Medical Ethics and Consumer Rights in India

• 09 Oct 2024

For Prelims: Principles of Medical Ethics, NCDRC, Central Consumer Protection Authority (CCPA)

For Mains: Ethical implications of medical negligence, Determinants and Consequences of Ethics in Human Action

Source: IE

Why in News?

Recently, the National Consumer Disputes Redressal Commission (NCDRC) has fined Johnson & Johnson Rs 35 lakh for supplying defective medical devices, following a case filed by a consumer who suffered complications from a faulty hip replacement. 

• This highlights the critical need for strict adherence to medical ethics and protocols.

Note: 

• Hip replacement surgery (hip arthroplasty) aims to relieve pain, improve hip joint function, and help patients move better.  
• Hip implants are used to alleviate pain and stiffness in the hip due to conditions like arthritis or avascular necrosis.  
  • These implants are made from various materials, including metal, ceramic, and plastic, with the ball often made from cobalt-chromium alloy or ceramic and the stem typically from titanium or cobalt-chromium alloy. 

How Ethics Guide Medical Practices? 

• About Medical Ethics: Medical ethics deals with the right choices of conduct in the field of human health, addressing the distinction between what is considered right or wrong at a given time in a given culture.  
  • It is concerned with the obligations of doctors, hospitals, other health professionals, and society towards patients. 
  • Ethical principles are fundamental in medical practice and often take precedence over legal obligations in guiding healthcare professionals' actions. 
• Principles of Medical Ethics: 
  • Respect for Autonomy: Acknowledging the patient's right to make informed choices regarding their treatment by ensuring proper informed consent is obtained. 
  • Beneficence: It involves prioritising the patient's health and well-being during the entire surgical procedure, acting in their best interests. 
  • Non-Maleficence: A medical practitioner/medical equipment supplying company must avoid harming patients and ensure they receive necessary medical care, refraining from any negligent acts that could deprive patients of essential healthcare. 
  • Justice: It involves treating all patients impartially and equitably, regardless of their religion, nationality, race, or social status. 
• Hippocratic Oath: The Hippocratic Oath is a fundamental tenet for newly graduated medical professionals, recited during convocation ceremonies to bind them to a code of ethics.  
  • It encompasses the principles set forth in the Indian Medical Council (Professional Conduct, Etiquette, and Ethics) Regulations 2002, committing them to serve humanity, comply with medical laws, respect life, prioritise patient welfare, maintain confidentiality, express gratitude to teachers, and foster collegial respect.  
  • This oath acts as a moral compass, guiding physicians in upholding the esteemed traditions and ethical standards of the medical profession. 

What is the National Consumer Disputes Redressal Commission (NCDRC)? 

• About: 
  • The National Consumer Disputes Redressal Commission (NCDRC) is a quasi-judicial body that was set up in 1988 under the Consumer Protection Act (CPA), 1986. 
  • NCDRC aims to ensure inexpensive, prompt, and summary resolution of consumer disputes. 
  • The NCDRC is headed by a sitting or a retired Judge of the Supreme Court of India or a sitting or retired Chief Justice of the High Court. 
• Provisions of the CPA, 1986: 
  • Jurisdiction: Section 21 of the CPA, 1986 provides the NCDRC authority to entertain complaints valued over Rs 2 crore.  
    • Additionally, it possesses appellate and revisional jurisdiction over orders issued by State Commissions and District Forums. 
  • Appellate Authority:  If a consumer is dissatisfied with a decision made by a District Forum, they can appeal to the State Commission.  
    • Subsequently, if the consumer is still unsatisfied with the State Commission's ruling, they can escalate the matter to the NCDRC. 
    • According to Section 23 of the Act, any individual aggrieved by a decision of the NCDRC may file an appeal to the Supreme Court of India within 30 days. 
  • Scope of Coverage: The provisions of this Act encompass both 'goods' and 'services.' 
• Consumer Forums: 
  • The Consumer Protection Act (CPA), 2019 provides that complaints can be filed into District, State, and National levels based on the value of the claim. 
    • District Consumer Disputes Redressal Commission (DCDRC): For claims up to Rs 50 lakh. 
    • State Consumer Disputes Redressal Commission (SCDRC): For claims between Rs 50 lakh and Rs 2 crore 
    • National Consumer Disputes Redressal Commission (NCDRC): For claims above Rs 2 crore. 

Central Consumer Protection Authority (CCPA): 

• CCPA is the regulatory body established under Section 10 of the Consumer Protection Act (CPA), 2019, it regulates matters related to consumer rights violations and unfair trade practices. 
• It operates under the Ministry of Consumer Affairs, Food and Public Distribution. 
• Powers of CCPA: 
  • Consumer Rights: Protects and enforces the rights of consumers as a group. 
  • Unfair Trade Practices: Prevents individuals from engaging in unfair trade practices. 
  • Advertisement Regulation: Section 21 of CPA, 2019 grants the CCPA the power to issue directions and penalties against false or misleading advertisements. 

What are the Issues of Medical Ethics in India? 

• Informed Consent: There is often inadequate or no informed consent obtained from patients, particularly in clinical trials involving vulnerable populations. 
  • Example: Controversy surrounding the Covid-19 vaccine trials conducted in various parts of the world. 
• Patient Privacy: There is a significant lack of robust measures to safeguard patient data and ensure confidentiality. 
  • Example: In 2023, a significant data breach of the ESIC database exposed the personal health information of millions of patients, including sensitive data such as Aadhaar numbers, medical histories, and contact details. 
• Conflicts of Interest: Instances arise where medical professionals have financial stakes in the treatments or procedures they recommend. 
  • In 2023, a prominent cardiologist in Delhi, was found to have financial ties to a stent manufacturing company, receiving substantial payments for consulting and holding equity stakes.  
• Doctor-Patient Trust: The commercialization of healthcare and a lack of transparency have led to an erosion of trust between doctors and patients. 
  • Example:  Doctors employed in government hospitals engaging in private practice and charging exorbitant fees from patients. 
• Regulatory Oversight: Weak enforcement and compliance with ethical guidelines result in abuses within clinical trials and patient care. 

What are the Initiatives for Consumer Protection? 

• Consumer Welfare Fund 
• Central Consumer Protection Council 
• Consumer Protection Rules, 2021 
• Consumer Protection (E-Commerce) Rules, 2020 
• National Consumer Day 

Way Forward 

• Cultivating Ethical Awareness in Healthcare: Implement extensive training programs and workshops to educate healthcare professionals on ethical principles and their practical applications.  
  • Encourage a culture of open dialogue and transparency within healthcare institutions to facilitate discussions on ethical dilemmas and share best practices. 
• Structured Communication Protocols: Implementing structured communication protocols, such as the SBAR (Situation-Background-Assessment-Recommendation) technique, can improve clarity and reduce errors. 
  • Ensuring informed consent involves a detailed explanation of the procedure, risks, benefits, and alternatives, along with verification of understanding. 
• Strengthening Redressal Mechanisms: The government can enhance consumer complaint resolution by utilising existing infrastructures of Alternative Dispute Resolution (ADR) and Online Dispute Resolution (ODR) through a Public-Private Partnership (PPP) model. 
• Creating a National Consumer Lok Adalat Helpline: A tech-enabled National Consumer Lok Adalat helpline can facilitate communication between complainants, companies, and legal authorities, ensuring faster resolutions.

Drishti Mains Question:

What is medical ethics? Discuss its significance, particularly in light of the deteriorating patient-physician relationship in India. 

UPSC Civil Services Examination Previous Year Question 

Prelims

Q.1 With reference to ‘consumers’ rights/privileges under the provisions of law in India, which of the following statements is/are correct ? (2012) 

1. Consumers are empowered to take samples for food testing. 
2. When a consumer files a complaint in any consumer forum, no fee is required to be paid. 
3. In case of death of consumer, his/her legal heir can file a complaint in the consumer forum on his/ her behalf. 

Select the correct answer using the codes given below: 

(a) 1 only 
(b) 2 and 3 only 
(c) 1 and 3 only 
(d) 1, 2 and 3 

Ans: c