This document provides an overview of medical jurisprudence, which refers to the application of law and ethics to the practice of medicine. It discusses key topics like doctor-patient relationships, informed consent, medical negligence, and legal duties and rights of doctors and patients. Some important terms related to legal procedures for medical cases are also defined. The document outlines ethical practices in medicine and legal aspects doctors must follow under various acts. It emphasizes the importance of maintaining accurate medical records and obtaining valid consent from patients.
2. Medical Jurisprudence
Juris = Law Prudentia = Knowledge
• in relation to practice of Medicine
• in relation with legal consequences
Knowledge of Law
5. ETHICAL ASPECTS OF MEDICAL PRACTICE
Ethics - Manner and habit of man relates to understanding of
moral Principles
Medical Etiquette – Sense of Courtesy and mutual relationship
b/w Members of Medical Profession
6. Qualified & Registered Med Practitioner(RMP)
– Realise his responsibility to the society.
A RMP – allowed to use knife on the body (or)
- Toxic medicine on his patient.
ETHICAL ASPECTS OF MEDICAL PRACTICE
7. Not to criticize colleague
Never take fees
Always help
Duties with regard to consultation
Duties of RMP Towards Professional
Colleague
Duties of RMP Towards State
Notify certain diseases
Uniform vital events
Under Geneva conventions
Regarding medico-legal cases
8. Provide all information related with health
Should follow doctor’s instruction/advice
should pay fee
If patient wish to take 2nd opinion, they must informed to
the 1st Doctor
Should have faith in the doctor chosen for treatment
Should not contribute to medical negligence
Should co-operate
Investigations
Treatment schedules
Duties of Patients
9. to issue certificate
Right for appointment to
public(government) hospitals
To Give evidence as an
expert witness in the court of
law
To claim payments of fees
for professional service given
Rights & Privileges of RMP(Registered Medical Practitioner)
Right to Practice Medicine
Right to Choose Patient
to Prescribe / Dispense
Medicine (inclu. Drug listed in
Dangerous Drug Act)
to add Professional titles to
his name
to Perform Surgical
Operation
10. Right to have privacy during
consultation or treatment
Right to receive full information
about diagnosis
Right to know the
procedure/results of surgery/ risks
involved/available alternatives/
the type of procedure/results &
Prognosis
Right to demand for the medical
record
Right to complain & rectification
of grievances
Rights & Privileges of Patients
Right to choose doctor
Right to access healthcare
facility available (regardless of
age,sex,caste,religion & economic
or social status)
Right to be treated with
diginity,with care, respect &
without any discrimination
right to have Confidentiality of
all his information furnished to
doctor
Right to seek 2nd opinion
Right to obtain compensation
(for medical injuries/negligence)
11. PROFESSIONAL SECRETS & CONFIDENTIALITY
Should know his professional capacity
Prof. secrets should not be disclosed to anyone
except under following circumstances
In a court of law under orders of the presiding
judge
Privileged communication
In case of notifiable diseases
13. LAW AND DOCTOR
•Sec 179 IPC – Omission to give notice or Information to
Public servant by person legally bound to give it
•Sec 177 IPC – furnishing false information
•Sec 191 IPC – give false evidence
•Sec 192 IPC – fabricating false evidence
•Sec 193 IPC – punishment for false evidence
•Sec 194 IPC – giving false evidence/intent to procure
conviction of capital offense
•Sec 194 IPC – giving false evidence/intent to procure
conviction of offence punishable with imprisonment for
life.
•Sec 197 IPC – issuing/signing false certificate
14. LAW AND DOCTOR
•Sec 201 IPC – disappearance of evidence of offence
•Sec 203 IPC – giving false information respecting an
offence committed
•Sec 204 IPC – destruction of documents to prevent its
production as evidence
•Sec 269 IPC – negligent act likely to spread infection of
disease dangerous to life
•Sec 270 IPC – malignant act likely to spread infection of
disease dangerous to life
•Sec 271 PC – disobedience to quarantine rules
•Sec 272 IPC – adulteration of foods
•Sec 273 IPC – sales of noxious food or drink
15. LAW AND DOCTOR
•Sec 275 IPC – sales of adulterated drugs
•Sec 274 IPC – adulteration of drugs
•Sec 276 IPC – sales of drugs as a different drug or
Preparation
•Sec 277 IPC – fouling water of public spring/reservoir
•Sec 278 IPC – making atmosphere noxious to health
•Sec 284 PC – negligent conduct with respect to
poisonous substances
•Sec 304 A IPC – causing death by negligence
•Sec 312 IPC – causing miscarriage
•Sec 39 Cr PC – public to give information of certain
offences
•Sec 53 Cr PC – examination of accused by practitioner
at the request of Police officer
16. LEGAL PROTECTION TO RMP
•Sec 88 IPC
Act not intended to cause death done by consent
in good faith for the persons benefit
•Sec 89 IPC
Act done in faith for benefit of child or insane
person by consent of guardian
In the above two Sec 88 IPC , Sec 89 IPC the law does not provide
sanction of mercy killing or euthanasia.
1. The intension is not to kill the patient but to cure his disease
2. Consent of the particular patient or guardian has been
obtained for the procedure
17. LEGAL PROTECTION TO RMP
•Sec 92 IPC
Act done in god faith for benefit of a person
without consent
•Sec 93 IPC
•Communication made in good faith
•No communication made in good faith is an offence
by reason of any harm to the person to whom it is
made, if it is made for the benefit for that person
This section highlights important principles that
1. The act is done in good faith for the benefit of patient
2. The intention of doctor is to save the life and not to kill
the person
18. Responsibility of RMP in Criminal Matters
Communication to Police
• Under Sec 39 Cr PC, RMP
should communicate to the
policy any information about
criminal act that has come to
his knowledge
•Offence to attempt to commit
sucide (Sec 309 IPC) is not
included in sec 39 of Cr PC.
•Under sec 175 Cr PC, the
doctor has to provide all the
information asked by police/
magistrate
•Not Providing such information
or concealing is punishable (Sec
202 IPC for destruction of
evidence)
•Giving false information is also
punishable
•Preservation of trace evidences
& samples in an injured or
poisoning pt or Sexually
offenses cases should done by
doctor and handover to police.
•Preservation of Record.
19. DOCTORS AND MEDICAL RECORDS
1. Medical Negligence cases
2. Life insurance policy
3. 3rd party claims – health/accident insurance
4. Proof of disability
5. Workman’s compensation cases
6. Traffic accidents cases
7. Follow-up cases or taking treatment from another doctor
8. Medico-legal cases
Medical Record required for Patients for
20. DOCTORS AND MEDICAL RECORDS
1. For Medical research
2. For cost accounting
3. Hospital audit
4. Evaluation of drug therapy
5. Planning
6. Legal purpose
7. Administration
8. Follow-up cases
9. Insurance claims
Medical Record required for Doctors/Hospitals for
21. DOCTORS AND MEDICAL RECORDS
1. OPD cards
2. IPD Cards
3. Details of provisional and final diagnosis
4. Treatment record
5. X-ray films/USG report/MRI
6. Laboratory reports
What constitute Medical records?
22. CONSENT
Sec 90 IPC, defines consent in negative terms. Consent given
under five circumstances will not be true.
1. Person under fear of injury
2. Person who is under misconception
3. Intoxicated person
4. Person who is of unsound mind
5. Person, below 12years of age
Defined as- Free and voluntary agreement,
compliance or permission or permission given for a
specified act or purpose
23. CONSENT
As per Sec 14 Indian contract Act, consent is said to be free
and voluntary.
1. Not obtained by coercion/force
2. Not obtained by fraud
3. Not obtained by influence
4. Not obtained under influence of intoxication
5. Not obtained by misrepresentation
6. Not obtained from mistaken subjects
7. Not obtained from mentally unsound persons
24. IMPORTANCE OF CONSENT
Consent obtained by a doctor to examine, treat or
operate a patient.
Treating/examining patient without consent is an assault
on patient
Adult who is conscious and have sound mind is at liberty
to decline the consent for treatment/examination.
Consent and submission are not same. Consent involves
submission, but it is not said that mere submission
amounts to consent.
If a doctor fails to ask consent, may be charged for
negligence
For operation which are negligible or unlawful, there
cannot be any valid consent, for ex. Procuring criminal
abortion.
26. Criteria for consent
Valid consent – Sec 90 IPC
1. Mentally free
2. Above 12 year of age
3. Not under any fear of injury/threat
4. Not under misconception or false conception of facts
5. Not be intoxicated
Other Types of consent
• Blanket consent
• Surrogate consent
• Proxy consent
27. Consent- not required
• Emergency
• Notifiable diseases
• Public interest
• Public health
• The court order
• Prisoner
• Immigrants
• Medico-legal postmortem
examinations
• Armed force – statutory
requirement
28. Consent of spouse
• Termination of pregnancy
• Sterilization
• Artificial insemination
• Donation of sperm
• Any operation that harms sexual right of spouse
Consent and Medico-legal cases
• For medico-legal autopsy-consent not required
• For clinical or pathological autopsy, consent is must
• Examination of Victim- Consent required
• Examination of accused for medico-legal purpose –
consent required.
29. Right to refuse Consent
A competent person has a right to refuse treatment
and refuse to consent for medical treatment or
Procedure
Advance directives
• Also know as living will
• Issuing or execution of advance directives entitles
the patient to refuse treatment at any time in future
• Advance directive is rather new concept and not
prevailing in India
30. Medical Negligence/ Malpractice
- want of reasonable degree of care and skill or willful
negligence on the part of RMP while treating a patient
resulting in bodily injury, ill health or death.
Two Components
Patient has died due to non
application of reasonable
degree of care and skill
Willful negligence on part of
doctor while treating a
patient
1 2
31. Classification
1. Civil Negligence
2. Criminal negligence
1. Civil Negligence
• In Civil negligence, patient has to approach
Consumer court
1. Recognised legal right of patient –infringed
2. Existence of a duty of care
3. Dereliction of duty
4. Breach of duty was the cause of injury or harm
5. Patient had suffered damage
32. 2. Criminal negligence
• In Civil negligence, patient brings allegation of
criminaling against a doctor
1. Operation on wrong limb
2. Removal of wrong organ
3. Wrong blood transfusion
4. Leaving instruments in abdomen
5. Performing criminal abortion