Doctors Must Not Exploit Patients' Trust


By ugesh sarkar, Section Health
Posted on Sun Dec 27, 2009 at 10:28:49 PM EST

ONE adverse effect of the judgment of the Supreme Court holding that the medical practitioners come within the ambit of the Consumer Protection Act has been that the doctors now do not prescribe medicines for a patient unless and until he is made to undergo several pathological and other tests.

Invariably the doctors have been insisting that the patient have a complete blood profile, ultrasound and Xrays done and get urine tested, both routine and even culture sometimes.

No one has any objection in undergoing so many tests in cases of serious ailments but certainly the patients and their relatives do get upset when they are asked to go in for various tests in ordinary ailments such as common cold, viral fever or minor injuries or bruises. The question arises as to whether these tests, involving considerable expenditure, are at all necessary? The doctors' version in this regard is that they do not want to take risk of getting involved in any litigation, especially under the Consumer Protection Act, under which the consumers do not have to incur any expenditure by way of court fees. Another argument is that in order to prescribe scientific treatment, the requisite tests are essentially necessary.

Noticing the above unhealthy state of affairs, P. R. Subhash Chandran, a journalist of Andhra Pradesh, went to the extent of filing a writ petition pro bono publico before the Andhra Pradesh High Court seeking issue of directions to the government to prevent the exploitation of the patients undergoing per force numerous tests required by the doctors. The high court appreciated the stand of the petitioner but expressed its inability to issue directions to the state government, as sought for. It, however, observed that there was a definite need to control and check the unethical practices being followed by the doctors in the judgement reported at AIR 2000 A. P. 272.

The author is an advocate and editor of Consumer Protection And Trade Practices Journal ( CTJ)

Source: Mail Today By Rosy Kumar Doctors Must Not Exploit Patients' Trust

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It may be noticed that the patient seeking treatment has no option but to do what his doctor wants. It was observed by the Supreme Court in Spring Meadows Hospital vs Harjot Ahluwalia 1998 CTJ 84 ( SC) ( CP) that " the influence exerted by a doctor is unique. The relationship between the doctor and the patient is not always equally balanced. The attitude of a patient is poised between trust in the learning of another and general distress of one who is in a state of uncertainty and such ambivalence, naturally leads to a sense of inferiority and it is, therefore, the function of medical ethics to ensure that the superiority of the doctor is not abused in any manner." In such matters, it is only the Medical Council of India, which can play a tangible role.

It may be recalled that when the Indian Medical Association went in appeal before the By Rosy Kumar Supreme Court to oppose the applicability of the Consumer Protection Act to the doctors in Indian Medical Association vs V. P. Shantha, 1995 CTJ 969 ( SC) ( CP), it was averred by it that there was no need to bring the doctors under the provisions of the aforesaid act because " the medical practitioners are governed by the provisions of the Indian Medical Council Act, 1956 and the Code of Medical Ethics made by the Medical Council of India under Section 3 of the Indian Medical Council Act, 1956 which regulates their conduct as members of the medical profession and provides for disciplinary action by the Medical Council of India and/ or state medical councils against a person for professional misconduct." No doubt making the patient to undergo very expensive and unnecessary pathological and diagnostic tests may not be treated as professional misconduct but in any case the same can tantamount to indulgence in unhealthy and undesirable practice.

All that is needed is to issue guidelines which should be followed by the medical practitioners while prescribing treatment for their patients. If the ordinary ECG can work in the initial stage of treatment then why the patient be burdened with the expensive tests of Echo cardiogram ( ECG), treadmill test and even the angiography. Likewise, if a routine urine test can be sufficient to detect an infection then why ask for the culture test? If ordinary blood test can work then why have the full blood profile? When the patient goes to his doctor for treatment he reposes trust and confidence in him. That trust must be kept intact. It will get shattered if the doctor, taking advantage of the patient's condition, imposes unjustified costs on him.

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