Chapter 4: Ethics of Medical Practice

science of moral values or principles.

moral principles which should guide the members of the medical profession in their dealings with the patients, their relatives, community, and with other colleagues in the profession.

physicians were required to have taken a written permission from the ruler (king) to practise medicine, their practice being regula- rised from time to time and they were punished for negligence.

Father of Indian Surgery was another famous authority in the Indian system of medicine.

the oldest code of medical ethics, which is 25 centuries old now; its basic tenets remain as valid as ever.

restated the Hippocratic oath in a modern style.

gives the guidelines for medical doctors concerning torture and other cruel, inhuman or degrading treatment or punishment in relation to detention and imprisonment.

the deliberate, systematic or wanton infliction of physical or mental suffering by one or more persons acting alone or on the orders of any authority, to force another person to yield information, to make a confession, or for any other reason.

This code of conduct for doctors emerged during 1964, introduced by the World Medical Association.

This was intended purely to embark upon any experimental scheme of treatment or whenever clinical trials for a new drug were proposed on human beings as an experiment.

an officer appointed by the Council who will maintain a register, the Indian Medical Register

comprises a set of members of the profession from each state and universities by election, as well as by nominations directly by the Government of India in consultation with State Governments.

It prescribes standards of postgraduate medical education for the universities and would also offer advice to universities so as to maintain uniformity all over the country.

It maintains standards at under- graduate medical education by appointing inspectors who inspect the facilities and examinations held by universities/medical institutions is in India, the purpose being to recommend recognition of the qualification to Central Government.

It may arise from accusations of professional misconduct either from a member of the public or a professional colleague or a certain public officer.

It may arise from a statutory notification from the court officials where a doctor is convicted for any criminal offence.

The case may be dismissed if no prima facie evidence against the accused.

If it is a case of first offense, doctor may be sent back merely with warning not to repeat the same.

It is the eraser of the name of the doctor from the register for a specific period considering the gravity of offense, to be reinstalled at the end of the period of suspension.

erasure of the name of the doctor from the register permanently when the offense is confirmed beyond doubt allowing not to practise the profession.

a qualified doctor who has been registered in State/Indian Medical Councils.

defined as something done by a doctor in 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.

Here a qualified surgeon performs a surgery on a patient on behalf of an unqualified, who enters the operation theatre after the patient is anaesthetist and leaves prior to returning to consciousness.

Here a qualified doctor covers unqualified persons as to enable them to practise midwifery by issuing a certificate to them, which enables them to conduct such practice.

A medical man should maintain the highest professional standard and should not abuse his/her position to seduce a female patient or some other member of the patient's family.

Includes procuring, assisting or attempting to procure a criminal abortion.

Supplying or selling _______ forming drugs to a person for other than medical grounds

the ones, which a doctor comes to know about his/her patient in his professional capacity as a physician/ doctor.

voluntary agreement, compliance, or permission.

presumed to have been given when the patient enters doctor’s consulting room, summons the doctor to his/her house or holds his or her arm for an injection.

written consent given by the patient after being informed of nature of illness, nature of operation or procedure to be done, its alternatives, its consequences and complications.

doctor should explain all relevant details to the patient.

Accordingly under such circumstances a doctor can reveal the details to any one of the close relatives of the patient.

A doctor can provide the treatment without taking prior consent from a patient who is gravely sick, critically ill, unconscious or not able to understand the suggestions or when mentally ill.

In emergency situations involving children, when their parents/ guardian are not available, according to this doctrine, consent can be obtained from the person accompanying.

Defined as a want of reasonable degree of care and skill or willful negligence on the part of a medical practitioner in treating a patient leading to injury or suffering or death.

applied in situations where the injury could not have happened, but for the negligence of the doctor.

comprises the element of failure on the part of the doctor to maintain proper care and skill.

Here the party has to prove that there was an existence of a duty of care by the doctor.

The party must prove that failure to exercise a duty of care acted as the proximate cause and led to the injury

Here the party must prove that the damage has actually been caused as a direct consequence of breach of duty. The damage resulted should be such that it permits objective assessment.

If the injury could have been foreseen or predicted by a reasonably competent man, then the particular doctor is held guilty of negligence.

If there is an intervention by a third person (i.e. second doctor) between the alleged act of negligence by the first doctor and injury, it is difficult to decide the negligence charge on the first doctor who treated first.

if the patient also refused to extend his cooperation during the course of treatment, charges of malpractice may be examined so as to apportion the damages between the negligent doctor and such contributing patient.

On certain occasion, despite all proper care given by the doctor during treatment, the patient might suffer severe injuries or permanent deformities

mischance or accident or disaster, in which an individual is injured or died due to some unintentional Act by a doctor/hospital.

A doctor may not be held responsible or liable for the deleterious effects of an Act proved to have resulted from error of judgement.

Involves the abuse of professional status, which lacks negligence.

It means an employer is held legally responsible for all.

the thing speaks for itself

reimbursement to compensate.

Refers to the gratuitous oral statements made to the patient and patient’s family as well as to other members of the treatment team.

The appeal is taken by filing a notice of appeal with the court that rendered the judgment or final order appealed from.

Judgement may result in a preliminary decree or a final decree or an order by itself, the judgement is always final.

Taken to warn against disciplinary action.