSTITUTION OF INDIA

State List

Concurrent List

Public Health

Population Control

Sanitation

Family Welfare

Health

Medical Profession

Dispensary

Indian Medical Council Act 1956


amended 1964, 1993, 2001 &
Ordinance 2013

Recognition of Colleges, Courses & Degrees


Indian Medical Register

State Medical Register


Change of Address

Professional Conduct

Code of Medical Ethics

Clinical Establishment (Registration


& Regulation) Act 2010

To prescribe minimum standards of facilities &


services
Covers ALL except Armed Forces
Clinical Establishment (Central Govt) Rules
2012
Applicable in all UT except Delhi, Sikkim,
Mizoram, Arunachal Pradesh,HP, UP, Bihar,
Jharkhand, Rajasthan

Some states have their own eg. Andhra Pradesh


Private Medical Care (registration & Regulation)
Act 2002

Minimum Standards for level of institution

Display of facilities available

Display of Rates for each facility

Environment Protection Act 1986


Biomedical Waste Management & Handling Rules
1998
Air (Prevention & Control of Pollution) Act 1981
Water (Prevention & Control) Act 1974
The Noise Pollution (Prevention & Control) Act
2000
NOC under Pollution Control Act
E-waste (management & handling) Rules 2011

Radiation Protection Certificate from BARC


for X ray, Cath Lab, CT Scanner
Atomic Energy Regulatory Body Approval

Boiler's Act 1923


Amended 2007
Indian Boiler Regulation 1950

Boilers of size more than 100 ltrs are covered

Dentist's Regulations 1976

Excise Permit for Spirit


Narcotics & Psychotropic Substances Act &
License
eg in Delhi

F-21 for Hospitals

F-34 for Doctors for <5 ltrs

DD-5 for Narcotics

Registration of Births & Deaths Act 1969

Pharmacy Act 1948


Retail Drug License (Pharmacy)

Maternity Benefit Act & Rules 1961


MTP Act 1971
amended 2002
& MTP Regulations 2003

Maharashtra PNDT Act 1988


PNDT Act 1994
The Pre-conception and
Pre-natal Diagnostic Techniques (Prohibition of
Sex Selection) Act
PCPNDT

PFA 1954
Food Safety & Standard Regulations 2011

Indian Lunacy Act 1912


Mental Health Act 1987
medical officer under act means any gazetted medical officer
in government service

Leprosy Act 1898


Local Elections
Driving License
Train Travel

The Leprosy Laws (Repeal) Act 1988

Blood Bank License

Transplantation of Human Organs Act 1994


& License

Drugs & Cosmetics Act 1940

Insecticide Act 1968

Insecticide Rules 1971


Specially rules 37 44 deal with worker
protection

Medical Examination & Training

Protective Devices & Antidotes

Registration of Insecticide

License to manufacture

License to stock & distribute

Fatal Accidents Act 1855


Protection of Human Rights Act 1993
Persons with Disability Act 1995

Protection of Women from Domestic Violence Act


2005
Prohibition of Sexual Harassment of Women at
Workplace Bill 2010

Vehicle Registration for Ambulance


Lifts & Escalators Act Permit
Sales Tax/VAT Registration
Arms Act 1950 if armed guards

Building Permit
NOC of Chief Fire Officer
Electricity Act 1998
National Building Code

Workmen Compensation Act 1923


SC & ST Act 1989
Indian Penal Code 1860
Persons with Disabilities Rules 1996

INDIAN EVIDENCE ACT 1872

Expert Opinion
May refresh memory by referring to any writing made by
him at the time of transaction or any writing made by any
other person and read by witness at that time. Reference to
professional treatise permitted.

Consumers Protection Act 1986

US

Right to SAFETY

Right to INFORMATION

Right to CHOICE

Right to REPRESENTATION

Right to CONSUMER EDUCATION

CPA

UN

Access to information to make choices

Physical safety of consumer

Protection of economic interests of consumer

Enable consumers to obtain redress

Satisfactory production & performance standards

Adequate business practices

System of distribution of essential goods

International co-operation

CPA

India : better protection of the consumer


interests

Right to protection against goods hazardous to life


or property
Right to be informed of quality, quantity, potency,
purity, standard & price of goods to protect against
unfair trade practices

Right to be heard

Right to seek redressal

Right to consumer education

CPA

Objectives to be promoted & protected by


Consumer Protection Council
Quasi-judicial machinery for speedy & simple
redressal of disputes based on principles of
Natural Justice

COMPLAINANT

A consumer

A registered voluntary consumer association

The central or state government

One or more consumers where numerous


consumers having same interest
In case of death of a consumer, his/her legal
heir or representative

CPA & MEDICAL SERVICE

Only exceptions are

A hospital where no charges are collected from


ANYBODY
Under contract of personal service i.e. A masterservant relationship

Medical service rendered as a condition of service eg in


Railways comes under CPA

Medical Negligence

A legal duty to exercise due care

Breach of said duty

Duty of care in deciding whether to undertake the case


Duty of care in deciding what treatment to give
Duty of care in the administration of the treatment
Reasonable skill & care as expected of a professional

Consequential damage

Establishing causal relationship between said negligence


& damage

CONSENT

Informed Consent

Therapeutic Privilege
Emergency

REDRESSAL MECHANISMS

MCI

Consumer Forum

Civil Courts under Law of Torts

Criminal Court under IPC (only for gross


negligence)

How to Avoid

Better Communication

Better Documentation

Better Competence

Best of Luck