“Patient Consent And Legal Rights In Treatment”

Abstract

The element of consent is one of the critical issues in medical treatment. The patient has a legal right to autonomy and self determination enshrined within Article 21 of the Indian Constitution. He can refuse treatment except in an emergency situation where the doctor need not get consent for treatment. The consent obtained should be legally valid. A doctor who treats without valid consent will be liable under the tort and criminal laws. The law presumes the doctor to be in a dominating position, hence the consent should be obtained after providing all the necessary information.

Introduction

Healthcare is not only a matter of science but also of law and ethics. Every individual has the fundamental right to autonomy over their body, and this principle lies at the heart of patient consent. When a patient approaches a doctor, the relationship that develops is based on trust, confidentiality, and mutual respect.

In India, patient rights have been strengthened through constitutional guarantees (Article 21 – Right to Life and Personal Liberty), statutory provisions, and a series of landmark Supreme Court judgments. Consent in medical treatment ensures that patients make informed decisions, while doctors remain protected from allegations of assault or negligence.

Thus, understanding patient consent and their legal rights is essential for both doctors and patients.

What is Patient Consent?

Consent means voluntary agreement given by a patient after being informed about the nature of treatment, risks, benefits, and alternatives. Without valid consent, any medical procedure may amount to battery, negligence, or violation of rights.

Types of Consent

1. Implied Consent – Not verbally expressed but understood through actions (e.g., stretching out arm for an injection).

2. Express Consent – Clearly stated by the patient, either orally or in writing.

3. Informed Consent – Detailed form of consent where the patient is fully informed about risks, benefits, alternatives, and prognosis.

4. Proxy Consent – Consent given by a parent/guardian in case of minors or mentally incapacitated persons.

Legal Rights of Patients in India

Patients in India enjoy several rights which are protected under law and judicial precedents:

1. Right to Information

Patients must be informed about their diagnosis, treatment options, risks, and possible side effects.

2. Right to Refuse Treatment

Except in emergencies, a patient has the right to say NO to any treatment, even if refusal may risk their life.

3. Right to Privacy and Confidentiality

Doctors are legally bound to protect the confidentiality of medical records and health conditions.

4. Right to Emergency Care

As per Article 21, hospitals cannot deny treatment in life-threatening conditions.

5. Right to Dignity and Autonomy

Medical treatment must always respect a patient’s dignity, beliefs, and autonomy.

Landmark Judgments on Patient Consent & Rights

1. Samira Kohli vs. Dr. Prabha Manchanda (2008) 2 SCC 1

Facts: Patient consented to a diagnostic procedure but the doctor performed a hysterectomy without specific consent.

Ruling: The Supreme Court held it as unauthorized and unlawful. The Court emphasized that informed consent is mandatory and doctors cannot exceed the scope of consent given.

2. Parmanand Katara vs. Union of India (1989 AIR 2039)

Facts: A PIL was filed after hospitals refused to treat an injured scooterist due to procedural issues.

Ruling: The Court held that every doctor has a professional obligation to save life in emergencies, regardless of whether the patient can pay. This strengthened the Right to

3. Aruna Shanbaug vs. Union of India (2011) 4 SCC 454

Facts: Aruna Shanbaug remained in a vegetative state for decades. The question before the Court was whether life support could be withdrawn.

Ruling: The Court recognized passive euthanasia under strict conditions, affirming that patients (or their guardians) have a right to refuse extraordinary life-sustaining treatment.

The Legal Basis Of Consent

Consent is perhaps the only principle that runs through all aspects of health care provisions today. It also represents the legal and ethical expression of the basic right to have one's autonomy and self-determination. If a medical practitioner attempts to treat a person without valid consent, then he will be liable under both tort and criminal law. Tort is a civil wrong for which the aggrieved party may seek compensation from the wrong doer. The consequences would be payment of compensation (in civil) and imprisonment (in criminal). To commence, the patient may sue the medical practitioner in tort for trespass to person. Alternatively, the health professional may be sued for negligence. In certain extreme cases, there is a theoretical possibility of criminal prosecution for assault or battery. The traditional definition of battery is an act that directly and either intentionally or negligently causes some physical contact with another person without that person's consent. If a person has consented to contact expressedly or by implication, then there is no battery. It is a rare case in which a doctor would be held liable for criminal breach, unless there is gross disrespect to the patient's bodily autonomy, for instance, if a patient's organs are taken without his consent.

In tort law, usage of force against any human body, without proper justification, is actionable irrespective of the quantum of force. If the medical practitioner attempts to treat a patient without obtaining proper consent, he will be held guilty under tort law. Consent for treatment may be expressed or implied. The patient entering the consultation chambers by his own volition may be considered to have given consent for a clinical diagnosis to be carried out. Consent may be inferred from the general submission by a patient to orders given by a doctor during clinical diagnosis. This is an excellent example of implied consent. During the clinical examination, there might arise the need for an intimate examination of the patient, such as a vaginal examination. For such an examination, the medical practitioner must ideally obtain another consent by asking the patient's permission orally. Furthermore, if there is a need to undergo an invasive examination, such as an incision or drawing of samples of body fluids, a written consent of the patient is ideally required.

Indian Legal Framework

Indian Contract Act, 1872: The Indian Contract Act establishes the legal basis for consent, requiring that agreements be entered into freely and with the understanding of their terms.

Indian Penal Code, 1860: The Indian Penal Code addresses issues related to medical negligence and consent, outlining the legal implications of performing medical procedures without proper consent. Informed consent occurs as a critical legal principle ensuring patients understand and voluntarily accept treatment.

Medical Council of India (MCI) Guidelines: The MCI, now replaced by the National Medical Commission (NMC), provided guidelines on informed consent, emphasising the need for transparency and patient autonomy in medical decision-making.

Supreme Court Rulings: The Supreme Court of India has reinforced the importance of informed consent in various rulings. For instance, in the case of Samira Kohli vs Dr Prabha Manchanda, the Court highlighted the necessity of obtaining informed consent before medical procedures.

Ethical Considerations

Respecting Patient Autonomy: Ethical medical practice requires respecting the patient’s autonomy and right to make informed decisions about their own health care. It is essential to ensure that patients make a voluntary and informed decision by providing them with adequate information to understand their options.

Ensuring Comprehension: Healthcare providers must ensure that patients fully understand the information provided, which may involve explaining complex medical terms in simple language.

Maintaining Confidentiality: The details of the informed consent process, including the patient’s health status and treatment preferences, must be kept confidential and used only for the intended medical purpose.

The Role Of Family Members & Health Care Providers

Family members and healthcare providers play crucial roles in the informed consent process:

Informed consent requires healthcare providers to disclose critical information, such as the patient's diagnosis, prognosis, and the risks and benefits of proposed treatments.

Family Members

Family members may be involved in the consent process if the patient is unable to make decisions due to illness or incapacity.

They should be informed about the treatment options and involved in discussions about the patient’s wishes.

Healthcare Providers

Healthcare providers are responsible for ensuring that patients receive all relevant information about their treatment options and understand the implications of their decisions.

They should facilitate an open dialogue and address any questions or concerns the patient may have. It is crucial to obtain consent through a thorough and engaging process, as this step requires significant provider time and effort to ensure patients are fully informed.

Conclusion

Patients place an immeasurable amount of trust in their healthcare providers. Embedded in that trust is that healthcare providers will provide their patients with the information they need to make the best decisions possible for their health and wellbeing. Staying informed of what information you have a right to receive is a first step in ensuring that you remain an active participant in all of your health care decisions.

The principle of consent is not just a legal requirement but a reflection of respect for human dignity. Indian courts, through cases like Samira Kohli and Common Cause, have ensured that patients’ autonomy is paramount in medical practice.

Doctors must see consent as more than a formality, and patients must understand their rights and responsibilities. Only then can healthcare in India become more transparent, ethical, and accountable.

Ultimately, patient consent and legal rights together strike a balance between medical expertise and individual choice. They encourage accountability in the healthcare system, reduce conflicts, and build trust between doctors and patients. A society that respects these principles not only strengthens the rule of law but also ensures that medical care remains humane, ethical, and patient-centered.

In conclusion, patient consent and legal rights in medical treatment are not merely formalities, but fundamental pillars of ethical healthcare and human dignity. Every individual has the right to make informed decisions about their own body and treatment, free from coercion and misinformation. The doctrine of informed consent ensures that patients are empowered with complete knowledge of the risks, benefits, and alternatives before undergoing any medical procedure. At the same time, legal rights act as a safeguard, protecting patients from negligence, exploitation, or unauthorized interventions.

Here are some questions and answers on the topic:

Q1. What is patient consent and why is it important in medical treatment?

Answer: Patient consent means taking permission from the patient before giving any medical treatment, surgery, or procedure. It is important because it gives the patient the right to decide about their own body and ensures that doctors do not act without their approval. Without valid consent, any medical treatment may be considered unlawful or even an assault.

Q2. What are the different types of patient consent?

Answer: There are mainly two types:

1. Express Consent – When a patient gives written or spoken permission (for example, signing a consent form before surgery).

2. Implied Consent – When consent is understood by actions (for example, a patient rolling up their sleeve for a blood test).

In serious treatments or operations, informed and written consent is legally required.

Q3. What legal rights do patients have in medical treatment?

Answer: Patients have several important legal rights, such as:

• The right to be informed about their treatment, risks, and alternatives.

• The right to privacy and confidentiality of medical records.

• The right to refuse treatment, even if doctors advise it.

• The right to compensation if harmed due to negligence.