The National Medical Commission has allowed medical practitioners to refuse treatment in case of abusive and violent patients or relatives but they must ensure that the patient is not abandoned, a step aimed at checking instances of violence against doctors. The move comes amid rising attacks on medical practitioners in the country.
According to 2019 data, the Indian Medical Association (IMA) suggests that up to 75 per cent of doctors have faced some kind of violence at work. Among this, nearly 50 per cent of violence was reported in intensive care units (ICUs), and, in 70 per cent of the cases, the patient’s relatives were actively involved. The healthcare fraternity has been demanding a central law to tackle violence against healthcare professionals. However, the Union Home Ministry denied the need for a separate law to address the issue.
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The NMC has now allowed doctors to refuse treatment to abusive patients. "In case of abusive, unruly, and violent patients or relatives, the RMP can document and report the behaviour and refuse to treat the patient. Such patients should be referred for further treatment elsewhere," the regulations said.
Other regulations
The NMC in the Professional Conduct Regulations also bar doctors from endorsing any drug brand, medicine or equipment, or advertise them. Registered medical practitioners and their families must not receive any gifts, travel facilities, hospitality, cash or monetary grants, consultancy fee or honorariums, or access to entertainment or recreation from pharmaceutical companies or their representatives, commercial healthcare establishments, medical device companies, or corporate hospitals, under any pretext. However, this does not include salaries and benefits that RMPs may receive as employees of these organisations, the regulations stated.
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Also, RMPs should not be involved in any third-party educational activity like seminar, workshop, symposia, conference, which involve direct or indirect sponsorships from pharmaceutical companies or the allied health sector.
"RMP individually, or as part of an organisation/association, shall not give to any person or to any companies or to any products or to software/platforms, whether for compensation or otherwise, any approval, recommendation, endorsement... concerning any drug brand, medicine, nostrum remedy, surgical, or therapeutic article, apparatus or appliance or any commercial product or article with respect of any property, quality or use thereof or any test, demonstration or trial thereof, for use in connection with his name, signature, or photograph in any form or manner of advertising through any mode nor shall he boast of cases, operations, cures or remedies..." the regulations said.
The regulations state that reasonable estimation of the cost of surgery or treatment should be provided to the patient to enable an informed decision. Consultation fees should be made known to the patient before examination or treatment of the patient. "RMP can refuse to treat or to continue to treat a patient if the fees, as indicated, are not paid. At the same time, this does not apply to doctors in government service or emergencies, but the doctor must ensure that the patient is not abandoned," the regulations stated.
The registered medical practitioner, who attends to the patient, will be fully accountable for his actions and entitled to the appropriate fees.
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It also specified that use of alcohol or other intoxicants during duty or off duty which can affect professional practice will be considered as misconduct. According to the regulations, any request for medical records to a RMP responsible for patient records in a hospital either by the patients or authorised attendant has to be duly acknowledged and documents have to be supplied within five working days instead of the existing provision of 72 days. In case of medical emergencies, efforts should be made to make the medical records available at the earliest.
