INDIAN MEDIGAL GOUNGIL ( PROFESSIONAL CON DUCT, ETIQUETTE AND ETHICS) REGULATIONS, 2OO2

INDIAN MEDICAL ASSOCIATION UTTARANCHAL STATE BRANCH (Registered under the Societies Act XXI of 1860)

Affiliated to IMA Hqrs., New Delhi

47, Ballupur Road, Dehradun – 248001

President Elect

Dr. C. S. Joshi jmhjoshi@gmail.com

Vice President, Zone-I

Dr. Dinesh Singh neelkanthnetralaya@gmail.com

Vice President, Zone-II Dr. D. M. Gahlot drdmgahlot@gmail.com

Hony. Treasurer

Dr. Sanjay Upreti drsanjayupreti@gmail.com

Hony. Jt. Secretary

Dr. Amit Singh dramitsingh@hotmail.com

Hony.Jt. Secretary

Dr. Rahul Singh drrahul_singh@yahoo.co.in

Editor, IMA UA State Bulletin

Dr. Shashi Upreti shashiupreti@rediffmail.com

Jt. Editor, IMA UA State Bulletin

Dr. Roopa Hanspal roopahans@yahoo.co.uk

Hony. Editor, IMA UA Academic Journal Dr. Puneet Agrawal apuneet@ymail.com

Hony. Jt. Editor, IMA UA Academic Journal

Dr. Pradeep Pandey pradeep09412093760@gmail.com

Director, IMA CGP

Dr. Shailendra Kumar Gupta drskg@bhelhwr.co.in

Hony. Secretary, IMA CGP Dr. Hansa Singh drhansasingh@gmail.com

Hony. Jt. Secretary, IMA CGP Dr. R. K. Vij drvij.raj@gmail.com

No. IMA /UA /2021-22/4526/16/102 To,

All Local Branch Presidents/ Hony. Secretaries, All SWC Members,

IMA UA State Branch

Date: 29/03/2022

Sub: Documents as required by you in the last SWC Meeting held on 27.03.2022 in Dehradun Sir(s),

As discussed in the last SWC meeting held on 27.03.2022 in Dehradun, kindly note the following points in relation to the Ethics & Disciplinary & Registration Committee of Uttarakhand Medical Council, Dehradun:

1. Ethics, Disciplinary and Registration Committee is a judicial body having powers under sections

198, 219 and 228 of Indian Penal Code.

2. Powers of EDRC of UKMC: IPC Sections are delineated below:

a) IPC Section 198: Using as true a certificate known to be false. — Whoever corruptly uses or attempts to use any such certificate as a true certificate, knowing the same to be false in any material point, shall be punished in the same manner as if he gave false evidence.

b) IPC Section 219: Public servant in judicial proceeding corruptly making report, etc., contrary to law.— Whoever, being a public servant, corruptly or maliciously makes or pronounces in any stage of a judicial proceeding, any report, order, verdict, or decision which he knows to be contrary to law, shall be punished with imprisonment of either description for a term which may extend to seven years, or with fine, or with both.

c) IPC Section 228: Intentional insult or interruption to public servant sitting in judicial proceeding.— Whoever intentionally offers any insult, or causes any interruption to any public servant, while such public servant is sitting in any stage of a judicial proceeding, shall be punished with simple imprisonment for a term which may extend to six months, or with fine which may extend to one thousand rupees, or with both.

3. Do’s and Don’ts in private practice: All the members are directed to go through the Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations, 2002, which is enclosed with this letter.

You are hereby requested to intimate the above to all your members within one month’s time w.e.f. today i.e.

Chairman, IMA AMS 29.03.2022. Dr. Sandhya Bhatnagar

jm.sandhya@gmail.com

Vice Chairman, IMA AMS Dr. Nakshatra Agarwal drnakshatra97@gmail.com

Secretary, IMA AMS

Dr. Mukesh Mishra drmukeshmishra@yaho.com

Your’s sincerely,

(Dr. Ajay Khanna) Hony.State Secretary IMA UA State Branch

C.c:

1. Registrar, Uttarakhand Medical Council, ukmedicalcouncil@gmail.com

2. State President, IMA UA State Branch; khuranajs1710@gmail.com

in

All communications intended for State Headquarters office should be addressed to the Hony. State Secretary.

State President

Dr. J. S. Khurana

Mob. No. : 9927044141

Email : khuranajs1710@gmail.com

Imm. Past State President

Dr. Arvind Sharma

Mob No.: 9837061444

Email: prakash.hospital444@gmail.com

Hony. State Secretary

Dr. Ajay Khanna

Mob. 9897082000

E-mail: drajaykhanna786@gmail.com

INDIAN MEDIGAL GOUNGIL

( PROFESSIONAL CON DUCT, ETIQUETTE AND ETHICS) REGULATIONS, 2OO2

MEDICAL COUNCIL OF INDIA SECTOR. 8, POCKET. 1 4, DWARKA

NEW DELHI.llOO77

Phone Nos. 0l 1 -25 367 033, 25367 035, 25367 036 Fa>r Nos. 0ll – 25367 024, 25367 025

Published in the Gazette of lndia Part-lll- Sec-4 dated 5th April, 2002

MEDICAL COUNCIL OF INDIA

NOTIFICATION

New Delhi dated the 1Lth March, 2002. No.MCl-211 (2) 2001 Regn. ln exercise of the powers conferred undersection 20A read with section 33 (m)of the lndian Medical councilAct, 1956 (1O2of 1956), the Medical Council of lndia, with the previous approval of the Central Government, hereby makes the following regulations relating to the professional Conduct, Etiquette and Ethics for registered medical practitioners, namely ;-

Short Title and Commencement: (1) These Regulations may be called the lndian Medical Council(Professiona I cond uct, Etiq uette a nd Ethics) Regulations, 2002.

{2) They shall come into force on the date of their publication in the Official Gazette. Chapter 1

1.CODE OF MEDICAL ETHICS

A. Declaration : Each applicant at the time of making an appiication for registration under the

provision of the Act, shall be provided a copy of the declaration and shall submit a duly signed Declaration as provided in Appendix 1. The application shall also certify that he/ she had read and agreed to abide by the same

B. Duties and responsibilities of the Physician in general:

1.1 Character of Physician:(Doctors with qualification of MBBS or MBBS with post graduate degree/

diploma or with the equivalent qualification in any medical discipline):

1.1.1 A physician shall uphold the dignity and honour of his profession.

L.1.2 The prime object of the medical professional is to render service to humanity; reward or

financial gain is a subordinate consideration. Who-so- ever chooses his profession, assumes the obligation to conduct himself in accordance with its ideals. A physician should be an upright man, instructed in the art of healings. He shall keep himself pure in character and be diligent in caring for the sick; he should be modest sober, patient, prompt in discharging his duty without anxiety; conducting himself with propriety in his profession and in all the actions if his life.

1.1.3 No person other than a doctor having qualification recognized by Medical Council of lndia and registered with Medical Council of lndia/ State Medical Council (s) is allowed to practice Modern system of Medicine or Surgery. A person obtaining qualification In any other system of Medicine is not allowed not allowed to practice Modern system of Medicine in any form.

1.2 Maintaining good medical practice :

.1.2.1 The Principal objective of the medical profession is to render service to humanity with full

respect for the dignity of profession and man. Physicians should merit the confidence of patient entrusted to their care, rendering to each a full measure of service and devotion. Physician should try continuously to improve medical knowledge and skills and should make available to their patients and colleagues the benefits of their professional attainment. The physician should practice methods of healing founded on scientific basis and should not associated professionally with anyone who violate this principle. The honoured ideals of the medical profession imply that the responsibility of the physician extend not only to individuals but also a society.

t.2.2 Membership in medical Societv : For the advancement of his profession, a physician should affiliate with associations and societies of allopathic medical professions and involve actively in the functioning of such bodies.

1.2.3 A Physician should participate in profession meetings as part of continuing Medical Education programme, for at least 30 hours every five years. Organized by reputed professional academic bodies or any other authorized organizations. The compliance of this requirement shall be informed regularly to Medical Council of lndia or the State Medical Councils as the case may be.

1.3 Maintenance of Medical records :

1.3.1 Every physician shall maintain the medical records pertaining to his/her indoor patients for

a period of 3 years from the date of commencement of the treatment in a standard

proforma laid down by the Medical Council of lndia and attached as Appendix 3.

L.3.2 lf any request is made for medical records either by the patients/ authorized attendant or legal authorities involved, the same may be duly acknowledged and documents shall be

issued within the period of 72 hours.

1.3.3 A Registered medical practitioner shall maintain a Register of Medical Certificates giving

full details of certificates issued. When issuing a medical certificate he/ she always enter the identification marks of the patient and keep a copy of the certificates. He/she shall not omit to record the signature and / or thumb mark, address and at least one identification mark of the patient on the medical certificates or report. The medical certificate shall be prepared as in Appendix 2.

1″.3.4 Efforts shall be made to computerize medical records for quick retrieval. 1.4 Displav of registration number :

1,.4.3, Every physician shall display the registration number accorded to him by the State Medical Council / Medical Council of lndia in his clinic and in all his prescriptions, certificates, money receipts given to his patients.

L.4.2 Physician shall display as suffix to their names only recognized medical degreds or such certificates/ diplomas and membership/ honours, which confer professional knowledge, or recognize a ny exemplary q ualification/ achievements.

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1.5 Use of Generic names of drugs : Every physician should, as far as possible, prescribe drugs with generic names and he/ she shall ensure that there is a rational prescription and use of drugs.

1.6 Highest Qualitv Assurance in patient care: Every physician should aid in safeguarding the

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1.8

profession against admission to it of those who are deficient in moral character or education. Physician shall not employ in connection with his professional practice any attendant who is neither registered nor enlisted under the Medical Acts in force and shall not such persons such persons to attend treat of perform operations upon patients wherever professional discretion or skill is required.

Exposure Unethical Conduct : A physician should expose, without fear or favour, incompetent or corrupt, dishonest or unethical conduct on the part of members of the profession.

Pavment of Professional Service : The physician, engaged in the practice of medicine shall give prioriiy to the interests of patients. The personal financial interests of a physician should not conflict with the medlcal interests of patients. A physician should announce his fees before rendering service and not after the operation or treatment in under way.

Remuneration received for such services should be in the form and amount specificaily announced to the patient ai the time the service is rendered. lt is unethical to enter into a contract of “no cure no payment”. Physician rendering services on behalf of the state shall refrain from anticipating or accepting any consideration.

1.9 Evasion of Leeal Restricths : The physician shall observe the laws of the country in regulation the practice of medicine and shall also not assist others to evade such laws. He should be cooperative in observance and enforcement of sanitary laws and regulations in the interest of public health. A physician should observe the provisions of the State Acts like Drugs and Cosmetic Act, 1940; Pirarmac! Act, 1″948; Narcotic Drugs and Psychotropic substances Act, 1985; Medical Terruination of Pregnancy Act, 1971″; Transplantation of Human Organ Act, 1994; Mental Healih Act, 1987; Environmental Protection Act, 1986; Pre-natal Sex Determination Test Act, 1994; Drugs and Magic Remedies (Objectionable Advertisement) Act, 1954; Persons with

Disabilities (Equai opportunities and full Participation) Act, 1995 and Bio- Medical Waste (Management and Hanciling) Rules, 1998 and such other Acts, Rules; Regulations made by the central/ State Government or local Administrative Bodies or any other relevant Act relating to the protection and promotion of public health.

Chapter- 2 2. DUTIES OF PHYSICIANS TO THEIR PATIENTS

2,1 Oblieations to the Sick:

2.1,.1, Though a physician is not bound to treat each and every person asking his services, he should not only be ever readyto respond to the calls of the sick and the injured, but should be mindful of the high character of his mission and the responsibility he discharge in the course of

his professional duties. ln his treatment, he should never forget that the health and the lives of those entrusted to his care depend on his skill and attention. A physician should endeavour to add to the comfort to the sick by making his visits at the hour indicated to the patients. A physician advising a patient to seek service of another physician is acceptable, however, in case of emergency a physician must treat the patient, no physician shall arbitrarily refuse treatment to a patient, however for good reason, when a patient is suffering from an ailment is not within the range of experience of the treating physician, the physician may refuse treatment and refer the patient to another physician.

2.1,.2 Medical practitioner having any incapacity detrimental to the patient or which can affect his performance vis-a-vis the patient is not permitted to practice his profession.

2.2 Patience. Delicacv and Secrecv : Patience and delicacy should characterize the physician. Confidences concerning individual or domestic life entrusted by patients to a physician and defects in the disposition or character of patient observed during medical attendance should never be revealed unless their revelation is required by the laws of the State. Sometimes, however, a physician must determine whether his duty to society requires him to employ knowledge, obtaining through confidence as a physician to protect a healthy person against a communicable disease to which he is about to be exposed. ln such instance the physician should act as he would wish another to act toward one of his own family in like circumstances.

2.3 Prosnosis : The physician should neither exaggerate nor minimize the gravity of a patient’s condition. He should ensure himself that the patient, his relatives or his responsible friends have such knowledge of the patient’s condition as will serve the best interests of the patient and the family.

2.4 The Patient must not be neglected : A physician is free to choose whom he will serve. He should, however, respond to any request for his assistance in an emergency. Once having undertaken a case, the physician should not neglect the patient, nor should be withdraw from the case without giving adequate notice to the patient and his family. Provisionally or fully registered medical practitioner shall not wilfully commit an act of negligence that may deprive his patient or patients from neccessary medical care.

2.s Engagement for an Obstetric case : When a physician who has been engaged to attend an obstretric case is absent and another is sent for and delivery accomplished, the acting physician is entitled to his professional fees, but should secure the patient’s consent to resign on the arrival of the physician engaged.

CHAPTER – 3 3. DUTIES OF PHYSICIAN IN CONSULTATION

3.1 Unnecessarv consultations should be avoided :

3.1.1 However in case of serious illness and in doubtful or difficult conditions, the physician should request consultation, but under any circumstances such consultation should be justifiable and in the interest of the patient only and not for any other consideration.

3.1.2 Consulting pathologists/ radiologists or asking for any other diagnostic Lab investigation should be done judiciously and not a routine and not a routine manner.

3.2 Consultation for Patient’s Benefit : ln every consultation, the benefit to the patient is of foremost importance. All physicians engaged in the case should be frank with the patient and his attendants.

3.3 punctualiw in Consultation : Utmost punctuality should be observed by a physician in making themselves available for consultations.

3.4 Statement to Patient after Consultations :

3.4.1 All statements to the patient of his representatives should take place in the presence of the consulting physicians, expect as otherwise agreed. The disclosure of the opinion to the patient or his relatives or friends shall rest with the medical attendant.

3.4.2 Differences of opinion should not be divulges unnecessarily but when there is irreconcilable difference of opinion the circumstances should be frankly and impartially explained to the patient or his relatives or friends. lt would be open to them to seek further advice as they so desire.

3.5 Treatment after Consultation : No decision should restrain the attending physician from making such subsequent variations in the treatment if any unexpected charge occurs, but at the next consultation, reason for the variations should be discussed/ explained’ The same privilege, with its obligation, belongs to the consultant when sent for in an emergency during the absence of attending physician. The attending physician may prescribe medicine at any time for the patient, whereas the consultant may prescribe only in case of emergency or as an expert when called for.

3.6 Patients Referred to Soecialists : When a patient is referred to a specialist by the attending physician, a case summary of the patient should be given to the specialist, who should communicate his opinion in writing to the attending physician.

3.7 Fees and other charges :

3.7.1. A physician shall clearly display his fees and other charges on the board of his chamber andlor the hospitals he is visiting. Prescription should also make clear if the Physician himself dispensed any medicine.

3.7.2 A physician shall write his name and designation in full along with registration particulars in his prescription letterhead.

Note: ln Government hospital where the patient_load is heavy, the name of the prescribing doctor must be written below his/ her signature.

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CHAPTER.4

A physician should consider it as a pleasure and privilege to render gratuitous service to all physicians and their immediate family

dependants

4’2 conduct in consultation : ln consultations, no insincerity, rivalry or envy should be indulged in’ All due respect should be observed towards the physician incharge of the case and no statement or remark be made, which would impair the confidence reposed in him. For this purpose no discussion should be carried on in the presence of the patient of his representatives.

4.3

When a physician has been called for consultation, the consultant should normally not take charge of the case, especially on the

solicitation of the patient or friends. The consultant shall not criticize the referring physician. He/she shall discuss the diagnosis treatment plan with the referring physician.

4’4 Appointment of substitute : whenever a physician request another physician to attend his patients during his temporary during absence from his practice, professional courtesy requires the acceptance of such appointment only when he has the capacity to discharge the additional responsibility along with his/ her other duties. The physician acting under such an appointment should give the utmost consideration to the interests and reputation of the absent

physician and all such patients should be restored to the care of the letter upon his/ her return.

4.5

to the physician in attendance so as to give him so an option of being present. The medical officer/ physician occupying an official position should avoid remarks upon the diagnosis or the

: When it becomes the duty of a physician occupying an official position to see and report upon an illness or injury, he should communicate

treatment that has been adopted.

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CHAPTER- 5

5’1

disseminate advice on public health issues. They should play their part in enforcing the laws of

Phvsician as citizens: Physician as good citizens, possessed of special training should

the community and in sustaining the institutions that advance the interest of humanity. They should particularly co-operative with the authorities in the administration of sanitary/ public health laws and regulations.

5.2 Public and Communitv Health: Physician, especially those engaged in public health work, should enlighten the public concerning quarantine regulations and measured for the prevention of epidemic and communicable diseases. At all times the physician should notify the constituted public health authorities of every case of communicable disease under his care, in accordance with the laws, rules and regulations of the health authorities. When an epidemic occurs a physician should not abandon his duty for fear of contracting the disease himself.

5.3 Pharmacists/Nurses : Physicians should recognize and promote the practice of different services such as, pharmacy and nursing as professions and should seek their cooperation wherever required.

CHAPTER.6

6. UNETHICAL ACTS : A physician shall not aid or abet or commit any of the following acts which shall be constructed as unethical.

6.1 Advertising :-

6.1 Soliciting of patients directly or indirectly, by a physician, by a group of physicians or by institutions or organizations is unethical. A physician shall not make use of him/her (orlhis/her name) as subject of any form or manner of advertising or publicity through any mode either alone or in conjunction with others which is of such a character as to invite attention to him or to his professional position, skill, qualification, achievements, attainments, specialties, appointments, associations, affiliations or honours and /or of such character as would ordinarily result in his self aggrandisement. A physician shall not give to any person, whether for compensation or otherwise, any approval, recommendation, endorsement, certificate, report or statement with respect of any drug, medicine, nostrum remedy, surgical, or therapeutic article, apparatus or appliance or any commercial product or article with respect of any property, quality or use thereof or any test, demonstration or trial thereof, for use in connection with his name, signature, or photograph in any form or manner of advertising through any mode nor shall he boast of cases, operations, cures or remedies or permit the publication of report thereof through any mode. A medical practitioner is however permitted to make a formal announcement in press regarding the following:

(1) On starting practice.

(2) On change of type of practice.

(3) On changing address.

(4) On temporary absence from duty.

(5) On resumption of another practice.

(5) On succeeding to another practice. (7) Public declaration of charges.

6.1.2 printing of self photograph, or any such material of publicity in the letter head or on sign board of the consulting room or any such clinical establishment shall be regarded as acts ol self advertisement and unethical conduct on the part of the physician. However, printing of sketches, diagrams, picture of system shall not be treated as unethical.

5.2 Patent and Copy rights: A physician may patent surgical instruments, appliances and medicine or Copyright application, methods and procedures. However, it shall be unethical if the benefits of such patents of copyright are not made available in situations where the interest of large population is involved.

5.3 Runnins an open shop (Dispensine of Drues and Appliances bv phvsiciansl:

A physician should not run an open shop for sale of medicine for dispensing prescriptions prescribed by doctors other than himself.or for sale of medical or surgical appliances. lt is not unethical for a physician to prescribe or supply drugs, remedies or appliances as long as there is no exploitation of the patient. Drugs prescribed by a physician or brought from the market for a patient should explicitly state the proprietary formulae as well as generic name of the drug.

6.4 Rebates and commission:

5.4.L A physician shall not give solicit, or receive nor shall he offer to give solicit or receive, any gift; gratuity, commission or bonus in consideration of or return for the referring, recommending or procuring of any patient for medical, surgical or other treatment. A physician shall not directly or indirectly, participate in or be a party to act

of division, transference, assignment, subordination, rebating, splitting or refunding of any fee for medical, surgical or other treatment.

6.4-2 Provisions of para 6.4.1 shall apply with equal force to the referring, recommending or procuring by a physician or any person, specimen or material for diagnostic purposes or other study/work. Nothing in this section, however, shall prohibit payment of salaries by a qualified physician to other duly qualified person rendering medical care under this supervision.

5.5 Secret Remedies : The prescribing or dispensing by a physician of secret remedial agents of which he does not know the composition, or the manufacture or promotion of their use is unethical and as such prohibited. All the drugs prescribed by a physician should always carry a proprietary formula and clear name.

6.5 Human Rishts : The physician shall not aid or abet torture nor shall he be a party to either infliction of mental or physical trauma or concealment of torture inflicted by some other person or agency in clear violation of human rights.

6.7 Euthanasia : Practicing euthanasia shall constitute unethical conduct. However on specific occasion, the question of withdrawing supporting devices to sustain cardiopulmonary function even after brain death, shall be decided only by a team of doctors and not merely by the treating physician alone’ A team of doctors shall declare withdrawal of support system. Such team shall consist of the doctor in charge of the patient, Chief Medical officer/ ruedical officer in charge of the hospital and a doctor nominated by the in-charge of the hospital from the hospital staff or in accordance with the provisions of the Transplantation of Human Organ Act, 1994.

CHAPTER.T

7. MISCONDUCT : The following acts of commission or omission on the part of a physician shall constitute professional misconduct rendering him/her liable for disciplinary action.

7.L Violation of the Resulations: lf he/she commits any violation of these Regulations.

7.2 lf he/she does not maintain the medical records of his/her indoor patients for a period of three years as per regulation 1-.3 and refuses to provide the same within 72 hours when the patient or his/her authorised representative makes a request for it as per the regulation 1..2.3.

7.3 lf he/she does not display the registration number accorded to himlher by the State Medical Council or the Medical Council of lndia in his clinic, prescriptions and certificates etc. lssued by him or violates the provision of regulatian !.4.?.

7,4 Adulterv or lmproper Conduct: Abuse of professional position by committing adultery or improper conduct with a patient or by maintaining an improper association with a paiient will render a Physician liable for disciplinary action as provided under the lndian Medica! Council Act, 1956 or the concerned State Medical CouncilAct,

7.5 Convictiqn by Court of Law i Conviction by a Court of Law for offences involving moral turpitude/ Criminal acts.

7″6 Sex Determination Test: On no account sex determination test snail be undertaken with the intent to terminate the life of a female foetus developing in her mother’s womb, unless there are other absolute indications for termination of pregnancy as specified in the Medical Termination of Pregnancy Act. L971. Any act of termination of pregnancy of normal female foetus amounting io femaie foeticide shal! be regai”ded as professional misconduct on the part of the physician leading to penal erasure besides rendering hirn liable to criminal proceedings as per the provisions of this Act.

z,T siening prqfessional certificates. Reports and other Documents :

Registered medical practltioners are in certain cases bound by law to give, or may from time to time be called upon or requested to give certificates, notification, reports and other ciocuments of similar character signed by them in their professional capacity for subsequent use in the courts or for administrative purposes etc. Such documents, among others, include the ones given at Appendix -4. Any registered practitioner who is shown to have signed or given under his name and authority any such certificate, notification, report or document of a similar character which a untrue, misieading or improper is liable to have his name deleted from the Register.

7.8 A registered medical practitioner shall not contravene the provisions of the Drugs and Cosmetics Act and regulations made thereunder. Accordingly, –

a) Prescribing steroids/psychotropic drugs when there is no absolute medical indication;

b) Selling Schedule’H’&’L’drugs and poisons to the public except to his patient; in contravention of the above provisions shall constitute gross professional misconduct on the part of the physician.

7.9 Performing or enabling unqualified person to perform an abortion or any illegal operation for which there is no medical, surgical or psychological indication.

7.tO A registered medical practitionershall not issue certificates of efficiency in modern medicine to unqualified or non-medical person.

(Note : The foregoing does not restrict the proper training and instruction of bonafide students, midwives, dispensers, surgical attendants or skilled mechanical and technical assistants and therapy assistants under the personal supervision of physicians.)

7.tt A physician should not contribute to the lay press articles and give interviews regarding diseases and treatments which may have the effect of advertising himself or soliciting practices; but is open to write to the lay press under his own name on matters of public health, hygienic living or to deliver public lectures, give talks on the radio/TV/internet chat for the same purpose and send announcement of the same to lay press.

7.L2 An institution run by a physician for a particular purpose such as a maternity home, nursing home, private hospital, rehabilitation centre or any type of training institution etc., may be advertised in the lay press, but such advertisements should not contain anything more than the name of the institution, type of patients admitted, type of training and other facilities offered and the fees.

7.13 lt is improper for a physician to use an unusually large sign board and write on anything other than his name, qualifications obtained from a University or a statutory body, titles and name of his specialty, registration number including the name of the state Medical Council under which registered. The same should be the contents of his prescription papers. lt is improper to affix a signboard on a chemist’s shop or in places where he does not reside or work.

1.1,4 The registered medical practitioner shall not disclose the secrets of a patient not have been learnt in the exercise of his /her profession except-

i) in a court of law under orders of the Presiding Judge;

ii) in circumstances where there is a serious and identified risk to a specific person and

/or community; and

iii) notifiable diseases.

in case of communicable / notifiable diseases, concerned public heaith authoriiies should be informed immediately

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7.15 The registered medical practitioner shall not refuse on religious grounds alone ;o give assistance in or conduct of sterility, birth control, circumcision and medical termination of pregnancy when there is medical indication, unless the medical practitioner feels himself/herself incompetent to do so.

7.16 Before performing an operation the physician should obtain in writing the consent from the husband or wife, parent or guardian in the case of minor, or the patient himself as the case may be, in an operation which may result in sterility the consent of both husband wife is needed.

7.77 A registered medical practitioner shall not publish photographs or case reports of his/ her patients without their permission, in any medical of either in a manner by which their identity could be made out. lf the identity is not to be disclosed, the consent is not needed.

7.1’8 ln the case of running of a nursing home by a physician and employing assistants to help him/her, the ultimate responsibility rests on the physician.

7.L9 A physician shall not use touts or agents for procuring patients.

7.20 A physician shall not claim to be specialist unless he has specialqualification in that branch.

7.21′ No act invitro fertilisation or artificial insemination shall be undertaken without the informed consent of the female patient and her spouse as well as the donor. Such consent shall be obtained in writing only after the patient is provided, at her own level of comprehension, with sufficient information about the purpose, methods, risks, inconveniences, disappointments of the procedure and possible risks and hazards,

7.22 Research: Clinical drug trials or other research involving patients or volunteers as per the guidelines of ICMR can be undertaken, provide ethical considerations are borne in mind. Violation of existing ICMR guidelines in this regard shall constitute misconduct. Consent taken from the patient for trial of drug or therapy which is not as per the guidelines shall also be construed a misconduct.

7.23 lf a physician posted in rural area is found absent on more than two occasions during inspection by the Head of the District Health Authority or the Chairman, Zila Parishad, the same shall be construed as a misconduct if it is recommended to the Medical Council of lndia/State Medical Council by the State Government for action under these Regulations.

7.24 lf a physician posted in a medical college institution both as teaching faculty or otherwise shall remain absent in hospital/college during the assigned duty hours. lf they are found absent on more than two occasions during this period, the same shall be construed as a misconduct if it is certified by the Principal medical Superintendent and forwarded through the State Government to Medical Council of lndia/State Medical Council for action under these Regulations.

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CHAPTER 8 8. PUNISHMENT AND DISCIPLINARY ACTION

8.1 lt must be clearly understood that the instances of offences and of Professional misconduct which are given above do not constitute and are not intended to constitute a complete list of the infamous acts which call for disciplinary action, and that by issuing this notice Medical council of India and or State Medical Councils are in no way precluded fi’om considering and deaiing with any other form of professional misconduct on the part of a registered practitioner, Circumstances may and do arise from time to time in relation to which there may occur questions of professional misconduct which do not come within any of these categories. Every care should be taken that the code is not violated in letter or spirit. ln such instances as in all others, the Medical Council of lndia and/or State Medical Councils have to consider and decide upon the facts brought before the Medical Councii of lndia and/or State Medical Councils.

8.2 lt is made clear that any compiaint with regard to professional misconduct can be brought before the appropriate Medica! Council for Disciplinary action. Upon receipt of any complaint of professional misconduct, the appropriate Medical Council would hold an enquiry and give opportunitvtothe registered medical practitionerto be heard in person or by pleader. lf the medicai practitioner is found to be guilty of committing professional misconduct, appropriate Medical Council may awarC such punishrnent as deemed necessary or may direct the removal altogether or for a specified period, from the register of the name of the delinquent registered practitioner. Deletion from the Register shall be widely publicized in local press well as in the pubiications of different Med ica I Associations/Societies/BoCies.

8.3 ln case the punishment of removal from the register is for a limited period, the appi’opriate Council may also direct that the name so remo’,red shall be restored in the register after the expiry of the period for ivhich the name was ordered to be removed.

8.4 Decision on complaint against delinquent physician shail be taken within a time taken of 6 months.

8.5 During the pendency of the ccmplaint the appropriate Council may restrain the physician from performing the procedure or practice which is under scrutiny.

8.6 Professional incompetence shall be judged by peer group as per guidelines prescribed by Medical Council of lndia.

1.2

I shall abide by the code of medicar ethics as enunciated in the lndian Medical Council (professional conduct, Etiquette and ethics) Regulations,2OOZ. I make these promises solemnly, freely and upon my honour.

1) 2)

3) 4)

5) 6) 7) 8) 9)

10) 11)

I solemnly pledge myself to consecrate my rife to service of humanity.

Even under threat, I will not use my medical knowledge contrary to the laws of Humanity.

I will maintain the utmost respect for human life from the time of conception.

I will not permit considerations of religion, nationality, race, party, politics or social standing to intervene between my duty and my patient.

I will practice my profession with conscience and dignity.

The health of my patient will be my first consideration.

I will respect the secrets which are confined in me.

I will give to my teacher the respect and gratitude which is their due.

I will maintain by all means in my power, the honour and noble traditions of medical profession.

I will treat my colleagues with all respect and dignity.

Date

A. DECLARATION

At the time registration, each applicant shall be given a copy of the following declaration by the Registrar concerned and the applicant shall read and agree to abide by the same;

13

APPENDIX -1

1. FORM OF CERTIFICATE RECOMMENDED FOR LEAVE OR

EXTENSTON OR COMMUNICATION OF LEAVE AND FOR FITNESS. Signature of patient

Or thumb impression

To be filled in the applicant in the presence of the Government Medical Attendant, or Medical Practitioner.

Identification marks: 1..

2.

l, Dr. that………… from

of

after careful examination of the case certify hereby …………whose signature is given above is suffering and I consider that a period of absence from duty

with effect from……….. ………is absolutely necessary for the restoration of his health.

l, Dr. that…………

Date ……….

after careful examination of the case certify hereby ..on restoration of health is now fit to join service.

Signature of Medical attendant. Registration-No……..’…’

(Medical Council of lndia/State Medical Council of’ ……………State)

Note :- The nature and probable duration of the illness should also be specified. This ertificate must be accompanied by a brief resume of the case giving the nature of the illness, its symptoms, causes and duration.

L4

APPENDIX-2

Name of the patient Age

Sex

Address

Occupation

Date of ls’visit

Clinicalnote (summary) of the case Prov: Diagnosis

Diagnosis aft er investigation

Advice

Follow up

Date

Observation

Signature in full

Name of Treating Physician

FORMAT FOR MEDICAL RECORD (see regutation 3.1j

15

APPENDIX.3

LtsT oF CERT|FICATES, REPORT, NOT|FICATIONS ETC., ISSUED BY DOCTORS FOR THE PURPOSES OF vARtous Acrs/ADMIN ISTRATIVE REQUI REMENTS.

a) under the Acts relating to birth, death or disposal of the dead.

b) Under the Acts relating to Lunacy and Mental Deficiency and under the Mental illness Act and the rules made thereunder.

c) Under the Vaccination Acts and the regulations made thereunder.

d) Under the factory Acts and the regulations made thereunder.

e) Under the Education Acts.

f) Under the Public Health Acts and the orders made thereunder.

g) Under the Workmen’s Compensation Act and Person with Disability Act.

h) Under the Acts and orders relating to the notification of infectious diseases.

i) Under the Employee’s State lnsurance Acts.

j) ln connection with sick benefit insurance and friendly societies.

k) Under the Merchant Shipping Act.

l) For procuring/issuing of passports.

m) For excusing attendance in courts of Justice, in public services, in public officers or in ordinary employment.

n) ln connection with Civil and Military matters.

o) ln connection with matters under the control of Department of Pensions.

p) ln connection with quarantine rules.

q) For procuring driving licence.

16

APPENDIX – 4

(Published in Part lll, Section 4 of the Gazette of lndia, dated 22nd February, 2003)

NOTIFICATION

MEDICAL COUNCIT OF INDIA

No.MCl-21 l(2)2002-Regn.- ln exercise of the powers conferred under section 20A read with section 33(m) of the lndian Medical Council Act, 1956 (102 of 1956), the Medical Council of tndia, with the previous approval of the Central Government, hereby makes the following amendments to the lndian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations,2OO2, namely:-

Short Title and Commencement:

(i) These Regulations may be called the lndian Medical Council (Professional conduct, Etiquette and Ethics) (Amendment) Regulations, 2003.

(ii) They shall come into force on the date of their publication in the Official Gazette.

(2) ln the lndian Medical Council (Professional conduct, Etiquette and Ethics) Regulations,2OO2, the regulations,7.23 and7.24 appearing under Chapter 7, shall be omitted.

77

New Delhi, dated 2fi)3

(Published in Part lll, Section 4 of the Gazette of lndia, Extraordinary dated 27th May,2OO4l MEDICAL COUNCIL OF INDIA

NOTIFICATION

New Delhi, dated 26th May,, 2gg4

No. MCI-21 l(2)/2o04-(Ethical). – ln exercise of the powers conferred under section 20Aread with section 33(mlof the lndian MedicalCouncilAct, 1956 (102 of 1956), the Medical Council of lndia, with the previous approval of the Central Government, hereby makes the following amendments to the lndian Medical Council (Professional conduct, Etiquette and Ethics) Regulations,2OO2, namely:-

(1) Short Title and Commencement: (i) These Regulations may be called the lndian Medical Council (Professional conduct. Etiquette and Ethics) (Amendment) Regulations, 2004.

(2) ln the lndian Medical Council (Professional conduct, Etiquette and Ethics) Regulations,2002, after the regulation 8.6 appearing under Chapter 8, the following regulations, shall be added:

“8.7 Where either on o request or otherwise the Medical Council of lndio is informed tttot ony complaint ogainst a delinquent physician has not been decided by o State Medico! Councii within a period of six months frcm the date of receipt of comploint by it and further the MCI hos reoson to believe thot there is no justified reoson for not deciding the compioint within the said prescribed period, the Medicol Council af lndio may-

(i) lmpress upon the concerned State Medical council to conclude ond decide the comploint within o time bound schedule;

(ii) Moy decide to withdraw the soid complaint pending with the cancerned Stote Medicsl Council straightoway or after the expiry oi the period which had been stipuloted by the MCI in accordance with poro (i) above, to itself and refer the some to the Ethical Committee of the Council for its expeditious disposal in a period of not more thon six months from the receipt of the complaint in the office of the Medicol Council of lndio. ”

“8.8 Any person oggrieved by the decision of the Stote Medicol Councii on ony complaint ogainst a delinquent physician, shall hove the right to file an appeal to the MCI within o period of 60 doys from the date of receipt of the order possed by the soid Medical Council:

Provided thot the MCI may. if it is satisfied thot the oppellant wos prevented by sufficient couse from presenting the appeol within the aforesoid period of 60 doys, allow it to be presented within a further period of 6a days.

18

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MEDTCAL COUNCIL OF- INDIA NOTTfFICATION

New Delhi, the lOth December,2009

No. MCI-21 I(l)/2009 (Ethies)/5566?.–ln exercise of the powers conferred by Section i3 of thc lndian Medical Council Act, 1955 ii02 of 1956), the lvledical CounciI of India with thc previous sanction olthe Ccntra!’ Government, hereb-v.. makes the foliowing Regulations to amend the “lndian Medicai Council (Prolessional Conduct, Etiquetle and Ethics) Regulations,100? :

l. (i) These Regulations may bc called the “lndian |l’ledi!a: Counril (Froicssiooal Conducr, L-tiq$etle and

Hthicsi (Arnendrnent) R.egulations, 2009 I’art 1”.

(ii) They shallcome into force tiom thc date of thcir puhlication in the Official Cazette.

2. In the “lndian Medical Council (Profcssionai Conduct, Etiquette and Ethics) Regulations, 2002”. thc fol lowing add itionslmodifi cations/dclctions/substiturions. shall be, as indicated therein :–

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i I’he tirll<.rwing clause shall be added aficr clause h.t

“6,E Code ofconduct for doctors and professional association of doctors in their relationship with pharma- ccutical and allicd health scctor industry.

6.8. I In dealing with pharmaceutical and allied health scctor industry. a medical practitioner shall follow and adhere to the stipulations given below :-

(iv) Ensure that thc.source trnd am{)unt of funding is publicly disclosed al lh0 besinning irsclf:

(v) Ensurc that proper carc and facilitics arc providcd ro human voluntccrs, il’ thcy arc ncccssary lor the rcsearch projcct(s);

(vi) Er:surc rhat undueanimal cxperimentations arc not done and when thcsc arc ticccssary thcy are done in a scientific and a humane way:

(vii) Ensurc that whiie accepling such an assign- ment a medical practitioncr shall havc thc frcedom to publish the results,rIihe research in thc greatcr intercst oF the socicty hy inserting such a clausc in thc MoU or any othur documcntlagreemenl lbr any such assi gn nrcnl.

(0 Maintaining Professional Autorromy: In dealing with pharmaceutical and allied healthcarc industry a rnedical practitiotlcr shall always ensure that there shall nevcr bc any compromisc either with higher own profcssional autononty andror with lhe aufonomv and freedom ol’thc medical insritution,

(g) Afliliation : A medical practitioncr may work fbr pharmaceutical and allied healthcarc industrics in advisory capacities, as corrsultants,:rs researchers. as tr€ating d<lctors or in any othcr prolessional capaciry. [n doing so, a medicai pracrilioner shall always :

(i) Ensure that his professional inte:rity and lr’ec- dom are maintained;

(ii) Ensure lhat patients intcrcst ar(: ltot contpro- mised in any way:

(iii) Ensure that such affiiiarions arc \virhin rhc law;

(iv) Ensure thal such affiiiations/employmcnts arc fully transparent and discloscd,

(h) Endorscmcnt : A medical practitioncr shaii not endorse any drug or product of the industry publically. Any study conducted on the etlicacy or otherwise ofsuch products shall be prescnied lo and/or through appropriate scicntific bodics or publishcd in appropriate scicntific joumals in r propcr \vay””

(a) Gifts : A rrredical practitioner shall not receive any gill lrom any pharmaceutical or allied healrh care industry and their sales people or represen- tatives

(b) Travel facilities : A medical practitioner shall not accepl any travel facility inside fhe country or outside, including rail, air, ship, cruise tickets. paid vacations, etc. from any pharmaceutical or al lied healthcare industry or their represenrarives tbr self and family members ior vacation or for attending conferences, seminars, workshops, CME programme etc. as a delegate.

(c) Hospitality : A medical practitioner shall not accepr individually any hospitality like hotel , accommodation for self and family members

under any pretext.

(d) Cash or monetary grarts : A medical practi- tioner .shall not.reieive any cash or monetary grants from any pharmaceutical and allied healthcare industry for individual purpose in individual capacity under any pretext. Funding for medical research, study etc. can only be received through approved institutions by modalities laid down by law/rules/guidelines adopted by such approved institutions, in a transparcnt manncr. It shall always be fully discloscd.

(e) Medical Research : A medical practitionermay carry out, participate in, work in research projects funded by pharrnaceutical and allicd healrhcare industries. A medical practitioner is obliged to knorv that the fulfillrnent of thc lollowing items (i) to (vii) rvill be an imperative for undertaking any research assignment/project funded by inciusiry– for being proper and ethical. Thus, jn accepting such a position a rnedical practirioner shall :- ”

Lt. Col. (Rc1d.) Dr. A. R N. S[‘l’A.l.VAD. Scc;,, lA DVT I I lr4l I 00/09-l-)xty l {r) 5;isu;eiiiaiilieprarricuiarresearch proposal(s) Foot Note : l-he Principal Rcguiatir;ns namelv.

has the due permission from the comperent conccrned autharities;

(ii) Ensure that such a research project(-s) has rhe c iearance of national,’statei’institr.rti ona I cthics committee’bodies;

(iii) [nsure that it frrlfils all the legalrequiremcnrs prescribed tbr medical research;

Pfinted by thc Manager. Coyefllmefit of lndia l,ress. Ri;ig Road and Published by the Controller ol Publicarrunr

“lndian lledical CoLrncil i l,rolessional Conduct, [,tiquettc and Ethics) Regula- tions,200?” werc publishe,l in Part IIl, Section (4) ol the (lazcfte ot’ India on thc 6th April,2002, and arrrcndcd vlzlc MCI notification dated 22.?-200i and

7&-5-200,1.

Mayaprri. Nclv I)elhi- i l{X}()4 Dclhi-i10051.

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