Book Review

Remedy To Medico-Legal Issues

Medical practise is a noble profession. There are innumerable incidents where a doctor is the first and last line of defence between a fatal disease and certain death faced by his patient. Many a times his judgement has made a difference between life and death.

However, a doctor no matter how competent and prudent is all too human. He may win a few battles, but ultimately death reigns supreme. He has to fail someday and that is compounded by his human failings and pressure of work- load as well as other professional hazards. This is when the trouble begins. No questions are asked if he succeeds and the patient survives or is cured. But if the patient dies, then all hell breaks loose. The doctor’s valiant struggle is overlooked and the patient’s relatives put all the blame on his doorstep.

The doctor has great powers and great responsibilities. In today’s world, patients are increasingly become demanding, suspicious and developing litigative tendencies. So a doctor requires not only a thorough knowledge of human anatomy and medicine, he also must have a detailed understanding of the relevant medico-legal laws, understanding of medico-legal situations which can explode into a full fledged litigation and how to deal with them and come out of it unaffected or with minimum damage.

Ironically, the things they need the most are never taught in the medical college so they are ill equipped and vulnerable when they come out in the complex world of medical practise. This book acts as a handy reference guide for doctors and provide enough practical tips and insights in simple language so the doctors can practise their profession in peace without the sceptre of litigation looming large over thier head.

The book targets both the readers with medico legal background as well as a casual reader with no medical or legal background at all. The book keeps medical and legal terminologies to a bare minimum. The language is clear, precise and simple. The book is well paced and has made good use of anecdotes to make it an interesting read. It has 32 chapters, but they are small enough and yet contain necessary information in detail on each topic covered by a chapter.

It focuses upon many day to day aspects which goes a long way in preventing medico-legal issues from arising at all. This includes record keeping know-how, maintaining proper documentation and history of the patient (a 19 point specimen of declaration of medical history), getting informed consent with patient’s own signature along with acknowledgement that they have understood the risks which was properly explained to them. It also covers the necessity of confidentiality and effective communication as far as patients are concerned.

From a medical perspective, the book highlights common medical problems and provides the practical ways of avoiding them or dealing with them, if they occur. It covers topics like what precautions a doctor should take while transferring patients, how to deal with accident emergencies, blood transfusion complications, drug reactions to injections. It also touches upon incidents of retained swabs and foreign bodies after operations, operation table death, allegations of wrong diagnosis, treatment due to wrong lab report and allegations of patients and how to deal with those issues.

It provides a clear do and don’t guidelines for doctors who act as consultants of charitable hospital and highlights risks of treating fellow doctors, faking and manipulating bills and certificates. It also explains how blame game can be counter productive and how surgeons and anaesthetists have inter-linked liabilities.

From legal perspective the book covers topics like out of court settlement, what to do when a patient does not pay his bill, what to do when a doctor is arrested. It also covers liability of medical negligence and refers to the recent supreme court judgement as well. It also covers how to deal with trial by media and dealing with consumer forum notice.

A wish list for future editions is addition of tables, boxes and illustrations to add more value to the content and make reading a more enjoyable experience. There is also a need to be more comprehensive as far as legal aspects are concerned. It can also cover other issues faced by doctors but not covered so far including sexual harassment, cosmetic surgery issues, AIDS and others.

This book is written by a doctor for a doctor and is a must read for doctors, para-medical staff and medico legal experts. It aims to help a doctor tackle any unfortunate medical accidents which suddenly transforms him from a well respected citizen to a criminal overnight. It cautions the doctors on paying attention to detail and prevent even small lapses which gets amplified during litigation and causes untold embarrassment as no proper explanation is forthcoming. It arms a doctor with an intelligent well-researched defence that can tide him out of unwanted litigation. The book sticks true to its main theme - the best way to deal with any medico-legal problem is to prevent them.

Kumar Dawada
kumardawada@gmail.com