Ensure medical practitioners are not unjustly targeted, punished: Madras High Court

It is important to acknowledge the services of medical practitioners and sufficient protection should be given to ensure that they are not unjustly penalised, targeted or punished, the Madras High Court observed on Tuesday (Dr. P. Basumani v. The Tamil Nadu Medical Council)..The Court observed that in the larger interest of society, the highest degree of care, caution, propriety and rectitude is expected from medical practitioners in the discharge of their noble profession. All the same, regard must be had to the fact that they work under tremendous pressure - physically, mentally, morally and also professionally, the Court said."They cannot be expected to perform their best, if the swords of damocles are kept hanging on their head constantly. Enough protection needs to be given to the medical practitioners in order that they may not be penalised, targeted or punished, unjustly," the Court observed..Justice R Mahadevan proceeded to issue a series of guidelines to be incorporated into proposed regulations under the National Medical Commission Act (NMC Act), 2019 in order to ensure that disciplinary proceedings against medical practitioners are conducted in a fair manner."It is the responsibility of the Medical Council to proceed against the medical practitioners, if there is any breach or violation of the Standard Operating Procedures (SOP) or instructions given from time to time. At the same time, the Medical Council also owes a duty to protect the medical practitioners, who are rendering yeomen service for the betterment of the general public, from the onslaught of frivolous complaints or to proceed against them in a hasty manner," he emphasised while issuing the guidelines..These guidelines are intended for the purpose of setting up an effective mechanism to handle complaints against medical professionals and to avoid unnecessary allegations against the Medical Board deciding on such complaints, the Court said. .The Court was dealing with a challenge filed by a doctor specialising in Gastroenterology, whose name had been removed from the Medical Register of the Tamil Nadu Medical Council for six months citing professional misconduct. It was found that such action was taken although the complaint was not directly against the doctor, and that he did not have sufficient opportunity to prove his innocence. Ultimately, the petitioner-doctor's plea was allowed by the Court. The disciplinary action taken against him was found to be wholly unjustified and liable to be set aside..In the course of case, the Court found that the various regulations governing the conduct of medical practitioners were sketchy and bereft of particulars. A perusal of the Code of Medical Ethics, 2002 also indicated to the Court that a procedure to be adopted in carrying out disciplinary action for professional misconduct against medical practitioners was "completely absent."."The Code is bereft of the stages to be followed from the initiation till end, in case of complaints are received against the medical practitioners. This requires a complete overhaul of the Code of Medical Ethics in the new Regulations to be framed under the NMC Act, 2019", the Court opined. .As such the Court has issued the several guidelines that may be included in the new Regulations to be framed under the NMC Act of 2019 to establish a "fair and reasonable disciplinary procedure in the interests of the medical professionals as well as the public in general.".These guidelines deal with several aspects including:.The need for the proposed code or regulations to enunciate general duties and to list specific duties, the breach of which would be construed as professional misconduct. The need to include a complete stage-wise mechanism or guidelines from the filing of a complaint to the registration of the same and the procedure to be followed thereafter. The procedure for dealing with complaints would include the issuance of show-cause notice, opportunity for the accused doctor to reply, constitution of an expert committee, opportunity to hear both parties while following principles of natural justice, the submission of a detailed report by the Enquiry Committee and the submission of its recommendation to the disciplinary board of the State Medical Council/Ethics and Medical Registration Board. In order to make the disciplinary proceedings free from any loopholes and to avoid multiplicity of proceedings, the report of the Enquiry Committee is to be made final and binding on the disciplinary board. Following this report, the disciplinary board may decide on the proposed punishment, if the accused doctor is found guilty. However, a show-cause notice must be issued calling for the doctor's remarks on the proposed punishment before meting out the same. The disciplinary board of the State Medical Council/Ethics and Medical Registration Board will have to a permanent tenure and a fixed three-member body. The enquiry committee will have to be appointed by the unanimous consent of the members of the Disciplinary Board concerned. The enquiry committee shall be a three-member committee with one member from the field of general/internal medicine and two other members from the concerned fields as required on a case to case basis. Any complaint made shall be disposed of within six months. To decide on the extent of powers to be conferred on an enquiry committee, inspiration may be drawn from how the disciplinary committee of the Bar Council has been empowered under Section 42 of the Advocates' Act, 1961. The code of ethics presently in force says that medical documents and records are to be preserved for three years. This can be extended for a period of ten years. The entire records can be digitalised and the same may be required for dealing with complaints. A period of limitation for filing a complaint against a medical practitioner can be loosely fixed by the Medical Council while giving liberty to the disciplinary board to relax the same, if the case so deserves..[Read Judgment]