IMA &MCI's opinion and advise over 4 crucial things concerned with medical fraternity!

The following matter is prepared by IMA think tank on the behest of MCI was duly submitted to the MCI and today(31-10-2017) MCI General Body has passed all the four documents made by MCI in collaboration with IMA.

Jacob Mathew guidelines:

Draft guidelines for prosecution under 304 A

 

Guidelines for protecting doctors from frivolous or unjust prosecution against medical negligence 

WHEREAS, the Hon'ble Supreme Court in Jacob Mathew vs. State of Punjab (AIR 2005 SC 3189) had observed that statutory rules or executive instructions incorporating certain guidelines need to be framed and issued by the Government of India and/or the State Governments in consultation with the Medical Council of India;

WHEREAS, the Hon'ble Supreme Court had, "so long as it is not done", proceeded to lay down certain guidelines which should govern the prosecution of doctors for offences for which criminal rashness or negligence is as ingredient. The following guidelines were laid down:

"A private complaint may not be entertained unless the complainant has produced prima facie evidence before the Court in the form of a credible opinion given by another competent doctor to support the charge of rashness or negligence on the part of the accused doctor.

8.6 Medical ethics MCI guidelines.

Rule 8.6 of the Code of Medical Ethics Regulations 2002 reads as under:

“Professional incompetence shall be judged by peer group as per guidelines prescribed by Medical Council of India”

 Composition of the peer group :

a)     Peer Group shall be constituted at Institutional / Clinical Establishment / State Medical Council / Medical Council of India level to judge the professional incompetency of a registered medical practitioner in a time-bound manner. 

b)    The peer group shall be a three-member committee with a chairman, one IMA nominee and one professional subject expert.

c)     The peer group on receipt of any complaint shall examine the allegation in a time-bound manner, preferably within two weeks and forward its reasoned-out speaking order following the principle of natural justice and based on “Bolam’s Test” to the Institutional Head, Clinical Establishment Head / Chairman of the Ethics Committee of the State Medical Council / Chairman of theEthics Committee of the Medical Council of India as the case may be.

Permenand Kataria supreme Court guidlines.

OBLIGATIONS OF DOCTORS/HOSPITALS CONCERNING SERIOUSLY ILL/INJURED PERSONS

It may be noted that in the case of Pt. Parmanand Katara v. Union of India [AIR 1989 SC 2039], the Medical Council of India has submitted and that has been recorded in the judgment of the Hon’ble Supreme Court as under:

“It is further submitted that it is for the Government of India to take necessary and immediate steps to amend various provisions of law which come in the way of Government Doctors as well as other doctors in private hospitals or public hospitals to attend the injured/serious persons immediately without waiting for the police report or completion of police formalities. They should be free from fear that they would be unnecessarily harassed or prosecuted for doing his duty without first complying with the police formalities .......... It is further submitted that a doctor should not feel himself handicapped in extending immediate help in such cases fearing that he would be harassed by the Police or dragged to Court in such a case. It is submitted that Evidence Act should also be so amended as to provide that the Doctor’s diary maintained in regular course by him in respect of the accident cases would be accepted by the courts in evidence without insisting the doctors being present to prove the same or subject himself to cross-examination/ harassment for long period of time.”

Whereas, the Council after consultation with the representatives of the Indian Medical Association has prepared the annexed format for Medico-legal cases that may be included as an Annexure to the Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations, 2002. The suggested format is annexed.

In order that, this record be considered as evidence in Court’s proceedings, without requiring the concerned registered medical practitioner to attend Court’s proceedings, it must be ensured that the Record is legible. Therefore, a typed copy of the record should be submitted to the Court. Further, in criminal cases, information regarding the nature of injury is crucial. Therefore, in the Medico-Legal Case Sheet/Doctor’s Diary that is prepared the Registered Medical Practitioner should clearly record:

(i)Findings

(ii) Diagnosis

(iii) Reasons for Declaring the injury as simple/grievous

(iv) Whether such injury is caused by accident/assault/unascertainable   

A proposal in this regard if deemed appropriate may be drafted by the Ministry of Law and Justice for amending the Indian Evidence Act, 1972, in a time bound manner considering the requirement of criminal investigation and trial. The above proposal after approval of the General Body of the Council be transmitted to the Ministry of Health and Family Welfare, Government of India for appropriate action at their end.

SUGGESTED FORMAT FOR MEDICO-LEGAL CASES

1. Name of the patient:

2. Age:

3. Sex:

4. Identification Marks     (i)                                       (ii)     

5. Address:

6. Occupation:

7. Brought by: 

8. Date of 1st visit:

9. History:

10. Clinical note (summary) of the case:

11. Prov.: Diagnosis :

12. Investigations advised with reports :

13. Diagnosis after investigation:

14. Nature of Injury:

15. Advice: (Including Procedure Done)

16. Reasons for Declaring the injury as simple/grievous

17. Whether the injury is caused by accident/assault/unascertainable

18. Whether the injury under reference can be caused by other means also?  

19. Follow up :

20. Observations:

21. Date:

Signature in full ………………………….

Name and Designation of Treating Physician

                                     Registration No.

                                                                   Registered with (Council Name):

    Name and Place of the Hospital:

Note:- The entries made in the above format should be typed. 

Document on Indian Medical Service.

Taking stock of the entire situation, it is recommended that the Govt. of India through the same mode, manner and modality vide which Indian Administrative Services came to be created, create a Indian Medical Services to cater to the larger cause of healthcare services in the country from the point of view of efficacious management and meaningful administration.

1.     The terms, service conditions, the modality of recruitment, allocation and allotment of cadre would be akin to the one as is applicable to the Indian Administrative Services personnel.

2.     The eligibility for appearing for the entrance examination for the Indian Medical Services would be a graduate degree in health professional sciences as recognized in the governing schedule.

The committee records its gratitude to the President, Medical Council of India for having taken the prompt initiative and constituted the present Study Group.