PRLog (Press Release) - Jul 04, 2008 -
Moolchand Medcity, New Delhi, August 30, 2004
Should euthanasia law be changed was the topic of hot discussion in a symposium held at Moolchand Hospital to commemorate Doctor’s Day falling on July 1, 2004. The Board of Medical Educationand Moolchand Hospital organized the symposium. The speakers on the occasion were Dr. K K Aggarwal, Deputy Dean; Dr. S K Nair, Dean of Board of Medical Education; Dr. J S Arora, Senior Consultant; and Ms. Arti, a nursing student in the Hospital.
In India, practising euthanasia constitutes unethical conduct. Even after brain death, the decision of withdrawing support devises to sustain cardiopulmonary function has to be taken by a team of doctors and not by the treating doctor alone.
Talking about the west, the experts said that the term “Do Not Resuscitate”
In the absence of DNR laws in India, lakhs of dying patients suffer in the hospitals and also end up with crores of unnecessary expenses. In the west the guidelines say “Efforts should be made to resuscitate patients who suffer cardiac or respiratory arrest except when circumstances indicate that Cardio Pulmonary Resuscitation (CPR) would be inappropriate or not in accordance with the desires or best interest of the patient.”
There the patients at risk of cardiac and respiratory failure are encouraged to express in advance their preferences regarding the use of CPR and the same is documented in the patient’s medical record. The physicians there have an ethical obligation to honor the resuscitation preference expressed by the patient. If the patient is incapable of rendering a decision regarding the use of CPR, a decision is made by surrogate decision maker based upon the previously expressed preferences of the patient or if such preferences are unknown, in accordance with the patient’s best interests.
“A doctor should not disclose the secrets of a patient that have been learnt in the exercise of his or her profession”, said the experts. The exceptions are when required by the law, in case of notifiable diseases and in the circumstances where there is serious and identified risk to a specific person and or the community.
In the US the HIPAA law is applicable where the health care provider is restricted from leaking any protected health information. There one cannot even put the OT patient’s list on the notice board or call the patients by their name in the OPD. The time has come when India should also think of starting such law.
Talking about medical negligence, the doctors said that in general, a professional man owes to its client a duty in tort as well as in contract to exercise reasonable care in giving advice or performing services. Duties that a doctor owes to his patients are clear:
A duty of care in deciding whether to undertake the case.
A duty of care in deciding what treatment to give
A duty of care in administering that treatment
A breach of any of these duties gives a right of action for negligence to the patient. If something goes wrong when you are having medical treatment, this is sometimes called a ‘medical accident’ or ‘adverse event’. If your treatment has not worked or there have been complications, it does not always mean that there has been a mistake, or that someone is to blame. In some cases, you have to accept errors or complications as unavoidable risks of treatment and the doctor or other healthcare professionals would not be considered to be blamed. For example, if you have a major heart surgery, you can expect that there will be risks because of the surgery. However, there can be complications with minor procedures too.
‘Clinical Negligence’ is the legal term used to describe a medical accident where patient has been harmed, not because of a complication which couldn’t be avoided, but because a doctor or other healthcare professional has not given the proper standard of care. It doesn’t mean that this person was incompetent. It can just mean that in a particular case, they made a mistake which they shouldn’t have made.
Clinical negligence includes things such as:
Making a mistake during surgery
Giving the wrong drug
Making the wrong diagnosis or delaying a diagnosis unnecessarily
Clinical negligence can also include not doing things that should be done such as:
Not giving treatment needed
Not getting consent (agreement) to treatment
Not warning about the risks of a particular type of treatment
