Role of WHO in Shaping International Health Law

The World Health Organization (WHO), established in 1948 as a UN agency, plays a central
role in shaping international health law by developing and updating frameworks like the
International Health Regulations (IHR), setting standards, and providing technical assistance
to countries to implement and comply with these regulations. It also leads global health
initiatives, coordinates responses to health emergencies, and promotes health equity and
access to healthcare worldwide.

1. WHO formulates both binding and non-binding legal instruments that shape the
legal framework governing global health.
a) International Health Regulations (IHR, 2005)
 A legally binding international legal instrument adopted by 196 countries.
 It aims to prevent and respond to Public Health Emergencies of
International Concern (PHEIC), such as pandemics.
 Example: During the COVID-19 pandemic, WHO declared COVID-19 a PHEIC
under the IHR framework and issued recommendations for surveillance,
reporting, quarantine, and travel restrictions.
b) Framework Convention on Tobacco Control (FCTC, 2003)
 WHO’s first international treaty, adopted by over 180 countries.
 It sets international legal standards for reducing tobacco consumption and exposure.

2. Standard-Setting and Norm Development: WHO develops global health standards

including guidelines on vaccination, disease classification (ICD), essential medicines lists,
and ethical standards in healthcare.
3. Guidance on Public Health Emergencies: WHO provides legal and technical guidance
during pandemics (such as COVID-19), coordinating global strategies and advising on travel
restrictions, quarantine, and vaccination policies.
4. Promotion of Human Rights in Health: WHO promotes health as a fundamental
human right, integrating principles of equity, non-discrimination, and access to care in its
health frameworks.
5. Coordination of International Health Response
WHO plays a central role in coordinating international responses to health threats and
facilitating legal cooperation between countries.
 Example: Through the COVAX facility, WHO facilitated legal agreements
between countries and pharmaceutical companies to ensure equitable access to
COVID-19 vaccines, especially for low-income countries.
 6. Monitoring, Reporting, and Compliance
Though WHO does not have enforcement powers, it plays a role in monitoring compliance
with international health law and promoting accountability.
 Under the IHR (2005), States are required to report outbreaks and WHO
monitors their responses.
 Example: WHO's response evaluation of China’s initial COVID-19 reporting

Challenges and Criticisms

1. WHO’s enforcement powers are limited; compliance depends largely on
member states’ goodwill and cooperation.
2. Political and economic interests of countries sometimes hinder uniform application
of WHO’s health laws.
3. Resource constraints and varying health infrastructure impact the implementation of
WHO standards globally.

Right to Health and its Constitutional Status

The Right to Health is a fundamental component of human dignity and well-being. In India,
although the Right to Health is not explicitly mentioned as a Fundamental Right in the
Constitution, it has been recognized and enforced through judicial interpretation under
various provisions of the Constitution.

1. Directive Principles of State Policy (DPSP)

The Right to Health is explicitly recognized under the Directive Principles in Part IV of
the Constitution. Though not enforceable by courts, they are fundamental in the
governance of the country.
Key provisions:
 Article 21 (Right to Life and Personal Liberty): The Supreme Court has
expansively interpreted Article 21 to include the right to health and medical care as an
integral part of the right to life. This interpretation imposes a positive duty on the
state to ensure healthcare facilities and protect citizens’ health.
 Article 39(e) & (f): Directs the State to protect the health and strength of
workers, men and women, and to ensure children are not abused.
 Article 41: Provides for public assistance in case of sickness and disablement.

 Article 42: Ensures humane conditions of work and maternity relief.

 Article 47: Makes it the duty of the State to raise the level of nutrition and standard of
living and improve public health.
 Landmark Cases:
 Bandhua Mukti Morcha v. Union of India (1984):
The Court held that the right to live with human dignity includes protection of health
and strength of workers.

 Paschim Banga Khet Mazdoor Samity v. State of West Bengal (1996):

The Court ruled that failure of a government hospital to provide timely medical
treatment to a person in need amounts to a violation of Article 21.

 Indian Medical Association v. Union of India (2011) 7 SCC 179: The Court
emphasized the state’s obligation to ensure medical services and formulate
policies promoting health.
 Common Cause (A Regd. Society) v. Union of India (2018) 5 SCC 1: Affirmed the
right to health as part of the right to life, including access to affordable treatment.

3. International Commitments
India is a signatory to several international instruments that recognize the right to health as a
basic human right, such as:

 Universal Declaration of Human Rights (Article 25)

 International Covenant on Economic, Social and Cultural Rights
(ICESCR, Article 12)
These international commitments influence the interpretation of constitutional provisions and the
duty of the State in ensuring public health.

Scope and Dimensions of Right to Health

• Access to healthcare services, including preventive, curative, and rehabilitative care.

• Availability of essential medicines and qualified healthcare professionals.

• Protection against hazardous environmental conditions impacting health.

• Right to emergency medical treatment without delay.

• Rights of vulnerable groups (children, pregnant women, disabled).

Legislative and Policy Framework Supporting Health Rights

1. National Health Policy, 2017: Aims to provide universal health coverage
and affordable healthcare.
 2. Ayushman Bharat Scheme: Government’s flagship health insurance program
to ensure financial protection.
3. The Clinical Establishments (Registration and Regulation) Act, 2010:
Regulates standards in healthcare.
4. Other sectoral laws like the Prevention of Food Adulteration Act and
Environmental Protection Laws also support health rights.

Vicarious Liability and Medical Negligence

Vicarious liability in medical negligence refers to the legal principle where an employer or
principal is held responsible for the negligent acts or omissions of their employees or agents
performed during the course of their employment. In the healthcare sector, this concept is
particularly significant because hospitals, clinics, and healthcare institutions can be held
liable for the negligence of doctors, nurses, and other staff. This principle aims to ensure
patients have effective remedies and promotes accountability in medical service
delivery.
Legal Basis of Vicarious Liability in India- Under Indian law, vicarious liability is
founded on the principle of respondeat superior (“let the master answer”), whereby an
employer is
liable for the acts of an employee if committed within the scope of employment.

 The Indian Contract Act, 1872 and principles of tort law provide the basis
for imposing vicarious liability.
 The Consumer Protection Act, 1986 (now 2019) also supports claims
against hospitals for deficiencies caused by their employees.

Scope of Vicarious Liability in Medical Negligence- Hospitals and healthcare institutions

can be held vicariously liable for:
1. Negligence committed by their staff, including doctors (both permanent and
visiting), nurses, paramedics, and other support staff.
2. Acts performed during the course of employment or as part of the duties assigned.
3. Failure to supervise or control the activities of their employees leading to patient
harm.
However, vicarious liability generally does not extend to independent contractors unless they are
considered employees.

Implications for Patients and Healthcare Providers

1. Vicarious liability ensures patient protection, providing a reliable
defendant (hospital) who is financially capable of compensating victims.
2. It motivates hospitals to implement stringent quality control, training, and
supervision mechanisms.
 3. Encourages hospitals to ensure proper credentials and ethical conduct of all
medical personnel.
4. On the flip side, the principle creates a risk for hospitals, increasing insurance costs
and legal exposure.

4. Landmark Case:

Savita Garg v. Director, National Heart Institute (2004) 8 SCC 56

 Facts: A woman died after undergoing heart surgery. The husband alleged
negligence on the part of the hospital and its staff.
 Held: The Supreme Court held the hospital vicariously liable for the negligence
of its medical professionals and directed compensation.
 Significance: Reinforced that private hospitals have a duty of care and will be
held liable for negligence by doctors or staff they employ or represent.

Spring Meadows Hospital v. Harjot Ahluwalia (1998) 4 SCC 39

 Facts: A child suffered brain damage due to negligent administration of an
injection by a nurse.

 Held: The hospital and doctor were held vicariously liable. The Supreme
Court awarded compensation to both the child and the parents (as consumers).
 Importance: Affirmed that both employer hospitals and treating doctors can
be held liable in cases of gross medical negligence.

Significance of Informal Consent in Clinical/Medical Practice

Consent in clinical practice is fundamental to respecting patient autonomy and ensuring ethical
medical care. While formal consent—usually written—is the gold standard for invasive
procedures, informal consent plays a significant role in everyday clinical interactions,
especially in routine examinations and minor treatments. Informal consent, though less
documented, is legally and ethically recognized, provided it is voluntary,
informed, and free from coercion. This answer explores the signs, legal significance, and
practical application of informal consent within the Indian healthcare context.
Concept of Consent in Indian Medical Law- Under Indian law, consent is the voluntary
agreement by a patient to undergo a medical intervention. It stems from the right to privacy
and bodily integrity under Article 21 of the Constitution. The Supreme Court in Samira Kohli
v. Dr. Prabha Manchanda (2008) 2 SCC 1 emphasized that valid consent must be informed, and
absence of valid consent can amount to assault or negligence. While the Medical
Termination of Pregnancy Act, 1971 and other statutes require written consent for specific
procedures, informal consent remains a crucial element in general clinical practice.
Signs of Informal Consent in Clinical Practice
1. Verbal Agreement A patient’s clear verbal expression of willingness to undergo
examination or treatment is a primary sign of informal consent. This may be as
simple as responding affirmatively when a doctor explains the procedure and asks for
permission.
2. Cooperative Behavior Non-verbal cues such as the patient willingly
positioning themselves for examination, removing clothing, or allowing the
practitioner to proceed indicate tacit consent.
3. Patient’s Questions and Clarifications When a patient asks questions or seeks
information about the treatment or procedure, it reflects engagement and an
intention to consent once satisfied.
4. Absence of Objection or Resistance If the patient does not resist or object to
the proposed intervention after explanation, it may imply informal consent,
though silence alone is not sufficient in all cases.
5. Follow-up Compliance Willingness to comply with instructions, such as
taking prescribed medication or returning for check-ups, can indicate ongoing
informal consent.

Legal and Ethical Importance

1. Voluntariness: Consent must be free from coercion or undue influence; the
patient should not feel pressured.
2. Information: Even informal consent requires adequate information about the
nature and purpose of the intervention.
3. Capacity: The patient must be mentally competent to give consent.
4. Scope: Informal consent is typically adequate for non-invasive, low-risk procedures
but not for major surgeries or invasive treatments where written consent is
mandatory.

Challenges and Considerations

1. Documentation: Lack of written proof may create challenges in legal
disputes. Healthcare providers are advised to document verbal consent in
clinical notes.
2. Emergency Situations: In emergencies, consent may be implied if the patient is
unconscious or unable to communicate, provided treatment is necessary to save life
or prevent serious harm.
3. Cultural Context: In Indian clinical settings, verbal and informal consent practices
are common, but increasing legal awareness is shifting emphasis toward formal
consent.

Samira Kohli v. Dr. Prabha Manchanda (2008) 2 SCC 1

A patient consented to diagnostic surgery but the doctor also performed a hysterectomy
without explicit consent.
Held: The Supreme Court held the doctor liable, ruling that every patient has the right to
autonomy and bodily integrity, and consent must be informed and specific.

Explain the concepts of Private Liability and Public Liability in healthcare with
reference to relevant laws and landmark cases.

Private Liability in Healthcare:

Private liability refers to the responsibility of private healthcare providers, such as individual
doctors or private hospitals, for any negligence or deficiency in the services they provide to
patients. When a private healthcare professional fails to exercise the standard duty of care
expected and causes harm to a patient, they can be held legally accountable.

 Legal Framework:
The primary law governing private liability in India is the Consumer Protection Act,
1986 (now updated to the Consumer Protection Act, 2019), under which patients are
treated as consumers and can seek compensation for medical negligence.

 Landmark Cases:
o Dr. Laxman Balkrishna Joshi vs. Dr. Trimbak Bapu Godbole (1969):
Established that doctors owe a duty of care and can be liable for negligence
under consumer law.
o Indian Medical Association vs. V.P. Shantha (1995): The Supreme
Court declared that medical services fall within the scope of the
Consumer
Protection Act, making private doctors and hospitals accountable for
negligence

Public Liability in Healthcare:

Public liability relates to the obligation of government hospitals and public health authorities
to provide adequate medical care to citizens. Since healthcare is a fundamental aspect of the
right to life, the State is constitutionally bound to ensure availability and accessibility of
medical services. Failure to do so may lead to liability under constitutional and public laws.

 Legal Framework:
The constitutional right to health is derived from Article 21 (Right to Life) of the
Indian Constitution. Additionally, the Public Liability Insurance Act, 1991 and
various Supreme Court rulings enforce State accountability in public healthcare.

 Landmark Cases:
o Paschim Banga Khet Mazdoor Samity vs. State of West Bengal (1996): The
Supreme Court held that the State must provide adequate healthcare
facilities, and failure to do so violates Article 21.
 o M.C. Mehta vs. Union of India (1986): Established the principle of absolute
liability of the State for hazardous activities, extending the duty to ensure
public health and safety.

Differences and Similarities

1. Nature of Obligation: Public healthcare providers have a constitutional and
statutory obligation to provide healthcare as a welfare function, while private
providers’
obligations are primarily contractual and tortious.
2. Resource Constraints: Public institutions often operate under resource and
infrastructural constraints, which courts may consider in assessing
liability.
3. Standard of Care: Both sectors are expected to maintain reasonable standards, but
private providers may be held to higher expectations given their commercial
nature.
4. Redressal Mechanisms: Both public and private providers are subject to consumer
forums; however, government hospitals may also face administrative
accountability.

Significance of Liability in Healthcare

 Ensures patient safety and promotes quality of care.
 Acts as a deterrent against medical negligence and malpractice.

 Encourages healthcare providers to follow ethical and professional standards.

 Enhances public trust in the healthcare system.

Explain in detail the application of the Consumer Protection Act in cases of medical
negligence.
Medical negligence occurs when a healthcare professional or institution fails to provide the
standard of care expected, causing harm or injury to the patient. The Consumer Protection
Act (CPA) provides a legal mechanism for patients to seek redress for such negligence by
classifying healthcare services as “services” under the Act and patients as “consumers.” This
has significantly enhanced patients’ rights and accountability of healthcare providers.
Impact of Consumer Protection Act on Medical Profession- The CPA has brought about
increased accountability in the medical profession by:
 Empowering patients to claim compensation for medical errors.
 Encouraging healthcare providers to maintain higher standards of care.
 Motivating hospitals and clinics to ensure better service delivery and
informed consent practices.

1. Healthcare Services as ‘Service’ under CPA

The landmark judgment in Indian Medical Association vs. V.P. Shantha & Ors. (1995) by
the Supreme Court was a turning point. The Court held that medical care provided by both
government and private hospitals, as well as doctors, comes within the ambit of “service”
under Section 2(1)(o) of the Consumer Protection Act, 1986. This means that medical
negligence is treated as “deficiency in service” under the Act.

2. Definition of Consumer in Medical Negligence Cases

According to the CPA, a “consumer” is any person who hires or avails any service for
consideration. Therefore:
 Patients who pay fees, either directly or through insurance, for medical services
are consumers.
 Even if treatment is partially paid or subsidized, the consumer status may still apply.

 However, free treatment or charity care without any consideration generally

falls outside the CPA jurisdiction.
3. Deficiency of Service in Medical Negligence
“Deficiency” means any fault, imperfection, shortcoming, or inadequacy in the quality,
nature, or manner of performance of services.
In medical negligence, deficiency may include:

 Surgical errors
 Wrong diagnosis or delayed diagnosis

 Prescribing wrong medication or dosage

 Failure to warn about risks or alternative treatments

 Refusal or delay in treatment

 Neglecting patient care or monitoring
 Unhygienic hospital conditions causing infections

4. Jurisdiction of Consumer Forums

 District Consumer Disputes Redressal Forum (District Forum) for claims up to
₹1 crore (earlier ₹20 lakh).
 State Consumer Disputes Redressal Commission (State Commission) for
claims above ₹1 crore and up to ₹10 crore (earlier ₹1 crore).

 National Consumer Disputes Redressal Commission (NCDRC) for claims above

₹10 crore (earlier ₹1 crore).
Patients can file complaints in these forums depending on the compensation amount sought.

5. Burden and Standard of Proof

 The patient (complainant) must prove that there was a deficiency or negligence on
the part of the medical professional or institution.
  Courts and consumer forums do not expect the patient to prove negligence with
the precision of a criminal trial.
 Medical expert opinions are generally relied upon to establish standard of care
and whether it was breached.
 If the healthcare provider fails to justify their actions as reasonable and
within accepted medical standards, liability is established.

6. Types of Relief Available

 Compensation for physical injury, pain and suffering, mental agony, loss of
wages, and medical expenses.
 Punitive damages in cases of gross negligence or willful misconduct.
 Refund of fees paid for deficient or incomplete services.

 Costs of litigation to cover legal expenses.

7. Exceptions and Limitations

 No compensation under CPA if the treatment is free and without any consideration.
 Complaints must be filed within two years from the date of cause of action.

 Consent obtained properly (informed consent) can limit liability.

 The CPA does not cover criminal liability for negligence, which may be dealt
with under other laws.

8. Landmark Cases on CPA and Medical Negligence

 Indian Medical Association v. V.P. Shantha (1995): Recognized medical
services under CPA and patient as consumer.
 Kunal Saha vs. AMRI Hospital (2013): The NCDRC awarded
significant compensation for death due to medical negligence, setting a
precedent on accountability.

Ayushman Bharat Scheme: A Comprehensive Overview

Introduction
Ayushman Bharat, launched on September 23, 2018, is a flagship healthcare initiative by the
Government of India aimed at providing accessible and affordable healthcare to the
country's underprivileged populations. It comprises two main components:([Link],
Karma AI)
 1. Pradhan Mantri Jan Arogya Yojana (PM-JAY): A health insurance scheme
offering coverage up to ₹5 lakh per family per year for secondary and tertiary
care hospitalization.([Link])
2. Health and Wellness Centres (HWCs): Aimed at delivering comprehensive
primary healthcare services, including maternal and child health, non-communicable
diseases, and mental health care.
Key Features
 Coverage: Targets over 10 crore poor and vulnerable families, approximately 50
crore individuals.
 Financial Protection: Provides cashless and paperless access to healthcare services
at empanelled public and private hospitals.
 Inclusive Eligibility: Covers families identified based on the Socio-Economic Caste
Census (SECC) 2011 data, including rural and urban households with specific
deprivation criteria.

 No Age Limit: All members of eligible families, including senior citizens, are
covered under the scheme.
Implementation and Impact
 Digital Integration: The Ayushman Bharat Digital Mission aims to create a digital
health ecosystem, linking patients and healthcare providers through real-time health
records. (Wikipedia)
 Infrastructure Expansion: The establishment of HWCs and Ayushman
Arogya Kendras (AAKs) has enhanced healthcare access, especially in rural
areas. (The Times of India)
 Healthcare Workforce Enhancement: Training programs for Accredited Social
Health Activists (ASHAs) and the recruitment of additional healthcare workers
have strengthened service delivery. (The Times of India)

Challenges
 Private Sector Participation: Some private hospitals express concerns over
package rates and reimbursement delays, affecting their participation in the scheme.
(The Times of India)
 Awareness and Accessibility: Efforts are ongoing to increase awareness and
ensure that eligible beneficiaries, especially in remote areas, are informed about the
scheme and can access its benefits.

Recent Developments
 Expansion of Coverage: As of May 2025, the scheme has been extended to
include all citizens above 70 years of age, irrespective of their economic status.
(Wikipedia)
  Special Campaigns: In Bihar, a special drive from May 26 to 28 aims to prepare
and distribute Ayushman cards at the panchayat level, enhancing accessibility for
rural populations. (The Times of India)

Conclusion
Ayushman Bharat stands as a transformative step towards achieving Universal Health Coverage
in India. By integrating digital health solutions, expanding infrastructure, and enhancing
healthcare access, the scheme aims to provide equitable healthcare to all,
particularly the underserved and vulnerable populations.
Certainly! Here's a detailed explanation of Dying Declaration from the medical sector
perspective, including legal provisions and important case laws:

Dying Declaration: Medical Perspective with Legal Provisions and Case Laws
A dying declaration is a statement made by a person who is in the last stage of life
(believing death is imminent) regarding the cause or circumstances of the injury or event that led
to their critical condition or impending death.
It is treated as a crucial piece of evidence in legal cases, especially in criminal trials involving
homicide or assault.

Conditions for a Valid Dying Declaration

1. The declarant must be alive at the time of making the statement but in a
condition where death is imminent or expected.
2. The statement must relate to the cause of death or the circumstances
surrounding it.
3. The declarant must have the mental capacity and consciousness to understand and
communicate.

4. It can be made to any person — police, doctors, relatives, or others.

5. The declaration must be voluntary, without any pressure, coercion, or inducement.

Nature of Evidence
 A dying declaration is substantive evidence; it can form the basis for conviction
even if there is no other corroborative evidence.
 However, courts prefer corroboration where possible, but conviction solely based on
a dying declaration is valid if it inspires confidence.

3. Legal Provisions Related to Dying Declarations

  Section 32(1) of the Indian Evidence Act, 1872. It states that statements made by
a person as to the cause of their death, or any circumstances connected with it, are
relevant if the person is dead, provided the statement relates to the cause or
circumstances of the death.

 Section 45 of the Indian Evidence Act, 1872

Expert opinion, such as from medical experts, is admissible regarding the nature of
injuries, cause of death, and assessment of mental capacity of the declarant at the time
of statement.

 Section 157 of the Criminal Procedure Code (CrPC)

Deals with the medical examination of a person who has sustained injuries and can be
related to collection of medico-legal evidence including dying declarations.

4. Important Judicial Precedents

 Kedarnath v. State of Bihar (1962 AIR 955, 1962 SCR (3) 769)
The Supreme Court held that the dying declaration must be made voluntarily and
must inspire confidence. It cannot be the sole basis for conviction unless it appears
reliable and trustworthy.
 Madan Gopal v. State of Punjab (1956 AIR 710)
The court ruled that the dying declaration is highly reliable because the person
making it is under the impression of impending death and unlikely to lie.

 Tukaram S. Dighole v. State of Maharashtra (2010 AIR SC 1907)

The Supreme Court emphasized that minor contradictions or discrepancies in the
dying declaration should not discredit the entire statement as long as the core facts are
consistent.

Importance of Dying Declaration in Medical Practice

 Provides critical information about the cause of injury or assault, which can help in
legal investigations and prosecutions.
 Helps in establishing the chain of events leading to the injury or death.
 Supports forensic and medico-legal documentation.
 Can assist in protecting healthcare providers by showing adherence to
legal protocols.

Criminal Negligence vs Tortious Negligence in Medical Context

1. Criminal Negligence
 Definition:
Criminal negligence refers to a situation where a healthcare provider’s conduct is so careless or
reckless that it shows a gross disregard for human life or safety, thereby constituting a
criminal offense. Unlike ordinary negligence, criminal negligence involves a higher degree of
fault and attracts penal consequences.

Legal Provisions:
 Indian Penal Code (IPC) Section 304A – Causing death by negligence:
This section penalizes causing death by a rash or negligent act not amounting to
culpable homicide. For example, a doctor’s gross negligence leading to patient death.
 IPC Sections 336, 337, 338 – Acts endangering life or personal
safety: These sections punish negligent acts that cause injury or
endanger life.

Key Characteristics:
 The negligence must be gross or reckless, not merely a simple error or oversight.

 It involves disregard for life or safety of the patient or public.

 The prosecution must prove the negligence beyond reasonable doubt.
 It is punishable with imprisonment, fine, or both.

 Intention to harm is not necessary, but the conduct must be so negligent as to

amount to criminal behavior.
Example in Medical Sector:
A surgeon operates under the influence of alcohol and causes fatal injury to a patient. Such
reckless conduct can be prosecuted as criminal negligence under IPC 304A.
Landmark Case:

 Dr. Laxman Balkrishna Joshi vs Dr. Trimbak Bapu Godbole (1969) AIR 128
The Supreme Court held that a doctor will not be held criminally liable for an
honest error of judgment but will be liable if the negligence is gross and reckless,
showing disregard for life or safety.

2. Tortious Negligence
Definition:
Tortious negligence is a civil wrong arising from a healthcare provider’s failure to exercise the
standard of care that a reasonably competent professional would provide, resulting in harm
or injury to a patient. It gives rise to a claim for compensation (damages) rather than
criminal punishment.

Legal Framework:
 The law of torts (common law principles) governs medical negligence as a tort.
  The claimant (patient) must prove:
o Duty of care owed by the healthcare provider.

o Breach of that duty by failing to meet the reasonable standard of care.

o Causation: The breach caused injury or damage.

o Damages: Actual harm or loss suffered by the patient.

Key Characteristics:
 The negligence involves a failure to take reasonable care.
 The fault is less severe than criminal negligence.

 The standard of proof is balance of probabilities (more likely than not).

 The remedy is monetary compensation or other civil remedies.

 It promotes accountability and quality in healthcare by allowing patients to

seek redress.
Example in Medical Sector:
A doctor prescribes the wrong medication due to careless diagnosis, leading to patient harm.
The patient can sue for compensation but the doctor is not criminally liable unless the negligence
was gross.

Landmark Case:
 Bolam vs Friern Hospital Management Committee (1957)
The "Bolam test" was established, stating that a doctor is not negligent if acting in
accordance with a practice accepted as proper by a responsible body of medical
opinion.

Differences Between Criminal and Tortious Negligence in Medical Practice

Aspect Criminal Negligence Tortious Negligence

Nature Crime punishable under IPC Civil wrong (tort)

Standard of ProofBeyond reasonable doubt Preponderance of probabilities

Degree of Gross negligence or reckless

Failure to exercise reasonable care
Negligence disregard for safety

Legal Consequences Compensation/damages to injured

Imprisonment, fine, or both
patient
Aspect Criminal Negligence Tortious Negligence

Operating while intoxicated Misdiagnosis or treatment error

Examples
causing death causing injury

Requirement of No intention, but conduct shows No intention; negligence based on

Intention reckless disregard lack of care

Duties of Doctors According to the Code of Medical Ethics

The Code of Medical Ethics is issued by the Medical Council of India (MCI) (now
replaced by the National Medical Commission (NMC)), and it lays down the professional,
ethical, and moral responsibilities that every doctor must follow. The Code is designed to
ensure good medical practice and protect patient rights.

1. Duty to the Patient

 Provide Competent Medical Care:

Doctors must provide professional, competent, and ethical care based on current
medical knowledge and skills.

 Respect Patient Autonomy:

Doctors should respect the patient’s right to make informed decisions about their
treatment and provide all relevant information to enable this.

 Confidentiality:
Maintain strict confidentiality of all patient information unless legally required to
disclose it.

 Informed Consent:
Obtain valid consent before any examination or treatment. Patients should be
informed about the nature, risks, benefits, and alternatives.

 Non-Discrimination:
Treat all patients equally without discrimination based on race, religion, caste, gender,
economic status, or social background.
 Avoid Exploitation:
Doctors must not exploit patients financially or emotionally.

2. Duty to Society
 Health Promotion:
Doctors should actively promote public health awareness and preventive medicine.
 Participate in National Health Programs:
Support and contribute to government health initiatives and emergency care.
  Uphold Medical Ethics:
Maintain the dignity and reputation of the medical profession.

3. Duty to Colleagues
 Respect Colleagues:
Maintain respectful and professional relationships with fellow doctors and healthcare
workers.
 Collaboration:
Cooperate with other professionals for the benefit of patients.

 Report Unethical Behavior:

Report unethical or unprofessional conduct by colleagues to the appropriate authority.

4. Duty to Maintain Professional Competence

 Continual Learning:
Doctors should continually update their medical knowledge and skills through
continuing medical education (CME).

 Avoid Malpractice:
Avoid negligent practices and maintain high standards of medical care.

5. Duty Regarding Fees and Financial Matters

 Reasonable Fees:
Charge fees that are fair, reasonable, and commensurate with the services rendered.

 No Overcharging or Kickbacks:
Avoid unethical financial practices like overcharging, unnecessary tests for profit, or
accepting commissions for referrals.

6. Duty in Emergencies

 Provide Immediate Care:

Doctors should provide urgent medical assistance regardless of the patient’s ability to
pay or other considerations.

 No Refusal in Emergencies:
It is unethical to refuse emergency treatment for any patient.

Relevant Legal and Ethical Framework

  The Indian Medical Council (Professional Conduct, Etiquette and Ethics)
Regulations, 2002 (as amended) lays out these duties.

 Doctors must adhere to Fundamental Principles of Medical Ethics — beneficence,

non-maleficence, autonomy, and justice.

Meaning of Epidemic
An epidemic refers to the sudden and rapid increase in the number of cases of a
particular disease in a specific geographic area or population, beyond what is normally
expected.
 It involves more cases than usual occurring in a community or region during
a particular period.
 Epidemics can be caused by infectious agents such as bacteria, viruses, or other
pathogens.
Example: The outbreak of the Ebola virus in West Africa (2014-2016) was an epidemic.

Indian Health Law-

The management of epidemics in India is governed principally by the Epidemic Diseases
Act, 1897, which empowers the government to take extraordinary measures during an
epidemic. This colonial-era law, despite its age, remains a cornerstone for legal
interventions to prevent the spread of infectious diseases.
 Impact: Epidemics can cause significant harm, including
o Health Impacts: Illness, death, and long-term health consequences.

o Social Impacts: Fear, stigma, and disruption of daily life.

o Economic Impacts: Loss of productivity, healthcare costs, and disruptions to
trade .
 Examples: Historical examples include the Black Death, the 1918 Spanish Flu,
and more recent events like COVID-19.

Significance of Epidemic
1. Public Health Impact
Epidemics pose serious health risks and can overwhelm healthcare systems, leading
to high morbidity (illness) and mortality (death) rates. Epidemics necessitate public
health interventions like vaccination campaigns, quarantine, and isolation to control
the spread
 2. Early Detection and Control
Recognizing an epidemic early allows for timely public health interventions like
quarantine, vaccination drives, and treatment protocols to control the spread.

3. Resource Allocation
Understanding an epidemic helps governments and health authorities allocate medical
resources, personnel, and funding effectively.
4. Policy and Preparedness
Epidemics highlight weaknesses in public health infrastructure, prompting the
development of better disease surveillance and emergency preparedness plans.
5. Economic and Social Impact
Epidemics can disrupt social life, economies, trade, and education, making control
measures crucial to minimizing these effects.

6. Scientific Research: Epidemics drive research into disease mechanisms,

transmission pathways, and the development of new treatments.
Judicial Recognition and Enforcement-
Courts have recognized the Epidemic Diseases Act as a necessary legal instrument in
protecting public health. For instance, during the COVID-19 pandemic, the Indian
government invoked this Act to impose lockdowns, quarantine measures, and mandatory use
of masks.
In Common Cause v. Union of India (2020) SCC Online SC 951, the Supreme Court
acknowledged the legitimacy of restrictions under the Act, balancing public health interests
with fundamental rights such as freedom of movement (Article 19).
Surrogate Motherhood and ART: Concept and Legal Provisions in India
Surrogacy:

Surrogacy is a method of assisted reproduction where a woman (the surrogate mother) agrees to carry
and deliver a child for another person or couple (intended parents). It is typically used when
pregnancy is medically impossible or risky for the intended mother.

Assisted Reproductive Technology (ART):

ART refers to all fertility treatments where both eggs and sperm are handled outside the body. This
includes:

 In-vitro fertilization (IVF)

 Intrauterine insemination (IUI)

 Cryopreservation of gametes or embryos

 Donor sperm/egg use

 Surrogacy

2. Legal Provisions in India

India has introduced two major laws to regulate surrogacy and ART services:

A. Surrogacy (Regulation) Act,

2021 Key Provisions:

 Altruistic Surrogacy Only: Commercial surrogacy is banned. Only altruistic surrogacy

(no monetary compensation except for medical expenses) is allowed.

 Eligibility of Intended Parents:

o Must be a legally married Indian heterosexual couple.

o Woman aged 23–50 and man aged 26–55.

o Must be infertile and childless.

 Eligibility of Surrogate Mother:

o A close relative of the couple.

o Married and has at least one biological child.

o Aged between 25 and 35 years.

o Can be a surrogate only once in her lifetime.

 National and State Surrogacy Boards: These are created to regulate and oversee
surrogacy clinics and services.

Offences and Penalties:

  Commercial surrogacy is punishable with imprisonment up to 10 years and a fine up to
₹10 lakh.

 Advertising or offering surrogacy services for commercial gain is also punishable.

B. Assisted Reproductive Technology (Regulation) Act,

2021 Key Provisions:

 ART Clinics and Banks Must Register: Clinics and sperm/egg banks must be
registered with the National Registry.

 Consent and Counseling: Informed written consent must be obtained from all
parties, including donors and intended parents.

 Gamete Donation Restrictions:

o A male donor can donate sperm only once.

o A female donor can donate oocytes only once in her lifetime and not more than
7 oocytes in one cycle.

 Prohibition of Sale/Trade of Embryos: Sale, transfer, or marketing of embryos/gametes

is prohibited.

 Confidentiality: Identity of donors and recipients must be kept confidential, except

in medical/legal necessity.

Penalties:

 Contravention of ART laws can lead to imprisonment up to 10 years and/or fines up to

₹25 lakh.

3. Legal Issues and Concerns

1. Commercial vs. Altruistic Surrogacy India allowed commercial surrogacy until 2015,
making it lucrative but also controversial due to exploitation risks. The surrogate mothers,
often from economically weaker sections, faced issues of coercion, inadequate medical
care, and social stigma. Recognizing this, the Indian government banned commercial
surrogacy through the Surrogacy (Regulation) Act, 2021, permitting only altruistic
surrogacy for Indian couples, thereby outlawing surrogacy for foreign nationals and single
individuals.

2. Parentage and Custody Establishing legal parentage of the child born through surrogacy is
complex. Indian laws initially lacked clarity on who the legal parents were—the surrogate
or the commissioning couple. The Surrogacy (Regulation) Act, 2021now declares the
intending couple as the legal parents from birth, addressing parentage and custody issues. The
Act also prohibits commercial contracts, mandating registration of surrogacy agreements to
protect surrogate mothers and commissioning parents.
3. Consent and Autonomy of Surrogate Mothers Ensuring the surrogate mother's informed
consent is a critical legal and ethical concern. There have been instances where women
were
 compelled or deceived into surrogacy. The Act prescribes strict consent requirements and
welfare provisions for surrogate mothers, including medical expenses and insurance coverage
during and after pregnancy.

4. Exploitation and Human Rights Concerns Exploitation remains a major concern in

surrogacy. Reports of inadequate compensation, poor living conditions, and lack of
legal safeguards propelled legal reforms.

5. LGBTQ+ and Single Individuals Exclusion:

 Both laws restrict ART and surrogacy access to married heterosexual couples, excluding:

o LGBTQ+ individuals

o Single men and women (except widowed/divorced women for surrogacy)

o Live-in partners

International Legal Landscape

 United States: Varies by state; commercial surrogacy is legal in many states.

 UK: Only altruistic surrogacy allowed; legal parentage must be transferred post-birth.

 Russia/Ukraine/Georgia: Commercial surrogacy legal and regulated.

 France/Germany/Italy: Surrogacy (both commercial and altruistic) is banned.

4. Judicial Precedents and Observations

a. Baby Manji Yamada v. Union of India (2008)

 Facts: A Japanese couple commissioned a surrogacy in India but separated before the
child was born. The grandmother sought custody.

 Held: The Supreme Court allowed the child to leave India, emphasizing the need for
legal regulation of surrogacy.

 Impact: It was a significant case that accelerated the debate on regulating surrogacy in India.

b. Jan Balaz v. Anand Municipality (2009)

 Facts: A German couple had twins via Indian surrogate, but citizenship and passport
issues arose.

 Held: Gujarat High Court granted Indian passports, but the case highlighted legal
ambiguities regarding parentage and citizenship.

 Impact: Reinforced the demand for comprehensive legislation.

Conclusion
Surrogacy and ART are transformative medical technologies offering hope to infertile couples, but
they raise complex legal, ethical, and social questions. The Surrogacy (Regulation) Act, 2021
and the ART (Regulation) Act, 2021 aim to address these challenges through strict regulations,
but
concerns remain about inclusivity, autonomy, and reproductive rights.

TRIPS and its Impact on Public Health Law

Introduction- The Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS),
administered by the World Trade Organization (WTO), sets global minimum standards for intellectual
property (IP) protection, including patents on pharmaceuticals. Since its enforcement in 1995, TRIPS
has had a profound influence on public health law worldwide, including in India. The challenge has
been to reconcile patent protections with the urgent need for affordable access to medicines, a vital
public health concern. India’s legal and policy framework reflects this balance, shaped by TRIPS
flexibilities, judicial pronouncements, and legislative reforms.

TRIPS and Pharmaceutical Patents- TRIPS requires member countries to grant patent protection
for pharmaceutical products for at least 20 years. This was a significant shift for India, which prior to
2005 only recognized process patents for drugs, allowing generic manufacturers to produce
affordable medicines through alternative processes. Post-TRIPS compliance necessitated amending
India’s Patent Act, 1970, culminating in the Patents (Amendment) Act, 2005, which introduced
product
patents in pharmaceuticals. This shift raised concerns about access to essential medicines, especially
for the economically disadvantaged, as patent monopolies could potentially lead to higher drug prices
and restrict availability.

Public Health Safeguards in Indian Law: TRIPS Flexibilities- India has utilized the flexibilities
provided under TRIPS to protect public health interests. Notably, Section 3(d) of

the Indian Patent Act restricts patents for new forms of known substances unless they significantly
enhance efficacy. This provision prevents 'evergreening', a practice where minor modifications extend
patent monopolies without therapeutic benefits. The Supreme Court’s decision in Novartis AG v.
Union of India (2013) 6 SCC 1 upheld this safeguard, denying a patent for the cancer drug Glivec.
The ruling was hailed as a landmark in preserving affordable access to medicines and reaffirmed
India’s commitment to public health under TRIPS.

Compulsory Licensing and Access to Medicines- One of the most important TRIPS flexibilities is
the provision for compulsory licensing (CL), allowing a government to authorize generic production
of patented drugs in the public interest without the patent holder's consent. India’s Patent Act
incorporates this mechanism under Section 84.

The issuance of India’s first compulsory license in Natco Pharma Ltd. v. Bayer Corporation
(2013) 5 SCC 705 for the cancer drug Nexavar was a watershed moment. The government granted
the license on grounds of affordability and unmet public need, allowing Natco to produce a cheaper
generic version. This action demonstrated how TRIPS flexibilities empower India to address public
health challenges while respecting international obligations.

Impact on Public Health Law and Policy- TRIPS has influenced the formulation of India’s public
health policies, reinforcing the need to balance patent protection with affordable healthcare. The
government and judiciary have recognized the primacy of health over commercial interests, aligning
with the World Health Organization’s emphasis on access to medicines as a human right.
India has also been proactive in negotiating at WTO forums to safeguard these flexibilities and resist
pressures for stricter IP norms that could undermine public health. The Doha Declaration on TRIPS
and Public Health (2001), which India supported, explicitly affirmed the right of WTO members to
protect public health and promote access to medicines.

Challenges and Ongoing Debates- Despite these advances, challenges remain. Multinational
pharmaceutical companies and some developed countries continue to push for "TRIPS-plus"
provisions through bilateral and regional trade agreements, which could limit India’s ability to use
public health safeguards effectively. Additionally, the global COVID-19 pandemic has reignited
debates on patent waivers for vaccines and therapeutics. India, alongside South Africa, has
spearheaded efforts at the WTO to temporarily waive certain TRIPS provisions to enhance vaccine
access for developing countries, underscoring the continuing tension between IP rights and public
health imperatives.

Positive Impacts of TRIPS on Public Health:

1. Encourages Innovation:

o Provides patent protection for pharmaceutical inventions, encouraging investment

in drug research and development.

o Incentivizes companies to develop life-saving medicines and vaccines.

2. Global Standardization of IP Laws:

o Harmonizes intellectual property rules across WTO member states.

o Creates a stable legal framework for cross-border pharmaceutical trade and

investment.

3. Allows Public Health Safeguards:

o Permits tools like compulsory licensing and parallel imports in public health
emergencies.

o The Doha Declaration (2001) reaffirmed member countries' right to protect

public health.

Negative Impacts of TRIPS on Public Health:

1. Delayed Access to Generic Medicines:

o 20-year patent protection delays the entry of cheaper generics into the market.

o Affects availability of essential drugs in low-income countries.

2. Increased Drug Prices:

o Patent holders can monopolize pricing, making medicines unaffordable to the poor.

o Leads to healthcare inequality and lack of treatment access.

3. Pressure on Developing Countries:

 o Developing nations face diplomatic and economic pressure to implement strict
IP laws.

o Often discouraged from using TRIPS flexibilities due to fear of trade retaliation.

Termination of Pregnancy and Legal Provisions in India

Termination of pregnancy, commonly referred to as abortion, is the medical or surgical process of
ending a pregnancy before the fetus can survive independently. In India, the termination of
pregnancy is primarily governed by the Medical Termination of Pregnancy Act, 1971, which was
substantially amended by the Medical Termination of Pregnancy (Amendment) Act, 2021 to
make the law more progressive and inclusive.

Legal Framework Governing Termination of Pregnancy

1. Medical Termination of Pregnancy Act, 1971

The MTP Act was enacted to provide legal access to safe abortion and reduce unsafe and illegal
abortions. The MTP (Amendment) Act, 2021, brought significant changes to align the law with
medical advancements and women's reproductive rights.

Section 3 – When Pregnancies May Be Terminated

 Up to 20 Weeks of Gestation:

o Pregnancy may be terminated by a registered medical practitioner if it is

believed in good faith that:

 Continuation of the pregnancy would pose a risk to the life or

physical/mental health of the pregnant woman, or

 There is a substantial risk that the child would be born with serious physical
or mental abnormalities.

o Only one doctor's opinion is required.

 20 to 24 Weeks of Gestation:

o Allowed only for certain categories of women, such as:

 Survivors of rape or incest

 Minors

 Women with change in marital status (e.g., widowhood or divorce

during pregnancy)

o Requires the opinion of two registered medical practitioners.

 Beyond 24 Weeks:
 o Termination is allowed only in cases of substantial fetal abnormalities, as
diagnosed by a Medical Board constituted by the state government (comprising a
gynecologist, radiologist, pediatrician, and other specialists).

o Also permissible if there is a risk to the life of the pregnant woman.

Section 4 – Place Where Pregnancy May Be Terminated

 Termination can only be performed at:

o A government hospital or

o A place approved by the government or a district-level authority.

Section 5 – Emergency Situations

 The 20 or 24-week time limit is not applicable if a registered medical practitioner is of the
opinion that the abortion is immediately necessary to save the life of the pregnant
woman.

Section 3B – Categories of Women Eligible for Termination Between 20–24 Weeks (Inserted by
2021 Amendment)

These include:

 Survivors of sexual assault or rape

 Incest victims

 Minors

 Women with physical disabilities

 Women with mental illness

 Women undergoing change in marital status (widowhood/divorce)

Consent Requirements

 Adult woman (18+ years): Her own written consent is sufficient.

 Minor or mentally ill woman: Consent of a guardian is required.

 Consent of the husband or partner is not legally required.

Related Provisions under the Indian Penal Code, 1860:

 Section 312 IPC: Causing miscarriage is a criminal offence unless it is done in good faith
to save the woman’s life.
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  Section 313 IPC: Causing miscarriage without the consent of the woman is punishable
even if it is done to save her life.

 Section 314 IPC: If the woman dies due to miscarriage caused without proper procedure, it
is punishable with imprisonment up to 10 years.

 Section 315 IPC: Any act with intent to prevent a child from being born alive or to cause
its death before birth is also punishable.

Important Case Laws:

1. Suchita Srivastava v. Chandigarh Administration (2009)

 The Supreme Court held that a woman's right to make reproductive choices is part of Article
21 of the Constitution (Right to Life and Personal Liberty).

 Emphasized the right to privacy, dignity, and bodily autonomy.

2. X v. Union of India (2016)

 Allowed termination of pregnancy beyond 20 weeks due to detection of fetal abnormalities.

 Set precedent for the judiciary to intervene in exceptional cases where continuation
of pregnancy could cause mental or physical trauma.

3. ABC v. Union of India (2020)

 Court considered the psychological impact on a woman forced to carry an

unwanted pregnancy.

 Reiterated that reproductive autonomy is a fundamental right.

Significance of the MTP Act:

 Ensures safe and legal abortions, thereby reducing maternal mortality and morbidity due
to unsafe procedures.

 Protects the reproductive rights of women and recognizes their autonomy and mental
health as valid grounds.

 Offers flexibility in cases involving rape, incest, and fetal abnormalities.

 Aligns with international standards on reproductive health rights.

Constitutional and Ethical Dimensions-

The termination of pregnancy implicates fundamental rights:

• Right to Life and Personal Liberty (Article 21): Courts interpret this to include
bodily autonomy and reproductive choice, allowing a woman to decide on abortion within legal
limits.

• Right to Privacy: The decision to terminate a pregnancy is protected under privacy

rights, emphasizing informed consent and confidentiality.
• Right to Equality (Article 14): Women’s reproductive rights are a dimension of
equality, empowering them to make autonomous health decisions.

The MTP Act strikes a balance between safeguarding women’s health and protecting fetal life,
incorporating medical, ethical, and social considerations.

Public Health and Social Impact- Legal provisions for termination of pregnancy aim to prevent
unsafe abortions, a major cause of maternal mortality and morbidity in India. By regulating the
conditions under which abortion is lawful, the Act encourages safe medical procedures and reduces
the stigma associated with abortion. Access to legal abortion services remains a challenge in rural
areas due to inadequate facilities, lack of awareness, and social taboos, highlighting the need for
robust implementation and public health outreach.

Amendments and Recent Developments 2021

 The gestation limit for termination was extended to 24 weeks for special categories of
women, including survivors of rape, incest, minors, women with disabilities, and those
in humanitarian crises.
 For pregnancies up to 20 weeks, the opinion of one medical practitioner is sufficient; for
pregnancies between 20 and 24 weeks, the opinion of two medical practitioners is
required.
 Pregnancies beyond 24 weeks may be terminated only if the pregnancy is diagnosed
with fatal fetal abnormalities, as certified by a medical board.
 The amendment also introduced provisions to maintain confidentiality and prohibits
the requirement of the woman’s consent for abortion in the case of minors if the
guardian consents.

Evolution and Scope of the Right to Health as a Fundamental Right under

the Indian Constitution
The Right to Health is not explicitly mentioned in the Constitution of India as a fundamental right.
However, through judicial interpretations and progressive jurisprudence, it has been recognized as an
inherent part of Article 21 – the Right to Life and Personal Liberty. The Supreme Court and various
High Courts have expanded the ambit of Article 21 to include a dignified life, which includes access
to healthcare.

Constitutional Provisions Related to the Right to Health in India

Although the Right to Health is not explicitly mentioned as a fundamental right in the Indian
Constitution, various provisions under the Constitution indirectly guarantee and promote the right to
health and healthcare.

1. Right to Life under Article 21

 Article 21 states: “No person shall be deprived of his life or personal liberty except
according to procedure established by law.”
  The Supreme Court has interpreted the right to life to include the right to live with
human dignity, which encompasses the right to health and medical care.

2. Directive Principles of State Policy (DPSP) - Part IV

 The DPSPs, though not enforceable by courts, guide the government to make
policies ensuring citizens' welfare, including health.

 Article 39(e) and (f): The state shall direct its policy to secure the health and strength
of workers and children.

 Article 41: The state shall, within its economic capacity, make provisions for
public assistance in cases of sickness and disablement.

 Article 42: The state shall make provisions for securing just and humane conditions of
work and for maternity relief.

 Article 47: This is particularly significant — it states: “The State shall regard the raising
of the level of nutrition and the standard of living of its people and the improvement of
public health as among its primary duties.”

Judicial Recognition of Right to Health

1. Bandhua Mukti Morcha v. Union of India (1984)

The Supreme Court held that the right to live with human dignity includes protection of the health and
strength of workers and access to medical care.

2. Consumer Education and Research Centre v. Union of India (1995)

The Court explicitly held that the right to health and medical care is a fundamental right under
Article 21, especially for workers.

3. Paschim Banga Khet Mazdoor Samity v. State of West Bengal (1996)

The Supreme Court ruled that the failure of a government hospital to provide timely medical
treatment to a person in need violates Article 21.

4. State of Punjab v. Mohinder Singh Chawla (1997)

Reaffirmed that the right to health is integral to Article 21 and that the government has a
constitutional obligation to provide health facilities.

Current Scope of the Right to Health

Based on judicial precedents, the right to health encompasses:

 Access to timely, affordable, and quality health care.

 Right to emergency medical treatment.

 Right to safe drinking water and proper sanitation.

 Right to maternal and reproductive health.

 Occupational health and safety.

  Right to health education and preventive care.

 Environmental conditions that do not jeopardize health.

International References Supporting the Right to Health

India’s interpretation and recognition of the right to health as a fundamental right have been
significantly influenced by international commitments and legal instruments. These frameworks
establish health as a basic human right and guide national policies.

1. Universal Declaration of Human Rights (UDHR), 1948

 Article 25 of the UDHR recognizes the right of every individual to a standard of living
adequate for their health and well-being, including food, clothing, housing, and
medical care.

 Although the UDHR is not legally binding, it serves as the foundation for many
binding treaties and reflects global consensus on basic human rights.

2. International Covenant on Economic, Social and Cultural Rights (ICESCR), 1966

 Article 12 explicitly states that every individual has the right to the highest
attainable standard of physical and mental health.

 It obligates signatory nations, including India, to take steps for the prevention, treatment,
and control of diseases, and to create conditions for access to medical care for all.

 While enforcement is progressive and based on available resources, it provides a legal

and moral framework for health policy.

3. Constitution of the World Health Organization (WHO), 1946

 Declares that "the enjoyment of the highest attainable standard of health is one of
the fundamental rights of every human being."

 This forms the ideological basis of global health rights and influences member
countries’ public health policies.

4. Sustainable Development Goals (SDGs), 2015

 Goal 3: "Ensure healthy lives and promote well-being for all at all ages."

 This includes targets like reducing maternal and child mortality, combating epidemics,
achieving universal health coverage, and ensuring access to essential medicines and vaccines.

National Health Programs and Schemes Supporting the Right to Health

 National Health Mission (NHM)

 Ayushman Bharat – PMJAY

 National Mental Health Programme

 Janani Suraksha Yojana

 Universal Immunisation Programme

Medical Duties and Role in Regulating the Conduct of Medical Profession
Doctors hold a unique and critical position in society due to their responsibility for human health and
life. Their duties are both ethical and legal and are crucial for maintaining trust in the medical
profession. Key medical duties include:

 Duty of Care: Doctors are obligated to provide a reasonable standard of care to their
patients, which means acting with competence, diligence, and skill. Failure to do so may
result in
negligence claims.

 Duty to Obtain Consent: Doctors must obtain informed consent from patients before
any examination, investigation, or treatment, respecting patient autonomy and rights.

 Duty to Maintain Confidentiality: Patient information must be kept confidential, except

in situations where disclosure is legally required or necessary to prevent harm to others.

 Duty to Provide Emergency Care: Medical professionals have an ethical and often legal
obligation to provide urgent care in emergencies, regardless of the patient’s background
or ability to pay.

 Duty to Keep Updated: Doctors must continually update their knowledge and skills
to provide the best care based on current medical standards.

 Duty to Avoid Conflicts of Interest: Physicians should avoid situations where

personal interests conflict with patient care.

 Duty to Respect Patients: Doctors must respect patients' dignity, rights, and cultural beliefs.

2. Role in Regulating the Medical Profession

The medical profession is self-regulated to a large extent, with oversight by statutory bodies, ethical
codes, and legal frameworks to ensure accountability, quality of care, and professional integrity.

 Medical Council of India (MCI) / National Medical Commission (NMC):

o These are statutory bodies responsible for regulating medical education and practice
in India.

o They maintain the register of qualified medical practitioners, grant recognition

to medical qualifications, and set standards for medical education.

o They enforce professional conduct codes and investigate complaints of professional

misconduct.

o They can impose penalties such as suspension or removal from the medical register
in cases of unethical behavior or malpractice.

 Code of Medical Ethics:

o Issued by regulatory bodies like MCI (now NMC), this code outlines the
ethical duties and conduct expected from doctors.
 o It covers aspects like patient care, confidentiality, advertising
restrictions, relationships with colleagues, and avoiding exploitation.

 Legal Oversight:

o Doctors must comply with laws such as the Consumer Protection Act, Indian
Penal Code (IPC) (sections related to medical negligence and criminal negligence),
and
other relevant statutes.

o Courts can hold medical practitioners liable for negligence, breach of duty,
or malpractice.

 Professional Accountability:

o Doctors are accountable not only to patients but also to the profession and society.

o They must maintain professional integrity and avoid malpractice, quackery,

or unethical behavior.

 Role in Public Health:

o Doctors play a vital role in disease prevention, health education, and implementing
government health policies.

o They are responsible for reporting certain diseases to authorities and participating
in vaccination and epidemic control efforts.

3. Importance of Medical Ethics and Regulation

 Protects Patients: Ensures patients receive safe, competent, and ethical care.

 Maintains Trust: Builds trust between patients and doctors essential for effective treatment.

 Ensures Professionalism: Upholds standards of practice and deters unethical conduct.

 Promotes Continuous Improvement: Encourages doctors to keep updated and

improve skills.

 Safeguards Public Health: Doctors’ compliance with public health regulations is critical
for community well-being.