Doctors Now Empowered to Decline Treatment To Unruly Patients

In a significant move, the National Medical Commission (NMC) has released a gazette notification empowering doctors to decline treatment for patients who display unruly or violent behavior. The NMC’s new regulations, titled “NMC Registered Medical Practitioner (Professional Conduct) Regulations 2023,” stipulate that doctors must properly document and report any instances of violence, their refusal to treat, and the subsequent referral of the patient to another healthcare facility. 

According to The Hindu, these newly introduced regulations mandate a code of ethics that every modern medicine practitioner, registered under the NMC Act, must adopt while practicing in the country. This new set of regulations will replace the Medical Council of India’s (MCI) Code of Medical Ethics from 2002. The regulations came into effect on August 2, 2023, as per their official gazette publication. 

A significant highlight of the notification is the provision allowing Registered Medical Practitioners (RMP) to document and report any abusive, unruly, or violent behavior from patients or their relatives. In such cases, the RMP can refuse treatment and recommend the patient seek treatment elsewhere. Furthermore, the regulations grant doctors the autonomy to choose their patients, with the exception of life-threatening emergencies. 

The document’s ‘Patient Care’ section elaborates that an RMP has the freedom to select their patients, barring life-threatening emergencies. Once a patient is accepted, the RMP must not neglect them or withdraw without providing sufficient notice to the patient and their family. If a change in the treating RMP becomes necessary, consent must be obtained from the patient or their guardian.

The attending RMP is held accountable for their actions and is entitled to appropriate fees. In situations involving abusive or violent patients or relatives, the RMP can document the behavior, refuse treatment, and advise the patient to seek treatment elsewhere. 

Additionally, doctors can decline treatment if the mutually agreed-upon fees are not settled. However, this provision does not apply to government doctors or in emergency situations. The regulations also emphasize transparency in consultation fees, requiring doctors to inform patients about the fees before examination or treatment.

A reasonable cost estimate for surgeries or treatments should be provided, enabling patients to make informed decisions. If the indicated fees are not paid, an RMP can choose not to treat or continue treating a patient, except in emergencies or for government doctors. However, doctors must ensure that patients are not left without care. Violations of these regulations will have consequences.

The notification states that any breach can result in strict disciplinary actions, including a suspension of the practicing license for a duration ranging from three months to three years. This move by the NMC aims to safeguard the rights and safety of medical practitioners while ensuring that patients receive the necessary care and attention. The decision has been taken in light of increasing incidents of violence against doctors and healthcare professionals.