Indian pharma market: Emerging medico-legal issues in COVID era

By Hiren Dhuvad,

The increasing spread of COVID-19 has led to the emergence of various controversial medico-legal issues. While some of these issues are related to medical responsibility and malpractice, others are related to medical ethics and the relationship between physician and patient.

Further, India has been fighting the pandemic without any prominent public health law in place. The laws that the country has been using to manage the situation are Indian Penal Code of 1860, a 123-year-old Epidemic Diseases Act, and a recent Disaster Management Act of 2005. Besides these, numerous notifications, guidelines, orders and rules have been issued by the Government related to COVID-19. As the healthcare sector in India is one of the highly scrutinised sectors with numerous laws governing it, it is a challenge for healthcare practitioners to be aware of all these rights and laws. Accelerating efforts are being made by the government as well as private organisations to protect the medical professionals from vexatious litigations and to make doctors aware of their rights.

Medico-Legal Issues Novel to COVID-19 and Government Initiatives to Protect Doctors

Special situations demand special measures and when such extraordinary steps are initiated, there is a scope of mistakes resulting in unintended damage. All authorities and officials act during such unusual circumstances like pandemic with protection granted to them for actions taken in good faith. Many new dangers and challenges keep emerging for healthcare practitioners who are actively engaged in pandemic management. For example, doctors face the risk of being dragged in a medico-legal case in today’s litigious world. Moreover, it is very difficult for healthcare practitioners to be aware of all the laws governing public health and their rights.

Today, when the country is reeling under the pandemic, some new acts have been brought out to protect the doctors. The violence against doctors has been happening in India for a long time but the issue enhanced after the coronavirus outbreak when people in uncountable numbers were reaching out to doctors and dragging them in vexatious litigation as there is lack of clarity about the disease, its treatment and its potential to spread. It can be said that the pandemic brought the issue out in the open. There were incidents of violence across quarantine centers, COVID designated hospitals, and even at the residence of healthcare workers.

The Indian Government issued “Telemedicine Guidelines” in March, 2020. Though the doctors in India have been practising telemedicine for a long time, there was no clarity on the legality of tele-consultation. The fresh guidelines not only legalised tele-consultation services by registered medical practitioners but also, permitted doctors to prescribe medicines, provide counselling and impart health education on a phone call or over chat. The act authorised the doctors to choose the medium of tele-consultation, making patient responsible for the accuracy of information and also stated that there is no fixed format for issuing a prescription in a tele-consultation. By clearly stating do’s and dont’s for patients and doctors, the Telemedicine Guidelines 2020was a significant move in protecting doctors from medico-legal issues.

Further, the Consumer Protection Bill, 2019, removed “healthcare” from the list of services to grant immunity to doctors from cases filed by disgruntled patients or their family members in consumer courts. In other words, patients or their family members can no longer approach a consumer court to file complaints against doctors or sue them for medical negligence.

Emerging Medico-Legal Services

As doctors face the risk of being involved in a medicolegal case in today’s litigious world, it becomes important for doctors to equip themselves with the necessary knowledge such as rights of physicians, special situations, different medico-legal issues etc. Various first-of-its-kind initiatives have made their way to keep doctors updated about advances in Medicine, Law and Technology as well as improve their knowledge in medical ethics and medico-legal issues. Certificate Course in Medical Ethics and Medico-legal Issues (CCMEMI) by Public Health Foundation of India and MedExel program by Indigital Technologies are some examples.

Further, Mediwise (Medico-Legal Assist Service), a 24*7 medico-legal & live lawyer assistance mobile app makes it possible for medical practitioners to get instant access to experienced doctors and expert lawyers. Some products like MedExel Plus cover medico-legal services plus provide professional indemnity insurance.

Medico-Legal Ethics from a Doctor’s Perspective

Medical ethics refer to examining a clinical case, using facts, logic and values to decide the best course of action. While some medical problems are fairly straightforward – differentiating right from wrong, others can be more perplexing, such as deciding between two “rights”. Doctors can consider various important values to decide ethical issues. These include transparency, autonomy, truth-telling, showing respect for patients’ own values, showing respect for patients and families etc.

Summing Up!

Medical law is undergoing various advancements. The legal preparedness for pandemic has weak supportive health legislations and even the ones which exist are not known to medical professionals. Therefore, there is an urgent need to make doctors aware about various medico-legal aspects of their practice as well as for measures to combat the emerging medico-legal challenges in the COVID-era such as the new generation of pandemic driven laws. Further, doctors need to be assisted with facilities that provide them easy access to laws that support medical services and their rights.

(The author is CEO, Indigital Technologies. Views expressed are personal and do not reflect the official position or policy of the Financial Express Online.)