INTRODUCTION
Law and medicine, each with its own different norms and rules, are interconnected specifically in the context of the protection of the fundamental rights of citizens. Article 21 of the Indian Constitution states that every citizen has a right to life and personal liberty, which inherently includes the right to health and healthcare. However, for many in India, the scenario is much dreary. As seen from the report published by NITI Aayog, data reveals a high poverty rate in the country, and the low-income groups[1]. Individuals who depend on low income to support their families can work as long as they’re healthy. Unfortunately, when the sole breadwinner of the family gets sick, the whole family becomes financially saturated, which often leads to preventable deaths due to a lack of awareness about medical insurance and insufficient funds. Though present, government hospitals usually need more support and help to handle the volume and complexity of cases. This is where law and government have a crucial function. There is a need to enhance the existing rules and ensure their enforcement in safeguarding the citizens’ rights and overseeing the operations of the health facilities.[2]. Nonetheless, it is pertinent to mention that, supported by robust legal frameworks, the government needs to develop viable strategies and policies to dilute the commercialization of healthcare. Health is an essential human right; thus, private hospitals should not capitalize on the same. Therefore, it is vital to apply strict legal standards to maintain ethical values, eliminate disparities in healthcare, and make healthcare affordable.
THE RIGHT TO LIFE AND HEALTH
It is from Article 21 of the constitution of India that every citizen possesses the right to life and personal liberty whereby they can have a life of dignity. The Supreme Court has unequivocally affirmed that the right to health is implicit in the right to life and that medical treatment is essential to maintain and promote the dignity of the human person[3]. The place of ethical medical practice has been well established in India under the National Medical Commission Act 2019[4]. This Act deals with the registration of medical practitioners and constitutes the National Medical Commission to standardize medical education and the profession. Further, the Indian Medical Council (Professional et al.) Regulations 2002[5] provides for the ethical code of the doctors & medical practitioners in India, what is in the patient’s best interest, the patient’s rights, the concept of confidentiality, & Medical professionalism.
IMPORTANCE OF EQUITABLE ACCESS
Equitable access to healthcare is paramount for safeguarding citizens’ right to life and health.[6]. However, with the rise of commercialization in delivering healthcare services, there has been a disparity in access among marginalized populations. Private facilities with economic incentives may attend to the needs of the wealthier persons much more than those with fewer resources, thus worsening the problem of disparity in accessibility of health care. This implies that the marginalized groups in the developing nations are unable to access the required healthcare because there is no social security that would guarantee them protection for such essentials. The Consumer Protection Act 2019[7] Seeks to provide a legal framework through which issues resulting from healthcare services may be addressed to protect consumer rights, promote consumer responsibility, and demand accountability within the system.
DEPRIVATION AND INFRINGEMENT OF RIGHTS
Failing to provide citizens with timely and adequate care blatantly violates their right to life and health. Either through charging exorbitant fees, refusing to administer life-sustaining treatment, or committing negligent actions, healthcare consumers are deprived of their rights, and all such actions perpetuate social injustice contrary to the Constitution[8]. The patient’s rights and safety are also ensured by the provisions of The Indian Medical Council Act, 1956, which enshrine the principles mandating the doctors to act in the best interest of the patient and to exercise a reasonable degree of skill in treating the patients for the protection of their rights and interests.
LEGAL AND ETHICAL IMPERATIVES
In reference to the constitutional provision on the right to life and health, there is a crucial need to develop a comprehensive legal framework that may suitably address this vice of the medicalization of the healthcare service. These are set by the Ministry of Health and Family Welfare, which implements policies to facilitate healthcare standards and provide society with affordable and quality healthcare standards. National Medical Commission Act 2019 is one of the radical reforms that has legal implications, which repealed the Indian Medical Council Act of 1956[9] To redefine the education system for the students in medical institutes and the professionalism and ethical behavior of doctors practicing in hospitals. Hence, the Act addresses the need to safeguard the patient’s rights and the practice of ethical medicine by granting the National Medical Commission the authority to set the practice of medicine within the country. Moreover, the Act helps focus on the funding for preventive and primary healthcare services necessary to meet the demand for healthcare services among minorities and other vulnerable populations.
DUTIES OF DOCTORS TO CITIZENS AND THE WORLD
The general but vital aspect to note is that all medical practitioners, however, specialized they may be, have some critical duties and responsibilities that are ethical not only to the individuals they attend to as patients but also to the entire society. The Hippocratic Oath emphasizes the moral principles and obligation that a doctor undertakes to embrace and maintain professionalism and safeguard the well-being of the patients. This means that doctors and other carers use four principles of beneficence, which implies doing good to the patient, non-maliciousness which implies avoiding harming the patient; the patient’s self-determination, which concerns whether the patient can make decisions for or not; and
then justice implying that the patient must be treated fairly[10]. In addition, physicians should also inform the public about health occurrences and concerns and engage in research that can further enhance the knowledge base of medicine to help increase the nation’s awareness of such issues and to fight for policies that aim at eliminating health inequalities. Besides, physicians ought to educate the public on health issues and conduct research in medicine to increase the nation’s awareness and advocate for policies that reduce health disparities.
THE ROLE OF INTERNATIONAL COOPERATION IN CONSTRUCTING A SUSTAINABLE HEALTHCARE SYSTEM
India has made improvements across various healthcare subsectors, but a few complex procedures require advancement in technology and human resources. Patients are inevitably forced to seek treatment in other countries, which may be expensive. However, relying on foreign medicines and specialists for specific surgeries is common, but it ultimately increases the cost of healthcare. India should focus on enhancing medical equipment and machinery to overcome these challenges. Thus, by strengthening healthcare facilities, the nation can minimize its dependence on imported professionals and ensure access to advanced care.[11].
Further, by signing cooperation agreements with foreign universities or engaging in international health systems, India can advance academic research and ongoing projects, educational programs for health professionals, and skill-building programs. Thus, through global partnerships, India can further improve its human capital in the health field, improve access to healthcare services, and contribute to achieving public health objectives, thus providing its citizens with quality medical care.[12].
SUGGESTIONS
Policymakers must enhance regulatory frameworks described in the Indian Medical Council Act of 1956 to counteract various complex issues ensuing from healthcare commercialization in India and protect the fundamental human rights of its citizens. This involves strengthening the official oversight and accountability structures to prevent unethical healthcare service delivery. Further, coordinated actions to increase the awareness of healthcare services are required, especially for vulnerable population groups. Free medical camps and clinics for target groups such as the rural populace and dwellers of the slum areas would go a long way in addressing health disparities. Initiatives like Ayushman Bharat PM-JAY and Pradhan Mantri Jan Arogya Yojana[13], which provides vulnerable families with the most significant health insurance, should be promoted more. Partnering with insurance companies to extend basic and quality healthcare insurance to low-income earners is crucial in enhancing health insurance and financial risk protection.
Additionally, community activities like blood donation, promotion of health, and disease prevention enhance healthcare standards and decrease instances of preventable diseases. Through effective partnerships with governmental and private sectors and adopting best practices, governmental and medical institutions can set the pace for change by promoting a fairer, more rational, patient-centered healthcare system. These joint actions are necessary for preserving citizens’ rights to life and health and for the country’s progress toward developing effective and efficient healthcare services for the entire population.
CONCLUSION
In conclusion, healthcare equity in India is a fundamental right that has its foundation in Article 21 of the Constitution, which provides for the right to life and health. However, inequalities in the access and availability of quality healthcare services continue to emerge and are compounded by the growth in the commercialization of health facilities. Effective regulation should be established, the general public should be educated to exercise reasoned decisions at the time of seeking medical treatments, and the government should enforce more policies such as Ayushman Bharat and Pradhan Mantri Jan Arogya Yojana through which every citizen of the country should be availed proper medical facilities. Thus, through global collaboration, enhancing medical facilities, and upholding the international code of conduct, India could strengthen the healthcare system’s equity to protect everyone’s rights and human dignity. Through these combined efforts, the nation can guarantee healthcare as a fundamental right rather than a luxury, thus preserving the health and wealth of the people.
Author(s) Name: Hemaja Sai Tammina (Symbiosis Law School, Hyderabad)
References:
[1] Prof. Ramesh Chand and Dr. Yogesh Suri, ‘National Multidimensional poverty: A Progress Review -2023’ (NITI Aayog, 12 January 2024) <https://www.niti.gov.in/sites/default/files/2024-01/MPI-22_NITI-Aayog20254.pdf> accessed 7 June 2024
[2] Swagata Yadavar, ‘More Indians Die Of Poor Quality Care Than Due To Lack Of Access To Healthcare: 1.6 Million’ (IndiaSpend, 6 September 2018) <https://www.indiaspend.com/more-indians-die-of-poor-quality-care-than-due-to-lack-of-access-to-healthcare-1-6-million-64432/> accessed 7 June 2024
[3] ‘Rural Healthcare in Odisha’ (April 2016) <https://magazines.odisha.gov.in/Orissareview/2016/April/engpdf/86-90.pdf> accessed 8 June 2024.
[4] National Medical Commission Act 2019, ss 3, 10, 11, 27
[5] Indian Medical Council (Professional Conduct, Etiquette, and Ethics) Regulations 2002, ss 2, 5, 6
[6] NCBI, ‘Public Health in India: Issues and Challenges’ (21 January 2017) <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5236078/> accessed 8 June 2024
[7] Consumer Protection Act 2019, ss 2(7), 2(42), 9, 17, 20
[8] Dr. Tedros Adhanom Ghebreyesus, ‘Health is a Fundamental Human Right’ (World Health Organisation, 10 December 2017) <https://www.who.int/news-room/commentaries/detail/health-is-a-fundamental-human-right> accessed 8 June 2024
[9] Indian Medical Council Act 1956, ss 20(A), 23, 32, 33
[10] Basil Varkey, ‘Principles of Clinical Ethics and Their Application to Practice’ (National Library of Medicine, 4 June 2020) <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7923912/ > accessed 8 June 2024
[11] Ankit Kumar, ‘The Transformation of The Indian Healthcare System’ (National Library of Medicine, 16 May 2023) <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10292032/> accessed 9 June 2024
[12] Xavier Becerra, ‘A US-India partnership to advance global health’ Hindustan Times (Delhi, 18 August 2023) <https://www.hindustantimes.com/opinion/a-us-india-partnership-to-advance-global-health-101692366379294.html> accessed 9 June 2024
[13] ‘Minimizing the Burden of Hospital Charges’ (Drishti IAS, 12 June 2023) <https://www.drishtiias.com/daily-updates/daily-news-editorials/minimizing-the-burden-of-hospital-charges> accessed 9 June 2024
