New NMC code allows doctors to refuse service; triggers controversy

Can a doctor refuse treatment to a patient if the family and friends of the patient are abusive, unruly and violent?

The National Medical Commission (NMC) has proposed a code of conduct which will empower doctors to say no to such patients. But the proposal triggered a row on Monday with a non-governmental organisation (NGO) sending a notice to the NMC opposing such a provision in the draft regulation.

“We are stunned and dismayed to find that the NMC has decided to include this potentially lethal and draconian new rule in the Registered Medical Practitioner Professional Conduct Regulations 2022 without any thoughtful consideration for its dangerous and potentially fatal consequences,” People for Better Treatment, an NGO, headed by NRI physician Kunal Saha, said in a statement.

Section 26 of the regulation says, "In case of abusive, unruly, and violent patients or relatives, the registered medical practitioners can document and report the behaviour and refuse to treat the patient. Such patients should be referred for further treatment elsewhere."

Over the last few years, violence against doctors and nurses has been reported in various states often leading to the demand for a strict law to offer a protective shield to the healthcare professionals.

In 2019, a major agitation erupted in Kolkata when young doctors at NRS Medical College were abused and beaten by a group of people who accompanied a patient to the government hospital in the eastern metropolis.

The Indian Medical Association (IMA), the country’s largest body of doctors, demanded such a law and received support from the then Union Health Minister Harsh Vardhan. IMA made a similar demand in 2015 as well.

“The PBT has always strongly condemned any act of mob violence or physical attack on doctors. However, providing a new legal caveat for the registered physicians to refuse treatment as proposed under Section 26 is patently wrong as it is against the fundamental right to life guaranteed under Article 21 of the Constitution,” Saha said.

There is no specific definition of “abusive” in law as it is purely a subjective interpretation that may depend on the personal opinion of any individual.

An emergency room doctor, Saha said, might now feel particular words or language used momentarily under a deeply stressful mental condition by a father whose child’s life was hanging on a balance as “abusive” and stopped providing any treatment to the dying patient by taking shelter behind this new draconian law.

Urging the NMC to reconsider and remove the provision from the draft regulations, Saha said no patient should be refused emergency medical care under any condition.

Once adopted, the proposed regulations will replace the Indian Medical Council (Professional Conduct, Etiquette, and Ethics) Regulations, 2002, which currently govern the code of conduct for doctors.