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When a patient consults a doctor about an ailment, he or she has every right to know the diagnosis and the line of treatment being prescribed. She/he also has a right to know the risks involved in the treatment, the options available to the patient, the side effects of the drugs being prescribed, other lines of treatment or options available to the patient, the time schedule involved and of course the cost factor. In short, the patient has the right to full and proper information pertaining to the treatment. But unfortunately, these rights are yet to be fully recognised by the medical fraternity. It’s for this reason that consumer groups have been demanding codification of patient’s rights through legislation. In fact almost 12 years ago, the Consumer Action Group in Chennai developed a draft charter of Patients’ Rights and Responsibilities. Subsequently, the Association for Consumers Action on Safety and Health (ACASH) and the Voluntary Health Association of India (VHAI) have been campaigning for implementation of the patient’s charter. Meanwhile, the consumer courts, through their orders, have been protecting the rights of patients, but I would like to draw attention to a recent order that fully recognises the patient’s right to information. In fact this order of the apex consumer court chastising a doctor for ignoring the right of his patient to adequate information should act as a shot in the arm for all those campaigning for patients’ rights. It should also send a clear signal to all medical professionals that the courts will not condone such violation of patients’ rights. Laying utmost emphasis on this crucial aspect of the doctor-patient relationship, the National Consumer Disputes Redressal Commission observed thus: "The doctor is duty bound to inform the patient about the details of the disease afflicting him, the various alternatives available to him and the risks involved in the proposed treatment. Obviously in this case, the patient was not informed of any of these…" The order stems from a complaint filed by of a factory worker, Rameshbhai Harmanbhai Kachhiya, alleging that the deficient services provided by Dr Shyam Kumar had resulted in his losing his vision in both eyes. His contention was that in January 1991, he developed some problem in his vision and approached Dr Kumar for treatment. Tracing the problem to glaucoma, the doctor operated on both his eyes and assured him that his vision would improve. However, even though Kachhiya followed all the instructions of the doctor, took the prescribed medicines and went for regular check-ups, there was no positive change in his eyesight. Subsequently, after two months, the doctor performed a cataract operation on his right eye, but still there was no improvement. In fact his eyesight worsened and subsequently two doctors to whom he was referred held that the retina in both the eyes were in poor condition and that he had suffered 100 per cent disability. Dr Kumar, in his response to the complaint argued that the patient’s loss of vision could not be attributed to negligence on his part. However, he could not produce any medical records to prove his point. In fact he claimed that the medical records had been destroyed and contended that the Medical Council of India had laid down that the doctors may preserve medical records for three years only. The district forum held the doctor negligent and awarded a compensation of Rs 1,85,000 along with 12 per cent interest. When the state commission also upheld this, the doctor filed a revision petition before the National Consumer Disputes Redressal Commission. The apex consumer court, after perusing all the evidence before it, upheld the view of the lower consumer courts. Its observations are important here: As per as the evidence produced by the patient, it was clear that he lost his vision following the operations. The doctor on the other hand, argued that his vision was already weak and despite his efforts to improve it through the operation, it could not be done. Now if this was the truth, the doctor should have given the patient all this information before undertaking the treatment. Why was this not done? The doctor was duty bound to inform the patient about the risk involved in the proposed treatment Secondly, the doctor had failed to produce any medical record to prove his point. (Dr Shyam Kumar Vs Mr Rameshbhai Harmanbhai Kachhiya, RP No 1486 of 2001)This order should force doctors to recognise the patient’s right to information. |
