Intended for healthcare professionals

Rapid response to:


India’s struggle with medical malpractice

BMJ 2023 ; 381 doi: (Published 03 April 2023) Cite this as: BMJ 2023;381:p632

Rapid Response:

Re: India’s struggle with medical malpractice

Dear Editor

Here is one of the multiple scenarios that happen in India. A patient becomes sick in a small nursing home/ hospital, where the patient’s attendant creates chaos, threats, abuses, and sometimes manhandles the treating doctors. Strict law is rarely enforced. Unfortunately, the mob ransacks the smaller nursing home or hospital if the patient dies. The patient's attendants protest on the roads and attract media attention. The case is filed under section CrPC 174, but there are certain circumstances, like Dr. Archana Sharma, who was charged with IPC 302 (murder) without a medical team expert opinion.

Rarely are there instances where attendants influence district collectors to instruct the local medical college deans and the forensic department to find medical negligence. Whole-body CT scans, X-rays of the deceased body, and VIDEO recordings of the postmortem are done to find the cause, which happens only in rare situations. Indian doctors have been harassed to a maximum extent that all laws in India will be used to find a cause to make them medically negligent, even if not.

In recent times India has witnessed the unethical and atrocious behavior of a few journalists, papers, and online media where the nursing home/ hospital and the treating doctors are named in their news without evaluating the truth and waiting for the medical expert committee's opinion. This flares more wrong information and false impressions about the Indian doctors and the hospital to the common man’s perception. There is no control over this now.

There are windows for the attendants where a criminal complaint can be made to the police commissioner, DIG, and the local police station, repeatedly pressuring them to recharge the complaint 174 to IPC section 302. Higher up on the ladder, the patient’s attendant complains to the state health minister and health secretary. India has no proper protocol and system where the medical grievances redressal mechanism functions and addresses the calls.

Further, in a democratic country, courts are always the savior. The patient’s attendants file many petitions under different constitutional powers masking the truth and demanding the arrest of the treating doctors under section 302. Also, there are various forums, such as the state medical council, Director of health services, and family and rural health services, where the petitioner can make a complaint. The doctors and the hospital face enquiry in all these forums for the petitioner's complaint.

In some situations, a state medical council clears the doctor and team of no negligence. Still, the case is being held in the criminal courts, state health, and rural service departments without being aware of the medical expert team's opinion of the medical council. The Joint directors or directorate of the state should be educated about medical negligence and errors of judgment. Error in judgment is not medical negligence. They should be unbiased, bold, and informative in dealing the medical negligence cases. A prompt inquiry by a medical expert team and a timely decision save the doctor from harassment, abuse, mental unwellness, and despondence. The complications, untoward incidents during surgery or after, not conducting a few tests, finding faults in clerical errors, and expecting the imaginary best healthcare are not medical negligence.

The saviors and frontline warriors of dreadful COVID-19 cannot be portrayed as criminals in untoward incidents. India needs a renaissance and a colossal change in handling medical negligence, and I pray through this letter that justice prevails for doctors. Pushing them to halt the minds of saving the patients because of harassment will be a national loss; no doctor will take any risk. This will bring a monumental catastrophe to Indian healthcare.

Competing interests: No competing interests

15 April 2023
Terrence Jose Jerome
Orthopaedics, Hand and Reconstructive Microsurgeon
Olympia Hospital and Research Centre
47,47A, Puthur High Road, Trichy-620017, Tamilnadu, India