LEGAL ASPECTS IN HOSPITAL

Laws & regulations applicable hospitals . Enquiries & Disciplinary actions Permits n& Licences.

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Introduction Definition Objectives Gen. Acts/legislation applicable to Hosp. Law of torts. Bill of Rights Ethical & legal Responsibilities

Society has laid down the laws of land prescribing normative behavior of Indls./Groups with provision of deterrent corrective punishment for any contravention by the society through various methods e.g. imprisonment/fine. Law can be divided into i)civil law is concerned with relationship among people & the protection of persons right . Violation may causes harm to an indl. or property but no threat to society & ii) criminal law includes rules forbidding conduct that is injurious to public order & specifies punishment to indl who exhibits injurious conduct.

Introduction

Society has laid down the laws of land prescribing normative behavior of Indls./Groups with provision of deterrent corrective punishment for any contravention by the society through various methods e.g. imprisonment/fine. Law can be divided into i)civil law is concerned with relationship among people & the protection of persons right . Violation may causes harm to an indl. or property but no threat to society & ii) criminal law includes rules forbidding conduct that is injurious to public order & specifies punishment to indl who exhibits injurious conduct.

Introduction

Society has laid down the laws of land prescribing normative behavior of Indls./Groups with provision of deterrent corrective punishment for any contravention by the society through various methods e.g. imprisonment/fine. Law can be divided into i)civil law is concerned with relationship among people & the protection of persons right . Violation may causes harm to an indl. or property but no threat to society & ii) criminal law includes rules forbidding conduct that is injurious to public order & specifies punishment to indl who exhibits injurious conduct.

Introduction

Society has laid down the laws of land prescribing normative behavior of Indls./Groups with provision of deterrent corrective punishment for any contravention by the society through various methods e.g. imprisonment/fine. Law can be divided into i)civil law is concerned with relationship among people & the protection of persons right . Violation may causes harm to an indl. or property but no threat to society & ii) criminal law includes rules forbidding conduct that is injurious to public order & specifies punishment to indl who exhibits injurious conduct.

Introduction

Society has laid down the laws of land prescribing normative behavior of Indls./Groups with provision of deterrent corrective punishment for any contravention by the society through various methods e.g. imprisonment/fine. Law can be divided into i)civil law is concerned with relationship among people & the protection of persons right . Violation may causes harm to an indl. or property but no threat to society & ii) criminal law includes rules forbidding conduct that is injurious to public order & specifies punishment to indl who exhibits injurious conduct.

Introduction

Society has laid down the laws of land prescribing normative behavior of Indls./Groups with provision of deterrent corrective punishment for any contravention by the society through various methods e.g. imprisonment/fine. Law can be divided into i)civil law is concerned with relationship among people & the protection of persons right . Violation may causes harm to an indl. or property but no threat to society & ii) criminal law includes rules forbidding conduct that is injurious to public order & specifies punishment to indl who exhibits injurious conduct.

Introduction

Society has laid down the laws of land prescribing normative behavior of Indls./Groups with provision of deterrent corrective punishment for any contravention by the society through various methods e.g. imprisonment/fine. Law can be divided into i)civil law is concerned with relationship among people & the protection of persons right . Violation may causes harm to an indl. or property but no threat to society & ii) criminal law includes rules forbidding conduct that is injurious to public order & specifies punishment to indl who exhibits injurious conduct.

Introduction

Society has laid down the laws of land prescribing normative behavior of Indls./Groups with provision of deterrent corrective punishment for any contravention by the society through various methods e.g. imprisonment/fine. Law can be divided into i)civil law is concerned with relationship among people & the protection of persons right . Violation may causes harm to an indl. or property but no threat to society & ii) criminal law includes rules forbidding conduct that is injurious to public order & specifies punishment to indl who exhibits injurious conduct.

Introduction

Criminal law is concerned with relationship between indls. & Govt. & acts that threatens the society & its order. Crime is an offense against a society that violates a law. Ignorance of law offers no protection from punishment. Public is now becoming aware of its own rights, obligation of Drs. & also obligation of hospitals consequently MLC are on rise.

MLC : Any case of injury or ailment where some criminality is involved is called as MLC. Criminality in a case may be Non Cognizable(Police has no auth to arrest without warrant) or cognizable (police can arrest without warrant). Dyeing Declaration: It is a statement of a person, written or oral, who is dying as a result of some unlawful act,relating to the material facts of cause of his death or bearing on the circumstances. Magistrate,Doctor, Public personality/police.

Various Medico-legal issues

Malpractice

Objectives

Increasing number of MLC has made it necessary for hosp. Administrators to understand Medico Legal issues. To understand Medico legal issues is necessary so as to do the right things and protect themselves & institutes from frivolous litigations & also do justice to patients.

DEFINITION

Law means body of rules to guide human action. Law is a system of rights & obligations which the state enforces. Law is the body of principles recognised by the state & the administration of justice.

Hospital Administration

Has an obligation to have clear understanding of Ethical & legal responsibilities. Mgt is responsible for policies, for maintaining a safe hosp., physical facilities & services, must ensure building conforms to local bye laws, safety regulations,sanitation arrangements. Hosp. Being an integral part of the social system is subject to all laws of the land. Hosp. Is responsible for safety from explosives & inflammatory gases,chemicals, machinery, steam damages from slippery floors etc.

Application of Law

There are no specific laws relating to hosp./staff/Equipment. Application of Laws related to hosp working, of interest are the ones which are concerned with Consent, Professional secrecy, evidence, Medical negligence, law of torts, & organ transplant.

General Acts/Legislation applicable to hosp.

Industrial dispute act 1948: Where >50persons. Minimum wages Act1948: Categories wise. Employees Provident Fund Act: where >20 persons & is punishable by imprisonment. Payment Of Bonus Act: Where >40 persons but not applicable to charitable/ Non profit hosp. Payment of Gratuity act 1972:Where 10 or more persons work. Payment of wages act 1936: within 7 days. ESI act 1948: Hosp contributes 4% of total wage bill.

Industrial dispute Act 1948 considers strikes a breach of contract in public utility service, if without 6 weeks prior notice, or within 14 days of notice of a strike, or during reconciliation proceedings are on.The notice of strike has to be intimated within 5days to Govt. Minimum Wages Act: States No.of hours of work/overtime/working days/holidays. Workmans compensation Act:loss of both hands/feet/one hand &one foot right/total disfigurement of face constitutes 100% loss.Act lays down the %age of loss of earning capacity.

Motor vehicle Act1988: Breath analyzer test/blood test. Police can detain a person for alcohol test for not more than 2 hrs. Drug Act 1940:Regulates import,manufacture,distribution & sale of drugs in India.Insecticide,disinfectant & contraceptives & cosmetics are included in this Act. It lays down the drugs which can be sold over the counter& those e.g. schedule H &L normally would not be sold without prescription.

Medical / professional Acts

Indian Medical Council Act 1933. Indian Nursing Council Act 1947. The Pharmacy Act1948: Hosp has to acquire drug licence if it sells drug otc. Births & Deaths & Marriages registration Act.Hosp is bound to inform all births/deaths taking place in a hosp.

Miscellaneous Acts Applicable to Hospitals

Societies registration Act,1860: It governs working & Mgt of institutions est. or owned by charitable trusts. State Public charitable Trust Acts. Acts in relation Establishment of Nursing homes.

Law of Torts

Tort is defined as Any wrong,injury or damage is done to the person for which a civil suit can be brought e.g. wrong operation, operating without consent, leaving instrument inside the body,invading the right of privacy, breach of professional secrecy, defamation,malicious prosecution, misrepresentation.

COPRA 1986

This Act came into force w.e.f.1 Sep,1987. Advantage Minimal cost is involved & matter is decided within 3 to 4 months. Provides redressal for defective goods,deficient service, unfair trade practices. Consumer A person who hires any services for any considerations, & any beneficiary of such services other than who hires, when such services are availed of with the approval of the first mentioned person.

Deficiency: Any fault,imperfection shortcoming or inadequacy in the qlty,nature & manner of performance of a contract,or otherwise in relation to the service. Service means service of any description except free service & personal service. A claim for compensation under COPRA must be filed within 3Yrs. National Forum deals cases >10 lacs, state forum >5lacs & district forum upto 5lacs.

BILL OF RIGHTS

Respectful care Complete information regarding diagnosis,tmt,&prognosis. Pt. Has right to information from Dr before he gives consent. Right to refuse tmt,to the extent permitted by law & to be informed of med. Consequences. Right to privacy, all communication & records be treated as confidential. Hosp must provide evaluation,service,&/or referral as indicated by the urgency of case.

Relationship of hosp to other hosp where one is being referred to. Right to refuse to participate in research. Right to know appointments/availability of DR, continuity of hlth care requirements after discharge. Right to examine & receive explaination of bill. Right to Hospital rules.

Offences & Professional Misconducts

Adultery/improper conduct/association with patient. Issuing false certificates. Conviction by court of law for offences involving moral factors. Selling of schedule poisons Performing an abortion or illegal operation/op without consent.Disclosing patients secrets. Issuing certificates to unqualified persons. Advertisement of services or the institutions run by the physicians. Use of agents.

Organ Transplant

There is no specific central legislation which permits sale/purchase of organs. Indian law is silent on trade in human organs. Transplant of Human organs Bill1992 is under consideration deals with various aspects of organ transplantation.It deals with measure to curb malpractice,punishment for donors,doctors & even advertisement seeking donation of organs.

MTP ACT 1972

Specifies conditions under which pregnancy can be terminated., the persons who can perform termination & places where such procedures can be performed. It can be performed either in Govt. hosp or other places approved by the Govt.

Current Ethical Issues

Aids Abortions Euthanasia Sterilization Adoption of children Ethical issues & poor patients Ethical Issue of Examination of females. Use of new drugs on trial on patients.

ETHICAL ISSUES

We will have to treat every case on its merits, if we do our best in all honesty, we will make the decision right. Respect for a patient is fundamental to the Dr. pt relation ship & respect we show reflects what we think of the patients worth.