Medical Negligence

Introduction

In legal terms, medical negligence denotes a failure to fulfill the duty of care, leading to harm or damage. This harm can manifest in various forms such as financial loss, deterioration of health, worsening the patient’s condition, causing emotional distress, or leaving the patient in a permanent state of disability. India has adopted principles from English law, and many current Indian laws are directly influenced by this legal heritage.

To prove negligence, the following essentials should be fulfilled:

• Duty of Care: The doctor owed a duty of care towards the patient or person who has suffered mental and physical injury.
• Breach of Duty: The second factor is the establishment of the fact that despite the doctor owing a duty of care towards the patient, the former failed to fulfill such duty and has breached his duty towards his/her profession.
• Causing of injury: It must be established that a doctor owed a duty of care towards the patient and he/she failed to fulfill his duty and such failure has resulted in injury or death to the patient.

The legal implication of negligence and patient’s rights

Medical negligence can be challenged under the following provisions:

• Criminal Negligence

Criminal negligence applies when the elements of intent or motive, the seriousness of the offense, and the character of the accused are established.

• Section 304A of the IPC: It states that whoever causes the death of another person by reckless or careless conduct that does not amount to culpable homicide shall be punished by imprisonment for up to two years, a fine, or both.
• Section 337 of IPC: Whoever causes harm to another person by acting rashly or recklessly in such a way as to jeopardize human life or the personal safety of others will be punished with imprisonment of either sort for a time up to six months, or a fine up to five hundred rupees, or both.
• Section 338 of IPC: The section states that whoever causes serious harm to another person by acting rashly or recklessly in such a way as to risk human life or the personal safety of others is subject to imprisonment of either sort for a time up to two years, or a fine up to one thousand rupees, or both.
• Section 80 of IPC: Nothing in the performance of a legitimate act in a lawful way by lawful methods and with adequate care and caution is an offence if it is done by accident or misfortune and without any criminal purpose or knowledge.
• Section 88 of IPC: A person cannot be charged with a crime if she or he acts in good faith for the benefit of another, does not want to injure the other even if there is a risk, and the patient has provided express or implicit permission.

• Civil Negligence

In cases where there is no intent and the level of negligence is not significantly severe, the matter falls under civil negligence. This area is particularly significant as it encompasses numerous instances of medical negligence. Typically, civil liability involves seeking compensation for damages. This domain also encompasses two levels of responsibility. 

The first involves an individual who either performs an action that a reasonable person would not in that situation, or fails to perform an action that a reasonable person would perform in that situation. This individual is liable for negligence towards the patient. 

The second involves supervisory liability. If a breach of duty occurs during a medical procedure or while a patient is under hospital or medical practitioner supervision, they are held vicariously responsible and are required to provide restitution in the form of damages.

• Consumer Protection Act

Section 2(1)(g) of the act deals with deficiency of service. It states that “Deficiency of service means any fault, imperfection, shortcoming, or inadequacy in the quality, nature, or manner of performance that is required to be maintained by or under any law for the time being in force or has been undertaken to be performed by a person in pursuance of a contract or otherwise about any service”. In 1995, Hon’ble Supreme Court judgment in Indian Medical Association v. VP Shantha brought the medical profession under the Consumer Protection Act of 1986’s definition of “service.” This formalized the relationship between consumers and medical professionals by allowing contractual patients to sue practitioners for compensation in ‘procedure-free’ consumer protection tribunals if they were injured during treatment.

Challenges and Concerns

Both patients and healthcare providers encounter unique challenges within the medico-legal framework:

• Patients: Patients often bear the responsibility of proving their claims, which demands expertise and resources to navigate intricate legal procedures. Moreover, limited awareness of their legal rights and concerns about potential repercussions can discourage patients from pursuing compensation.
• Doctors: Healthcare providers operate under the shadow of litigation, which can lead to a defensive approach in practice, impacting clinical decision-making. Furthermore, worries about frivolous lawsuits and prolonged legal proceedings can be demoralizing for medical professionals.

Conclusion

Medical negligence in India continues to be a nuanced and sensitive matter, requiring a balanced approach that protects patient rights while recognizing the difficulties healthcare professionals encounter. Through thorough reforms, increased awareness initiatives, and fostering empathy and communication, India can establish a healthcare system founded on trust, transparency, and accountability. This ensures that the focus on healing prevails over the challenges posed by negligence.

FAQs

What is medical negligence under IPC?

Medical negligence under the Indian Penal Code (IPC) refers to the failure of a medical professional to provide the standard of care expected in their field, resulting in harm to the patient. It’s primarily covered under Sections 304A (causing death by negligence) and 336-338 (endangering life or personal safety of others). To prove medical negligence, one must establish that the doctor owed a duty of care, breached that duty, and the breach directly caused harm to the patient. The punishment can include fines and imprisonment, depending on the severity of the negligence and its consequences.

Is 304A a bailable offence?

Section 304A of the Indian Penal Code, which deals with causing death by negligence, is generally a bailable offense. This means that if a person is arrested under this section, they have the right to be released on bail. The police can grant bail at the station, or it can be obtained from a court. However, it’s important to note that being bailable doesn’t guarantee automatic release. The court or police may impose certain conditions for granting bail. The maximum punishment under this section is imprisonment up to two years, or a fine, or both.

What is the Doctor Protection Act?

The ‘Prevention of Violence Against Healthcare Professionals and Clinical Establishments Bill, 2022’ is an Indian legislative proposal aimed at protecting healthcare workers and medical facilities from violence and damage. It seeks to address the growing concern of attacks on medical professionals and vandalism of hospitals. The bill proposes stricter penalties for offenders, including fines and imprisonment. It also aims to create a safer working environment for healthcare professionals and ensure uninterrupted medical services. The legislation reflects the government’s response to demands from the medical community for better protection in the wake of increasing incidents of violence against healthcare workers.

Is 304A compoundable?

Section 304A of the Indian Penal Code, which deals with causing death by negligence, is not compoundable. This means that once a case is filed under this section, it cannot be settled out of court between the parties involved. The offense is considered serious enough that the state maintains the right to prosecute, even if the victim’s family wishes to withdraw the complaint. This non-compoundable nature reflects the gravity of the offense and the state’s interest in deterring negligent acts that result in death. Only a court can decide on the outcome of such cases.