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Duties of medical practitioner

Bachelor in Law (Dr. D. Y. Patil Vidyapeeth, Pune)

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B. RIGHTS AND DUTIES OF A MEDICAL PRACTITIONER

Who is a registered medical Practitioner?
The definitions of the expression "registered medical practitioner are almost identical in the
Transplantation of Human Organs and Tissues Act, 1994 and the Pre-conception and Pre-
natal Diagnostic Techniques (Prohibition of Sex Selection) Act, 1994, and run as under:
"Registered medical practitioner" means a medical practitioner who possesses any recognised
medical qualification as defined in S. 2(h) of the Indian Medical Council Act, 1956, and
whose name has been entered in a State Medical Register.
Under the Drugs and Magic Remedies (Objectionable Advertisements) Act, 1954, the
definition of the term is not the same as above, but as follows: "Registered medical
practitioner" means any person -
(a) who holds a qualification granted by an authority specified in, or notified under S.
3 of the Indian Medical Degrees Act, 1916, or specified in the Schedules to the Indian
Medical Council Act, 1956; or
(b) who is entitled to be registered as a medical practitioner under any law for the time
being in force in any State to which this Act extends relating to the registration of
medical practitioners."
RIGHTS OF A MEDICAL PRACTITIONER
In India, there is no statutory declaration of the rights of a medical practitioner, such rights
vary from country to country. The generally accepted rights of a doctor may be summarised
as under.
1. Right to choose his patients:
A doctor has the right-and the privilege- to choose his patients. However, once
he has begun the treatment of a patient, he cannot refuse to continue his
treatment, unless there is a valid and acceptable reason for such refusal.
However, he cannot refuse to give treatment to anyone in an emergency. In the
case of emergency treatment, it is immaterial whether or not that person is his
regular patient.
2. Right to use his title and qualifications:
A medical practitioner has the right to use his title (as for instance, "Dr.") and
description of the qualifications which he possesses and which are recognised
by the Medical Council of India or by a State Medical Council.
3. Right to receive and recover fees and expenses:
He has the right to receive reasonable fees for the treatment given by him with
due care and skill, irrespective of whether the patient is cured or not. He can
also charge the patient for the medicine given by him, as also conveyance
charges for his home visit. If such lawful charges are not paid, he can take
recourse to legal proceedings to recover such amount. This right is also
expressly recognised by the Medical Council Act, 1956, although suits of this
nature are rarely filed in actual practice.
It is, however, unethical on his part to enter into a "No cure, no payment
contract with his patient.

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4. Right to be appointed in hospitals and institutions:

He has the right to be appointed in local, government and public hospital and
institutions. This is, however, not an absolute right, as the discretion in t matter
of such appointments vests with the concerned hospital or institution
5. Right to practise medicine and dispense medicines:
A medical practitioner has the right to practise the line of medicine (which he
holds the required qualification) from his clinic, dispensary or hospital. He can
also dispense medicines to his patients. However, he must ensure the there is a
rational use of drugs, and as far as possible, he must prescribe drugs with
generic names.
It is also unethical on his part to run a shop for the sale of medicine or medical
or surgical appliances.
A person who is practising as a qualified homeopath cannot prescribe
allopathic medicine to his patient. If he does, and the patient suffers any ham
or injury (including death, as in the present case), the doctor is liable to pay
damages. (Poonam Verma v. Ashwin Patel, AIR 1996 SC 2111)
Likewise, a person specializing in the Unani system of medicine will become
legally liable if he administers allopathic drugs to a patient who dies as a
consequence. (Prof. P. N. Thakur v. Hans Charitable Hospital, 2007 CPJ 40).
6. Right to issue medical certificates:
He has a right to issue medical certificates required by employers, schools
colleges, etc, as also for procuring a passport or a driving license, or under
certain statutes like the Factories Act, Vaccination Act, etc. Issuing a false
medical certificate is a violation of the Code of Ethics Regulations of the
Medical Council of India.
This right is expressly recognised by the Medical Council Act, 1956, which
lays down that a medical practitioner is entitled to sign or authenticate a
medical or fitness certificate or any other certificate required by any law to be
signed or authenticated by a duly qualified medical practitioner.
7. Right to give evidence:
He has a right to give evidence in a court of law and appear as a witness in a
case concerning a patient whom he has treated. He can also appear as an
expert witness in any other case.
8. Right to remove organs and tissues from a dead body:
A medical practitioner has the right to remove organs and tissues from a dead
body for transplantation purposes or for an inquest. However, he must, in such
cases, comply with all the provisions of the relevant laws and also observe the
prescribed formalities.
9. Right to perform medical termination of pregnancy:
He can perform medical termination of a pregnancy, provided he has the
proper qualifications and experience to do so, and provided that all the
requirements of the law have been complied with. In particular, he must
observe, in letter and in spirit, all the provisions of the Medical Termination of
Pregnancy Act, the Pre-conception and Pre-natal Diagnostic Techniques
(Prohibition of Sex Selection) Act and other relevant statutes.

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10. Right to disclose confidential information in exceptional circumstances:

Although a medical practitioner is bound to observe strict confidentiality as
regards all the personal information obtained by him from his patient in the
exercise of his profession, he can disclose such information in exceptional
cases, as for example, when so ordered by a court of law or in circumstances
where if the information is not disclosed, there is a serious and identified risk
to a specific person or the community at large.
[See Mr. X v. Hospital Z, discussed at length in Chapters 2 and 4.]
11. Right to be exempted from serving as a member of a Jury:
In countries where the jury system prevails, subject to the laws and regulations
of such a country, a doctor has the right to be exempted from serving as a
member of a jury.
12. Right to use the Red Cross emblem:
Members of the medical service of the army or a Red Cross Society can use
the emblem of the Red Cross in times of war or when exercising their duties
for humanitarian services in times of peace.
13. Right to disclose and report injuries:
He has the right- and also a duty- to disclose and report all cases of injuries
and burns, where the circumstances suggest the commission of a crime.
Likewise, he must report cases of self-infliction of injuries or attempted
suicide.
14. Right to access information:
He has the right to access information - and in particular, medical information
- held by the state or by private institutions, subject to the laws in force (as for
instance, the Right to Information Act).
15. Right not to be unfairly discriminated:
A medical practitioner has the right not to be unfairly discriminated against by
the medical faculty or under a medical scheme or by an institution, on the
basis of race, religion, gender, caste, creed, place of origin, etc.
16. Right to make political decisions:
He has a right to take political decisions, make political choices and
participate in political activities, as long as in doing so, he does not infringe
medical ethics or the laws, rules and regulations in force, and as long as he not
bring the medical profession into disrepute.
17. Right to refuse to conduct an unlawful bodily search or seizure:
He has right not to be harassed or arrested or detained for having refused to
conduct or take part in any bodily search or seizure that is unlawful under the
law.

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DUTIES OF A MEDICAL PRACTITIONER

In India, the duties of a medical practitioner (physician) are enumerated in the Indian Medical
Council (Professional Conduct, Etiquette and Ethics Regulations, 2002, often referred to as
the Code of Ethics Regulations, 2002 The said Code lists these duties under the following
five heads:
I. General duties and responsibilities II. Duties to patients
II. Duties at the time of consultation
III. Duties towards other physicians
IV. Duties to the public.

I. General duties and responsibilities:

The general duties and responsibilities of a physician are given in Chapter I of the Code and
may be summed up as follows:
1. The physician must uphold the dignity and honour of his profession rendering a full
Physicians must merit the confidence of their patients, measure of service and
devotion to each patient.
2. The prime object of the medical profession is to render service to humanity The
reward or gain is a subordinate consideration.
3. No person other than a physician having a qualification recognised by the Medical
Council of India (MCI) and registered with MCI or a State Medical Council can
practise the "modern system of medicine and surgery"(tha is, allopathy). A person
obtaining a qualification from any other system d medicine cannot practice the
modern system of medicine in any form.

[A reference may be made to Poonam Verma v. Ashwin Patel, and Prof. P. N. Thakur
v. Hans Charitable Hospital discussed earlier in this Chapter. ]
4. Physicians should try to continuously improve their medical knowledge and skills and
should make available to their patients, the benefits of their professional attainments.
5. A physician should practise methods of healing which are founded on scientific basis.
He should not associate professionally with anyone who violates this principle.
6. 6. For the advancement of his profession, the physician should affiliate with
associations and societies of allopathic medical professions and involve himself
actively in the functioning of such bodies.
7. He should participate in professional meetings as part of continuing medical
education programmes for at least 30 hours during every period of five years.
8. He must maintain the medical records of his patients in the prescribed form for a
period of three years from the date of commencement of treatment of a patient. If a
request is made for such records either by the patient or his authorised representative

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or by legal authorities, he must issue such documents within a period of seventy-two

hours.
9. He must maintain a Register of medical certificates issued by him, giving full details
of such certificates. He must record the sign (or thumb mark) and address and at least
one identification mark of the patient on every medical certificate and report. [See
Medical Certificates, discussed later in this Chapter.]
10. All efforts should be made to computerise medical records for a quick retrieval of
such records.
11. He must display the Registration Number given to him by the IMC or a State Medical
Council in his clinic, as also on all the prescriptions, certificates and receipts issued by
him.
12. As far as possible, he should prescribe drugs with generic names and ensure that there
is a rational use of drugs.
13. In connection with his professional practice, he should not employ any attendant who
is not registered or listed under the Medical Acts in force.
14. He must expose incompetent, corrupt, dishonest or unethical conduct on the part of
other physicians without any fear or favour.
15. He must inform the patient about his fees before he starts the treatment, and not when
the treatment is under way or after a surgery. It is unethical on his part to agree to a
"No cure, no payment contract with the patient.
16. He must observe all the laws of the country, and must not assist others to evade such
laws. He must observe the provisions of the Acts listed in Clause 1.9 of the Code, as
for instance, the Drugs and Cosmetics Act, the Narcotic Drugs and Psychotropic
Substances Act, the Mental Health Act, the Drugs and Magic Remedies
(Objectionable Advertisements) Act, the Transplantation of Human Organs and
Tissues Act, the Pre-conception and Pre-natal Diagnostic Techniques (Prohibition of
Sex Selection) Act, etc.

II. DUTIES TO PATIENTS

1. Although a physician is not bound to treat each and every patient who the calls of
asks for his services, he should always be ready to respond to the sick and the
injured.
2. He should endeavour to add to the comfort of the sick by making his visits at the
time indicated to his patients.
3. A physician can advise the patient to seek the services of another physician if the
patient is suffering from an ailment which is not within the range of the
experience of the treating physician. However, in case of emergency he cannot
refuse to give treatment to a patient.

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4. He must treat the sick person with patience and delicacy. Anything mentioned by
the patient regarding his individual or domestic life or his character during
medical attendance should not be revealed - except in the circumstances discussed
in Chapter 4.
5. He must neither exaggerate nor minimise the gravity of the patient's condition. He
must ensure that the patient and his relatives have such information about the
patient's condition as will serve the best interests of the patient and his family.
6. Once a patient is accepted by a physician, he should not neglect the patient. Nor
should he withdraw from the case without giving adequate notice to the patient
and his family. He should not willfully commit an act of negligence that may
deprive the patient from necessary medical care.
7. When he has been engaged to attend to an obstetric case and is absent at the time
of the delivery and another physician performs the delivery the latter is entitled to
his professional fees.

III. DUTIES AT THE TIME OF CONSULTATION

1. All unnecessary consultations should be avoided. However, in case of a serious

illness and in doubtful or difficult conditions, the physician can request
consultation if it is in the interests of the patient.
2. Advising a patient to undergo a diagnostic laboratory investigation or to consult a
pathologist or a radiologist should be done judiciously- and not in a routine
manner.
3. In every consultation, the benefit to the patient is of the foremost importance.
4. Utmost punctuality must be observed by physicians when making themselves
available for consultations.
5. Differences of opinion should not be divulged unnecessarily, but if there is
irreconcilable difference of opinion, the circumstances should be frankly and
impartially explained to the patient or his relative.
6. The physician can make a variation in the treatment if any unexpected change
occurs, but in that case, he must explain the reason for such a variance at the time
of the next consultation.
7. When a patient is referred to a specialist, a case summary should be prepared by
the attending physician and given to the specialist. The latter must then
communicate his opinion in writing to the attending physician.
8. A physician must clearly display his fees and other charges on a board in his clinic
or hospital. His prescription should also make it clear if the physician himself has
dispensed any medicine to the patient.
DUITES TOWARDS OTHER PHYSICIANS
1. A physician should consider it to be a pleasure and privilege to render gratuitous
service to other physicians and their immediate dependents.
2. No feelings of rivalry, envy or insincerity towards another physician should be
displayed by a physician during consultations.

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3. When a physician has referred a patient to a consultant, the latter should normally not
take charge of the case or criticise the referring physician.
4. When a physician requests another to attend to his patients during his temporary
absence, the other physician should give utmost consideration to the interests and
reputation of the absent physician and restore the patient to his care upon his return.
5. When it becomes the duty of a physician occupying an official position to observe and
report upon an illness or injury, he should communicate this to the physician in
attendance, so as to give him an option of being present. Remarks on the diagnosis
and treatment given by the attending physician should be avoided in such cases.
DUTIES TO THE PUBLIC
1. Physicians, as good citizens possessed of special training, should disseminate advice
on public health issues. They should play their part in enforcing the laws of the
country and in sustaining the institutions that advance the interests of humanity.
2. Physicians, especially those engaged in public health, should enlighten the public as
regards quarantine regulations and measures for the prevention of epidemic and
communicable diseases.
3. The physician must notify the public health authorities of every case of communicable
disease under his care.
4. When an epidemic occurs, the physician should not abandon his duty out of fear of
contracting the disease himself.
5. Physicians should recognise and promote the practice of different para medical
services like pharmacy and nursing as professions, and should seek their co-operation
whenever required.

C. MEDICAL CERTIFICATES

Medical certificates are often required to be issued by doctors, certifying the nature of the
illness of a patient. At times, this could also be a fitnes certificate of the patient after his
illness. Such certificates may be required for several reasons listed below.
The Code of Ethics Regulations, 2002, issued by the Medical Council of India lists twelve
purposes for certificate, as for instance:
 for procuring a driving license
 for procuring or issuing a passport
 for procuring sick benefit insurance

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 for excusing attendance in employment (or even in a school or other institutions)

 for excusing attendance in a court of law or public services
 for registration of births or deaths or for disposal of a dead body
 under Acts relating to lunacy, mental deficiency or mental illness
 in connection with quarantine rules
 under various statutes, as for instance, the Workmen's Compensation Act, the
Merchant Shipping Act, the Employee's State Insurance Act etc.
Regulation 7.7 of the Code has made specific provisions for such certificates. The said
Regulation provides that in certain cases, registered medical practitioners are bound by law to
give, or may from time to time, be requested to give, certificates, notifications, reports and
other documents of a similar nature, signed by them in their professional capacity, for
subsequent use in a court of law or for administrative purposes.
Under the said Code, the doctor must maintain a Register of medical certificates
issued by him, giving full details of such certificates. He must record the sign (or thumb
mark) and address and at least one identification mark of the patient on every medical
certificate and report.
Taking a strict view in the matter of issue of false certificates, the Regulation lays
down that any registered medical practitioner who is shown to have signed or given under his
name and authority, any such certificate or document of a similar nature which is untrue,
misleading or improper is liable to have hi name deleted from the Register of the Medical
Council.

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