Doctors And Patients – Relationship - Professional Negligence

INTRODUCTION:

Doctors in India since Vedic times have been equated to God. That is one of the reasons that the profession of a doctor is considered to be the most pious, noble and respected. The ability of a doctor to cure the patients commands an immense trust of his patients. It is, therefore, imperative for a doctor that he must not let down his patients and give his patients all due care and attention. Needless to emphasise that any negligence on the part of a doctor may cause severe hardships for the patient, even leading to his death.

REGULATIONS IN GENERAL:

To promote quality of care and to protect the patients, a number of regulations have been promulgated by the governments, both National or State Governments. They include

a) The Medical Council Act, 2001, repealing the Indian Medical Council Act, 1956 as was modified in 1964, 1993 and 2001. This Act seeks to maintain uniform standards of medical education, recognition and de-recognition of medical qualifications for medical institutions of India or foreign countries, permanent or provisional registration of doctors with the recognised medical qualifications, and the reciprocity with foreign countries in the matter of mutual recognition of medical qualifications.

b) Graduate Medical Education Regulations, 1997, which define the general consideration and teaching approach of medical students, besides the eligibility and process for admission into the medical colleges in India.

c) P.G. Medical Education Regulations, 2000, aiming at the goal of postgraduate medical education to produce competent specialists and / or medical teachers, besides defining the nomenclature and major components of the post graduate curriculum.

d) Minimum Qualifications for Teachers in Medical Institutions Regulations, 1998, which define the minimum qualifications for teachers in medical institutions.

e) Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations, 2002 governing the conduct of medical professionals, specifying the duties and responsibilities of the physicians in general and also formulating the guidelines for good medical practice.

f) Eligibility Certificate Regulations, 2002, to establish the eligibility requirement for taking admission in an undergraduate medical course in a foreign medical institution.

g) Screening Test Regulations, 2002, which provide that an Indian citizen possessing a primary medical qualification awarded by any medical institution outside India and desirous of getting registration with the Medical Council - India or State, as the case may be – on or after 15.03.2002 shall have to qualify a screening test for that purpose.

h) The Pharmacy Council of India, which formulates and executes the policies governing the profession of the pharmacists.

i) Indian Nursing Council, responsible to ensure uniform standard of nursing in India.

j) Testing Laboratories and Experimental Institutions, required for doing analysis of various kinds of samples such as blood, urine, and stool, as also the procedures such as X-Ray, CT Scan, MRI, ECG etc.

k) Drugs and Cosmetics Act, 1940, which provides for testing and clinical trials for launching new drugs.

l) Other Important Acts governing medical profession, Central or State Acts:

Nursing Home Act;
Private Hospitals and Medical Clinics (PHMC) Act;
Consumer Protection Act, 1987;
Pharmacy Act, 1948;
Narcotic Drugs and Psychotropic Substances Act, 1985;
Medical Termination of Pregnancy Act, 1971;
Transplantation of Human Organ Act, 1994;
Mental Health Act, 1987;
Environmental Protection Act, 1986;
Pre–natal Sex Determination Test Act, 1994;
Drugs and Magic Remedies (Objectionable Advertisement) Act, 1954;
Persons with Disabilities (Equal Opportunities and Full Participation) Act, 1995; and
Bio-Medical Waste (Management and Handling) Rules, 1998

MEDICAL NEGLIGENCE:

Negligence, whether under torts or under the criminal law, is applicable to the doctors as well. The medical profession was brought within the ambit of the Consumer Protection Laws in 1992. The Hon'ble Supreme Court in the judgment of Indian Medical Association vs V.P. Shantha and Ors., AIR 1996 SC 550, inter alia concluded as under:-

"(1) Service rendered to a patient by a medical practitioner (except where the doctor renders service free of charge to every patient or under a contract of personal service), by way of consultation, diagnosis and treatment, both medicinal and surgical, would fall within the ambit of 'service' as defined in Section 2(1)(o) of the Consumer Protection Act.

(2) The fact that medical practitioners belong to the medical profession and are subject to the disciplinary control of the Medical Council of India and/or State Medical Councils constituted under the provisions of the Indian Medical Council Act would not exclude the services rendered by them from the ambit of the Act.

(3) A 'contract of personal service' has to be distinguished from a 'contact for personal services'. In the absence of a relationship of master and servant between the patient and medical practitioner, the service rendered by a medical practitioner to the patient cannot be regarded as service rendered under a 'contract of persona] service'. Such service is service rendered under a 'contract for personal services' and is not covered by exclusionary clause of the definition of 'service' contained in Section 2(1)(o) of the Act.

(4) The expression 'contract of personal service' in Section 2(1)(o) of the Act cannot be confined to contracts for employment of domestic servants only and the said expression would include the employment of a medical officer for the purpose of rendering medical service to the employer. The service rendered by a medical officer to his employer under the contract of employment would be outside the purview of 'service' as defined in Section 2(1)(o) of the Act.

(5) Service rendered free of charge by a medical practitioner attached to a hospital/Nursing home or a medical officer employed in a hospital/Nursing home where such services are rendered free of charge to everybody, would not be "service" as defined in Section 2(1)(o) of the Act. The payment of a token amount for registration purpose only at the hospital/nursing home would not alter the position.

(6) Service rendered at a non-Government hospital/Nursing home where no charge whatsoever is made from any person availing the service and all patients (rich and poor) are given free service - is outside the purview of the expression 'service' as defined in Section 2(1)(o) of the Act. The payment of a token amount for registration purpose only at the hospital/Nursing home would not alter the position.

(7) Service rendered at a non-Government hospital/Nursing home where charges are required to be paid by the persons availing such services falls within the purview of the expression 'service' as defined in Section 2(1)(o) of the Act.

(8) Service rendered at a non-Government hospital/Nursing home where charges are required to be paid by persons who are in a position to pay and persons who cannot afford to pay are rendered service free of charge would fall within the ambit of the expression 'service' as defined in Section 2(1)(o) of the Act irrespective of the fact that the service is rendered free of charge to persons who are not in a position to pay for such services. Free service, would also be "service" and the recipient a "consumer" under the Act

(9) Service rendered at a Government hospital/health center/dispensary where no charge whatsoever is made from any person availing the services and all patients (rich and poor) are given free service - is outside the purview of the expression 'service' as defined in Section 2(1)(o) of the Act. The payment of a token amount for registration purpose only at the hospital/nursing home would not alter the position.

(10) Service rendered at a Government hospital/health center/dispensary where services are rendered on payment of charges and also rendered free of charge to other persons availing such services would fall within the ambit of the expression 'service' as defined in Section 2(1)(o) of the Act irrespective of the fact that the service is rendered free of charge to persons who do not pay for such service. Free service would also be "service" and the recipient a "consumer" under the Act.

(11) Service rendered by a medical practitioner or hospital/nursing home cannot be regarded as service rendered free of charge, if the person availing the service has taken an insurance policy for medical care whereunder the charges for consultation, diagnosis and medical treatment are borne by the insurance company and such service would fall within the ambit of 'service' as defined in Section 2(1)(o) of the Act.

(12) Similarly, where, as a part of the conditions of service, the employer bears the expenses of medical treatment of an employee and his family members dependent on him, the service rendered to such an employee and his family members by a medical practitioner or a hospital/nursing home would not be free of charge and would constitute 'service' under Section 2(1) (o) of the Act."

The doctor – patient contract is normally in the nature of an implied contract, save and except where a written informed consent is obtained. May be there is no express contract between the doctor and his patients, however, it is implied that the doctor is expected to cure the patient and the patient shall pay fee for consideration. While offering medical advice and treatment, the doctors implicitly state that they have skill and knowledge to do so, and to decide the treatment as also to administer the same. It is 'implied undertaking' on the part of a medical professional. A medical professional owes his patient a duty of care, not only in deciding whether to take the case but also a duty to decide the treatment, and a duty of care while administering the said treatment. However, a doctor is not a guarantor, guaranteeing cure of the patient, but he is only to provide treatment which may be the most appropriate by the medical professionals in similar situations.

A doctor is expected to possess the average degree of skill. The treatment may differ depending upon the different choices available. However, it is expected that the doctor shall not undertake any procedure beyond his skill. The Hon'ble Supreme Court in the judgment of Laxman Balkrishna Joshi vs Trimbak Bapu Godbole and Ors., AIR 1969 SC 128 stressed as under:

"11. The duties which a doctor owes to his patient are clear. A person who holds himself out ready to give medical advice and treatment impliedly undertakes that he is possessed of skill and knowledge for the purpose. Such a person when consulted by a patient owes him certain duties, viz., a duty of care in deciding whether to undertake the case, a duty of care in deciding what treatment to give or a duty of care in the administration of that treatment. A breach of any of those duties gives a right of action for negligence to the patient. The practitioner must bring to his task a reasonable degree of skill and knowledge and must exercise a reasonable degree of care. Neither the very highest nor a very low degree of care and competence judged in the light of the particular circumstances of each case is what the law requires (cf. Halsbury's Laws of England, 3rd ed. vol. 26 p. 17). The doctor no doubt has a discretion in choosing treatment which he proposes to give to the patient and such discretion is relatively ampler in cases of emergency..."

MEDICAL NEGLIGENCE

As recently reiterated by Hon'ble Supreme Court in Maharaja Agrasen Hospital and Others vs Master Rishabh Sharma and Others, 2019 SCC OnLine SC 1658, medical negligence comprises of the following constituents: (1) A legal duty to exercise due care on the part of the medical professional; (2) failure to inform the patient of the risks involved; (3) the patient suffers damage as a consequence of the undisclosed risk by the medical professional; (4) if the risk had been disclosed, the patient would have avoided the injury; (5) breach of the said duty would give rise to an actionable claim of negligence.

The cause of action for negligence arises only when damage occurs, since damage is a necessary ingredient of this tort. In a complaint of medical negligence, the burden is on the complainant to prove breach of duty, injury and causation. The injury must be sufficiently proximate to the medical practitioner's breach of duty. In the absence of evidence to the contrary adduced by the opposite party, an inference of causation may be drawn even though positive or scientific proof is lacking.

Medical negligence is the breach of a duty of care by an act of omission or commission by a medical professional of ordinary prudence. Actionable medical negligence is the neglect in exercising a reasonable degree of skill and knowledge to the patient, to whom he owes a duty of care, which has resulted in injury to such person. The standard to be applied for adjudging whether the medical professional charged has been negligent or not, in the performance of his duty, would be that of an ordinary competent person exercising ordinary skill in the profession. The law requires neither the very highest nor a very low degree of care and competence to adjudge whether the medical professional has been negligent in the treatment of the patient.

The Hon'ble Apex Court in the judgment of Jacob Mathew vs State of Punjab and Ors., AIR 2005 SC 3180, as followed in Martin F. D'Souza vs Mohd. Ishfaq, AIR 2009 SC 2049 and Maharaja Agrasen Hospital and Others vs Master Rishabh Sharma and Others (supra), summed up as under:

"...

(1) Negligence is the breach of a duty caused by omission to do something which a reasonable man guided by those considerations which ordinarily regulate the conduct of human affairs would do, or doing something which a prudent and reasonable man would not do. The definition of negligence as given in Law of Torts, Ratanlal & Dhirajlal (edited by Justice G.P. Singh) holds good. Negligence becomes actionable on account of injury resulting from the act or omission amounting to negligence attributable to the person sued. The essential components of negligence are three: 'duty', 'breach' and 'resulting damage'.

(2) Negligence in the context of medical profession necessarily calls for a treatment with a difference. To infer rashness or negligence on the part of a professional, in particular a doctor, additional considerations apply. A case of occupational negligence is different from one of professional negligence. A simple lack of care, an error of judgment or an accident, is not proof of negligence on the part of a medical professional. So long as a doctor follows a practice acceptable to the medical profession of that day, he cannot be held liable for negligence merely because a better alternative course or method of treatment was also available or simply because a more skilled doctor would not have chosen to follow or resort to that practice or procedure which the accused followed. When it comes to the failure of taking precautions what has to be seen is whether those precautions were taken which the ordinary experience of men has found to be sufficient; a failure to use special or extraordinary precautions which might have prevented the particular happening cannot be the standard for judging the alleged negligence. So also, the standard of care, while assessing the practice as adopted, is judged in the light of knowledge available at the time of the incident, and not at the date of trial. Similarly, when the charge of negligence arises out of failure to use some particular equipment, the charge would fail if the equipment was not generally available at that particular time (that is, the time of the incident) at which it is suggested it should have been used.

(3) A professional may be held liable for negligence on one of the two findings: either he was not possessed of the requisite skill which he professed to have possessed, or, he did not exercise, with reasonable competence in the given case, the skill which he did possess. The standard to be applied for judging, whether the person charged has been negligent or not, would be that of an ordinary competent person exercising ordinary skill in that profession. It is not possible for every professional to possess the highest level of expertise or skills in that branch which he practices. A highly skilled professional may be possessed of better qualities, but that cannot be made the basis or the yardstick for judging the performance of the professional proceeded against on indictment of negligence.

(4) The test for determining medical negligence as laid down in Bolam's case [1957] 1 W.L.R. 582 holds good in its applicability in India.

(5) The jurisprudential concept of negligence differs in civil and criminal law. What may be negligence in civil law may not necessarily be negligence in criminal law. For negligence to amount to an offence, the element of mens rea must be shown to exist. For an act to amount to criminal negligence, the degree of negligence should be much higher i.e. gross or of a very high degree. Negligence which is neither gross nor of a higher degree may provide a ground for action in civil law but cannot form the basis for prosecution.

(6) The word 'gross' has not been used in Section 304A of IPC, yet it is settled that in criminal law negligence or recklessness, to be so held, must be of such a high degree as to be 'gross'. The expression 'rash or negligent act' as occurring in Section 304A of the IPC has to be read as qualified by the word 'grossly'.

(7) To prosecute a medical professional for negligence under criminal law it must be shown that the accused did something or failed to do something which in the given facts and circumstances no medical professional in his ordinary senses and prudence would have done or failed to do. The hazard taken by the accused doctor should be of such a nature that the injury which resulted was most likely imminent.

(8) Res ipsa loquitur is only a rule of evidence and operates in the domain of civil law specially in cases of torts and helps in determining the onus of proof in actions relating to negligence. It cannot be pressed in service for determining per se the liability for negligence within the domain of criminal law. Res ipsa loquitur has, if at all, a limited application in trial on a charge of criminal negligence."

A doctor thus may be liable to civil or the criminal negligence, as the case may be, necessarily depending upon the situation.

CIVIL NEGLIGENCE:

The question of civil negligence may normally arise when either the patient dies or is not cured. However, the civil negligence may be alleged by the aggrieved, when the doctors owed him a duty to a particular standard of conduct but he was derelict and failed to perform the duty resulting into suffering of actual damages and the conduct of the doctor being the direct or proximate cause of the said actual damage.

However, in certain cases, it may not be necessary for the aggrieved, more so where the principle of res ipsa loquitor (i.e., situation speaks for itself) applies, to prove the negligence of the doctor, where the same may, subject to certain conditions, be presumed.

CRIMINAL NEGLIGENCE:

Death or serious injury to a patient caused by criminal negligence may give rise to the question of 'criminal negligence'. The doctor may be charged under Section 304A of Indian Penal Code in case of death and under Sections 336, 337 or 338 of Indian Penal Code in case of serious injury. However, for the criminal negligence, the degree of negligence has to be so grave so as to go beyond compensation and deserves to be penalised, in as much as the harm is caused not only to the victim but also to the society, as the said conduct disregards the life and safety of the patient deserving punishment.

To err is human. However, an error of judgement taken in good faith in the best interest of the patient may not make a doctor criminally liable. A doctor cannot be tried in all cases of medical mishaps or misfortunes for criminal negligence. A doctor may be liable for a civil case for negligence but mere carelessness or want of due attention and skill in all cases cannot be described as so reckless or grossly negligent so to make doctor criminally liable. This distinction has been duly approved and accepted by the courts. The complaint against the doctor, to make him / her punishable under the criminal law, is required to show negligence or rashness of such a degree as to indicate a mental state which may be described as total apathetic towards the patient. To save a doctor from unnecessary harassment and undue pressure in performing of their duties, a private complaint of criminal rashness or negligence against a doctor shall not be entertained without prima facie evidence in the form of a credible opinion of another competent doctor supporting the allegations.

The Hon'ble Supreme Court in the case of Jacob Mathew (supra) issued following guidelines regarding prosecuting medical professionals: -

"51. As we have noticed hereinabove that the cases of doctors (surgeons and physicians) being subjected to criminal prosecution are on an increase. Sometimes such prosecutions are filed by private complainants and sometimes by police on an FIR being lodged and cognizance taken. The investigating officer and the private complainant cannot always be supposed to have knowledge of medical science so as to determine whether the act of the accused medical professional amounts to rash or negligent act within the domain of criminal law under Section 304A of IPC. The criminal process once initiated subjects the medical professional to serious embarrassment and sometimes harassment. He has to seek bail to escape arrest, which may or may not be granted to him. At the end he may be exonerated by acquittal or discharge but the loss which he has suffered in his reputation cannot be compensated by any standards.

52. We may not be understood as holding that doctors can never be prosecuted for an offence of which rashness or negligence is an essential ingredient. All that we are doing is to emphasize the need for care and caution in the interest of society; for, the service which the medical profession renders to human beings is probably the noblest of all, and hence there is a need for protecting doctors from frivolous or unjust prosecutions. Many a complainant prefers recourse to criminal process as a tool for pressurizing the medical professional for extracting uncalled for or unjust compensation. Such malicious proceedings have to be guarded against.

53. 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. So long as it is not done, we propose to lay down certain guidelines for the future which should govern the prosecution of doctors for offences of which criminal rashness or criminal negligence is an ingredient. 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. The investigating officer should, before proceeding against the doctor accused of rash or negligent act or omission, obtain an independent and competent medical opinion preferably from a doctor in government service qualified in that branch of medical practice who can normally be expected to give an impartial and unbiased opinion applying Bolam's test to the facts collected in the investigation. A doctor accused of rashness or negligence, may not be arrested in a routine manner (simply because a charge has been leveled against him). Unless his arrest is necessary for furthering the investigation or for collecting evidence or unless the investigation officer feels satisfied that the doctor proceeded against would not make himself available to face the prosecution unless arrested, the arrest may be withheld."

It may however be emphasised that in Maharaja Agrasen Hospital case (supra), the Hon'ble Supreme Court suggested that in recent years, the Bolam's test has been discarded by the Courts in England after identifying the basic flaw involved in approaching the standard of duty of care of a doctor as noted therein, and the said test must evolve in consonance with its subsequent interpretation adopted by English and Indian Courts, more particularly in cases of Bolitho v. City and Hackney Health Authority, (1997) 4 All ER 771 (HL); Montgomery v. Lanarkshire Health Board, [2015] UKSC 11; V. Kishan Rao v. Nikhil Super Speciality Hospital, (2010) 5 SCC 513; and Arun Kumar Manglik v. Chirayu Health and Medicare (P) Ltd., (2019) 7 SCC 401.

DUTIES/ OBLIGATIONS OF A DOCTOR:

Duties and obligations of a doctors are enlisted in ordinary laws of the land and various Codes of Medical Ethics and Declarations, Indian and International, which are:-

i) Code of Medical Ethics of Medical Council of India;

ii) Hippocratic Oath;

iii) Declaration of Geneva;

iv) Declaration of Helsinki;

v) International Code of Medical Ethics; and

vi) Government of India Guidelines for Sterlization.

On the basis of these various Codes of Ethics and Declarations, the duties can be summarised as under: -

i) Duties towards Patient;

ii) Duties towards Public;

iii) Duties towards Law Enforcers;

iv) Duties not to violate Professional Ethics;

v) Duties not to do anything illegal or hide illegal acts; and

vi) Duties to each other.

i) Duties towards Patient, include

a) Standard care which an average person takes while doing a similar job in a similar situation;

b) Duty to provide information to patient / attendant;

c) Obtain consent including the specific informed consent before any operation;

d) Provide emergency care of humanitarian grounds;

e) Warn the patient of any known or possible side effect of drug, device or operation;

ii) Duties towards Public, include

a) Health education;

b) Medical help when natural calamities like drought, flood, earth quakes, etc. occur;

c) Medical help during train accidents;

d) Compulsory notification of births, deaths, infections, diseases, food poisoning etc.; and

e) Help victims of house collapse, road accidents, fire, etc.

iii) Duties towards Law Enforcers, include

a) To inform the police all cases of poisoning, burns, injury, illegal abortions, suicide, homicide, manslaughter, grievous hurt and its natural complications like tetanus, gas gangrene etc. This includes vehicular accidents, fractures etc.;

b) To call a Magistrate for recording dying declaration; and

c) To inform about bride burning and battered child cases.

iv) Duties not to violate Professional Ethics, so as to uphold the dignity and honour of medical profession, like

a) Not to associate with unregistered medical practitioner and not allow him to practice what he is not qualified for;

b) Not to indulge in self-advertisement except such as is expressly authorised by the M.C.I. Code of Medical Ethics;

c) Not to issue false certificates and bills;

d) Not to run a medical store/ open shop for sale of medical and surgical instruments;

e) Not to write secret formulations;

f) Not to refuse professional service on grounds of religion, nationality, race, party politics or social status;

g) Not to attend patient when under the effect of alcohol;

h) No fee sharing;

i) Not to talk loose about colleagues;

j) Information given by patient / attendant to be kept as secret. Not to be divulged to employer, insurance company, parents of major son / daughter without consent of patient. Even in court this information is given only if ordered by the court;

k) Recovering any money (in cash or kind) in connection with services rendered to a patient other than a proper professional fee, even with the knowledge of the patient; and

l) To recognise and promote the practice of different medical services such as pharmacy and nursing as profession and seek their co-operation whenever required.

v) Duties not to do anything illegal or hide illegal acts, include

a) Perform illegal abortions / sterilization's;

b) Issue death certificates where cause of death is not known;

c) Not informing police a case of accident, burns, poisoning, suicide, grievous hurt, gas gangrene;

d) Not calling Magistrate for recording dying declaration;

e) Unauthorised, unnecessary, uninformed treatment and surgery or procedure; and

f) Sex determination.

vi) Duties towards other Doctors, include

a) A doctor must give to his teachers respect and gratitude;

b) A doctor ought to behave to his colleagues as he would like them to behave to him;

c) A doctor must not entice patients from his colleagues, even when he has been called as a specialist;

d) When a patient is referred to another doctor, a statement of the case should be given. The second doctor should communicate his opinion in writing / over telephone / fax direct to the first doctor;

e) Differences of opinion should not be divulged in public; and

f) A doctor must observe the principles enunciated in 'The Declaration of Geneva' approved by the World Medical Association.

Besides, it is expected from a doctor to maintain the proper records of the patient, more particularly to prove, if required, that the doctor gave the appropriate medical care and treatment. The maintenance of the record of the patient is to, inter alia, include the precise history of illness and substantial physical findings about the patient on the doctor prescription; notes that the patient or attendant was erring on any account; condition of the patient in specific / objective terms in specific terminology, records of drugs, allergy of the patient and if a drug may appear to be poisonous on certain local applications, the appropriate warning for the same.

The significance and importance of the above was reiterated by the Hon'ble Supreme Court in Maharaja Agrasen Hospital case (supra).

DUTIES OF THE PATIENT OR ATTENDANT:

It may not be correct to emphasise that it is the doctors alone which owe duties. Even a patient or attendant who hires or avails the services of a doctor for any treatment owes certain duties, inter alia,

a) He must disclose all information that may be necessary for proper diagnosis and treatment;

b) He must cooperate with the doctor for any relevant investigations required to diagnose and treat him;

c) He must carry out all the instructions as regards drugs, food, rest, exercise or any other relevant / necessary aspect;

d) In the case of a private medical practitioner, he must compensate the doctor in terms of money and money alone. Moral considerations apart, failure on the part of the patient / attendant to do his duty may enable the doctor to terminate patient – physician contract and that would free him from his legal responsibilities and may be constructed as contributory negligence, and weaken the case of the patient for compensation.

e) He must honour the doctor with all respect and should not misbehave or cause any harm or injury to a doctor (more recently noted against some patients while undergoing COVID-19 medical investigations as also treatment in the hospitals, leading to the Epidemic Diseases (Amendment) Ordinance, 2020 to amend the Epidemic Diseases Act, 1897).

TO CONCLUDE:

All the relationships including that of a doctor and a patient may not be spelled out in words. The faith and trust that a patient holds for his / her doctor, cannot be permitted to be withered away. The doctors have greater responsibility towards the society, no doubt within the frame work of law. No doctor is to let down his patient even in adversaries, and to perform his/ her solemn and pious duties towards the patient and society in general upholding the meaning of the difference between life and death.

Authors' views are personal only.

(Mr. Faisal Sherwani is an Advocate – on - Record at the Supreme Court of India and is currently a Partner in the Dispute Resolution Practice at L&L Partners Law Offices, New Delhi. Mr. Achal Gupta is an Advocate and a qualified Chartered Accountant. He is currently a Senior Associate in the Dispute Resolution Practice at L&L Partners Law Offices, New Delhi).

The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.

India: Doctors And Patients – Relationship