As part of their practice, doctors are required to abide by ethical and legal obligations and ensure that they uphold the laws of the country. Doctors performing their duties will at some point come across a case that can be termed as a ‘Medicolegal Case’ or an MLC. An MLC is a case of injury/illness that needs to be investigated by legal entities to set the responsibility regarding the causation of the particular injury/illness. All doctors must keep in mind that their knowledge of medico-legal cases is essential to the enforcement of law and justice of the land.
Doctors can consider the following cases as medicolegal: (1) all cases of injuries and burns – the circumstances of which suggest commission of an offense by somebody (irrespective of suspicion of foul play); (2) all vehicular, factory, or other unnatural accident cases specially when there is a likelihood of patient’s death or grievous hurt; (3) cases of suspected or evident sexual assault; (4) cases of suspected or evident criminal abortion; (5) cases of unconsciousness where its cause is not natural or not clear; (6) all cases of suspected or evident poisoning or intoxication; (7) cases referred from court or otherwise for age estimation; (8) cases brought dead with improper history creating suspicion of an offense; (9) cases of suspected self-infliction of injuries or attempted suicide; (10) any other case not falling under the above categories but has legal implications.
Current Scenario of MLCs
Currently, doctors are apprehensive about taking on MLCs as they feel they might be sued and risk their reputation in the field. Doctors shy away from these cases as they think MLCs come with a lot of disputes, rough police staff, inordinate hours in the court, unsparing defense counsels, etc. However, if equipped with the right knowledge, doctors can assist the legal system to carry out the legal procedures. Due to concerns that their reputation might be at stake, many doctors do not share their concerns regarding medico-legal cases.
Challenges in India Vis-a-Vis MLCs
In India, there is limited medico-legal and forensic expertise and legal experts that can fight these cases. Healthcare entities also lack basic infrastructure to handle medico-legal issues. To add to it, the number of medico-legal cases have risen in recent years. Those being sued include gynecologists, surgeons, orthopedics and dermatologists among others for negligence or even harassment. Doctors and healthcare entities must take cognizance of this aspect, as cases are being promptly reported and courts are swiftly dealing with them.
Doctors are now answerable to patients as they may be sued for negligence and have to appear in courts. However, they must not avoid going to the courts, as appearing for a case can actually help them make their practices safer for patients. They will also gain knowledge on how to deal with an MLC, how to communicate with patients and why they must maintain documents for every case. Qualified experts can help doctors understand the documentation procedures and follow medical ethics.
The number of MLCs has seen a marked increase, as patients are growing more aware of treatments and diagnosis due to online resources. Medical personnel must take extra precautions to prevent cases of medical negligence. For instance, a hospital had to cough up Rs 11.5 crore penalty in a recent case of medical negligence, the highest compensation ever granted in the history of India. The 15-year-long case was fought by a US-based doctor Kunal Saha. He was granted the 11.5 crore compensation that had caused his 36-year-old wife Anuradha’s demise. Structured documentation, compliances, certification, and awareness about MLCs can address most of these concerns. Legal services that specialise in MLCs can educate and train doctors to prevent them, and handle them in a nuanced manner.