Junior
doctors in West Bengal are on a strike since Tuesday after two of their
colleagues were attacked and seriously injured at the NRS Medical College and
Hospital in Kolkata by the relatives of a patient who died. Showing solidarity
with their colleagues in Kolkata, doctors across the country have joined the
protest. The Indian Medical Association (IMA) has called a nationwide strike on
Monday.
Violence
against doctors is unacceptable and needs to be condemned. The medical
fraternity is very disturbed and concerned about the rising incidents of
physical violence and assault or attack on doctors and their staff, clinical
establishments, etc.
The
government of India had constituted an Inter-Ministerial Committee, which had
promised to soon enact a central Act for violence against doctors. But, sadly,
this has yet to see the light of the day. It’s time that the medical profession
unites and stand firm till the government brings a Bill for violence against
doctors in the coming Parliament session.
If
the doctors and other healthcare staff, etc. are always under a constant threat
and pressure from the ongoing violence and assault then they will not be able
to do justice with their profession and also they shall not be able to manage
their patients who need emergency treatment and are therefore undergoing risk
and danger of their life, properly and promptly.
It
is therefore in the interest of public at large that such cases of physical
violence against doctors must be condemned and controlled and must not be
allowed to happen.
Persons
committing such offences and crimes can be punished under the following laws:
Criminal
law
The
Act of physical violence, assault, attack on doctors, nurses, their staff,
clinical establishments, etc. amounts to following criminal offences, which are
punishable under the provisions of Indian Penal Code (IPC), 1860:
Criminal conspiracy: Section 120A and Section 120B of IPC
Offences against the public tranquility
Unlawful assembly: Section 141, 143 and 144 IPC.
Rioting: Section
146 IPC, Section 147 IPC and Section 148 IPC.
Affray: Section
159 IPC and Section 160 IPC.
Offences affecting the public health, safety,
convenience, decency and morals
Public nuisance: Section 268 IPC, Section 269 IPC and Section 294
IPC.
Offences affecting human body
Hurt: Section 319 IPC, Section 323 IPC and Section 324 IPC.
Grievous hurt: Section 320 IPC, Section 325 IPC, Section 326 IPC
and Section 326A IPC.
Act endangering life or personal safety of others: Section 336 IPC, Section 337 IPC and Section 338 IPC.
Wrongful restraint: Section 339 IPC and Section 341 IPC.
Criminal force and assault: Section 350 IPC, Section 351 IPC, Section 352 IPC and Section 355
IPC.
Offences against property
Theft: Section 378 IPC and Section 379 IPC.
Mischief: Section
425 IPC and Section 426 IPC.
Criminal trespass: Section 441 IPC and Section 447 IPC.
Offence of defamation: Section 499 IPC and Section 500 IPC.
Offences of criminal intimidation, insult and
annoyance: Section 503, Section 504 IPC and Section 506
IPC.
Offences of outraging, insulting the modesty of
women: Section 354 IPC, Section 354A IPC, Section 354B
IPC, Section 354C IPC and Section 509 IPC.
If
any person commits any of the above mentioned offence, then the doctors and
their staff can lodge a police complaint under Section 154 of
the Criminal Procedure Code and get an FIR lodged against the said
offender.
Civil
law
Doctors,
hospitals, its staff, clinical establishment, etc. can also file civil suits
like suit for permanent injunction, suit for damages and suit for defamation
against the aforesaid Acts and offences of physical violence, assault, attack,
etc.
Besides
the above mentioned remedies under IPC or CrPC, around 15 States and Union
Territories (UTs) in India have their respective State or UT legislations on
the issue of physical violence or assault of doctors, for example: Delhi
Medicare Service Personnel and Medicare Service Institutions Act, 2008; Bihar
Medical Service Institution and Person Protection Act, 2011, etc. In all these
legislations, punishment is imprisonment which may extend to 3 years or with
fine up to Rs. 10,000/- or both and compensation of twice the purchase price of
property damaged and loss caused to be recovered as arrears of land revenue on
default. However, the said legislations framed by the 15 States or UTs are not
effective and also there is no awareness about the same either amongst the
doctors or the concerned police authorities.
Then
there are laws relating to sexual harassment at the workplace.
Women can file a complaint against the offence of sexual harassment at
workplace as per the provisions of the Sexual Harassment of Women at Workplace
(Prevention, Prohibition and Redressal) Act, 2013 (hereinafter referred to as
Act, 2013).
As
per the provisions of the Act, 2013, the hospitals, clinical establishments,
etc. should constitute an Internal Committee for redressing the complaints
relating to the sexual harassment at workplace made by any aggrieved women.
Some
Remedies
Here
are few suggestions to avoid doctor-patient disputes. More suggestions are
welcome.
·
There is an urgent need to legislate a Central Act
on prevention of violence against
doctors while on work and duty. Any act of violence against
doctors should be made a punishable, non-bailable offence with
imprisonment of up to 14 years.
·
Also, the State Acts on violence against
doctors should be advertised and also acted upon by the state government.
·
Workshops, seminars etc should be organize to educate the
general public and doctors about the penal provisions in case of violence
against doctors. This can be done by the government and professional
associations.
·
Patients’ rights should be displayed in every hospital
and clinic. Associations should educate their doctors about Etiquettes,
conduct, ethics.
·
Patients should be educated about the significance of
informed consent.
·
Patients should be educated about triage in emergency.
·
Patients should be sensitized that error of judgment does
not automatically mean negligence.
·
There should be a grievance redressal mechanism for both
patients and doctors in every health care establishment.
·
Right communication is the key to a strong doctor-patient
relationship, based on mutual trust and respect.
·
The charges should be clear and transparent - there
should not be a large difference between the estimated cost of treatment and
the actual cost of treatment; there should be no hidden charges or kickbacks.
·
It is important to acknowledge the altered dynamics of
doctor-patient relationship, which has undergone a paradigm shift from doctor’s
right to take decision to patient’s rights to take decision.
·
Rational treatment, rational prescription, transparency
in investigations and treatment
·
Hospitals should identify high risk areas and install
audio-based CCTV cameras in all sensitive and high risk areas.
·
Bodies of deceased patients cannot be held as
hostage for financial disputes.
·
Hospitals should make adequate security arrangements;
protection to be given to doctors and nurses working the night shift in
particular.
·
Provide transparent daily billing to avoid future
disputes
·
CPR and first aid to be available everywhere
·
Briefing to the legal heirs
·
PRO in challenge and high risk areas
·
Nurses and paramedical staff to be trained about soft
communication
Besides
the doctors and patients who are direct stakeholders in this, the media and
police too have an important role to play in preventing violence against
doctors and hospital staff.
Guideline
for media
· No
media trial
· Negative
news about the doctors should not be published
· Name
of the doctor and patient should not be published.
· No
news story should be reported without proper verification
Guideline
for police officers
·
To be sensitized about the violence against doctors Act
·
To be sensitized about the guidelines as laid down by
Hon’ble Supreme Court in Jacob Mathew case
Dr KK Aggarwal
Padma Shri
Awardee
President Elect Confederation of Medical
Associations in Asia and Oceania
(CMAAO)
Group
Editor-in-Chief IJCP Publications
President Heart
Care Foundation of India
Past National President
IMA
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