Section 304A IPC: Laws on Medical Negligence in India

Medical negligence is the breach of a duty of care owed by healthcare professionals to their patients, resulting in harm or injury due to a failure to meet the standard of care expected in the medical field. 

While the Indian Penal Code (IPC) primarily deals with criminal offences, medical negligence is addressed under civil and consumer protection laws. However, there are instances where medical negligence can have criminal implications under the IPC. 

Imagine trusting your health to a doctor, but sometimes things don't go as planned. This is when Section 304A IPC steps in, and questions about what went wrong and who's to blame, start swirling around. 

So, let's delve into this article to answer such questions.

What Is Medical Negligence?

Medical negligence is like a legal jigsaw puzzle, with pieces scattered across different laws. One crucial piece fits under Section 304A of the Indian Penal Code, defining it as 'causing death by negligence' as a death caused by "doing any rash or negligent act not amounting to culpable homicide."

In simpler terms, if a person's careless actions lead to someone's demise, they could face imprisonment, a fine, or both. Now, imagine this in healthcare cases—it's what we commonly call medical negligence.

• Medical negligence is when a healthcare provider messes up, either by doing something they shouldn't have or by not doing something they should have. 
• Medical malpractice, or negligence, is when a healthcare provider goofs up either by doing something they shouldn't or missing out on something they should have done (act or omission). 
• "Whoever causes the death of any person by doing any rash or negligent act not amounting to culpable homicide, shall be punished with imprisonment of either description for a term which may extend to two years, or with fine, or with both," Section 304A states.

Who bears the burden of proof in Medical Negligence cases?

In medical negligence cases, the burden of proof typically lies with the patient or the plaintiff. It is their responsibility to demonstrate, with supporting evidence, that the healthcare provider's actions or omissions shifted from the accepted standard of care and that this deviation directly resulted in harm or injury.

Medical Negligence under Bharatiya Nyaya Sanhita, 2023

Now, medical negligence (causing death by negligence) has been defined under Section 106(1) of the Bharatiya Nyaya Sanhita (BNS), replacing the previous section 304A of the Indian Penal Code (IPC).

Section 106(1) of BNS reads as "Whoever causes death of any person by doing any rash or negligent act not amounting to culpable homicide, shall be punished with imprisonment of either description for a term which may extend to five years, and shall also be liable to fine; and if such act is done by a registered medical practitioner while performing medical procedure, he shall be punished with imprisonment of either description for a term which may extend to two years, and shall also be liable to fine."

Simply section 106 (1) of BNS says:- 

• If a registered medical practitioner, while performing a medical procedure, causes the death of a person by performing a rash or negligent act that does not amount to culpable homicide, the punishment is imprisonment for up to 2 years, along with a fine.
• The term "registered medical practitioner" is also defined in the BNS as referring to a medical professional who holds a recognized medical qualification under the National Medical Commission Act 2019 and whose name is listed in the National Medical Register or a State Medical Register as per the Act.

Which other laws penalize Medical Negligence?

Apart from the IPC:

• Medical professionals in India are also subject to the regulations and disciplinary mechanisms set by medical councils, such as the Medical Council of India (MCI) and State Medical Councils. 
• These bodies can take administrative and disciplinary actions against healthcare professionals for professional misconduct, which may include cases of medical negligence. 
• Additionally, consumer protection laws allow patients to seek compensation for medical negligence through consumer forums. 
• Civil litigation is also an alternative for patients to seek damages for injuries caused by medical negligence, where compensation is sought for medical expenses, loss of income, and other damages. 

Medical negligence is multifaceted, involving criminal and civil aspects and administrative actions by regulatory bodies. So, it can be penalized under civil & criminal laws and by administrative actions.

Landmark Cases on Medical Negligence 

1. Dr. Jacob Mathew vs. State of Punjab & Anr. (2005)

Held: The Supreme Court, in this case, outlined the principles related to medical negligence, emphasizing that a doctor may be held liable for negligence under these circumstances:

• Lack of Requisite Skill: If the doctor did not possess the requisite skill that he professed to have.
• Failure to Exercise Reasonable Care: If the doctor did not exercise reasonable care in a given case, even if he possessed the necessary skill.

The Supreme Court, in this case, acknowledged the 'Bolam Rule,' which is a standard used to assess medical negligence. The Bolam Rule, derived from the English case Bolam v. Friern Hospital Management Committee (1957), states that a medical professional is not negligent if he acts following a practice accepted as proper by a responsible body of medical practitioners skilled in that particular art. In other words, a medical practitioner is judged by the standard of a reasonable and competent practitioner in the same field.

2. Hukam Chand v. State (2016)

Held: Delhi High Court ruled that: "To proceed against a doctor, the complainant is required to, even at the stage of summoning, prima facie show that the negligence is of such a kind that either the doctor was not processed of the requisite skills which he professed to possess or the negligence and recklessness was of a high degree which could be termed as gross."  

According to the Court, doctors can only be held responsible for negligence if their negligence is severe or they do not possess the necessary skills required for treatment.

In the present case, there was no evidence to suggest that the doctors who treated the victim were grossly negligent. The committee of doctors also did not mention any negligence on the part of the treating doctors.

3. Dr A.K. Banerji v. State (2014)

The Delhi High Court, in this case, while dealing with a criminal revision in a matter relating to medical negligence where the victim's hand had to be cut off, held that because the Medical Council said the doctor did nothing wrong, the Court said no to the magistrate's order for charges under Section 338 IPC (Causing grievous hurt by act endangering life or personal safety of others).

The judges decided that without the green light from Section 197 CrPC (issue of sanctions for prosecution of public servants), the doctors couldn't be called out for medical negligence.

Conclusion

In simple terms, medical negligence under the IPC deals with cases where a healthcare provider's actions lead to someone's death due to negligence. Section 304A outlines the consequences of such incidents. Resolving these cases involves carefully examining medical standards and circumstances. Striking a balance between holding providers accountable and promoting ethical practices is crucial. Pursuing justice requires ongoing collaboration to maintain trust between healthcare professionals and patients.

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