Download - Medicolegal Book Contents
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SECTION I Medical Ethics and Law
1. Te Ethics of Medical Practice 3 VP Singh, Parmod Goyal
Medical Ethics 3; Autonomy 3; Beneficence 4; Nonmaleficence 4
Does Paternalism Really Serve the Purpose? 5
Should Physicians do Whatever Patients Say? 6 ; What Serves the Patient Best? 6 Indian Medical Council (Professional conduct, Etiquette and Ethics) Regulations 7
2. Confidentiality and Disclosure in Medical Practice 17 VP Singh, Akashdeep Aggarwal
When Confidentiality may be breached? 17 ; Guidelines on Medical Confidentiality 18
Right to Information Act and Medical Confidentiality 19
Medical Confidentiality and HIV Status 21; Guidelines on HIV esting (March 2007) 22
Judicial Decisions on Medical Confidentiality and HIV Status 23
HIV esting of Patients Prior to Surgery 23
3. Disclosing Medical Errors: Why, When and How? 26 VP Singh, Gautam Biswas
Medical Errors 26 ; Disclosure of Medical Errors 27
Consequences of Disclosing Medical Errors 28
Guidelines on Disclosing Medical Errors 29
4. End of Life Care Decisions: Ethical and Legal Issues 35 Rashmi Datta, Pradeep Sreevastava, Arvind Kumar Singh
Palliative Care at the End of Life 35 ; Magnitude of the Problem 36 Medical Futility 36 ; Withholding or Withdrawal of Life Support 37
Advanced Directives and Do-Not-Resuscitate Orders 38 ; Euthanasia 39
Implications to Human Organ ransplantation Act 39
Legal Aspects of End of Life Issues in India 40
5. Medical Professionalism: Focus on Communication Skills 43 Shalini Ratan
Physician and the Patient: A Changing Relationship 43; Te patient’s Perception 44
Engaging Patients Trough Effective Communication 45
Miscommunication to Litigation 46 ; Physician-patient Communication in Practice 46
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Legal Issues in Medical Practice: Medicolegal Guidelines for Safe Practicexviii
SECTION II Documentation of Patient Care: The Legal Aspects
6. Medicolegal Aspects of Informed Consent 51 VP Singh, Dasari Harish
Evolution 51; Objectives 52 ; Meaning 53
What Makes the Consent Legally Acceptable? 54; Exceptions 57
Obtaining Consent: Te Procedure 57 ; Documentation of Informed Consent 57
Judicial Decision on Informed Consent 58
7. Medicolegal Aspects of Medical Records 61 Joseph Tomas, Arun Mavaji Seetharam
ypes of Medical Records 61
Electronic Health Records: An Emerging rend in India 62 Guidelines on Medical Records 64; MCI Guidelines 64
NABH Guidelines 64; Medicolegal aspects of Medical Records 69
Ownership of Medical Records 69 ; Summoning Medical Records by Courts 70
Judicial Decisions Related to Medical Records 70
SECTION III Litigation Against Medical Practitioners
8. Medical Negligence: Meaning, Scope and Legal Interpretation 75
VP Singh, Vivekanshu Verma What is Medical Negligence? 75 ; Essential Components of Medical Negligence 75
ypes of Medical Negligence 77 ; Burden of Proof of Medical Negligence 78
Yardstick used to determine Medical Negligence: Te Bolam’s Rule 79
Criminal Liability of Medical Professionals 80
Guidelines: Prosecution of Doctors for Criminal Rashness or Criminal Negligence 81
9. How to Defend Medical Negligence Lawsuit? 83 VP Singh, MC Gupta
Pattern of Complaints against Medical Practitioners 83
Complaints under Consumer Protection Act—Step-by-Step Approach 83 Facing the Court: Medicolegal ips and Advice 86
10. Compensation in Medical Negligence: How much is Justified? 89 VP Singh, Mukesh Yadav
Compensation in Medical Negligence 89
Multiplier Method: Can it be Used in Medical Negligence Cases? 89
How Much Compensation is Just and Adequate? 92
Impact of High Quantum of Compensation 92
Medical Liability—A Future Crisis: Learning from the Other Countries 93
Crisis Reform Models 93; Caps on Noneconomic Damages 93 No-fault Compensation 94; Health Courts 94
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Contents xix
11. Professional Indemnity Insurance: Better Safe than Sorry 97 Rajendra S Bangal
Professional Indemnity Insurance 97 ; What does it Cover? 98
What it Does not Cover? 98 ; AOO: AOY Ratio 100
Premium Rates (Individuals) 100 ; Premium Rates (Individuals) 100
Premium Rates (Clinical Establishments) 100 ; Retroactive Date 101
An Ideal Indemnity Insurance Policy: Proposed Components 101
SECTION IV Medical Laws and Judgments Governing the Medical Professionals
12. Landmark Judgments Related to Medical Professionals 105 VP Singh, Krishnadutt Chavali
Dr Suresh Gupta’s Case 105 ; Jacob Mathew’s Case 107
Supreme Court’s Observation on Negligence 108
Martin D’Souza’s Case 109 ; V Kishan Rao’s Case 111
Supreme Court’s Observation on Expert Medical Opinion 111
Supreme Court’s Observation on Martin D’Souza’s Case 112
13. Medicolegal Outlook on ransplantation of Human Organs Act 113 Sunil Shroff, Sumana Navin, Hemal Kanvinde, Sujatha Niranjan, Christopher Barry
ransplantation of Human Organs and issues Rules 2014 113
Medicolegal Aspects of Living Donation and ransplantation 115 Medicolegal Aspects of Deceased Organ Donation and ransplantation 116
Future Challenges 117
14. Medicolegal Outlook on Biomedical Waste Management Act 120 VP Singh, Pardeep Singh
Biomedical Waste 120 ; Biomedical Waste (Management and Handlings)
Rules, 1998 121; Penalties under the Environment Protection Act 130
15. Medicolegal Outlook on PC-PND Act 132
Chandrashekhar A Sohoni Preconception and Prenatal Diagnostic echniques Act in a Nutshell 132
PC-PND Act–Controversies and Practical Difficulties: Safety Measures to be
taken by the Doctors 135
SECTION V Medicolegal Issues in Various Specialties
16. Medicolegal Issues in Obstetrics and Gynecology 143 Charu Mittal, Prabuddh Sheel Mittal
Medicolegal Issues in Obstetrics 144; Medicolegal Issues in Gynecology 148 Medicolegal Issues in Perioperative Patient Care 148
Surgical Complications: Medical and Legal Implications 150
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Legal Issues in Medical Practice: Medicolegal Guidelines for Safe Practicexx
Specialist as an Expert Witness in a Court of Law 151
General Precautions during day to day Practice:
Avoiding Malpractice Lawsuits 152
17. Medicolegal Issues in Surgery 154 Manu Shankar
Preoperative Period in Surgery 154; Peroperative Period 156
Postoperative Period 156 ; Consent in Surgery 157
Role of Anesthesia 157 ; Surgical Complications 158
‘Never Events’ in Surgery 159 ; ake Home Message for the Surgeons 160
18. Medicolegal Issues in Orthopedics 162 Sarvdeep S Dhatt, Siva Swaminathan S
Why Orthopedicians are Vulnerable to Malpractice Lawsuits? 162
Consent in Orthopedics 163; Complications in Orthopedics 164
Wrong-Site Surgery 164; Avoiding Malpractice Lawsuits 164
19. Medicolegal Issues in Ophthalmology 167 Dinesh Verma, Amandeep Singh
Medicolegal Issues in Ophthalmology 167
Vulnerable Domains in Ophthalmic Practice 168
Managing the Risk of Lawsuits 171
20. Medicolegal Issues in Pediatrics 174 Yogesh Dave
Why Study Medicolegal Issues in Pediatrics? 175
Informed Consent in Pediatrics 175
Error in Diagnosis during Emergencies 176
Patient Safety in Pediatrics 177
Neonatal Intensive Care: Vulnerable to Malpractice Lawsuits 177
Communication Skills—Key Role in Pediatrics 178
21. Medicolegal Issues in Radiology 181 Chandrashekhar A Sohoni
Errors in Radiology 181; Judicial Decisions on Radiological Errors 184
Why Radiology is Vulnerable to Medicolegal Conflicts? 182
Avoiding Litigation in Radiology 186
22. Medicolegal Issues in Blood ransfusion Practice 189 Ranabir Pal, Gautam Sarker, Debashis Sinha
Where we Stand as of Now in India? 189 ; National Blood Policy 189
Medicolegal Aspects in Blood ransfusion Services 191
Challenges of Blood Screening 192 ; Who will Bell the Cat? 193 ake Home Message 194
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Contents xxi
23. Medicolegal Issues in Dentistry 197 Shilpa Pharande
Medicolegal Aspects of Dental Practice 197; Medical Emergencies in Dentistry 198
Protection Against Litigation 201; How to Avoid Litigation? 201
24. Medicolegal Issues in Anesthesiology 205 Manpreet Singh, Ajay Kumar, Lakesh Anand
Standard of Care 205 ; Duty of Care and Liability 206
Medicolegal Issues in Anesthesiology 206 ; Error of Judgement 209
Mistake 210 ; Burden of Proof 210 ; Res ipsa loquitur 210
How to Decrease the Likelihood of a Lawsuit? 211
Accepted Practices and Procedures 212
Accidents, Misadventures, and Mishaps 212 Inherent Risks 213; Choice of reatment 213
Keeping the Professional Knowledge and Skill up-to-date 213
Cases to Observe 213
Index 217