Consumer Protection Act and Medical Profession Chapter Notes | Forensic Medicine and Toxicology (FMT) - NEET PG PDF Download

Introduction

Humans are social and rational beings. Throughout history, we have always tried to improve our thoughts, inventions, and discoveries. This process of thinking helps us reflect on ourselves and connect with others. Interaction is crucial for survival and progress. It reflects the vitality of civilization, where more freedom and fairness lead to greater advancement. Education, trade, governance, research, and international relations are all forms of human interaction. One important interaction, often overlooked in today’s commercialized world, is between the seller and buyer, the giver and receiver, the skilled individual and those benefiting from their skills—the trader and consumer. For instance, is the relationship between a doctor and a patient unique, or is it similar to any other commercial transaction?

The Consumer Protection Act, also known as COPRA or CPA, was established in December 1986. In April 1992, the National Commission ruled that medical services fall under COPRA. Justice Bal Krishna Erade confirmed this inclusion. On November 13, 1995, the Supreme Court upheld this decision, stating that patients (consumers) can file complaints regarding poor service if they have paid for it. In this context, a defective doctor’s service refers to negligence. A deficiency indicates a fault or inadequacy in the quality or manner of medical services provided by a hospital or medical professional. The Act has undergone several amendments, which are part of the Consumer Protection (Amendment) Act, 1993.

Key Points

• Humans are social and rational by nature.
• There is a constant effort to improve thoughts and inventions.
• Interaction is essential for survival and progress.
• Education and trade are crucial forms of human interaction.
• The relationship between traders and consumers is fundamental.
• COPRA, established in December 1986, safeguards consumer rights.
• Medical services are protected under COPRA, as confirmed by the Supreme Court.
• Patients have the right to file complaints for negligent services.
• Deficiency in service refers to shortcomings in the quality or performance of medical services.
• Amendments to the Act were made in 1993.

Objective of the Act

• The Act aims to enhance the protection of consumers by establishing a framework for addressing their grievances more effectively.
• It sets up consumer councils and other authorities responsible for resolving disputes between consumers and businesses.
• Consumers can submit their complaints to a designated redressal forum, which offers a quicker and more cost-effective solution compared to the traditional legal process. This is particularly beneficial for disadvantaged consumers who may find legal proceedings lengthy and expensive.
• Understanding the various provisions of the Act is essential to appreciate its significance and to invoke it effectively when necessary.

Application of the Act

The Act is applicable to all goods and services unless the Central Government specifies otherwise through a notification.

Who is a Consumer?

A consumer is defined as an individual who purchases goods or hires services for payment, whether the payment is made in full or partially promised. This definition also extends to individuals who use those goods with the permission of the original buyer. However, if goods are purchased for resale or commercial purposes, the buyer does not qualify as a consumer and is not entitled to protection under this Act. Similarly, individuals who hire services are considered consumers, including any beneficiaries of those services, as long as they have the approval of the original consumer. Therefore, users of goods or beneficiaries of services have the legal right to take action under the Act.

On February 17, 1994, the Madras High Court, in the case of Dr. CJ Subramania vs. Kumaraswamy, interpreted the Act concerning medical practitioners:

• The services provided to a patient by a medical practitioner or hospital for diagnosis and treatment (both medical and surgical) do not fall under the definition of ‘service’ as per Section 2(1)(d) of COPRA, 1986.
• A patient who receives treatment from a medical practitioner or hospital cannot be considered a ‘consumer’ under Section 2(1)(d) of the Act.
• Medical practitioners or hospitals providing paramedical services do not enjoy the same immunity from the Act's provisions and are regarded as providing a service. Therefore, a person utilizing such services is a consumer under the Act.

This matter has been definitively resolved by the Supreme Court. Consequently, the Consumer Protection Act has raised significant concerns among medical professionals, apprehending potential negative impacts on their profession and public service. Despite counterarguments from doctors, if the Act continues to encompass medical services, its application must be approached with utmost caution.

Consumer Rights Under the Consumer Protection Act

The Consumer Protection Act grants consumers six essential rights when they purchase goods or services:

• Right to Safety: Consumers have the right to safety, ensuring that the products they buy do not pose any harm to their health or safety.
• Right to Choose: This right allows consumers to have a variety of options to choose from, ensuring fair competition among sellers.
• Right to Information: Consumers are entitled to receive all necessary information about the products or services they are purchasing, enabling them to make informed decisions.
• Right to Education: This right empowers consumers by educating them about their rights and responsibilities, as well as the products and services available to them.
• Right to be Heard: Consumers have the right to voice their complaints and concerns, ensuring that their opinions are taken into consideration by businesses.
• Right to Seek Redressal: This right allows consumers to seek remedies and solutions for any grievances they may have regarding a product or service.

Understanding Complaints

A complaint is an expression of dissatisfaction directed towards an organization regarding its products or services. It signifies the need for a response and resolution from the concerned party.

Process for Filing Complaints and Resolving Cases

Complaints can be filed at various centers, either with or without legal assistance, by paying a nominal fee of Rs 1.25 (One Rupee and Twenty-Five Paise only). There are three tiers for lodging complaints:

District Level

• The District Forum, also known as the District Consumer Dispute Redressal Forum, is led by a district judge and comprises two additional members.
• One of the members must be a reputable individual, while the other should be a female social worker.
• Initially, the District Forum could handle claims for damages up to Rs 1 lakh, but this limit has been raised to Rs 5 lakhs.

State Level

• Rs 5 to 20 Lakhs: Complaints should be filed with the State Commission or the State Consumer Dispute Redressal Commission.
• Forum Composition: The State-level forum will be headed by a High Court Judge and include two other members appointed from the district redressal forum.

National Level

• Exceeding Rs 20 Lakhs: Complaints must be directed to the National Forum or the National Consumer Redressal Commission.
• Commission Composition: The National body is headed by a Supreme Court Judge appointed by the Union Government, along with four other members, including at least one female member.

Proper Procedure

• Filing a Complaint:. complaint can be filed in the relevant consumer court by the Consumer, any recognized Consumer Association, or the Central or State Government if there is a defect in goods or a deficiency in service.
• Time Limit:. complaint must be submitted within two years from the date of the issue.
• Appeals: Any appeal against the order of the District or State Commission under the Act must be filed within 30 days of the order.
• Reply to Complaint: If the complaint is accepted, the opponent must file a reply within 30 days.
• Appeal to Supreme Court: Under Section 23 of the Act, anyone dissatisfied with an order from the National Commission can appeal to the Supreme Court within 30 days. The Supreme Court may grant an extension for valid reasons.
• Court Fees: No court fees are required, regardless of the compensation claimed.
• Copies of Complaint: Four copies of the complaint must be submitted: three for the court and one for each opponent. Additional copies are needed for multiple opponents.
• Case Resolution Time: Cases are usually expected to be resolved within 90 days, with a maximum extension of 150 days. There is no time limit for appeals or revised petitions.
• Adjournments: Generally, only one adjournment is allowed.
• Legal Representation: Lawyers are not mandatory; both parties can present their case personally, although legal representation is an option.
• Court Procedures: Summons, evidence, and principles of natural justice are applicable, similar to ordinary courts.
• Contempt of Court: Ignoring notices or summons from these courts may result in contempt, fines, or imprisonment.

Penalties for Frivolous Complaints

• When a complaint is determined to be frivolous or vexatious, it must be documented in writing.
• The complaint will be dismissed, and the complainant may be ordered to pay a penalty to the opposing party, not exceeding Rs. 10,000.00 (Rupees ten thousand).
• Since the introduction of COPRA and CPA 1986, numerous cases have been filed against doctors and hospitals, resulting in awarded damages.
• The Supreme Court of India has ruled that medical services, regardless of whether they are paid for or provided free to those who can afford it, fall under the Act.
• If an individual has a medical insurance policy covering all charges, the service provided by the medical practitioner is not considered free treatment and is classified as service under the Act.
• Consumers have also successfully addressed issues of medical malpractice.
• If a practitioner is qualified in one medical system but practices another, they are regarded as a quack and a charlatan.
• The Supreme Court has upheld the right of consumers to hold such practitioners accountable in Consumer Courts.

Acts and Apprehensions in Medical Profession

• Medical professionals are often uneasy because they fear potential misuse and the chaos it could bring to their field. Here are the reasons behind their worries:
• Disruption of the Doctor-Patient Relationship: There is a genuine concern that this act could fundamentally disrupt the doctor-patient relationship, which is crucial for effective healthcare.
• Defensive Medical Practice: Medical practitioners might shift towards Defensive Medical Practice. This means that the Act could lead doctors, particularly general practitioners and recent graduates, to be more cautious and avoid taking on responsibilities. They may start referring more patients to specialists and ordering unnecessary tests, which could increase healthcare costs and make it less accessible for the public.
• Over-Cautiousness: Another concern is that doctors may become overly cautious in their practices to protect themselves, potentially impacting the quality of care.

Comments and Countercomments on COPRA

How Doctors Should Address the Issue If the Profession Is Covered by the CPA (1986)

• The existing laws are adequate for dealing with doctors who make errors.
• Negligent doctors should be held accountable for their actions.
• Cases of negligence by doctors can be addressed under the Criminal Procedure Code (Cr PC) and the Indian Penal Code (IPC).
• Less severe cases of negligence can be taken to civil courts for compensation.
• The Medical Council of India and State Medical Councils are responsible for addressing serious misconduct and unethical behaviour by registered medical practitioners.

Counterarguments by Proactive Lobbies

• The process of determining compensation for an injured patient in court is often seen as lengthy and costly.
• There is a belief that regular users of medical services should have access to a new forum for addressing their complaints.
• Concerns have been raised about the Medical Council (both State and Central) being composed of doctors, which may lead to a bias in favor of doctors who make mistakes. Additionally, some state medical councils are perceived as ineffective or slow in their responses, making it difficult for patients to seek justice for negligent behavior.
• Doctors have expressed various concerns regarding COPRA, 1986 on different platforms. However, most of these concerns are considered misguided, with only a few being valid.

Conclusion

After examining the arguments and counterarguments, we can draw several important conclusions:

• Revitalizing Medical Councils: Medical councils can be made more effective by granting them the authority to determine compensation for patients harmed by negligent doctors.
• Understanding Negligence and Misconduct: Only members of the medical profession can accurately assess cases of negligence and misconduct by doctors. However, it is beneficial to include individuals from other sectors in the medical council to ensure a comprehensive evaluation of cases.
• Accountability of Doctors: Doctors should be held accountable for their actions, just like everyone else, especially given the life-and-death nature of their work.
• Involvement of Medical Professionals in Consumer Redressal Forums: Including some medical professionals in consumer redressal forums is appropriate, particularly for cases involving therapeutic controversies, as doctors have suggested.
• Need for Reliable Judgments: If the government and society believe the current legal system is inadequate for addressing negligent doctors, they should establish provisions for more reliable judgments from a medical perspective.
• Inclusion of Medical Professionals in Negligence Cases: There should be provisions for including members of the medical profession in any forum addressing a doctor's negligent act.
• Compensation for Non-Negligent Doctors: Efforts should be made to compensate a doctor if they are proven to be non-negligent by the complaining party.
• Caution in Publicizing Negligence Allegations: Allegations of negligence should not be publicized through the media, as this can harm a doctor's professional life, especially if the case turns out to be a misunderstanding without wrongdoing.
• Utilization of CPA for Improving Medical Care Standards: The profession should utilize CPA to enhance medical care standards and urge the government to improve facilities in government hospitals and alleviate patient congestion.
• Commitment to Hippocratic Oath and Code of Medical Ethics: Reflecting on the saying "Prevention is better than cure," we should reaffirm our commitment to the Hippocratic Oath and the Code of Medical Ethics. This commitment will help restore patient confidence, prevent litigation, and recover some of the lost nobility and reputation of Vaidyo Narayano Hari.