overview of legal issues in medical practice

1. Overview of the legal Issues in Medical Practice
DR VARUN MODGIL
ASSISTANT PROFESSOR, DEPTT OF FORENSIC MEDICINE
DMCH LUDHIANA
CME ON LEGAL ISSUES IN DAY-TO-DAY
MEDICAL PRACTICE (GMCH CHANDIGARH)

2. Agenda
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Historical antecedents
Medico-legal Case [M.L.C.]
Consent
Principles of Ethics
Medical Negligence
End of life (E.O.L) decisions
Case studies
Conclusion

3. History
Vedic era (1500 and 500 BCE)
The era of Suśruta (800–700 BC)
The era of Bṛhat-Trayī
Hippocratic Oath
The era of modern medicine: current
medicolegal issues
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4. APPRAISAL OF LEGAL ISSUES IN MEDICAL
PRACTICE
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L A W CONSENT AGE
MEDICAL
ETHICS
MISCONDUCT
M E D I C I N E
REPORT
NOTIFICATION
MCCD
TOHOA
PREGNANCY PATERNALISM BOLAM BOLITHO CANTERBURY MONTGOMERY
SPORTS AUTHORITY (SAI)
NCAAF POCSO ORGAN
HARVESTING
MTP
AMENDMENT ACT
2021
MEDICAL MALPRACTICE INFORMED CONSENT

5. 5
A—Attention
B—Bona fide
information
D—
Documentation
C—Consent
E—Empathy
F—Female
attendant
MEDICOLEGAL
SENSITIZATION
S. 52 IPC, S. 80 IPC, S. 88 IPC,S. 89
IPC,S.92 IPC,S. 93 IPC,S. 304 A IPC,S.
336-338 IPC – Relevant laws applicable to
medical professionals

6. NORMATIVE ETHICS
Deontology
6
No
.
Teleology
Virtue Ethics
1
No
.
2
No
.
3
Ethics
Normative
Descriptive
Applied
Metaethics

7. Autonomy
Beneficence
Non-Maleficence
Justice
Dignity
Truthfulness & Honesty
Medical privacy
VALUES IN MEDICAL ETHICS
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8. End of Life care guidelines
 On 24 January 2023, a five-judge Constitution Bench modified the
2018 Euthanasia Guidelines to ease the process of granting passive
euthanasia to terminally ill patients
 Verification of an advance directive be done by a notary now
 Modified guidelines reduced the experience criteria of doctors to five
years from 20 years
 The guidelines imposed a preferable time limit of 48 hours for both
boards to provide their opinion
 Additionally, they removed the involvement of the Chief District
Medical Officer from the secondary board
 The number of members on both boards was reduced to three
people
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9. Legal Issues in
Daily Practice
Should I register as an MLC
for dog bite and snakebite
cases? Which animal bite
cases are to be registered as
MLC?
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Dead-on-Arrival : Issue
of BD MCCD
Changing Landscape of
Transplantation of
Human Organ Act

10. 10
DILEMMA (CASE STUDY)
I am a practising gynaecologist. A 39-year-old married
female who had taken regular antenatal checkup from me
now delivered a congenital malformed baby with missing
lower limbs and webbing of fingers. The lady had a normal
pregnancy course, though she underwent CS delivery due
to pre-existing diabetes. However, the radiologist
I referred the patient to for USG scanning during ANC had
given USG reports with ‘no congenital anomalies in head,
neck, and spine’. Now the patient sued me for a malformed
baby. What should I do?

11. ADMINISTRATIVE HIGH HANDEDNESS & LEGAL
SAFEGUARDS- CASE STUDY
A lady judicial magistrate has visited my OPD for a
health check-up. I politely asked her to come in and
offered her a seat. But after some time, in the middle
of our talk, she asked me, ‘Do you know who I am?’
And she kept asking the same question multiple times
with a rising voice. Finally, she screamed at me, ‘If I
want, I can finish your career in minutes!’ Cutting a
long story short, finally, I came to know she was
annoyed because I did not offer my seat to her;
instead, I offered the seat before me. Did I commit any
mistake not offering my seat to her? Would there be
any legal problem for me? What should I do? 11

12. Rajender Singh & Others v/s State of Haryana
(2017)- P&H H.C.
 “While giving opinions the Doctors are supposed to give the
exact injury report as at that stage they are not supposed to
give medico judicial opinion/inference whether the case is one
of murder or of accident or of friendly hands. Such a course
obviously favours the accused that too at initial stage, which
must be deprecated”
 “The Director General Medical Services for the States of
Punjab and Haryana and Union Territory Chandigarh are
requested to take notice of this fact and do the needful and
make a report to this Court”
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