1. Dr. S.N.Krishnamoorthy MD DA DNB BGL PGDMLE

2. EMERGING TRENDS In India, we have a Supreme Court, a National Consumer Commission, 26 State Consumer Commissions and 22 High Courts with over 16 circuit and other benches, doling out hundreds of judgments every day. Each of these judgments has the potential to become a new law or change an existing one

3. EMERGING TRENDS The Consumer Protection Act 1985 was introduced in deference to a UN mandate with the aim of strengthening consumer movement. It seeks to ensure that people get their money’s worth when they buy goods or services

4. EMERGING TRENDS Medical services were brought within the purview of the Consumer Protection Act in the year 1995 IMA v. V.P.Shantha

5. EMERGING TRENDS Sec 2 (1) (o) Service of any description which is made available to potential users and includes the provision of facilities in connection with banking, financing, insurance, transport, supply of electrical or other energy………..

6. EMERGING TRENDS WHAT DOES THE LAW WANT FROM DOCTORS? Reasonable degree of Care Ordinary skill

7. EMERGING TRENDS Dr.Laxman Balakrishnan Joshi v. Dr.Trimbak Babu Godbole

8. EMERGING TRENDS WHO SETS THE PROFESSIONAL STANDARD? IT IS NOT THE JUDGE!!!

9. EMERGING TRENDS CONSENT OF THE PATIENT 1. Blanket consent 2. Informed Consent 3. Real Consent

10. INFORMED CONSENT - INGREDIENTS 1. Nature of the disease & treatment options 2. Likelihood of its success and failure 3. Alternatives available 4. Perils of each 5. Effect of no treatment 6. Complications of surgery– recent, remote 7. Life after surgery

11. REAL CONSENT Samira Kohli v. Dr. Prabha Manchanda “minimum of adequate level of information about the nature of the procedure being performed” Substantial and material complications Patient has the capacity to understand Submits voluntarily to surgery Truthful answers to questions from patient

12. EMERGING TRENDS Substantial complication – 10% incidence or more – frequently occurring Material Complication – serious complication which would make the patient reconsider his decision to have the surgery- may be substantial or remote

13. EMERGING TRENDS M.Chinnaiyan v. Sri Gokulam Hospital Consent must be procedure and patient specific “Consent for surgery does not mean and include consent for blood transfusion, anaesthesia and / or other interventions. Each must be specifically explained and consent obtained.

14. EMERGING TRENDS Smt. Saroj Chandoke v. Sir Genga Ram Hospital, Delhi If any alternative procedure is anticipated in a planned procedure, specific consent in advance must be obtained. Consent form must carry an authorisation clause to cover deviations.

15. EMERGING TRENDS Martin d’souza v. Mohd. Ishfaque Supreme Court has issued directions to all Consumer Courts [district, state, National] to issue notice to doctors in medical negligence cases only after getting medical opinion which points out prima facie negligence.

16. EMERGING TRENDS CRIMINAL NEGLIGENCE: Negligence of a gross degree, utter disregard to patient’s safety and health, wanton neglect of warning signs Punishable without proof of damage

17. EMERGING TRENDS Dr.Suresh Gupta v. NCT, Delhi Dr.Jacob Mathew v. State of Punjab Supreme Court directives: 1. Arrest not as a matter of routine 2. Case referred to a committee of doctors, preferably in Government service

18. EMERGING TRENDS Sec 304-A Indian Penal Code: Whoever causes the death of any person by doing any rash or negligent act not amounting to culpable homicide shall be punished with imprisonment of either description for a term which may extend to two years, or with fine or with both.

19. EMERGING TRENDS Offence described in sec.304-A is BAILABLE

20. EMERGING TRENDS The recently proclaimed Supreme Court decisions have the salutary effect of reducing the rigour of consumer law on doctors. It is in our best interests to take advantage of these decisions and bring about respectability and dignity to the profession.