The increasing number of medicolegal cases has made it necessary for hospitals and medical administrators to become aware of the medicolegal aspects to minimise civil and criminal litigation and ensure quality of medical care.
In India, lawyers as yet have very little training and exposure in the complex issues involved in medical care.
Therefore, health care personnel must understand the basic medicolegal issues involved in personal injury, negligence, malpractice, medical frauds, professional incompetency, and ethical issues in human experimentation, defensive medicine, organ transplants, reproduction medicine, sex determination and genetic counselling.
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Then only they can do the right things, and protect themselves from frivolous litigations.
Government hospitals in the past were considered to represent the sovereign power, and under the dictum “sovereign can do no wrong” were considered immune from ‘tort’ liability in respect of their employees who were considered to be engaged in official acts.
The principle of sovereignty has now been abandoned everywhere except in India, where it is still on the statute book.
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However, it is noteworthy that the courts have now started talking more humanistic views in favour of plaintiffs even in cases involving sovereign immunity.
There is an increasing awareness among the public about the duties and obligations of medical practitioners (as individuals) as well as of the hospitals where they work.
Many recent cases such as electrocution of the patient on the operation table in a government hospital, operating in wrong eye in a government hospital, death in hospital due to denial of bed in ICU, irreparable damage to the knee joint as a result of surgical operations, etc. have refocused the attention of medical administrators to the problem.
In a point of view about the hospitals, people feel that a doctor can get away with it because he has the protection of an institution. A patient has to suffer because he does not know his legal rights and is not aware of legal remedies.
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Nobody ever tells the patient his rights and nobody guarantees against a doctor’s carelessness which may cause him physical injury forever, or even death.
There are a larger number of nursing homes which have changed their boards to ‘Hospitals’. Many of them are unregistered. A large number of hospitals are being established by businessmen and political leaders.
There is hardly any system of pricing, even for common ailments, the price depends upon the customer how much the patient can pay or how much one can extract out of him.
In the process of generating additional revenue, large number of hospitals have purchased and installed modern technology for diagnosis and treatment, and the patients are pressurized for additional diagnostic tests and procedures.
The consumer cannot think rationally during an episode of sickness and, therefore, is subjected to these additional tests. A large proportion of the population is poor and illiterate, ignorant about their rights and responsibilities, and therefore, at the mercy of the doctors and of the hospitals.
The hospital administration has an obligation to have a clear understanding of its ethical and legal responsibilities. Hospital management is responsible for the policies, for maintaining a safe hospital, physical facilities and services.
In addition, the hospital is also governed by regulations of the local government authorities in respect of building codes, safety and fire regulations and sanitation arrangements.
Being an integral part of the social system, it has to be subject to all laws of the land.
The administration should take due care in establishing policies for selection and appointment of members of medical staff, because it is through the actions of the staff that most legal problems arise.
There should also be an understanding of the management’s civil and criminal liability. Responsibility for safety from explosive and inflammable anaesthetic gases and chemicals, machinery, steam and even damages from falls on slippery floors is that of the administration.