NMC proposes allowing doctors to deny treatment in case of abusive, violent patients or relatives

NEW DELHI: With the aim to check violence against medicos, the National Medical Commission (NMC) in its draft professional conduct regulations has proposed allowing doctors to refuse treatment in case of abusive and violent patients or relatives. According to the draft National Medical Commission Registered Medical Practitioner (Professional Conduct) Regulations, 2022, any request for medical records to a registered medical practitioner (RMP) responsible for patient records in a hospital either by a patient or authorised attendant has to be duly acknowledged and documents have to be supplied within five working days instead of the existing provision of 72 hours. In case of medical emergencies, the medical records should be made available on the same day.

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"The RMP who attends to the patient will be fully accountable for his actions and entitled to the appropriate fees. In case of abusive, unruly, and violent patients or relatives, the RMP can document and report the behaviour and refuse to treat the patient. Such patients should be referred for further treatment elsewhere," the draft regulations stated. It also specified that the use of alcohol or other intoxicants during duty or off-duty which can affect professional practice will be considered as misconduct.

According to the draft regulations, reasonable estimation of the cost of surgery or treatment should be provided to the patient to enable an informed decision. "An RMP can refuse to continue to treat a patient if the fees, as indicated, are not paid. This is a new addition. It does not apply to doctors in government service or emergencies and the draft regulations clarify that the doctor must ensure that the patient is not abandoned," the NMC's Ethics and Medical Registration Board (EMRB) member Dr Yogender Malik said.

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Also, for the first time, the term 'emergency' has been defined as "life and limb saving procedure". Previously, the term 'emergency' was not clearly defined, Dr Malik said. "In case of emergency (life and limb saving procedure), an RMP shall provide first-aid and other services to the patient according to his expertise and the available resources before referral," the draft regulations read.