SN7 SHORT NOTE 5M

Describe the rights of a patient and the rights and duties of a doctor.

Forensic Medicine · 2nd Professional — Para-Clinical

Definition and Historical Position

Rights OF A patient are the entitlements a person has in the doctor-patient relationship, derived from the constitutional right to life under Article 21, from statute, and from the professional conduct regulations. The Charter of Patients' Rights was formulated by the National Human Rights Commission and circulated by the Union Health Ministry.

Right	Content
Right to emergency care	Immediate treatment without prior payment or police formality (Parmanand Katara); no hospital, public or private, may refuse
Right to information	The diagnosis, nature and cause of illness, proposed treatment, risks, alternatives, expected cost and expected outcome, in a language the patient understands
Right to records	Copies of case papers and investigation reports — within 24 hours during admission and 72 hours after discharge
Right to informed consent	And to refuse treatment, and to leave against medical advice
Right to confidentiality, privacy and dignity	Including the presence of a female attendant when a woman is examined by a male doctor
Right to a second opinion	And to have the records made available for it
Right to non-discrimination	Irrespective of illness (including HIV), sex, caste, religion, disability or ability to pay
Right to transparency IN rates	Display of charges, and the right to choose the source of medicines and the diagnostic centre — the patient may not be compelled to buy from the hospital pharmacy
Right to be discharged, and to receive the body	A hospital may not detain a patient, or withhold a dead body, for non-payment of dues — a practice the courts have repeatedly held unlawful
Right to redress	To complain, and to know the grievance procedure

CLINICAL PEARL

A hospital may not detain a living patient or a dead body for unpaid bills. It happens routinely in India and it is unlawful — detention of a person is wrongful confinement, and withholding a body from a grieving family has been condemned by every court that has considered it. The hospital’s remedy for an unpaid bill is a civil suit for recovery, exactly like any other creditor’s. It is not permitted to take the patient as security.

Duties of a Doctor and Rights of a Doctor

Duties to the patient — to attend when called and to give emergency care; to exercise reasonable care and skill; to obtain consent; to maintain confidentiality; to keep records; to inform honestly; to continue treatment until the relationship is properly ended; to refer when the case is beyond one's competence; and to visit as often as the case requires
Duties to the profession — to maintain the honour of the profession, not to advertise or canvass, not to cover an unqualified person, not to take or give commissions, and to help a colleague in difficulty
Duties to the state and the public — to notify births, deaths and notifiable diseases; to report medicolegal cases; to give evidence when summoned; to assist in disasters and epidemics; and to participate in public health measures
Rights of a doctor — to practise and to recover reasonable fees; to choose the patient in a non-emergency and to refuse a case, provided the patient is informed and can seek care elsewhere; to withdraw from a case after giving reasonable notice and an opportunity to obtain another doctor; to be treated with respect and to work in safety; and to expect protection from violence
Violence against healthcare workers is a serious and growing problem in India. Most states have enacted Medicare Service Persons and Medicare Service Institutions (Prevention of Violence) Acts, making assault on a healthcare worker a cognizable, non-bailable offence; and the Epidemic Diseases (Amendment) Act 2020 introduced stringent central provisions during epidemics after the assaults on health workers during COVID-19
The doctor may not abandon a patient once treatment has begun; withdrawal requires notice, an opportunity for the patient to make other arrangements, and the handing over of records. Abandonment is both negligence and misconduct

Applied Aspects

Never detain a patient or a body for unpaid bills; it is unlawful, attracts adverse publicity and judicial censure, and the hospital's proper remedy is a suit for recovery
Do not compel a patient to buy medicines or investigations in-house; the right to choose the source is explicit, and tying is both an ethical and a consumer issue
Have a female attendant present whenever a male doctor examines a female patient, and record that she was present; this protects the patient's dignity and the doctor equally
Give the records within 72 hours; refusal is misconduct, is a deficiency in service, and converts a doubtful complaint into a strong one
If you must withdraw from a case, give notice in writing and hand over the records; withdrawal without notice is abandonment and is indefensible
Report violence and use the state Act; under-reporting has allowed the problem to grow, and the protective legislation is of no value if it is never invoked

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