Medico-Legal Aspects Of Clinical Practice

Definitions

1. A medico-legal case is defined as one, “where an attending doctor, after taking the history and examination of the patient, thinks that some investigations by the law enforcing agencies are required so as to fix responsibility regarding the case in accordance with the law of the land.”

Duties and Responsibilities of Doctors

1. As the basic objective of medical profession is to provide service to humanity, medical practitioners have certain obligations to the state. The duties or responsibilities can be broadly categorised into the following:

Compulsory Duties

These include:

1. Compulsory notification of births, deaths and various notifiable diseases.
2. Responding to call for emergency military service.
3. Reporting of cases of homicidal poisoning.
4. Reporting of all un-natural deaths.
5. Reporting of cases covered under privileged communications.

Voluntary Duties

These comprise:

1. Responsibility to continue to treat patients with reasonable skill and care. Keep professional secrets inviolate (except under privileged communications) and take special precautions whenever needed.
2. To conduct medical examinations after obtaining due consent.
3. To conduct operations after taking informed consent and observing the necessary precautions for safety of patients.
4. To issue certificates with regard to illness, death, fitness, vaccination, insurance etc. after taking due care.
5. To conduct post-mortem examination in medico-legal cases after proper authorisation.
6. To inspect prisons and reformatories after obtaining authorisation.
7. To attend to accidents as a moral duty.
8. To conduct medico-legal examinations and issue relevant certificates.

It is purely the responsibility of the attending doctor to register the medico-legal case at the earliest. It is important to remember that request of the patient or attendants (relatives, friends) for not registering the case as medico-legal should not be entertained. Doctors working in hospitals run or aided by government cannot refuse medico-legal cases; and are perforce bound to accept such cases. Private practitioners have the choice to select patients. The main duty of the doctor in such cases is to observe and record findings carefully and correctly. In case the patient is to be referred to another hospital the referral slip should be attached to the medico-legal report form. Duplicate copy should be preserved.