Book Review| Patients' Rights in India by Dr Mohamed Khader Meeran

Past few years, there have been increasing incidents of assault on doctors without adequate condemnation from civil society or effective intervention by Police. There were jury awards of heavy compensation to the patients on avoidable medical negligence. Very often the clarifications provided by the treating doctor about the dilemma in diagnosis and uncertainty of prediction of successful outcome or accurate prognosis are not heard sympathetically by the panel of judges in the Civil court or Consumer Grievance Redressal Forum. Public image of medical profession has been brought down from the high pedestal of Demi God. There was a time when you are wheeled into an Emergency Room of a hospital in pain, suffering and distress the doctor was seen as your only saviour and healer. Pervading mood is that of Trust and absolute submission. Physician receives patient as a valued customer, reciprocates the sentiments- "I am the one who can help you now". What is the problem? What tests to be carried out? What procedures to be done? What medications to be given? Only the doctor knows. The doctor understands the helplessness of the customer and the sanctity of the judgement or decision taken on behalf of the client. It is this trust that is apparently betrayed in an asymmetry of power scenario. Once upon a time doctors practiced "Clinical Medicine" where in a doctor took reasonable guess in diagnosis and case management. Then came a transition to a more scientific, fully investigation oriented "Evidence based medicine". Even worse, the "Evidence based Medicine" is now giving way to "Defensive Medicine" by ordering all sorts of investigations and procedures only to safe guard doctors and hospitals under Consumer Protection Act and from litigations on medical negligence. Signing "Informed Consent form" became more important than supplication in absolute trust. People on the other hand sees medical practice as a skilled labor rather than as a means of service. "Potential to err" is getting increasingly realised by doctors and patients and the "aura of infallibility" is crumbling. Under this background we need some bridging between both the doctors and patients. The bridge is better communication with the aid of tools for better understanding. Both the doctors and patients need to be educated. This small simple book of 192 pages, with easy-to-understand language and case illustrations, and legal references is a must for every doctor at the start of their professional career, during the internship period. It can be a life long guide like your formulary for prescription of medicines. Every student nurse when they start clinical posting must read it and practice it. Every hospital administrator must have a copy for reference and as a tool for organising orientation of newly recruited hospital staff from the Executive to Paramedical and Ministerial staff. Honouring and safe guarding Patient's rights is the responsibility of entire staff of the hospital and not just the doctors and Nurses. For patients, it guides them on their duties and entitlements and the scope of genuine grievances. It can prevent undue demands and frivolous litigations. This book that way would be useful to patient's rights activists, practicing lawyers and law students to understand various laws formulated to protect rights of patients and decide whether there is a strong case. It can even sensitize the judiciary to be sympathetic to a hurt patient and add the flavour of judicial activism in their judgements. There are 21 chapters on different rights of patients like treatment in emergency, timely referral, quality, impartiality, confidentiality, full information, freedom to choose, second opinion, discharge summary, transparent billing, grievance redressal, etc. The book also describes various health insurances for the poor and gives contact information of National and State level grievance redressal forums in addition to various formats and application forms relevant for ensuring Patient rights. It also documents briefly the history of Patient Rights movement in India. Patient's Rights and its enforcement should not be seen as a threat to medical profession. Instead, its recognition is edifying to both. This book enables that understanding and mutual respect. Dr Meeran and his team of young doctors dedicated to the marginalised communities deserves encouragement and support from the entire medical fraternity.

Book Review| Patients' Rights in India by Dr Mohamed Khader Meeran

Dr. K.R. Antony

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