How A Doctor Navigates Through Legal and Moral Conflicts

A survey by the Indian Medical Association (IMA) revealed that 75 percent of doctors complain of verbal abuse and 12 percent of physical attacks. For a profession that deals with matters of life and death on a daily basis, the tiniest of mistakes can lead to the harshest of consequences — consequences, that on certain occasions, could be disproportionate and unwarranted. The 6th Annual MNLAG Conference 2020, organized by the Medicos Legal Action Group, was held on 2nd February to address these very issues.Also Read: Why Doctors and Patients Need to Work TogetherSpeaking at the event, Chief Guest Justice Indu Malhotra, advised doctors on how they can best protect themselves from legal battles and accusations, and explained what constitutes a legal or illegal act. She assured them that the court is not a place they need to fear.Justice Indu Malhotra“I must tell you, the trend of the court is to protect the doctors wherever possible. Negligence is only awarded when it is established that a doctor has clearly been unlawful. So there isn’t a need to fear the law if you know you are not wrong.”In her session, she advised doctors to make it a point to document each and every detail about a case, to inform the patient of the nature of the treatment, procedures, alternative treatments, side effects, and risks — and then to take their written consent. Recording the case details is the only solid proof that can work in a case and help during litigation. No detail is too small, she asserted.FIT interviewed Dr Ashwini Setya, the Organising Chairman of the event, who spoke at length about matters concerning consent, violence, everyday problems and moral and legal dilemmas that doctors face regularly.Medicine and Law Share a Unique RelationshipSpeaking at the event, senior advocate for the Supreme Court of India, Sidharth Luthra, explained the importance of doctors to appear during the proceedings and to be proactive during a case. “For doctors who are fighting a case or defending themselves, it is crucial to engage with their lawyers and be present when needed. The field is so technical and specialized, that a lawyer may not understand the nuances. So in court, a doctor is more than just a litigant.”In fact, this is precisely why Justice Indu Malhotra called for the medical fraternity to lobby for a specialized tribunal for itself, so that no detail is neglected or misinterpreted. Speaking out of her own experience, she shared that she often had the practitioner sitting right next to her to help her understand his/her decision regarding the intricacies of a case.Also Read: Why Violence Against Doctors Must StopWhat Happens When the Legal Gets in Conflict With the Moral?The lines between right and wrong often get blurred in cases that require urgent intervention but leave no time for a proper protocol to be followed. But when someone’s life is at stake, what does a doctor do?In Dr Setya’s words, “Sometimes, what your morals tell you to do may go against the law. If you don’t treat the patient, you are unethical. And if you inform others, then you violate the confidentiality between the patient and the doctor. In cases of life-saving surgery, it is fine. There may be occasions when you circumvent the law to act in the interest of a patient and save a life, but you must remember that the law will acknowledge something done in good faith. The law is foremost.”The ABCDE Guide for DoctorsIn conclusion, Dr Setya comes up with five simple suggestions for doctors to ensure they are going in the right direction and making the right decisions for themselves and their patients:Awareness: You must be aware that you are not insulated from the law.Building Structures: You should have a structured history of records.Communication with the patients: Not many of us — because of constraints of time or lack of training — communicate with the patients. That is what brings upon a problem.Documentation of all records: The document is the only thing the court can go by after several years of the incident.Empathy“Empathise with the patients and know that if you follow the law, inform the patients about all important details, and take all necessary steps, there will never be a need to fear the law or to opt for out-of-court settlements — which often run into lakhs.”Also Read: Burnouts, Stress, the ‘Nasha’ of Healing: The Life of a Trauma Doc

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How A Doctor Navigates Through Legal and Moral Conflicts

How A Doctor Navigates Through Legal and Moral Conflicts

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