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Whether A Patient Is Entitled For Emergency Medical Care, and Whether Medical Professionals Have A Duty To Provide Emergency Medical Care

The document discusses India's laws and Supreme Court rulings around the right to emergency medical care. 1) Under Article 21 of the Indian Constitution, individuals have the right to life which includes the right to prompt emergency medical care without having to pay upfront fees. 2) The Supreme Court has ruled this right to life includes the right to health and medical care, and that the government has an obligation to provide these to citizens. 3) While there is no specific law, Supreme Court rulings have established that hospitals cannot refuse emergency care to anyone, regardless of ability to pay, as this would violate their right to life. Failure to provide timely emergency treatment can result in legal penalties.

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0% found this document useful (0 votes)
115 views5 pages

Whether A Patient Is Entitled For Emergency Medical Care, and Whether Medical Professionals Have A Duty To Provide Emergency Medical Care

The document discusses India's laws and Supreme Court rulings around the right to emergency medical care. 1) Under Article 21 of the Indian Constitution, individuals have the right to life which includes the right to prompt emergency medical care without having to pay upfront fees. 2) The Supreme Court has ruled this right to life includes the right to health and medical care, and that the government has an obligation to provide these to citizens. 3) While there is no specific law, Supreme Court rulings have established that hospitals cannot refuse emergency care to anyone, regardless of ability to pay, as this would violate their right to life. Failure to provide timely emergency treatment can result in legal penalties.

Uploaded by

Soumiki Ghosh
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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Whether a patient is entitled for emergency medical care, and whether medical

professionals have a duty to provide emergency medical care

In an emergency situation, one can avail medical care in any government or private hospital.
Under Article 21 of the Constitution, which ensures that every person has the right to life and
personal liberty, one has the right to prompt emergency care by doctors without compromise on
quality or safety and without having to pay full or an advanced fee to the hospital.

The Supreme Court of India has held that the right to life guaranteed under Article 21 includes
within its ambit the right to health and medical care. 1 The right to life consists of the right to live
a healthy life to enjoy all facilities of the human body.2

The Supreme Court has repeatedly emphasized to the government and other authorities for
focusing and giving priority to the health of its citizens as it makes one's life meaningful,
improves one's efficiency, and also provides an optimum output. To secure protection of one's
life has been declared to be one of the foremost obligations of the State. It is not merely a right
enshrined under Article 21 but an obligation cast on the State to provide this, both under Article
21 and under Article 47.3

In India, there is no specific law laid down by the government to provide emergency medical
care. A plethora of medical literature on the subject affirms that the ‘GOLDEN HOUR' is the
first hour in which ‘emergency medical care' is necessary and most victims die if no such care is
made available or is not provided soon. The purpose of emergency medical care is to ‘stabilize'
the patient, and this, unfortunately, is never followed. Private practitioners are under the
impression that “medico-legal” emergencies are to be dealt with only by government doctors and
usually refer such cases to a government hospital. Government doctors have no option but to
attend medico-legal cases.

This problem was mitigated to some extent when the judicial system mandated the delivery of
care by any and every hospital regardless of a patient's paying and medico-legal status in times of
emergency. Failure on the part of any hospital to provide timely medical treatment to a person in

1
State of Pubjab v. M.S. Chawla AIR 1997 SC 1225
2
Mr. X vs. Hospital Z, AIR 1997 SC 1225
3
State of Punjab v. Ram Lubhaya Bagga, AIR 1997 SC 1225
need of such treatment results in a violation of the patient's "Right to Life,” which is guaranteed
under Article 21 of the Constitution of India. This is the closest India has come to enacting laws
similar to The EMTALA (Emergency Medical Treatment and Labor Act) and the COBRA
(Consolidated Omnibus Budget Reconciliation Act), which are well recognized in the USA.
Enacted in 1986, the Emergency Medical Treatment and Active Labor Act, commonly known as
EMTALA, is a Federal law that requires anyone coming to almost any emergency department to
be stabilized and treated, regardless of their insurance status or ability to pay. The Act has been
referred to as the “anti-dumping” law as it was designed to prevent hospitals from transferring
uninsured or Medicaid patients.

According to Code of Medical Ethics Regulations, 2002 published by Medical Council of India-
physicians have certain duties towards their patients.

 Obligations to the Sick- A physician advising a patient to seek service of another


physician is acceptable; however, in case of emergency a physician must treat the patient.
No physician shall arbitrarily refuse treatment to a patient.
 The Patient must not be neglected: A physician is free to choose whom he will serve.
He should, however, respond to any request for his assistance in an emergency.

Law Commission of India 201st Report On Emergency Medical Care To Victims Of


Accidents And During Emergency Medical Condition And Women Under Labour

A three member commission headed by Justice M Jagannadha Rao has drafted a bill 4 pertaining
to private hospitals and practitioners and the treatment of accident victims and emergency
patients. According to the bill, hospitals cannot refuse care to an accident victim even on the
ground that it was a medico-legal case. At the very least, they must provide emergency treatment
and transport, with medical support, to another hospital, seeking the help of the police if an
ambulance is not available. Doctors or hospital administrators who refuse emergency treatment
face six months’ imprisonment and a fine of Rs 10,000. On the whole, irrespective of legal
concerns, doctors should not refuse emergency treatment, at least on moral grounds. The report

4
Law Commission of India. 201st report. Emergency medical care to victims of accidents and during emergency
medical condition and women under labour. [Internet]. New Delhi: ministry for law and justice, government of
India; 2006 Aug [cited 2011 Feb 26]. Available from: http://lawcommissionofindia.nic.in/reports/rep201.pdf
said provided that no hospital or medical practitioner shall refuse to provide emergency medical
care to victims of accidents or those in emergency medical condition on the ground that it is a
medico-legal case or that the person is not able to pay immediately or that he has no medical
insurance or other reimbursement facilities. If they refuse without justifiable reason, that will be
an offence.
Also the report suggested that a law to compel hospitals and medical practitioners to attend on
victims of accidents those in emergency medical condition and women under labour is one of
urgent necessity.
So it can be interpreted, in emergency or critical cases, doctors should discharge their duty/social
obligation of rendering service without waiting for fee or for consent. Since emergency treatment
is required to be given to a patient who was brought in seriously injured condition there was no
question of waiting for consent. Consent is implicit in such cases.

Leading Cases

The first time when medico-legal case ever discussed by the Supreme Court of India was in the
case of Pt. Parmandand Katara vs. Union of India and Ors.5 In this case, a public-spirited
person has filed a Public Interest Litigation under Article 32 of the Constitution of India, 1950.
The said petition was filed in response to a news report of a scooterist who was knocked down
by a car and died due to lack of medical treatment. Following the accident, the scooterist was
taken to the nearest hospital but was turned away and sent to another hospital 20 km away, which
was authorized to handle medico-legal cases. The scooterist died while he was being transported
to the other hospital. In this case, the Supreme Court of India for the very first time held that
Article 21 of the Constitution of India includes right to emergency medical care and articulated
importance of golden hour. The Hon'ble Apex court held that it is the Right of the Citizen and
also the obligation on the State to preserve life and doctors at government hospitals are therefore
required to provide medical assistance to preserve life. 6 This judgment was the first initiative
taken by the Supreme Court of India to protect the right of the citizens of this country as per
Article 21. In the Parmanand Katara judgment, access to emergency care was declared a
fundamental right. Critics described it as a symbolic and “paper right”.

5
1989 SCR (3) 997
6
ibid
The Supreme Court observed that when accidents occur and the victims are taken to hospitals or
to a medical practitioner, they are not taken care of for giving emergency medical treatment on
the ground that the case is a medico-legal case and the injured person should go to a Government
Hospital. The Supreme Court emphasized the need for making it obligatory for hospitals and
medical practitioners to provide emergency medical care. This is not the only reason for not
attending on injured persons or persons in a medical emergency; for sometimes such persons are
turned out on the ground that they are not in a position to make payment immediately or that they
have no insurance or that they are not members of any scheme which entitles them to medical
reimbursement.
In the case of Consumer Education And Research Centre Vs Union Of India 7, the Supreme
Court held that timely medical aid is an integral part of the right to life as per Article 21. “Social
justice which is a device to ensure life to be meaningful and livable with human dignity required
the State to provide to workmen facilities and opportunities to reach a minimum standard of
health, economic security and civilized living. The health and strength of the worker, the Court
said, was an integral facet of right to life. Denial thereof denudes the workmen the finer facets of
life violating Article 21”.

Thereafter a serious issue was put before the Supreme Court of India, in Paschim Banga Khet
Mazdoor Samiti vs State of West Bengal 8 where the victim, an agricultural labour, who fell
from a train and was denied emergency medical aid in 5 public hospitals and ultimately was
admitted in a private hospital where he had to pay an exorbitant amount. The victim then
approached the Supreme Court claiming damages as he was denied medical aid by the public
hospitals, which amounts to a breach of Article 21 of the Constitution of India. The issue before
the Supreme Court was in the context of availability of facilities in Government hospitals for
treatment of persons sustaining severe injuries. During the pendency of this writ petition before
the Supreme Court, the State Government, by appointing an Enquiry Committee decided to
investigate the matter meticulously. Supreme Court held that preservation of human life is
utmost important because if timely medical care is not provided to the victim it may cause his
death or leave him permanently paralyzed, in such cases obtaining status-quo ante is impossible.

AIR 1995 SC 922


8
(1996) 4 SCC 37
The National Consumer Disputes Redressal Commission in Pravat Kumar Mukherjee vs.
Ruby General Hospital & Others declared that a hospital is duty bound to accept accident
victims and patients who are in critical condition and that it cannot refuse treatment on the
ground that the victim is not in a position to pay the fee or meet the expenses or on the ground
that there is no close relation of the victim available who can give consent for medical treatment.
Sumanta Mukherjee, a 20 year old student was injured when a Calcutta Tramway Corporation
bus hit his motorcycle. The victim was taken to the nearest hospital, the Ruby General Hospital.
The victim was conscious when he reached the hospital and showed the doctors his medi-claim
policy insuring him for Rs. 65,000/-. He assured the hospital that all the bills would be cleared
and requested that treatment be given. The doctors started emergency treatment but soon
demanded Rs.15,000/- from the persons who brought Mukherjee in. Those persons immediately
pooled Rs.2,000/- and informed that they had contacted the parents of the victim and the parents
were willing to pay the balance. However, since the amount of Rs.15,000/- was not arranged, the
hospitals discontinued treatment. The victim died.
The National Consumer Commission while imposing damages in a sum of Rs.10 lakhs on the
Hospital observed that doctors at the hospitals cannot first demand fees before agreeing to treat
the patient and they cannot also insist on consent of relatives of the victim before starting
emergency treatment. The National Commission relied on Paramanand Katara decided by the
Supreme Court, referred to above. It held that the preservation of human life is of paramount
importance. That is also in consonance with the Code of Medical Ethics. Recovery of fees can
wait, but treatment cannot be denied.

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