Medical Ethics

1. Deals with the moral principles
2. which should guide the members of medical profession
3. In their dealings with each other, their patients and the State.

 

Medical etiquette

1. Conventional laws of courtesy
2. observed between the members of medical profession

 

Medical jurisprudence

1. It is the study of law in relation to medicine.
2. It deals with the legal aspects of medicine
3. such as legal rights, privileges, and obligations of medical practitioner

 

Hippocratic Oath

Different Codes of Ethics

1. Hippocratic oath: Oldest one
2. Declaration of Geneva – 1948
3. International code of medical ethics- 1949
4. INDIAN MEDICAL DEGREES ACT -1919
5. INDIAN MEDICAL COUNCIL ACT-1933, 1956
6. MCI Amendment Act 2010
7. NATIONAL MEDICAL COMMISSION ACT-2019

 

Associations

1. World Medical Association
2. National medical council
3. State medical council

 

Indian Medical Council

Constitution

1. 1 member from each state (nominated by central Govt)
2. 1 member from each university-medical faculty
3. 1 member from each state
4. 7 members from persons in any SMR
5. 8 members nominated by central government
6. Term of 5 years

 

Functions Of Indian Medical Council

1. Recognition of medical qualification
2. Supervision of undergraduate & postgraduate medical education
3. Recognition of foreign medical qualification
4. Recognition of medical institutions
5. Warning notice
6. Appeal against disciplinary action

 

Warning notice

1. IMC and SMC give examples of offences which constitutes serious professional misconduct
2. but it stresses the fact that it is not a complete list.
3. Each case has to be decided on its specific facts and merits

 

National Medical Commission

1. Passed in Lok Sabha in July 29, 2019
2. NMC came into force from September 25, 2020
3. Consists of 33 members
4. A chairperson -a medical professional
5. 10 ex officio members
6. 22 part time members (law, research, public representatives)
7. Chairman- Dr Suresh Chandra Sharma (former HOD, ENT, AIIMS) for 3 years.
8. Secretary- Dr Rakesh Kumar Vats (former secretary of boards of governors of IMC) for 3 yeas.

 

Functions of NMC

1. Ensuring compliance by SMC with the regulations made under the bill
2. Framing guidelines for determining the fee for up to 50% seats in Private medical Colleges

 

Regulatory boards under NMC

4 autonomous boards

1. The Under Graduate Medical Education Board (UGMEB)
2. Post Graduate Medical Education Board (PGMEB)
3. The Medical Assessment and Rating Board (MARB)→ licensing new institutions, maintenance of standards
4. The Ethics and Medical Registration Board➜ misconduct

 

Community Health Providers

1. India in Jan 2018 Doctor: Population ratio=1: 1655
2. This gap is to be filled by Community health providers who are licensed mid level medical practitioners provided by NMC
3. They prescribe specific medicines in Primary and Preventive health care
4. Uniform NEET (National Eligibility cum Entrance Test)
5. National Exit Test
6. Common final year undergraduate exam for students graduating from medical institutions
7. To obtain license for practice
8. Serve as the basis for admission to postgraduate courses

 

State Medical Council

Constituted by

1. Medical teachers
2. Registered medical practitioners
3. State government nominees

Functions

1. Medical register
2. Disciplinary control

 

Judicial procedure in SMC

Professional Misconduct/ Infamous Conduct

1. Professional misconduct can be defined as something done by a doctor in the profession, which is considered as disgraceful and dishonourable by his or her professional brethren of good repute and competence, after the enquiry by the State Medical Council.
2. Act of a medical man in the pursuit of his profession, with regard to which it would be reasonably.
3. Regarded as Disgraceful or dishonourable by his professional brethren of good repute & competence.
4. Professional misconduct by doctors is governed by The Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations, 2002 made under Indian Medical Council (IMC) Act, 1956.
5. Currently, Medical Council of India (MCI) is an Appellate Authority in all cases of medical negligence and malpractice by medical professionals referred to it by all State Medical Councils.

 

6 ‘A’s

1. Abortion
2. Addiction
3. Adultery
4. Advertising
5. Association with unqualified person
6. Alcohol

 

Apart from these, the councils can also consider any other form of alleged infamous conduct, which is not in the above list for deciding the punishment:

1. Dichotomy
2. Touts
3. Professional secrets
4. Conviction- immoral & criminal acts
5. Not notifying notifiable diseases
6. Refusing Rx- on basis of caste, religion,
7. Race, sex, nationality, some diseases (A.I.D.S)
8. False/misleading certificates
9. Refusing to Rx emergency cases
10. Abuse of dangerous drugs act/scheduled drugs act.
11. Owning a chemist shop/ surgical.
12. Adopting unfair means – Secret remedies
13. Patient snatching
14. Association with unqualified people
15. Violation of PNDT (prohibition of sex selection) Act 1994
16. Not abet / aid torture- human rights violation
17. Publish photos/case report
18. Failure to obtain consent- both spouses in sterilization / in vitro fertilization
19. Violating I.C.M.R. guidelines in clinical drugs trails or other research.
20. Euthanasia

 

Punishment

1. Warning-minor offence
2. Penal erasure

 

Penal Erasure/Professional Death Sentence

1. Serious professional misconduct name is removed from the register temporarily/ permanently
2. Permanent removal of name from the medical register→ PENAL ERASURE
3. Death of practitioner
4. Entries made in error
5. Professional misconduct
6. Not traceable in his address

 

Rights & Privileges Of Rmp

1. Choose the patient
2. Use title &description of qualification
3. Appointment in public & local hospital
4. Prescribe & dispense medicine
5. Realize fee &expenses
6. Issue medical certificates &ml reports
7. Give evidence in a court of law
8. Removal of organ for transplantation
9. Perform MTP

 

Duties of medical practitioner

1. To uphold dignity of honour of profession
2. To exercise reasonable degree of skill and knowledge
3. With regard to attendance and examination
4. To furnish proper and suitable medicines
5. To give instructions
6. To control and warn
7. To third parties
8. Towards children and adult’s incapable of taking care of themselves
9. Inform patients of risks
10. With regards to poison
11. To notify certain diseases
12. With regards to operations
13. With regards to consultations
14. In connection with X-ray examination
15. Professional secrecy
16. Privileged communication

 

Professional Secrecy

1. Doctor is obliged to keep as secrets all that he comes to know about his patient during treatment
2. Implied term of contract
3. Disclosure without genuine reasons professional misconduct

 

Privileged Communication

1. Doctor can reveal certain information about a patient to protect the interest of public or state.
2. Better to get the consent of the patient
3. Veneral diseases spouse
4. Infectious diseases hostel
5. Notifiable diseases COVID 19
6. In patien’ts interest
7. Suspected crime criminal case
8. Courts of Law offences
9. Insurance reports

 

Duties of a patient

1. Furnish the doctor with complete past medical history, family history of diseases and the facts and circumstances related to the disease.
2. He should strictly adhere to the instructions of the doctor with regard to diet, medicines, life style changes.
3. He should pay reasonable fee to the doctor.