Doctors can refuse to treat in case of Abusive, Unruly, Violent Patients, relatives: NMC Draft Medical Ethics Regulations 2022

New Delhi: Taking a major step toward curbing the ongoing instances of violence against doctors, the National Medical Commission in its draft Ethics guidelines for the first time has implied that the doctors can now refuse to treat "abusive, unruly, and violent patients or relatives".

However, in case the doctors turn down such patients, they should be "referred for further treatment elsewhere" and the RMP will have to document and report the unruly behaviour, NMC has further clarified in the recently released Draft Registered Medical Practitioner (Professional Conduct) Regulations, 2022.

While specifying the duties of the doctors towards their patients, these new guidelines stated,

"In case of abusive, unruly, and violent patients or relatives, the RMP can document and report the behavior and refuse to treat the patient. Such patients should be referred for further treatment elsewhere."

Numerous incidents of violence have been reported over the years. These instances reached their peak earlier this year when Rajasthan-based Dr. Archana Sharma had committed suicide after being booked for the murder of a patient who had died due to Postpartum haemorrhage (PPH). Doctors are being beaten up daily by unruly attendants but have got only limited relief in terms of law.  Doctors have demanded Central Doctors Protection Act, however the same has still been out of reach of doctors.

However, in terms of minor relief, these new Draft RMP (Professional Conduct) Regulations, 2022 have empowered the doctors to refuse treatment to the patients in case of "abusive, unruly, and violent patients or relatives", thereby taking a first step toward curbing the violence against medical professionals. Doctors will have to although document and report the behaviour in such circumstances. 

Other duties of doctors regarding patient care

Apart from freedom of denying treatment in case of violence, NMC has also specified the other duties of doctors regarding patient care, giving medical practitioners liberty to choose whom they will serve, except in case of a life-threatening emergency. 

These new norms, however, order accountability as after the doctors accept a case, they can neither neglect the patient nor withdraw from the case without giving adequate notice to the patient and his family.

The guidelines read,

"A RMP is free to choose whom he will serve, except in case of a life-threatening emergency. Having accepted a case, the RMP should neither neglect the patient nor withdraw from the case without giving adequate notice to the patient and his family. If a change of RMP is needed (for example, the patient needs a procedure done by another RMP), consent should be obtained from the patient himself or the guardian. The RMP who attends to the patient will be fully accountable for his actions and entitled to the appropriate fees."

Any violation of these guidelines may cost the doctors a suspension term ranging from 30 days to 3 years. "...the extent of action recommended may range from reformation alone to a maximum of suspension for the period indicated at the level, depending on the quantum of responsibility of the RMP for the harm/injury caused," stated the guidelines.

In an attempt to address the various issues of professional conduct of registered medical practitioners, the Ethics & Medical Registration Board (EMRB) of NMC has introduced the Draft RMP (Professional Conduct) Regulations, 2022. These new regulations have addressed the issue of Professional Conduct of Registered Medical Practitioners (RMPs) including their duties and responsibilities, continuing professional development program, remuneration, prescribing generic medicine, prohibition of commission, restriction on advertisement, responsibilities regarding sale of drugs, medical reports, etc.

Also Read: NMC releases Draft Registered Medical Practitioner Professional Conduct Regulations 2022, invites comments