Duties and Obligations of a Doctor

Duties and obligations of a Doctor as per Medical council of Inida (MCI) / State medical council (SMC), Moral & Legal responsibility of a Doctor, MCI Ethics Regulations 2002 (including amendments), Duties towards patients, Duties towards Public, Duties towards another Doctor, Duties towards Law, Duties towards society, Rights & Privileges of a Doctor in India.

1. DUTIES & OBLIGATIONS
OF ADOCTOR

Dr Gaurav Aggarwal
MBBS, MD, DNB (Forensic Medicine)

Medicolegal Consultant
& Ex-Professor

2. DUTIES & OBLIGATIONS
OF A DOCTOR

Duty = moral responsibility

Obligation = legal responsibility

3. The Indian Medical Council Act,
1956

Functions of Medical Council India:

1. To maintain Medical Register of medical
practitioners.

2. Medical education: Council maintains the
standard of U.G. & P.G. education.

3. Recognition of Foreign Medical
Qualifications.

4. The Indian Medical Council Act,
1956

4. Appeal Against Disciplinary Action: If the
name of any person Is removed from the
state medical register, he may appeal to
Central Govt. after exhausting all the
remedies under state medical council act.

5. Warning Notice: If standard of
professional conduct and codes of ethics
are not followed or if there is serious
professional misconduct, then warning
notice may be served to the doctor.

5. DUTIES & OBLIGATIONS
OF A DOCTOR

For an allopathic medical practitioner are
enlisted in ordinary laws of the land and the
Code of Medical Ethics and Declarations -
(Indian and International) :-

(i) Indian Medical Council (Professional
conduct, Etiquette and Ethics) Regulations,
2002- the code of medical ethics

(11) Hippocratic Oath
(iii) Declaration of Geneva

6. DUTIES & OBLIGATIONS
OF A DOCTOR

(iv) Declaration of Helsinki
(v) International Code of Medical Ethics

(vi) Government of India Guidelines for
Sterilization

(vii) Supreme court judgements

7. MEDICAL ETHICS

Dentists- The Dentists Act, governed by the
Dental Council of India

Ayurveda, Unani, Siddha (AYUSH) Doctors-
Indian Medicine Central Council Act, 1970 ;
Delhi Bhartiya Chikitsa Parishad Act, 1998
Homeopathy Doctors- Homeopathy Central
Council Act, 1973

8. Indian Medical Council
(Professional Conduct, Etiquette and Ethics)
Regulations, 2002

First publised in Part-Ill, Section (4) of the
Gazette of India on the 6th April, 2002
Amended 4 times - on 22/02/2003,
26/05/2004, 14/12/2009 & 01/02/2016

9. INDIAN MEDICAL COUNCIL

R lations, 200

(AMENDED UPTO 1st FEBRUARY 2016)

MEDICAL COUNCIL OF INDIA
Pocket-14, Sector 8, Dwarka

10. DUTIES &
OBLIGATIONS
OF ADOCTOR

Duties to Patient Duties to Public

Duties towards Law Duties not to violate
Enforcers Professional Ethics

Duties not to do
anything illegal or hide Duties to each other
illegal acts

11. DUTIESE
OBLIGATIONS
OF ADOCTOR

Duties to Patient

12. Duties
to
Patient

Providing
Information
to the Consent for
Patient Treatment
/Attendant

Emergency
Care
(also as per
CEA2010)

13. 1. Duties to Patient

(A) Standard Care

> this means application of the principles of
standard care which an average person
takes while doing similar job in a similar
situation :

4 Duty of care and diligence of a prudent
octor

2) Standard, suitable equipment in good
repair

14. 1. Duties to Patient

3) Standard assistants : Where a senior
doctor delegates a task to a junior doctor or
paramedical staff, he must assure himself
that the assistant is sufficiently competent
and experienced to do the job, and fulfills
the prescribed qualifications.

(P.N.Thakur Vs Hans Charitable Hospital)

15. 1. Duties to Patient

4) Non-standard drug is a poison by
definition

5) Standard procedure indicated in
treatment and surgery

6) Standard premises, e.g. Nursing Home,
ospital, must comply with all laws
applicable as imposed by the State and
these must be registered wherever required

7) Standard proper reference to appropriate
specialist

16. 1. Duties to Patient

8) Standard proper record keeping for
treatment given, surgery done, X-ray and
pathological reports

9) Standard of not to experiment with patient
(Declaration of Helsinki)

10) Anticipation of standard risks of
complications and preventive actions taken
in time

11) Observe punctuality in consultation

17. 1. Duties to Patient

(B) Duty to provide information to patient
/ attendant

1) Regarding necessity of treatment
2) Alternative modalities of treatment

3) Risks of pursuing the treatment, including
inherent complications of drugs,
investigations, procedure, surgery, etc.

18. 1. Duties to Patient

(B) Duty to provide information to patient
/ attendant

4) Regarding duration of treatment

5) Regarding prognosis. Do not exaggerate
nor minimize the gravity of patient’ s
condition.

6) Regarding expenses and break-up
thereof

19. 1. Duties to Patient

(C) Consent for treatment

Various types of consent and implications
thereof.

20. 1. Duties to Patient

(D) Emergency Care

A doctor is bound to provide emergency
care on humanitarian grounds, unless he is
assured that others are willing and able to
give such care.

lt may be noted that prior consent is not
necessary for giving emergency / first-aid
treatment.

21. DUTIESE
OBLIGATIONS
OF ADOCTOR

Duties to Public

22. 2. Duties to the Public

1. Health Education

2. Medical help when natural calamities like
drought, flood, earth-quakes, etc occur

3. Medical help during train accidents

23. 2. Duties to the Public

4. Compulsory notification of births, deaths
and notifiable diseases

5. To help victims of house collapse, road
accidents, fire, etc.

24. List of notifiable diseases

Cholera
Diphtheria
Encephalitis
Leprosy
Meningitis
Pertussis
Plague
Scarlet fever
Bacillary dysentery
Tetanus

EB.

Typhoid
HIV/AIDS
Dengue

JE.
Chickenpox Chikungunya
Hep.A, Hep.B
Herpes zoster
Measles

Polio

Rabies

Yellow fever
Malaria

25. u DUTIES& =
OBLIGATIONS
OF A DOCTOR

=

Duties towards Law —|
Enforcers

26. 3. Duty towards Law Enforcers-

Police, Courts, etc

1) To inform the police all cases of poisoning,
burns, injury, illegal abortion, suicide,
homicide, manslaughter, grievous hurt and
their natural complications like tetanus, gas-
gangrene, etc. This includes vehicular
accidents, etc.

2) To call a Magistrate for recording dying
declaration

3) To inform about bride burning and
battered child cases

27. 3. Duty towards Law Enforcers-
Police, Courts, etc

4) A doctor should report the commission of
a crime like murder, dacoity, etc to the police
or Magistrate (S. 39 CrPC). If the doctor
does not do so, he may be punished under
sec. 202 IPC.

5) If a doctor treats a person who has
attempted to commit suicide, his primary
responsibility is to treat the patient. He is
also legally bound to report the matter to the
police.

28. OBLIGATIONS
OF A DOCTOR

Duties not to violate
Professional Ethics

29. 4. Duty not to violate
Professional Ethics

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

2) Not to indulge in self-advertisement
(name, signature, photo) except such as
authorized by the M.C.l.

3) Not to issue false certificates and bills

30. 4. Duty not to violate
Professional Ethics

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

5) Generic + Propriety names
6) Not to write secret formulations
T) No fee sharing ( Dichotomy )

31. 4. Duty not to violate
Professional Ethics

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

9) Not to attend patient when under the
effect of alcohol

10) Not to talk loose about colleagues

32. 4. Duty not to violate
Professional Ethics

11) Information given by patient /attendant to
be kept as secret.

> Not to be divulged to employer, insurance
company (only when requested for), parents
of major son/daughter without consent. Even
in court this information is given only if
ordered by the Court.

33. PROFESSIONAL MISCONDUCT

1) 6 A's - Association with unqualified
persons in professional matters,
Advertising, Adultery (S. 497 IPC) arising
out of professional relation, Unlawful
Abortion (against MTP act), Addiction,
Alcohol

2) Not maintaining medical records or not
providing a copy thereof within 72 hours

3) Not displaying name and regn. number

4) Conviction by a court

34. PROFESSIONAL MISCONDUCT

5) Sex-determination

6) Issuing false certificates

7) Prescribing steroids/psychotropic drugs
without indication or selling Schedule H &
L drugs to public (except his patients)

8) Contributing articles to press with the
effect of advertising himself

35. PROFESSIONAL MISCONDUCT

9) Can advertise institution but not self

10) Using unusually large sign board

11) Divulging information about his patients
12) Using touts to procure patients

13) Not taking proper consent

36. PROFESSIONAL MISCONDUCT

Gift, Travel,
Hospitality, Cash
or Monetary
grant

Medical
Research,
Affiliation,
Endorsement

1000 - 5000 = Censure

5000- 10,000= Removal of name x 3 mth

Gift 10,000-50,000= Removal of name x 6 mth
Gift 50,000 - 1 Lakh= Removal of name x 1 year
> 1 Lakh= Removal of name > 1 year

ist = Censure

Subsequent = removal of name

37. ‘DUTIES &
OBLIGATIONS
OFA DOCTOR

Duties not to do o
anything illegal or hide inn
| illegal acts

38. 5. Duty not to do anything illegal
or hide illegal acts

1) Perform illegal abortions / sterilization

2) Issue death certificates where cause of
death is not known

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

39. 5. Duty not to do anything illegal
or hide illegal acts

4) Not calling Magistrate for recording dying
declaration

5) Unauthorized, unnecessary, uninformed
treatment and surgery or procedure

6) Sex determination

40. OBLIGATIONS
OF A DOCTOR

1 Duties to each other
40

41. 6. Duty to each other

1) A doctor must give to his teachers due
respect and gratitude

2) A doctor ought to behave to his
TS as he would like them to behave
to him

42. 6. Duty to each other

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

4) 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.

43. 6. Duty to each other

5) Differences of opinion should not be
divulged in public

6) A doctor must observe the principles
enunciated in 'The Declaration of Geneva’
approved by the WMA in 1948.

44. RIGHTS & PRIVILEGES OF A

DOCTOR

45. RIGHTS & PRIVILEGES OF A DOCTOR

a) Right to choose a patient
b) Right to practice medicine
c) Right to dispense medicines

d) Right to possess and supply
dangerous drugs to his patients

e) Right to add title, descriptions, etc

46. RIGHTS & PRIVILEGES OF A DOCTOR

f) Right to recovery of fees

g) Right to issue medical certificate

h) Right to give evidence as an expert

i) Right for appointment in public/govt.
hospital

j) Exemption from serving as a juror at an
inquest

47. Thank you !