Aayurvigyan pragati – national medicos

(58-60 issues:2022-2024)

(Advances in the Science of Health and longevity) NMO’s Quarterly Bilingual Journal of Modern Medicine

(Initiated, Darbhanga, 8.8.1977

Est. Varanasi, 5.11.1977)

Vol.44 ; No. 1: 30 January 2024 60 th E-issue

Medicos of VAMC,Shahjehanpur in Jai ShreeRam mood on 22.1.2024 noon

C O N T E N T S

Editorial: NMO_Contoversy III….is over?.-Dhanakar Thakur 1

Crying lung breath may be impending heart failure -Rajkumar Gupta 4

Medico-legal Queries and Answers -M C Gupta (MCG),**RK Sharma(RKS) 5

CELEBRATE March 16 as National Doctors’ Degree Day (as the Real Doctors’ Day) 11,iii

THE INDIAN MEDICAL DEGREES ACT, 1916 (ACT No. VII of 1916)

स्कूल स्वास्थ्य दौरों में क्या सुझाव दें?- धनाकर ठाकुर                                  13

AIMS AND OBJECTS OF NMO (Reg. No. 21/1987-88),Central

 Executive Committee of  NMO (1.4.2023-31.3.2024),Units of NMO-  16

ABOUT THE INSIGNIA, Supplement (Vol.43: 2023)- (59^th Issue), Membership of NMO, Form of Declaration ii

National Doctors’ Degree Day (as real Doctors’ Day) ,GMC,Haldwani (Uttrakhand) on 16.3.2023 iii

Felicitation of the Founder of NMO,Dr.Dhanakar Thakur in NMO-NMC Teachers’ Meet,KN Uduppa Auditorium, IMS,BHU,Varanasi 5.11.2023 iv

NMO Central office: c/o Dr.Shanti Prakash ,Dr.Abaji Bhavan, Near RIIMS,Bariatu,Ranchi 834009

Mobile: 8210360429,9430141788 dhanakar@gmail.com

ABOUT THE INSIGNIA

AAYURVIGYAN PRAGATI is a medical journal with a Bharatiya approach. The medical insignia adopted throughout the world has been derived from the GREEK mythology–the snake/s encircling the staff (rod) of Aesculapius or Caduceus.

NMO searched for an ancient Hindu legend to symbolize Bhartiya heritage in its true sense. Rishi (Saint) Dhanwantari, the first physician treated as the mythological figure, who rejuvenated the patients by his treatment, represents the golden era of Hindu medical sciences.

The insignia visualizes Rishi Dhanwantari stepping on the land of Bharat after emerging from Samudra-Manthan (Sea-churning) said to be held between Suras (gods) and Asuras (demons) with Kalash (pot) filled with the Amrita (The Elixir of Life) which was dispensed to the patients, which also symbolises the assimilation of all living creatures and thus divinity. The manuscript in His left hand denotes Aayurvigyan (The knowledge of the medical sciences) which an Upveda of the Rig-Veda (one of the four holy books of this land). प्राणिनाम् आर्तिनाशनम् ~ (PRANINAM ARTINASHANAM) is the concluding part of a Sanskrit shloka, uttered by Raja Rantideva when he was asked by the God to ask for anything he wanted after Rantideva’s all types of tests, as described in The Srimadbhagvata. This shloka has been the source of inspiration for the people of this Hindu land since time immemorial. The full shloka is: त्वहं कामये राज्यम् न स्वर्गं नापुनर्भवम्। कामये दुःखतप्तानाम् प्राणिनाम् आर्तिनाशनम् (Na Twaham Kamaye Rajyam, Na Swargam, Na Punarbhavam Kamye Dukhtaptanam,Praninam Artinashanam) (One should not desire for a kingdom nor the Heaven, nor freedom from rebirth. Let one desire for total freedom of the ailing creatures from sufferings and diseases.)

Supplement (Vol.43: 2023)- (59^th Issue)

Subject Index

BMS (Bachelor in Medical Science) Equivalent to pre-Independence LMP be Started. – Dhanakar Thakur 1

Medico-legal Queries and Answers -M C Gupta (MCG), RK Sharma (RKS) 2

Diet and Exercise relationship- MC Gupta 8

Virus: Poison Particle or Genesis of New Life -Dhanakar Thakur 13

विषाणु: विष वा नवजीवनक निर्माण(मैथिली)- धनाकर ठाकुर – 15

ABOUT THE INSIGNIA, Supplement (Vol.42: 2022) – (58^th Issue), Membership of NMO,

Form of Declaration ii

National Medicos Organisation – इतिहास के पन्नों से (14. 8.1977)। सेवा हि धर्मः। iii

Central Executive Committee of NMO (1.4.2022-31.3.2023), Units of NMO- iv

AUTHOR Index

धनाकर ठाकुर – – विषाणु: विष वा नवजीवनक निर्माण(मैथिली)- 15

Dhanakar Thakur – BMS (Bachelor in Medical Science) Equivalent to pre-Independence LMP \

be Started. (Editorial)- 1

Virus: Poison Particle or Genesis of New Life 13

M C Gupta (MCG) – Diet and Exercise relationship 8

Medico-legal Queries and Answers 2

RK Sharma (RKS)- Medico-legal Queries and Answers 2

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Membership of NMO – Annual membership will be effective from 1st April to 31^st March next. Emphasis is on life membership. Writing your details and permanent address with a photo on Whatsap on 9430141788, inform on us after depositing your Life Membership fee( with donation & for the Aayurvigyan Pragati) -Rs. 500 students (MBBS/ BDS students, interns and PGs) / other Doctors Rs.1000 in the account of “National Medicos Organisation,” in the S/ B account no. 480102010871390 at UNION BANK of INDIA, Shyamli, Ranchi ,IFSC: UBIN0548014 and inform on SMS 9430141788.

Form of Declaration (Form 4, Rule 8)- Statement about ownership and other particulars about newspaper :

Name of Journal – Aaurvigyan Pragati, R.N. 39581/81, 1. Place of publication – C/O Ramnaresh Jha, Professor colony, Lalbagh, Darbhanga 846004,2. Periodicity –quarterly, 3. Printer’s name – Dr. Dhanakar Thakur, Nationality- Indian ,Address – C/O Ramnaresh Jha, Professor colony, Lalbagh, Darbhanga 846004. 4. Publisher’s name – Dr. Dhanakar Thakur, Nationality- Indian, Address – C/O Ramnaresh Jha, Professor colony, Lalbagh, Darbhanga 846004 5. Editor’s name- Dr.Dhanakar Thakur , Nationality Indian, c/o Ramnaresh Jha, Professor colony, Lalbagh, Darbhanga 846004 .

Name and address of Association who own the newspaper and partners and shareholders more than 1% of the total- National Medicos Organisation, D-234, Vive Vicar, New Delhi 110095 – 100%

I, Dr. Dhanakar Thakur, Publisher of Aayurvigyan Pragati, hereby declare that the particulars given above are true to the best of my knowledge and belief Dated: 30.1.2024. (Sd/Dhanakar Thakur),Publisher (applied through SDO Press section, Darbhanga for changes on 22.2.2121) आयुर्विज्ञान प्रगति Aayurvigyan Pragati 43;1:ii

CELEBRATE March 16 as National Doctors’ Degree Day (as the Real Doctors’ Day) as was celebrated at GMC,Haldwani(Uttrakhand) on 16.3.2023

आयुर्विज्ञान प्रगति Aayurvigyan Pragati 43;1:iii

Regd. with the Registrar Newspapers for India R.N.39518/1981 आयुर्विज्ञान प्रगति AAYURVIGYAN PRAGATI

Felicitation of the Founderof NMO,Dr.Dhanakar Thakur in NMO-NMC Teachers’ Meet,KN Uduppa Auditorium, IMS,BHU,Varanasi 5.11.2023

Published E-Printeduused to be printed at National Printers,

Ranchi 834010 (applied through SDO Press section,

] Darbhanga for changes on 22.2.2121) by

Dr. Dhanakar Thakur For the National Medicos Organisation

Editor: Dr. Dhanakar Thakur Prof.Medicine

]VAMC,BismilasfaqueRoshanur(Shahjehanpur)242307

Editorial: NMO_Contoversy III….is over?

– Dhanakar Thakur, Founder, NMO, 9843376861, dhanakar@gmail.com

November 5,2023,KN Uduppa Auditorium, BHU is a milestone in my personal life when some important members of the NMO ( Dr. Vijayendra Kumar, Dr Vihswambhar Singh, Dr.Sachhidanad, Dr. CB Tripathy, Dr. Ashwini Tandon, Dr. Saurabh K Jha etc.) realized that what happened with the founder of the NMO in the previous two decades after an informal split in the NMO on 22.12.2005 at Agra was wrong and wrong decisions were washed away in the water of holy Ganga by their efforts.

Timeline-

November 10, 2002- Delhi Silver Jubilee,

February 23, 2003 Mumbai– Secret core committee meeting to dissolve

NMO in Ayogya Bharati with my exclusion probably thinking me as an obstacle

April 12-13,2003- Indore- XXVI National Conference

September 14-15,2002 Meeruth – CEC

March 20-21 2004 Patna XXVII National Conference

July 23-24, 2005 Ranchi CEC

XXVIII Dec. 22, 2005 Agra –NMO split

As PP Guruji used to say,’ in a big meeting workers are broken and small workers are mad,’ so happened with the Silver Jubilee of the NMO on November 10,2002 and some of those persons who had an idea to exclude me met at Mumbai on February 23,2003 without my information which was the most pathetic part. I never used to say that I was the founder of the NMO with its first concept and sincere work devoted so much that my even newly-wed wife left me for this writing in a letter within five months of marriage (NMO-RSS mujhse nahi chalega, although she was hinted about it showing the photograph of the Vivekananda Rock memorial under the table glass of the chambers of Dr Sujit Dhar where I had invited them to come instead any hotel..but merely saying that Dr Dhar dedicated his life for the Vivekananda Rock Memorial Kanyakumari and I was also doing such work was probably not sufficient)..

Indore conference was my last decision and local workers were unaware what happened in between after Mumbai meeting and when I knew the decision through an inland letter of Ma. Bhaiyaji Joshi I kept mum that the conference goes smoothly. I took a chance to visit Omkareshwar leaving my journey at Khandwa and when I reached Indore already inauguration etc had been done. When Dr Pravin Bhavsar asked me for some names in the CEC I told now decisions are to be taken by others.

When Ma. Bhaiyaji called me second day in the presence of Dr PT Chandra Mouli and Dr. Narendra Prasad. I asked him why you did not call me for the Mumbai meeting. He told me that I had called many more persons at Kolkata meeting (14.7.2002) when Ma. Sarkarywah (Dr Mohan Bhagwat) had come for that meeting. (I had a thinking that when Dr Punit Bedi will leave for many years there will not be possible any big meeting so I had called the whole executive there and had asked for a general meeting of medicos which was held where Dr. Dilip Sarkar announced to be a full time worker and meeting was very successful otherwise. There on my direction that we should have good work at Delhi till it was our capital Dr Mohan Bhagwat frowned me why to which I had replied Delhi represents the defeated Hindu nation not the pride. I did not tell him that I had already written somewhere would rather prefer Jabalpur as new Capital).

In fact after Kolkata meeting I had written him in a postcard that we may instead have again a meeting of some important NMO workers at Ujjain, after the Conference but he instead had called Mumbai meeting.

Ma. Bhaiyaji told me to work whatever was asked in a Sanghik parmpara to which I simply said kindly do not say me that as I was son of a Sanghchalak father who was 20 months in jails in 1948 when my mother had 4 months child, my eldest brother, in her laps (and in fact, she had told me that out of familial criticism by my aunts she once had decided to suicide by jumping in the village pond with child).

And then I asked Ma. Bhaiyaji to kindly explain under which Sanghik tradition I was not called in the Mumbai meeting to which he told,’Galti Ho Gayee.’ I would have been very happy had he told to relinquish NMO work and could have told me to work in the political or other fields which I could have accepted happily as by that time I had already established my reputation in Mithila (and by the next year my mother tongue Maithili came in the VIII Schedule for which my founded Antarrashtriy Maithili Parishad was the greatest contributor).

When I had shown his inland letter to me (karyakartaon ne vichar kiya etc…After Mumbai meeting) to Dr H P Narayan he was shocked and even he was not informed about that meeting.

On Dr. H.P. Narayan’s insistence I went Meerut for the CEC but there my views to have national conference at Gaya was modified to Patna by Dr Narendra Prasad that Ma. KS Sudarshanjee may address to which I had opposed (tthat conference be held for the organizational necessity not for the proximity of top persons which even Bhaiyaji accepted at Ranchi 24.7.2005 where I had also suggested to him that as to who should not be given post of President/Secretary for which reason but it was not accepted ). I had gone for some minutes Patna conference also on 20.3.2004 where I felt as if I was a persona non grata there. When I was informed for a single day conference on a working day , Wednesday, December 22,2005 with uninformed constitutional overhaul which in fact were invalid I was surprised. Leaving my mother alone with my nephew at Ranchi I had first gone to my ailing brother Mumbai and from there I reached Agra . Instead with the workers I was from the Cant station taken to Dr Pawan Gupta’s residence and in the morning in the conference I would have announced the democratically invited names of the president and secretary which the office secretary Dr K P Sinha had given me the in the envelopes which I as the first life member had invited through email groups to rejuvenate work amongst young medicos of whom the NMO belonged but the anchor announced some name which was not acceptable by all and an evitable was split when Dr. Madhup Kumar in general body expressed unhappiness that even founder was not allowed to speak in the inauguration. Someone remarked something on the treasurer to which I protested that Dr. Satish Midha was very honest worker.

Then I decided to go with younger workers. For two decades I had been aloof but in working with some new faces and could do something. Dr. Archana Sharma in between invited me to come to Tirupati conference but again I thought may be Patna repeated and did not go. Dr. Vijayendra Kumar on phone regularly used to talk me in between and always informing the progress in Sewa yatras.

Providentially it happened so that I had to join as a professor of general medicine at the Heritage IMS, Varanasi on 19.8.2023. Dr Vishwambhar Singh, IMS, BHU in long telephonic talks probably realized the truth was with me. At Kalyani Conference an article from my autobiography was extracted by Dr Saurabh Jha and Dr Vijayendra Kumar but there expression of ‘WE’ instead ‘I’ of the autobiography made things worse and I had to protest. Every ‘we’ for an organasation starts from’I’ and that they could understand quickly.

I would have been happy if the article would have a conclusion that the founder of the NMO Dhanakar Thakur was expelled or excluded from the NMO for this or that reason as one cannot change the history who was the founder who conceptualized first. Saurabh had long talks with me when I visited his house on 19.5.2023 at Katihar.

On 10.6.2023, a delegation of NMO led by Dr CB Tripathy, Dean, Dahod Medical College, Gujarat came to meet me at the HIIMS, Varanasi. Ashwini Tandon, youth as one of the Ashwini Kumaras was now a professor at the AIIMS, Bhopal who was only known face to me. Dr. Vishwambhar was there and also Dr.Sachhidananad from Jaunpur who later talked regularly on phone and also Dr S Tiwary, IMS, BHU. I was overwhelmed but refused to take felicitation as the matter should be from the Margdarshak level. Dr CB Tripathy despite being a senior person even touched my feet though he might have been unaware that I was a Brahmin and touching feet of senior non-Brahmin is only exceptional.

I was then invited for Nov 5, 2023 meeting by Dr. Sachhidanand and Dr Vishwambhar tracked me all along but I did not ask any arrangement for me. I asked Dr.Rajkumar Gupta of Agra who in the intervening period had successfully rooted NMO in Agra and around. I also asked young joint secretary Mohit whether I should go there and they said to go. Still I was skeptical. Reaching Varanasi I had already done my puja at station itself and reached KN Uduppa auditorium where programme was already going on. I sat on back bench but someone noticed me and my name was announced and I was escorted to front bench and was the introduced by Dr Vijayendra Kumar as the founder of the NMO and so many good words that how from one person the NMO could be nationwide by my efforts and was asked to have standing ovation.

The NMC chairman Dr BN Gangadhar and his team was there and in reply I said that it was an honor to the founder a 22 year boy Dhanakar not to Prof Thakur again telling that it was an organization of medicos , medical students.

For me this was an honor when my home was demolished by goondas and was under severe mental tension .Question is whether Crisis III was over…? Margdashak is not organising secretary but a friend, philosopher and guide needs to be understood before the matter is resolved finally…..and despite being founder I had chosen a role of the Organising Secretary in 1980 in I NMO Conference which even today I hold without expectation of any return in personal life..Yet thanks who had given honor to me…

Crying lung breath may be impending heart failure

* Rajkumar Gupta

Breathing difficulty or shortness of breath is one of the most common symptoms reported these days. It is often accompanied with chest tightness and feeling suffocated. People of all age groups at some point of time or the other have had trouble breathing, which may be due to cold climate, individuals having past history of allergic conditions, asthma or it could be due to the ongoing corona virus induced or other infections. However, there is always a possibility that this symptom may be due to some other reasons or an underlying medical problem related to heart disease.

Most common other causes of difficulty in breathing include: catching common cold or flu, lack of exercise, obesity, pregnancy, stress, anxiety or depression. On the other hand, there are certain serious medical conditions that can also cause breathing difficulty. These include: lung diseases such as asthma, COPD, chronic bronchitis, emphysema or it can even be an early warning sign of developing heart failure as well.

In fact, shortness of breath is considered to be one of the early warning signs of heart failure as per Heart Failure Society of America. Shortness of breath initially occurs with exertion but may get progressively worse and eventually occur at rest in severe cases.

Heart failure is a condition where the heart is unable to pump enough blood to satisfy the body’s need for blood, oxygen and other nutrients. This is caused by either diseased heart muscle which is too weak to pump enough blood to the body or a thick, stiff heart muscle which does not relax enough to be filled with blood.

Several studies have suggested that people who faced a heart failure often had certain warning signs hours, days or even weeks ahead of the actual event and if these were addressed early, potential event including re-hospitalization & risk of worsening of symptoms & death could have been be averted.

It is important that Heart failure is identified early and treated. Nowadays, advanced tests are available to help determine the cause of Heart Failure and treatments are available that have been shown to reduce hospitalizations and death from heart failure.

Hence, one should never ignore unexplained breathlessness, as it may be due to a serious underlying health condition including risk of developing heart failure. If one experience shortness of breath repeatedly and even after taking any medications or treating any underlying infections or other medical conditions if it is not getting cured, then further medical care be sought without any delay.

*Dr. Rajkumar Gupta, (M.B.B.S., M.D., FIACM, FISC) Agra Medicity, Agra

Medico-legal Queries and Answers

*M C Gupta (MCG), **RK Sharma (RKS)

The conflict of medical ethics and law;IMA–Haryana Why healthcare services should not be included within the purview of Consumer Protection Act; suggested that medical professionals should be protected from legal action just like public servants are protected against bonafide errors in their action.;

1612–Can an anaesthetist hand over the case to another anaesthetist midway during an operation?

The black goat’s milk

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The conflict of medical ethics and law

June 08, 2022

What is medical ethics and how does it conflict with law in India. My own definition of medical ethics is a way of life and the way we conduct ourselves which we imbibe during our professional training by observing and working with our seniors. Ethics is related more to morality than to law. In India however Doctors face difficult decisions which challenge their ethics whiletrying to remain within boundaries defined by law. Today

there is so much incursion of law into medicine that ethics is fast becoming a casualty. There is a difference between an unethical act and an illegal act and I would today prefer to do something unethical rather than fall foul of the law.

Is it ethical that a Senior Resident posted in emergency decides to give the only available ventilator to a patient whose death will result in higher compensation claim. With the legal dictum of “restitution in integrum” being the catch phrase while deciding the quantum of compensation in cases of medical negligence, it is natural that such decisions would favor the rich. A poor patient’s death will not result in massive compensation claims. This is a classical situation where law as it exists today is in direct confrontation with medical ethics.

Then there is the issue where even a High Court mentions in its judgment that had patient died it might have been better for the relatives compared to the existent vegetative state.

The patient had had cardiac arrest and was resuscitated but had suffered brain damage. This is not a one off example.

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Ex-Prof. *M C Gupta, MD (Medicine), LLM, Advocate mcgupta44@gmail.com

medico-legal-queries-subscribe@yahoogroups.co.in

** R K Sharma, MBBS (AIIMS), MD (AIIMS), FIAMLE, FICFMT, Medico-Legal Consultant, President, Indian Association of Medico-Legal Experts, New Delhi.,Ex- HOD, FMT, AIIMS, New Delhi, Supreme Medico-legal Protection Services Pvt Ltd,1704, Logix Office Tower, Logix City Centre Mall, NOIDA 201301 E-mail: medicolegalhelpline@gmail.comWebsite: http://www.smlps.in

Compensations in general are calculated on the basis of what will be the future medical and other needs of a patient who is in a vegetative state or who develops a disability but whose life has been saved.

It is well neigh impossible to predict beforehand which case of cardiac arrest will recover fully and which will suffer brain damage despite Cardio Pulmonary Resuscitation. To avoid huge compensations a thought will start to cross the minds of healthcare workers leading to doubts which will not be interest of the patients and society.

We know very well that medical science today can save a patient with renal

Failure by doing a kidney transplant.

How does it remain ethical for doctors in India that we allow 1.18 lakh of 1.25 lakh cases of renal failure occurring every year in India to die a slow and expensive death but refuse to do transplant. A poor person wanting to sell his kidney so that he can marry his daughter offends our sensibilities. These sensibilities are not offended when we see abandoned elderly and poor in religious places, or when we see people sleeping on footpaths with their families trying desperately to eke out a living in our cities. The kidney sale racket flourishes despite the legal clampdown, and donors are exploited by tall promises which remain unfulfilled later because of the mafia which operates this trade. Why could it not be legal that a person wanting to sell his kidney gets a fair amount of money and assured healthcare supervised by the state agencies while simultaneously saving thousands of lives. We have allowed sale of semen, hair, human eggs for reproduction, blood and even the renting of a surrogate mother’s womb so far. There is a desperate need for donor kidneys, there are thousands of farmer suicides and incidents of parents selling or killing their children because of poverty and the technology and the expertise to tackle both the issues exists across the nation.

We are shackled today by Honorable Supreme Court Guidelines in Samira Kohli vs. Dr Prabha Manchanda case where it has been ordered that if a patient is already under anesthesia and a doctor finds something which requires a furtheprocedure he should let the patient to come out of anesthesia, and do the second surgery at a later date after separate consent even though it may be in interest of the patient to do the second procedure

during the first surgery itself. As per the judgment Doctors should not to be concerned that the cost and risk of the second surgery and anesthesia could be avoided. This is again an incident where ethics of doctors clash with the law as it exists today.

Is it ethical that doctors today are forced to practice defensive medicine. Despite having much more experience, senior gynecologists are refusing to deal with obstetrics. High risk cases are now routinely referred to tertiary care centers when treatment given early at the periphery itself could have saved the patient. I myself am guilty of this since I have stopped taking cases of GI Bleed, Foreign body ingestions, dilatations and CBD stones all of which I treated my entire life . Now I refer them to others despite having so much more experience than what I had 32 years ago.

Doctors are afraid today to assist those in need of their expertise in an emergency for fear of legal problems and compensation claims. The way a patient walks into the consultation chamber, history , gentle probing fingers of the doctor and a stethoscope, generally is sufficient to make a diagnosis but fear of litigation forces doctors to do imaging studies and investigations which only confirm what they already know.

The permission given to do abortions up to 24 weeks has opened another r vista of conflict where a doctor who knows that a 23 week fetus can survive with proper care is asked to do abortion and he cannot on religious grounds refuse to do the same. Denying a doctor permission to advertise and only rely on word of mouth to source his patients has resulted in cuts and commissions which have become so rampant. Even doctors who leave the country face an ethical dilemma where law denies them opportunities and rewards which they otherwise deserve.

Law has barred doctors from claiming to be specialists when they do not have a MCI/NMC recognized qualification in that branch. A number of MBBS & MD/MS doctors have received training and are experienced in particular specialties and superspecialties but they are not qualified. In areas of need there are opthlamologists who have been giving anesthesia in a mission hospital for more than 20 years. Today it is negligence per se and generous compensations awarded. Even in Government hospitals specialists and superspecialists are not available in each category and those with training and experience carry the load. So many Government / army surgeons have been operating by giving anesthesia themselves with good results primarily because anesthetists were not available. For doctors to refuse the work assigned specially for the patient in need knowing that he can help, it is very difficult. Law however today is forcing them to change. The days when a surgeon or even an MBBS doctor could work in area of need and perform general surgery, Gynae surgery , orthopedic surgery and even neurosurgery are surely over. He may be competent and experienced to save many more lives but it is now important that the first person he saves is he himself.

Similarly senior retired doctors or those with medical issues used to do a limited medical practice for a few hours every day in their residence. With Clinical Establishment Act notified there is now a need to fulfill all minimum standards of the appropriate category plus maintain infrastructure and staff to tackle any emergency patient even outside of their working hours. Rather than stabilize any emergency which comes to their clinical establishments, they prefer to stop practice altogether even though they have so much to give to the society in terms of their professional experience & knowledge even though it is in conflict with their own ethics.

The Artificial Reproductive techniques have opened another can of worms as regards ethics. Forcing a 60 year old woman to be a surrogate or conjuring a baby for Karan Johar through surrogacy is fraught with ethical pitfalls even though it may not have been illegal when it was done.

The PCPNDT Act has forced many an ultrasonologists to stop doing obstetric ultrasound. Despite ultrasound being single handedly responsible for decreasing the maternal mortality its use is restricted because of legal problems. Ideally this useful equipment should be ubiquitous and should be available in all clinics like a stethoscope but unfortunately at least in my case I had sold my ultrasound machine the day PCPNDT Act became operational in Chandigarh. In the last 20 years feticide has been replaced by infanticide. A social ill has been tried to be treated with a bureaucratic pill and unfortunately it has obviously not achieved its objective and simultaneously y has probably contributed to some avoidable maternal mortality.

Passive euthanasia though has been permitted by the honorable Supreme Court in Common Cause Society vs. Union of India case decided in 2018. However the procedure prescribed is so convoluted that to my knowledge not a single incident of legally correct procedure being followed to honor an advanced directive is there so far. This despite the fact passive euthanasia occurs daily in or immediately outside all hospitals across the country. Switching off the ventilator even as prescribed under TOHOA is difficult. Cost of treatment is the most frequent reason for the request to remove the ventilator and doctors are routinely placed in the moral and ethical quagmire having to decide issues with an unsympathetic law and order machinery looking over the shoulder. Unfortunately the cost of treatment has been taken out of a doctor’s control.

Trying to accede to a special request of a patient is another area where doctors fall foul of law of the land. Not informing the police following tearful requests parents of a 16 year old suicide attempt patient, performing MTP on rape victim, not mentioning history of ethanol intake so that insurance claim of patient is not denied, trying to conduct delivery at the date and times asked for are all examples where doctors land up in a soup even when their intention is to help the patient Both the Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations, 2002 as well as the voluminous National Medical Commission Registered Medical Practitioner (Professional Conduct) Regulations, 2022 draft of which has been placed in public domain by the NMC do little to settle the issues raised here. It may be better for the NMC to ponder some more, try and solve the conflicts between medical ethics and law, before adopting the new regulations.

Dr Neeraj Nagpal, Managing Trustee Medicos Legal Action Group9316517176 hopeclinics@yahoo.com www.mlag.in

Rep_MCG-: We have allowed sale of semen, hair, human eggs for reproduction, blood and even the renting of a surrogate mother’s womb so far.

>>> I think this is a wrong statement. I do not think we have allowed sale of semen, human eggs and blood.

[medico-legal-forum] The Karnataka High Court has suggested that medical professionals should be protected from legal action just like public servants are protected against bonafide errors in their action.

Mahesh Sinha Wed, Jan 19, 2022, 4:43 PM The Karnataka High Court has suggested that medical professionals should be protected from legal action just like public servants are protected against bonafide
Dr T.A. Vasu Sun, Jan 23, 2022, 2:45 PM A welcome decision. Dr T.A.Vasu, M.S, FMAS, FIAMS, LL.B. +919447018687 Professor of Surgery, Azeezia Medical College, Meeyannur, Kollam. Former Professor of Surgery
Dr Dhanakar Thakur dhanakar@gmail.com

Welcome and a just stand ,

Dhanakar Thakur, Founder, National Medicos Organisation

medico-legal-forum] 1612–Can an anaesthetist hand over the case to another anaesthetist midway during an operation?

Thu, May 27, 2021, 5:51 PM

On Thu, May 27, 2021, 5:51 PM Dr.M.C. Gupta <mcgupta44@gmail.com> wrote:

1612–QUESTION—Is it OK medico-legally that when the patient is on the operation table, the anesthetist who started the anesthesia hands over the case midway to another anesthetist who was expected to be present from the beginning but was not available initially?

ANSWER:

1—In theory, there is no illegality involved as long as there was proper handing taking over (also, explaining in writing the reason for such handing-taking over) with necessary documentation.

2—It would be prudent to avoid such a situation because it is an uncommon situation that unnecessarily puts the focus and blame upon the anesthetist in case of a mishap.

3—It should be ensured that consent for the anesthesia / anesthetist is taken and recorded.

[medico-legal-forum] The black goat’s milk

		Mon, Apr 19, 2021, 1:30 PM
The black goat’s milk I once witnessed a very successful senior consultant explain precautions for a patient with Irritable Bowel Syndrome. He said that on full

Dr Sanjay P S Tue, Apr 20, 2021, 11:48 AM This is unbelievable sir. A modern medicine doctor endorsing a so called ayurvedic drug and that too for COVID. It’s plain unethical and probably illegal too. T
Akhil Sangal <akhil.sangal@gmail.com>	Wed, Apr 21, 2021, 8:16 PM
to Anagha, Anagha, MLForum

Dear Dr. Nagpal,

Thanks for your outspoken statement. Kudos.

There used to be a hakim in Daryaganj in the 70s – a specialist in “Jaundice” – viral hepatitis A (mostly at that time). His strategy was to see patients not before the third week of illness and then his “miraculous potions” would work like magic; reinforcing his reputation. If the patient did come earlier, he would disdainfully send to then Irwin Hospital or incompetent “angrezi dawai wale” to try them out lest somebody tells them that they should have had “proper” medical care (a brilliant marketing strategy – killing two birds with one stone.

The two references that you have quoted are not the only ones –

Q: After travelling from high risk Delhi and Delhi Airport, As a precaution, how many days of self isolation is better for safety of my family and other precaution plus

Looking for expert advice only.

A: From a colleague of his 14 days

And ivermectin 12mg one tab three days should be taken with natural giloy and tulsi..it’s from Medanta
Additional Answers – both non – medicos!!

Be safe !! With medicines also try home therapy.. it is beneficial..
5 days will give you a good sense of well being !!! from a policy advisor in exalted circles.

There are a plethora of examples of bigotry. My comments about the “Medical research” https://roastedamygdala.com/2021/04/research-in-india/ (You may enjoy the Gastroenterology connection or may have come across already).

* Compliance – Conformance pressures initiate this(mostly) leading to Vainglory (Highly addictive) and perpetuated by greed and power.

Discerning common sense is the only saviour rather OMG, what can I do!!!

* Falsified data is a widespread problem. So are many claims. However, it is recommended to keep an open mind and have a fair trial before concluding either way.

* “Anekantvad” and “vivek” have been distinct Jain tenets. Find and traverse your own path and at your own pace are fundamental. However, we all need some guidance (hence Gurus and groups like these), but don’t follow blindly or reject out rightly.

Dr. Akhil K. Sangal,Honorary Director – Indian Confederation for Healthcare Accreditation, Phone: 91-11-79602752 Mobile: 9811061853
B 2 / 211, FF, Safdarjung Enclave, New Delhi – 110 029 INDIA. Alt E-mail: dr_sangal_hon_dir@icha.in Please Visit Web Page: https://www.icha.in

CELEBRATE March 16 as National Doctors’ Degree Day (as the Real Doctors’ Day)

THE INDIAN MEDICAL DEGREES ACT, 1916 (ACT No. VII of 1916)

(Passed by the Indian Legislative Council) (Received the assent of the Governor-General on the 16th March 1916)

An Act to regulate the grant of titles implying qualification in Western medical Science and the assumption and use by unqualified persons of such title. Short title and definitions

WHEREAS it is expedient to regulate the grant of titles the grant of titles implying qualification in western medical Science and the assumption and use by unqualified persons of such titles, it is hereby enacted as follows.-

1. This Act may be called the Indian Medical Degrees Act.1916.

2. In this Act. “Western medical science” means the western methods of Allopathic Medicine Obstetrics and Surgery but does not include the Homeopathic or Ayurvedic or Unani system of medicine and 1(state) means all the territories which immediately before the 1st November 1956 were comprised within Part A State, Part C States. Right to confer degrees, etc

3. The right of conferring granting or issuing in 2(the State) degrees diplomas, licenses certificates or other documents stating or implying that the holder grantee or recipient there of qualified to practices western medical science, shall exercise able only by the authorities specified in the schedule and such other authority as the 3(State Government) may, by notification in the 4(Office Gazette) and subject to such conditions and restrictions as (if) thinks fit to impose authorize in this behalf. Prohibition of unauthorized conferment of degrees etc

4. Save as provided by section 3 no person in 2(the States) shall confer grant or issue or hold himself out as entitled to confer grant or issue any degree, diploma license certificate or other document, stating or implying that the holder grantee or recipients qualified to practice western medical science.

Contravention of section

5. Whoever contravenes the provisions of section 4 shall be punishable with fine which may extend to one thousand rupees; and if the person so contravening is an association, every member of such association, who knowingly and willfully authorizes or permits the contravention shall be punishable with fine which may extend to five hundred rupees.

Penalty for falsely issuing or using medical titles

6. Whoever voluntarily and falsely assume or uses any title or description or any addition to his name implying that he holds a degree, diploma, license or certificate conferred granted for issued by any authority referred to in section 3 or recognized the General Councils of Medical Education of the United Kingdom or that he is qualified to practice western medical science, shall be punishable with fine which may extend to two hundred and fifty rupees, or if the subsequently commits and is convicted of an offence punishable under this section with fine which may extend to five hundred rupees.

1 Added by the Adaptation of Laws order, 1950 and the words, “the territories of the time being comprise” were replaced by the words “the territories which immediately before the 1st November 1946” were comprised by the Adaptation Laws, No.2 Order of 1956.

2 Substituted ibid for “the Province”

3 Substituted for “Provincial Government” by the Adaptation order, 1950.

4 Substituted by the Government of India (Adaptation of Indian Law) Order, 1937 for “Gazette of India” Provided that nothing in this section shall apply to the use by any person of any title, description or addition in which 6(Prior to commencement of this Act) he used in virtue of any degree, diploma license or certificate conferred upon or granted or issued to him.

Cognizance of offence

7. No Court shall take cognizance of an offence punishable under this Act, except upon complaint made by order of the 3(State Government) or upon complaint made, with the previous sanction of the 3(State Government) by a Council of Medical Registration established by an enactment for the time being enforce in 5(the State) Jurisdiction of Magistrates

8. No Court inferior to that of a Presidency Magistrate or a magistrate of the First class shall try any offence

punishable under this Act

SCHEDULE. (See Section 3)

1. Every University established by 1(a Central Act.)

2. The State Medical Faculty in Bengal

3. The colleges of Physicians and Surgeons of Bombay.

4. The Board of Examiners, Medical College, Madras.

The following authorities are been subsequently added to the Schedule

5. The united Provinces State Board of Medical Examination 2 (Government of India Medical department, Notification No.524 dated 11th August 1916)

] 6. The Burma Medical Examination Board 3(Government of India. Home Department. Notification no.22 dated 3rd April 1917).]

7. The Bihar and Orissa Medical Examination Board (Government of India. Home Notification no.22 dated 3rd April 1917)

8. The Assam Medical Examination Board (Government of India, Home Department Notification No.1024-C, dated 22nd December 1917),

9. The Central Provinces, Medical Examination Board (Government of India, Home Department Notification No.533-c, dated 28th January 1918)

10. The Punjab State Medical Faculty (Government of India, Department of Education and Health Medical Notification No.1140, dated 9th November 1921) 6 Prior to “April 1946” for Banganapalee and Pudukkottai State, Vide notification in Fort ST. George Gazette Extraordinary, dated 31st March 1949 G.O.Ms.No.1180, P.H. dated 29th March 1949.

5 Substituted “ibid for the”

1 Substituted by the Adaptation of Laws Order 1950 for “an Act of the Central Legislature”

2 Converted into the United Provisions State Medical Faculty from 15th November 1926 (vide item11 above)

3 VII of 1916 (that paragraph by section

5 of the Madras Re-enacting No. 1 Act, 1948 (Madras Act VII of 1948)

11. The United provisions State Medical Faculty 4(Government of India Notification Department of Education, Health and Lands No.1964, dated 16th December 1926 with effect from 15th November 1929).

12. The University of Rangoon 5(Government of India, Department of Education, Health and Lands, Notification No.52-60-33-H, dated the 11th July 1933. Recognition granted retrospectively from 1st December 1920).

13. The Andhra University Government of India, Department of Education, Health and Lands Notification No.52-6033-H, dated the 5th October 1933.

स्कूल स्वास्थ्य दौरों में क्या सुझाव दें?

धनाकर ठाकुर

(जैसा कि जब भी मेरे पास समय होता है तो मैं दौरा करता हूं; लगभग 70-75  स्कूलों का दौरा किया; एनएमओ सदस्यों को इसे अपनी आदत बनानी चाहिए) -

सुबह उठकर बोले हाथ देखते –

कराग्रे वसते लक्ष्मी करमध्ये सरस्वती करमूले तु काली प्रभाते करदर्शनम्।

समुद्रवसने देवी पर्वतस्तन मंडले

विष्णुपत्नीं नमस्तुभ्यं पादस्पर्शं क्षमस्व मे

कह पृथ्वीमाता को छू प्रणाम कर बिस्तर से उतरें।

पैखाना के बाद पेशाब रास्ते को‌ नहीं छूवैं केवल पीछे धोने हाथ लगाएं।वह हाथ आगे न लायें। वह नहाते समय धूल जाएगा।

तीन बार साबून से हाथ धोयें। 15 दिन में नाखून काटें।

दांत के लाल ऊपर और उजले के बीच रगड़ना,उजले पर नहीं।

रात में सोते समय दांत धोना अधिक आवश्यक।

जलपान में मोटी रोटी या चूड़ा –दही-केला खाना।

उसना चांवल अच्छा अरवा से।

भोजन में दाल गाढ़ी। दूध एक गिलास दिन में।

साग सब्जी अधिक,आलू कम,गाजर जरूर।

घी,सरसों तेल,सफोला बराबर बराबर महीना भर ख़र्च के लिए पैकेट खरीद कर प्रयोग करें।

नमक कम, चीनी कम ।

हरेक एक अमरूद

का पेड़ रोपे। जन्मदिन पर कोई एक वृक्ष हर साल।

हर घर में सब्जी एक खेत में उपजायें।

खेलकूद कबड्डी,खो आदि जरूर।

नशापान नहीं करें। निराश नहीं हो।आत्महत्या की बात सोचें नहीं।ऊंचा लक्ष्य रखें।परिश्रम करें।कल कभी नहीं आता है। पढ़ कर दूसरे को पढ़ाया करें साथी या जूनियर को।भारत माता की जय।

A list of schools visted by Dr.Dhanakar Thakur for school health services

No	Date/s	Place	State	School	What

AIMS AND OBJECTS OF NMO (Reg. No. 21/1987-88)

To create a nationwide organisation of the medicos on a democratic basis, irrespective of caste, colour, creed and sex for ‘positive health’ of the nation.
To work for the all-round welfare and development of the medical profession.
To utilize their energy and dissemination of the medical knowledge for solving the various health problems of the downtrodden people of the nation particularly for the rural and tribal people with the help of central and state governments, educational, professional and voluntary organisations.
To work for satisfying the basic needs of the medicos and to guide and help them in solving their various problems arising from time to time.
To develop national character and discipline among the medicos.
To promote constructive activities in social and cultural spheres and utilise medicos’ energies in the various nation-building activities.
To promote progressive outlook among them along with love for the cultural heritage of the land.
To develop harmony and homogeneity among the various components of the society by reviving a sense of tolerance and brotherhood.
To seek the cooperation and good- will of doctors, educationists, educational and health authorities in the work of the NMO.
To promote better teacher-student relationship in medical colleges and institutes.* * and to establish such model institutions.(added in 2007)
To promote the academic environment in medical colleges and institutes.
To form a common platform on the basis of a common mode of work for all the members of the medical community, viz., students, doctors and educationists for the reorganisation of medical education in the comprehensive context of national reconstruction.

Central Executive Committee of NMO (1.4.2023-31.3.2024)

President –Dr.Ashok Goyal, 45/2 Kashmir Avenue, Amritsar 143001 Mo.9815799687

Vice-President:-Dr.Shanti prakash,Hilsa(Nalanda) 801302

Secretary – Dr.Lal Thadani, Ajmer Mo. 8005529714

Joint Secretaries:-Dr.Ashutosh shukla ,Prayagraj Mo 9721292604

Vikaskumar, Motihari Mo.8127751651

Organising Secy.-cum- Treasurer-cum-editor AP: Dr. Dhanakar Thakur,

Vill.Samaul,PS Madhubani 8472222 Professor Medicne, VAMC, Banthra, Sgahjehanpur(UP)Mo. 9430141788, 9843376861, e-mail: dhanakar@gmail.com

Members-:Dr. Rajkumar Gupta,Agra, Medicity Hospital, Sikandara, Agra Mo.9837078814

Dr Manish Kumar,Delhi.Neurosurgeon, Gohi(Samastipur), Mo.9840267857,

Dr.Niranjan, Karnataka Mo.  9412293365,7248124467

Dr. Gaurishankar K.,Gattupalli(AP) Mo.  9397626207

Kumari Nivedita,Patna Mo.  6287331147,Aman Abhilash,Gaya Mo.  9065094822

Rakesh Kumar, Patna Mo. 8271836347,\Dr.Kritant Singh,Ayodhya Mo 9415104458

Dr.Pranjal Maheshwari, Agra Mo. 94111837601

Nominations for the President and Secretary of NMO for year 2024-25 Names for the President and Secretary of the NMO for the Central Executive Committee of 2024- 2025, from among members of the NMO, who have served at least one term in the CEC may be proposed by any member of the NMO till March 8,2024 by emailing to nmocentral@rediffmail.com and cc to dhanakar@gmail.com.

Names may be withdrawn till March 15, 2024, and if required election may be held at the NMO conference (which will be informed shortly.),Dr.Dhanakar Thakur, Organising Secretary & Founder 9843376861

Units of NMO- will be recognized only if having 26 / more members in institutional /11 or more non-institutional. Presidents and Secretaries of such units + one for each 25 members elected will be member of the Central General Body.

59th issue Cover

(Advances in the Science of Health and longevity) NMO’s Quarterly Bilingual Journal of Modern Medicine

(Initiated, Darbhanga, 8.8.1977

Est. Varanasi, 5.11.1977)

Vol.43 ; No. 1: 30 January 2023 59 th E-issue

C O N T E N T S

AIMS AND OBJECTS OF NMO (Reg. No. 21/1987-88)

To create a nationwide organisation of the medicos on a democratic basis, irrespective of caste, colour, creed and sex for ‘positive health’ of the nation.
To work for the all-round welfare and development of the medical profession.
To utilize their energy and dissemination of the medical knowledge for solving the various health problems of the downtrodden people of the nation particularly for the rural and tribal people with the help of central and state governments, educational, professional and voluntary organisations.
To work for satisfying the basic needs of the medicos and to guide and help them in solving their various problems arising from time to time.
To develop national character and discipline among the medicos.
To promote constructive activities in social and cultural spheres and utilise medicos’ energies in the various nation-building activities.
To promote progressive outlook among them along with love for the cultural heritage of the land.
To develop harmony and homogeneity among the various components of the society by reviving a sense of tolerance and brotherhood.
To seek the cooperation and good- will of doctors, educationists, educational and health authorities in the work of the NMO.
To promote better teacher-student relationship in medical colleges and institutes.* * and to establish such model institutions.(added in 2007)
To promote the academic environment in medical colleges and institutes.
To form a common platform on the basis of a common mode of work for all the members of the medical community, viz., students, doctors and educationists for the reorganisation of medical education in the comprehensive context of national reconstruction.

NMO Regd office:C/O रामनरेश झा, प्रोफेसर कॉलोनी,एमआरएम कॉलेज के सामने, लालबाग, दरभंगा 846004 Mobile: 9430141788 dhanakar@gmail.com

ABOUT THE INSIGNIA

NMO searched for an ancient Hindu legend to symbolise Bhartiya heritage in its true sense. Rishi (Saint) Dhanwantari, the first physician treated as the mythological figure, who rejuvenated the patients by his treatment, represents the golden era of Hindu medical sciences.

The insignia visualises Rishi Dhanwantari stepping on the land of Bharat after emerging from Samudra-Manthan (Sea-churning) said to be held between Suras (gods) and Asuras (demons) with Kalash (pot) filled with the Amrita (The Elixir of Life) which was dispensed to the patients, which also symbolises the assimilation of all living creatures and thus divinity. The manuscript in His left hand denotes Aayurvigyan (The knowledge of the medical sciences) which an Upveda of the Rig-Veda (one of the four holy books of this land). प्राणिनाम् आर्तिनाशनम् ~ (PRANINAM ARTINASHANAM) is the concluding part of a Sanskrit shloka, uttered by Raja Rantideva when he was asked by the God to ask for anything he wanted after Rantideva’s all types of tests, as described in The Srimadbhagvata. This shloka has been the source of inspiration for the people of this Hindu land since time immemorial. The full shloka is: त्वहं कामये राज्यम् न स्वर्गं नापुनर्भवम्। कामये दुःखतप्तानाम् प्राणिनाम् आर्तिनाशनम् (Na Twaham Kamaye Rajyam, Na Swargam, Na Punarbhavam Kamye Dukhtaptanam,Praninam Artinashanam) (One should not desire for a kingdom nor the Heaven, nor freedom from rebirth. Let one desire for total freedom of the ailing creatures from sufferings and diseases.)

Supplement (Vol.42: 2022)- (58^th Issue)

Subject Index

(Editorial) 1 NMO in Controversy- III (2002-…) -Dhanakar Thakur, as the founder & Organiser 1

Medico legal Queries and Answers –M C Gupta,RK Shrama 3

Central Executive Committee of NMO (Reg. No. 21/1987-88) for 2021-22 14

12 जनवरी 2022 को स्वामी विवेकानंद जी की 158 वें जन्म दिवस के उपलक्ष में 15

सन् १८९३ में शिकागो (अमेरिका) में विश्व धर्म परिषद् में को स्वामी विवेकानंद जी का भाषण- 16

ABOUT THE INSIGNIA; Supplement (Vol.41: 2021), Units of NMO, Membership of NMO Cover ii

Form of Declaration Cover ii

इतिहास के पन्नों से । सेवा ही धर्मः। Cover iii

NMOCON21-22 ,Condolences: Dr. Satish K. Oberoy, Dr.Atul Tiwary , बन्दे मातरम् Cover iv

AUTHOR Index

Form of Declaration (Form 4, Rule 8)- Statement about ownership and other particulars about newspaper :

Name and address of Association who own the newspaper and partners and shareholders more than 1% of the total- National Medicos Organisation, D-234, Vive Vicar, New Delhi 110095 – 100%

I, Dr. Dhanakar Thakur, Publisher of Aayurvigyan Pragati, hereby declare that the particulars given above are true to the best of my knowledge and belief Dated: 30.1.2023. (Sd/Dhanakar Thakur),Publisher (applied through SDO Press section, Darbhanga for changes on 22.2.2121) आयुर्विज्ञान प्रगति Aayurvigyan Pragati 43;1:ii

National Medicos Organisation – इतिहास के पन्नों से । सेवा ही धर्मः।

स्वास्थ्य जीवन की एक महती आवश्यकता है, जो रोटी, कपड़ा, और मकान के सवाल का ही उपफल है। अन्य महत्वपूर्ण समस्याओं की तरह यह सार्वदेशिक ही नहीं अपितु सार्वभौमिक भी है। विज्ञान के अधुनातन विकास ने इस समस्या को घटाया ही नहीं, अपितु बढ़ाया भी है। महानगरों की अट्टालिकाएँ ही गन्दी बस्तियों के उद्गम स्रोत हैं। कारखानों की चिमनियाँ ही वायुमंडल के प्रदूषण के कारण हैं। जल-प्रदूषण से मनुष्य ही नहीं, वरन् जल-जन्तुओं पर भी विषम संकट आ गया है। विज्ञान के बहुआयामीय विकास के क्रम में आज एक चिकित्सक के हाथों में भी अनेक ब्रह्मास्त्र आ गये हैं। पर जीवन की विभिन्न सामाजिक एवं आर्थिक विषमताओं की तरह यहाँ भी दो मानव के बीच गहरी खाई है, जो दिन पर दिन बढ़ती ही जा रही है। एक ओर जहाँ चिकित्सा-विज्ञान हृदय-प्रतिरोपण और ‘डायलिसिस’ जैसी अत्याधुनिक चिकित्सा कुछ लोगों को दे रहा है, वहाँ बहुलांश को ‘सल्फाडायजिन’ की एक गोली भी नसीब नहीं हो पाती है। समस्या और भी जटिल हो जाती है जबकि हम अपनी नजरों को उन इलाकों तक ले जाने का कष्ट करते हैं – जहाँ अभी भी प्रगति के नाम पर बैलगाड़ी के पहिये भी मुश्किल से ही चल पाते हैं। यदि हम अपने ही देश की बात लें और उन करोड़ों हरिजनों, गन्दी बस्तियों में रहने वाले मजदूरों की बातें भी छोड़ दें, जिनके पास अस्पताल की कल्पना मात्र भी है, तो भी छोटानागपुर, नागा प्रदेश, बस्तर, अंडमान एवं कार-निकोबार एवं लक्षद्वीप जैसे दूर-दराज के इलाकों में रहने वाले उन करोड़ों गिरिवासी एवं वनवासी बन्धुओं के बारें में सोचें तो लगेगा कि वे आज भी जादू-मन्तर एवं टोने-टोटके के युग में ही रह रहे हैं, अभी तक ‘अलकेमी’ का युग भी उनके लिये नहीं आया है या नहीं आने दिया गया है। विज्ञान मुट्ठी भर लोगों का क्रीत-दास बन गया है एवं इसका प्रवेश इन क्षेत्रों में निषिद्ध-सा हो गया है।

निश्चय ही यह एक राजनैतिक, सामाजिक एवं आर्थिक समस्या है, पर सबके साथ-साथ हम चिकित्सकों के भी कुछ नैतिक दायित्व इनसे बंधे हैं। चाहे यह सत्य हो या मिथ्या पर चरक एवं सुश्रुत की भूमि पर चिकित्सकों की तुलना ‘शायलाॅक’ से भी की जा रही है। अतः आवश्यकता है कि हम खुले दिल से विचार करें और एक ऐसी स्वयंसेवी संस्था का निर्माण करें, जिसके सदस्य चिकित्सक एवं छात्र दोनों ही हों, क्योंकि आज के छात्र ही कल के चिकित्सक होने वाले हैं। एक प्रजातान्त्रिक देश में स्वयंसेवी संस्थाओं का राष्ट्रनिर्माण के कार्य में बहुत बड़ा महत्व होता है। सरकार से ही सब कुछ की अपेक्षा रखना, प्रगति को लोगों के पास पहुँचने देने से रोकना ही है।

यह सत्य है कि हमारी व्यावसायिक समस्याएं भी दिनानुदिन जटिल होती जा रही हंै, फिर भी यह स्पष्ट करना उचित होगा कि दधीचि के इस देश में हम इसकी बात न कर अपना अल्पतम सहयोग सेवा-भावना को ध्यान में रखते हुये ही करेंगे। आयुर्वेद का एक ग्रन्थकार कहता है – “शिष्य ! तुम जो भी औषधि निर्माण करो, उसका चतुर्थ भाग ‘धन्वन्तरि भाग’ के रूप में निकाल कर दीनों की सेवा में लगाओ।“ आज के युग मे यह एक बहुत बड़ी बात होगी, पर यदि हममें ‘प्रत्येक छात्र एक पैसा प्रतिदिन और चिकित्सक दस पैसा प्रतिदिन’ इस पुनीत कार्य के लिये अर्पित कर सकें तो हमें विश्वास है कि चिकित्सा-विज्ञान की विद्युत-प्रतिभा से यदि इन दूरस्थ इलाकों को न आलोकित कर पाऐं तो कम-से -कम टाॅर्च की एक बैटरी का प्रकाश निश्चय ही अपने ही इन बन्धुओं तक पहुँचाने में समर्थ होंगे। ( मा, गोविन्दाचार्य काा 8.8.1977 को दरभंगा स्टेशन पर मेडिकोज के अलग संगठन के लिये मैंने कहा। फिर यह प्रस्तावना मैंने 14. 8.1977 को अपने पैतृक गाँव समौल, मधुबनी, मिथिला में लिखी थी। उन दिनों मैं एम0 बी0 बी0 एस0,चतुर्थ वर्ष का छात्र दरभंगा चिकित्सा महाविद्यालय, लहेरियासराय में था। इस प्रस्तावना एवं संगठन के उद्देश्य एवं स्वरूप के आधार पर मुम्बई में 25. 8.1977 एवं दरभंगा में 3.10.1977 को प्रारंभिक चर्चाओं के बाद वाराणसी में 5.11.1977 को ‘नेशनल मेडिकोज आॅरगेनाजेशन’ की स्थापना देश भर के मेडिकोज ने की।) Later on in January 1978, I chosethe following shloka of Rantideva to be themotto of the nmo, part of which NMO प्राणिनाम् आर्तिनाशनम् ~ is visible in the insignia of the त्वहं कामये राज्यम् न स्वर्गं नापुनर्भवम्। कामये दुःखतप्तानाम् प्राणिनाम् आर्तिनाशनम्।।I do not desire the kingdom, nor the heaven, nor even the freedom from the rebirth, my desire is the total freedom of the ailing living creatures from sufferings and diseases)- Rantideva as described in the Upanishad, said thus when he was asked by the gods to ask any vara (divine promise) for anything he desired. Gods were pleased after rantideva donated his all worldly things; even food and water instead of saving his own life to the gods who had come to examine him successively as a Brahmin, a hungry and a thirsty). आयुर्विज्ञान प्रगति Aayurvigyan Pragati 43;1:iii

Regd. with the Registrar Newspapers for India R.N.39518/1981 आयुर्विज्ञान प्रगति AAYURVIGYAN PRAGATI

Central Executive Committee of NMO (1.4.2022-31.3.2023)

President –

Dr.Ashok Goyal, 45/2 Kashmir Avenue, Amritsar 143001 Mo.9815799687

Vice-Presidents:-

Dr. Rajkumar Gupta,Agra, Medicity Hospital, Sikandara, Agra Mo.9837078814, 8630135597

Dr Manish Kumar,Delhi.Neurosurgeon, Gohi(Samastipur), Mo.9840267857, E-Mail: drmanishkumar1@rediffmail.com

Dr.Bharat Kumar, Darbhanga medical College, Mo. 9431263245

Secretary – Dr.Lal Thadani, Ajmer Mo. 8005529714

Joint Secretaries:-

Vikaskumar,Ratanpur Motihari Mo.8127751651

Dr. Pranjal Maheshwari, Agra Mo. 94111837601

Dr.Ronit Sharma Chandrapur(MH), Mo. 8329538223

Organising Secy.-cum- Treasurer-cum-editor AP: Dr. Dhanakar Thakur,

c/oRamnareshJha, Professor Colony,Opp.MRM College, Lalbagh, Darbhanga 846004

Mo. 9430141788, 9843376861, e-mail: dhanakar@gmail.com

Members-:

Dr. Niranjan, Karnataka Mo.  9412293365,7248124467

Dr. Ranu Sharma, Chhattisgarh Mo.  8986871366

Dr. Gaurishankar K.,Gattupalli(AP) Mo.  9397626207

Dr. Harsha Maheshwari,Agra Mo. 9634788614

Ruby Dhaliyan, Uttarakhand Mo.  9105319413

Kumari Nivedita,Patna Mo.  6287331147

Aman Abhilash,Gaya Mo.  9065094822

Rakesh Kumar, Patna Mo. 8271836347

Dr.Abhay Kr ashok,Nahan(HP) Mo. 7018305257

Nominations for the President and Secretary of NMO for year 2023-24 Names for the President and Secretary of the NMO for the Central Executive Committee of 2023- 2024, from among members of the NMO, who have served at least one term in the CEC may be proposed by any member of the NMO till March 8,2023 by emailing to nmocentral@rediffmail.com and cc to dhanakar@gmail.com.

Names may be withdrawn till March 15, 2023, and if required election may be held at the NMO conference (which will be informed shortly.),

Dr.Dhanakar Thakur, Organising Secretary & Founder 9843376861

Published at Professor’s colony, Lalbagh, Darbhanga, E-Printed

(used to be printed at National Printers, Ranchi 834010 (applied through SDO Press section, Darbhanga for changes on 22.2.2121) by Dr. Dhanakar Thakur For the National Medicos Organisation

Editor: Dr. Dhanakar Thakur c/o Ramnaresh Jha, Professor Colony,Opp. MRM College,Darbhanga 846004

Text Editorial*: Health of Medical Education in India in Peril

*Dr. Dhanakar Thakur, Founder, NMO, 9843376861, dhanakar@gmail.com

NMO needs honest workers, not posts/ pride seekers I asked about in the previous issue.

The role of NMO is going to be changed in the coming decades.

The medical community is on the cross-fare, increasing the number of MBBS seats in substandard institutions with very few patients and faculties. Inspections by the NMC have failed to establish its reputation.

Every private practitioner around has been taken in a fake faculty list. All said claims of Adhar-linked biometrics are almost false. Why not lectures and clinical postings or tutorials are videotaped directly to NMC? It is not that the NMC is not aware of it that many colleges have even fake Principals and HODs who never work. Any person not even attending a day in a year or month is being promoted sequentially to be a professor. Inspections after inspections but dates are known to colleges and inspectors are managed somehow so that favourable reports for even 250 seats do come.

One faculty in one department has become the norm for most of such colleges and parliament is replied that seats in UG and PGs are doubled, etc. amid thundering applause whereas in post-Corona a reply was given that none of the patients died due to the lack of oxygen.

Most such colleges are opened by politicians who might have the wrong source of money to divert it and also gain fame.

Why has NMC not taken a stand to take examinations like NBE?

I am not against privatization but against falsification.

Stringent measures are needed against FAKE faculties like the permanent erasing of names from the Indian Medical Register.

Faculties are at the mercy of such institutions and are fired just after the inspection which I personally experienced. Why not NMC instead issues relieving certificates and any faculty should have a right to appeal to NMC against arbitraries.

Higher indexing research papers made essentials for promotion only multiplied heavily the charges of brokers who are taking up all types of false research and thesis writings only adding miseries to genuine teachers. At the same time, faculties need to be organized under an umbrella, maybe under NMO.

Students who join here for their low NEET marks are exploited by many colleges and ultimately some rush to Courts, majority keep mum being threatened to be failed or being detained. NMO wants a radical change in health education and services.

Till a MEDICAL DIPLOMA after the +2 level is started quackery will not be eradicated. Every district should have such a MEDICAL SCHOOL.

Now MBBS, MD/MS is just like a double degree BTech/MTech. Let us go far: in 100 chosen medical colleges, other cheaters colleges be closed down permanently or demoted to Paramedical institutions.
System overhaul is needed otherwise the country will die of iatrogenic diseases and be looted by ‘medical dacoits’ and ‘star hospitals’ as the country still spends dismal(hardly over one per cent of GDP on health).

Medico-legal Queries and Answers

*M C Gupta (MCG),**RK Sharma(RKS)

Q Sun, Sep 15, 2019, at 5:14 AM Dr Babu KV <drbabukv2017@gmail.com> wrote:

History is being repeated in a different way!

“Asian Paints in its advertisement of the “anti-bacterial paint” featuring Bollywood celebrities Ranbir Kapoor and Deepika Padukone claims that its anti-bacterial technology kills bacteria that enter the house. The advertisement also claims that it is recommended by the Indian Medical Association (IMA). This was not adequately substantiated.

“The advertisement was misleading by implication that the IMA has endorsed the product, whereas IMA had permitted the use of their logo for the “Asian Paints Silver Ion Technology” and not for the product as a whole. The advertiser did not provide any evidence showing that the celebrities had done due diligence prior to the endorsement. The advertisement was misleading due to ambiguity regarding the nature of germ kill and omission with respect to the required contact time, the ASCI said in its order.”

https://www.dailypioneer.com/2019/pioneer-exclusive/crackdown-on-misleading-ads-featuring-celebrities.html

On Sun, Jun 30, 2019, at 11:52 AM Dr.. M.C. Gupta <mcgupta44@gmail.com> wrote:

Ref: Will history be repeated?

Yes. History needs to be repeated… After all, we burn an effigy of Ravana every year! The IMA needs periodic reminders that they are not a private monolithic group but representatives of 3 lakh doctors.

Dear Dr. Babu, go ahead and be the repeater. The 1025 members of the MLQ group are behind you to support you in whatever way they can.

The way to control the IMA is to bring it under the RTI Act. I think there are grounds enough to do so. That is bound to make the IMA more transparent. How to do so is simple. Let somebody file an RTI application with the IMA. On their refusal, an appeal will lie with the appellate authority. Ultimately, the CIC may hold that, like the Fortis Hospital, (which it held as liable under the RTI act), IMA also is liable.

NOTE–Before embarking on the RTI course, it would be better to get a legal opinion from someone actively working in this area.

–MCG

——————————————

Ex-Prof. *M C Gupta, MD (Medicine), LLM, Advocate mcgupta44@gmail.com

medico-legal-queries-subscribe@yahoogroups.co.in

1433–QUESTION—Is it correct that health is a state subject?

ANSWER–

1–There is a common perception that health is a state subject and thus it is the responsibility of the states alone and the centre has no role to play in this regard. This is not the true position as would be clear from the following.

2—Article 246 of the Constitution deals with the power of the centre or the states to make laws regarding various subjects. It reads as follows:

“246. Subject-matter of laws made by Parliament and by the Legislatures of States.— (1) Notwithstanding anything in clauses (2) and (3), Parliament has exclusive power to make laws with respect to any of the matters enumerated in List I in the Seventh Schedule (in this Constitution referred to as the “Union List”).

(2) Notwithstanding anything in clause (3), Parliament, and, subject to clause (1), the Legislature of any State also, have the power to make laws with respect to any of the matters enumerated in List III in the Seventh Schedule (in this Constitution referred to as the “Concurrent List”).

(3) Subject to clauses (1) and (2), the Legislature of any State has exclusive power to make laws for such State or any part thereof with respect to any of the matters enumerated in List II in the Seventh Schedule (in this Constitution referred to as the “State List”’).

(4) Parliament has the power to make laws with respect to any matter for any part of the territory of India not included in a State notwithstanding that such matter is a matter enumerated in the State List.”

3—Seventh Schedule of the Constitution—This schedule has three lists.

— List 1 enumerates the subjects regarding which the power to make laws rests solely with the Centre.

— List 2 enumerates the subjects regarding which the power to make laws rests solely with the States.

— List 3 (Concurrent list) enumerates the subjects regarding which the power to make laws is shared both by the Centre and the states.

4—It is true that as per entry 6 of the State List, the state alone has the power to make laws regarding—“6. Public health and sanitation; hospitals and dispensaries.”

5—It is equally true that health as a concept is much wider than that stated in entry 6 of the state list. The reasons are as follows:

i)—Public health can never be the sole domain of the states. The various national public health programs, including the eradication of smallpox, leprosy, polio etc.., can never be successful without the centre playing a central role. As a matter of fact, various national programs are heavily funded by the Centre.

ii)—While matters related to hospitals and dispensaries funded by the states lie within the exclusive legislative domain of the states, there are a large number of hospitals and dispensaries which are funded by the Centre, such as the CHS, CGHS, Railways, ESI, Defence services and the paramilitary organisations and, as a result, naturally come under the legislative domain of the Centre.

6- A close scrutiny of the three lists reveals several health-related matters that are listed in the Central and concurrent lists, as given below:

Health-related matters in the Central List:

“64. Institutions for scientific or technical education financed by the Government of India wholly or in part and declared by Parliament by law to be institutions of national importance.

65. Union agencies and institutions for—

(a) professional, vocational or technical training, including the training of police officers; or

(b) the promotion of special studies or research; or

66. Coordination and determination of standards in institutions for higher education or research and scientific and technical institutions.”

Health-related matters in the Concurrent List:

“16. Lunacy and mental deficiency, including places for the reception or treatment of lunatics and mental deficiencies.

18. Adulteration of foodstuffs and other goods.

19. Drugs and poisons, subject to the provisions of entry 59 of List I with respect to opium.

20A. Population control and family planning.

25. Education, including technical education, medical education and universities, subject to the provisions of entries 63, 64, 65 and 66 of List I; vocational and technical training of labour.

26. Legal, medical and other professions.

30. Vital statistics including registration of births and deaths.”

7—It is thus clear that the simplistic statement that health is a state subject is not conceptually and legally correct or true. As a matter of fact, Articles 249, 250 and 252 of the Constitution empower the Centre, to make law on a subject mentioned in the state list. The Clinical Establishments Act, 2010, was made by the centre under Article 252.”

8—There used to be an Indian Medical Service which was second in protocol only to the ICS. The IMS was disbanded soon after independence. That was the day when the health and medical scene in India suffered a setback. Demands have been made by the medical profession to re-constitute an All-India medical service. The stock answer of the government has been that health is a state subject and hence the creation of an all-India health and medical service is not legally / constitutionally possible. This is a false argument in view of the above.

9—Furthermore, entry no. 70 of the Central list reads—“70. Union Public Service; All-India Services; Union Public Service Commission.”. This means that the moment the government creates an all-India health and medical service, it would automatically fall under the central list. Hence it would automatically fall under the Central List.

–(Ex)Prof. M C Gupta

QUESTION 1606—What are the main features of the National Medical Commission Act, 2019?

ANSWER—

1–The NMC Act has been passed by the Parliament. It repeals the erstwhile Indian Medical Council Act, of 1956. [Note—the 2017 Bill lapsed with the dissolution of the 16th Lok Sabha. The 2019 Bill was introduced in the 17th Lok Sabha with certain changes.]

2—The contrast between the two legislations is striking if one reads the preambles of the two Acts:

The preamble of the 1956 Act: “An act to provide for the reconstitution of the medical council of India and the maintenance of a medical register for India and for matters connected therewith.”

The preamble of the 2019 Act:

“An Act to provide for a medical education system that improves access to quality and affordable medical education ensures availability of adequate and high-quality medical professionals in all parts of the country; that promotes equitable and universal healthcare that encourages community health perspective and makes services of medical professionals access to all the citizens; that promotes national health goals; that encourages medical professionals to adopt latest medical research in their work and to contribute to research; that has an objective periodic and transparent assessment of medical institutions and facilitates maintenance of a medical register for India and enforces high ethical standards in all aspects of medical services; that is flexible to adapt to changing needs and has an effective grievance redressal mechanism and for matters connected therewith or incidental thereto.”

3—The following provisions of the Act came into force with effect from the 02nd day of September 2019 through a gazette notification last year: sections 3, 4, 5, 6, 8, 11, 16, 17, 18, 19, 56 and 57.

[NOTE—The said sections primarily pertain to the constitution of the National Medical Commission and the various bodies under it. Section 3,4,5,6 deals with the composition, the constitution, the appointment of the search committee and the term of members of the Commission respectively. Section 8 deals with the Appointment of Secretary, experts, professionals, officers and other employees of the National Medical Commission Section 11 of the NMC Act deals with the Constitution and the composition of the Medical Advisory Council while sections 16, 17, 18 and 19 deal with the Constitution, Composition of Autonomous Boards, the Search Committee for appointment of President and Members and the Term of office and conditions of service of President and Members respectively. Sections 56 and 57 define the powers to make rules and regulations under the Act.]4—According to a recent government notification:

–The NMC Act takes effect from 25-09-2020, from which date the IMC Act, 1956 stands repealed.

–Former head of Delhi All India Institute of Medical Sciences ENT department, Dr Suresh Chandra Sharma has been appointed for a period of three years with effect from September 25 while Rakesh Kumar Vats, the Secretary-General in the Board of Governors of the MCI, presently, would be the secretary of the commission.

–Rakesh Kumar Vats, the Secretary-General in the Board of Governors of the MCI was appointed as the secretary of the commission for a similar term on January 2.

5—Some of the reasons for repealing the IMC Act, of 1956, were as follows:

i)—There were grave charges of corruption against the MCI.

a)–MCI has the dubious distinction of being the only regulatory body to have been dubbed as a “den of corruption” by a high court, a “big source of corruption” by a health minister and “corruption-ridden” by a parliamentary panel.

https://www.dailyo.in/technology/medical-council-of-india-health-sector-national-medicalcommission/story/1/21237.html#:~:text=MCI%20has%20the%20dubious%20distinction,ridden%22%20by%20a%20parliamentary%20panel.

b)—The MCI was supposed to be the legal custodian of medical education (licencing of medical colleges and curriculum), medical ethics, licencing of doctors, and medical negligence. However, the MCI failed in each of these areas. Its leaders, especially Dr Ketan Desai, have brought disgrace to the medical fraternity.

c)—The March 2016 report of the parliamentary committee was unprecedented as it contained one full chapter titled “Corruption in MCI” and recorded the unqualified admission by the MCI president that there was “corruption in sanctioning of medical colleges or increasing or decreasing medical seats.” The Committee noted–“The situation has gone far beyond the point where incremental tweaking … can give the contemplated dividends. That is why the Committee is convinced that the MCI cannot be remedied…”

d)—In 2001, the Delhi High Court described the MCI as “a den of corruption”. Its former president Dr. Ketan Desai was arrested for corruption in April 2010.

ii)—The MCI consisted only / mainly of doctors. There was a view that it should not be the sole preserve of the medical community. It must include eminent people from different walks of life, particularly public health experts, social scientists, and health economists. For example, in the United Kingdom, the General Medical Council which is responsible for regulating medical education and practice consists of 12 medical practitioners and 12 lay members (such as community health members, administrators from local government etc. As a matter of fact, a non-medical member can even become its chairman.

(Note–In the British Medical Council, non-doctors are in majority and can even become its chairman.)

iii)—The MCI is an elected body where its members are elected by medical practitioners themselves, i.e., the regulator is elected by the regulated. Experts have recommended a nomination-based constitution of the MCI instead of an election, and separating the regulation of medical education and medical practice.

6—The states will establish their respective State Medical Councils within three years. These Councils will have a role similar to the NMC, at the state level

7—Composition of the NMC

A–“4. (1) The Commission shall consist of the following persons to be appointed by the Central Government, namely:—

(a) a Chairperson;

(b) ten ex officio Members; and

(2) The Chairperson shall be a medical professional of outstanding ability,”

B—“(3) The following persons shall be the ex officio Members of the Commission, namely:—

(a) the President of the Under-Graduate Medical Education Board;

(b) the President of the Post-Graduate Medical Education Board;

(d) the President of the Ethics and Medical Registration Board;

(e) the Director General of Health Services, Directorate General of Health

Services, New Delhi;

(f) the Director General, Indian Council of Medical Research;

(g) a Director of any of the All India Institutes of Medical Sciences, to be nominated by the Central Government;

(h) two persons from amongst the Directors of Postgraduate Institute of Medical Education and Research, Chandigarh; Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry; Tata Memorial Hospital, Mumbai; North Eastern Indira Gandhi Regional Institute of Health and

Medical Sciences, Shillong; and All India Institute of Hygiene and Public Health, Kolkata; to be nominated by the Central Government; and,

(i) one person to represent the Ministry of the Central Government dealing with Health and Family Welfare, not below the rank of Additional Secretary to the Government of India, to be nominated by that Ministry.”

C—“(4) The following persons shall be appointed as part-time Members of the Commission, namely:—

(a) three Members to be appointed from amongst persons of ability, integrity and standing, who have special knowledge and professional experience in such areas including management, law, medical ethics, health research, consumer or patient rights advocacy, science and technology and economics;

(b) ten Members to be appointed on a rotational basis from amongst the nominees of the States and Union territories, under clauses (c) and (d) of sub-section (2) of section 11, in the Medical Advisory Council for a term of two years in such manner as may be prescribed;

(c) nine members to be appointed from amongst the nominees of the States and Union territories, under clause (e) of sub-section (2) of section 11, in the Medical Advisory Council for a term of two years in such manner as may be prescribed.”

8–Functions of the NMC—“10. (1) The Commission shall perform the following functions, namely:—

(a) lay down policies for maintaining high quality and high standards in medical education and make necessary regulations on this behalf;

(b) lay down policies for regulating medical institutions, medical researchers and medical professionals and make necessary regulations on this behalf;

(c) assess the requirements in healthcare, including human resources for health and healthcare infrastructure and develop a road map for meeting such requirements;

(d) promote, co-ordinate and frame guidelines and lay down policies by making necessary regulations for the proper functioning of the Commission, the Autonomous Boards and the State Medical Councils;

(e) ensure coordination among the Autonomous Boards;

(f) take such measures, as may be necessary, to ensure compliance by the State Medical Councils of the guidelines framed and regulations made under this Act for their effective functioning under this Act;

(g) exercise appellate jurisdiction with respect to the decisions of the Autonomous Boards;

(h) lay down policies and codes to ensure observance of professional ethics in the medical profession and to promote ethical conduct during the provision of care by medical practitioners;

(i) frame guidelines for the determination of fees and all other charges in respect of fifty per cent. of seats in private medical institutions and deemed to be universities which are governed under the provisions of this Act;

(j) exercise such other powers and perform such other functions as may be prescribed.”

9–Regulatory bodies under the NMC?

The Act sets up four autonomous boards under the supervision of the NMC. Each board will consist of a President and four members (of which two members will be part-time), appointed by the central government (on the recommendation of a search committee). These bodies are:

The Under-Graduate Medical Education Board (UGMEB) and the Post-Graduate Medical Education Board (PGMEB): These two bodies will be responsible for formulating standards, curriculum, and guidelines for medical education, and granting recognition of medical qualifications at the undergraduate and post-graduate levels respectively.

The Medical Assessment and Rating Board: The Board will have the power to levy monetary penalties on institutions which fail to maintain the minimum standards as laid down by the UGMEB and the PGMEB. It will also grant permissions for establishing new medical colleges, starting postgraduate courses, and increasing the number of seats in a medical college.

The Ethics and Medical Registration Board: This Board will maintain a National Register of all the licensed medical practitioners in the country, and also regulate professional and medical conduct. Only those included in the Register will be allowed to practice as doctors. The Board will also maintain a register of all licensed community health providers in the country.

10—NEET—“14. (1) There shall be a uniform National Eligibility-cum-Entrance Test for admission to the undergraduate and postgraduate super-speciality medical education in all medical institutions which are governed by the provisions of this Act.”

11—NET—“15. (1) A common final-year undergraduate medical examination, to be known as

the National Exit Test shall be held for granting a licence to practice medicine as medical practitioner and for enrolment in the State Register or the National Register, as the case may be.

12—Professional misconduct

The State Medical Council will receive complaints relating to professional or ethical misconduct against a registered medical practitioner. If the medical practitioner is aggrieved by a decision of the State Medical Council, he may appeal to the Ethics and Medical Registration Board. If the medical practitioner is aggrieved by the decision of the Board, he can approach the NMC to appeal against the decision.

(NOTE– It is unclear why the NMC is an appellate authority with regard to matters related to professional or ethical misconduct of medical practitioners.

It may be argued that disputes related to ethics and misconduct in medical practice may require judicial expertise. For example, in the UK, the regulator for medical education and practice – the General Medical Council (GMC) receives complaints with regard to ethical misconduct and is required to do an initial documentary investigation into the matter and then forward the complaint to a Tribunal. This Tribunal is a judicial body independent of the GMC. The adjudication decision and final disciplinary action are decided by the Tribunal.

13—Community health providers

“32. (1) The Commission may grant limited licence to practice medicine at mid-level as Community Health Provider to the such person connected with a modern scientific medical profession who qualify such criteria as may be specified by the regulations:

Provided that the number of a limited licences to be granted under this subsection shall not exceed one-third of the total number of licenced medical practitioners registered under sub-section (1) of section 31.”

“(3) The Community Health Provider may prescribe specified medicine independently, only in primary and preventive healthcare, but in cases other than primary and preventive healthcare, he may prescribe medicine only under the supervision of medical practitioners registered under sub-section (1) of section 32.”

Sun, 9 Feb 2020 at 00:43, Dr.M.C. Gupta <mcgupta44@gmail.com> wrote:

As regards the medico-legal certificate courses, I am not enamoured of them.

—-Ex-Prof. M C Gupta, MD (Medicine), LLM, Advocate(with courtesy to <medico-legal-queries@yahoogroups.co.in>).

सुबह उठकर बोले हाथ देखते

समुद्रवसने देवी पर्वतस्तन मंडले

विष्णुपत्नीं नमस्तुभ्यं पादस्पर्शं क्षमस्व मे

कह पृथ्वीमाता को छू प्रणाम कर बिस्तर से उतरें।

पैखाना के बाद पेशाब रास्ते को‌ नहीं छूवैं केवल पीछे धोने हाथ लगाएं।।वह हाथ आगे न लायें वह नहाते समय धूल जाएगा।

तीन बार साबून से हाथ धोयें।

15 दिन में नाखून काटें।

दांत के लाल ऊपर और उजले के बीच रगड़ना,उजले पर नहीं।

रात में सोते समय दांत धोना अधिक आवश्यक।

जलपान में मोटी रोटी या चूड़ा –दही-केला खाना।

उसना चांवल अच्छा अरवा से।

भोजन में दाल गाढ़ी।

साग सब्जी अधिक,आलू कम

गाजर जरूर।

नमक कम, चीनी कम ।

दूध एक गिलास दिन में।

हरेक एक अमरचंद का पेड़ रोपे।

जन्मदिन पर कोई एक वृक्ष हर साल।

हर घर में सब्जी एक खेत में उपजायें।

खेलकूद कबड्डी,खो आदि जरूर।

नशापान नहीं करें।

निराश नहीं हो।

आत्महत्या की बात सोचें नहीं।

ऊंचा लक्ष्य रखें।

परिश्रम करें।

कल कभी नहीं आता है।

पढ़ कर दूसरे को पढ़ाया करें साथी या जूनियर को।

भारत माता की जय।

Sun, Oct 18, 2020, 9:57 PM

Q -sneha pawar snehapwr88@gmail.com [medico-legal-queries] <medico-legal-queries@yahoogroups.co.in>

One gentleman was suffering from breathlessness, no covid test was performed on him and he died at home. Now the hospital authorities are saying since he had few symptoms the covid test will have to be performed.

AP 58th issue cover and text

(Advances in the Science of Health and longevity) NMO’s Quarterly Bilingual Journal of Modern Medicine

(Initiated,Darbhanga,8.8.1977)

Vol.42 ; No. 1: 30 January 2022 58 th E-issue

C O N T E N T S

(Editorial) 1 NMO in Controversy- III (2002-…) -Dhanakar Thakur, as the founder & Organiser 1

Medico legal Queries and Answers –M C Gupta,RK Shrama 3 ABOUT THE INSIGNIA; Supplement (Vol.41: 2021), Form of Declaration cover ii

bfrgkl ds iUuksa ls A lsok gh /keZ%A cover iii

Condolences: Dr. Kamleshwari Prasad Deo, Dr. Satish K. Oberoy, Dr.Atul Tiwary cover iv

Central Executive Committee of NMO (Reg. No. 21/1987-88) for 2021-22 cover iv

Units of NMO, Membership of NMO cover iv

AIMS AND OBJECTS OF NMO (Reg. No. 21/1987-88)

To create a nationwide organisation of the medicos on a democratic basis, irrespective of caste, colour, creed and sex for ‘positive health’ of the nation.
To work for the all-round welfare and development of the medical profession.
To utilize their energy and dissemination of the medical knowledge for solving the various health problems of the downtrodden people of the nation particularly for the rural and tribal people with the help of central and state governments, educational, professional and voluntary organisations.
To work for satisfying the basic needs of the medicos and to guide and help them in solving their various problems arising from time to time.
To develop national character and discipline among the medicos.
To promote constructive activities in social and cultural spheres and utilise medicos’ energies in the various nation-building activities.
To promote progressive outlook among them along with love for the cultural heritage of the land.
To develop harmony and homogeneity among the various components of the society by reviving a sense of tolerance and brotherhood.
To seek the cooperation and good- will of doctors, educationists, educational and health authorities in the work of the NMO.

To promote better teacher-student relationship in medical colleges and institutes.* * and to establish such model institutions.(added in 2007)

To promote the academic environment in medical colleges and institutes.
To form a common platform on the basis of a common mode of work for all the members of the medical community, viz., students, doctors and educationists for the reorganisation of medical education in the comprehensive context of national reconstruction.

NMO Central Office: D-234, Vivek Vihar, New Delhi 110095 , Mobile: 9430141788, 8273491261, 9424107395, E-mail : dhanakar@gmail.com

ABOUT THE INSIGNIA

The insignia visualises Rishi Dhanwantari stepping on the land of Bharat after emerging from Samudra-Manthan (Sea-churning) said to be held between Suras (gods) and Asuras (demons) with Kalash (pot) filled with the Amrita (The Elixir of Life) which was dispensed to the patients, which also symbolises the assimilation of all living creatures and thus divinity. The manuscript in His left hand denotes Aayurvigyan (The knowledge of the medical sciences) which an Upveda of the Rig-Veda (one of the four holy books of this land). izkf.kuke~ vkfrZuk’kue* (PRANINAM ARTINASHANAM) is the concluding part of a Sanskrit shloka, uttered by Raja Rantideva when he was asked by the God to ask for anything he wanted after Rantideva’s all types of tests, as described in The Srimadbhagvata. This shloka has been the source of inspiration for the people of this Hindu land since time immemorial. The full shloka is: Þu Roga dke;s jkT;e~ u LoxZa uk iquHkZoe~A dke;s nq%[krIrkuka izkf.kuke~ vkfrZuk’kueAß(Na Twaham Kamaye Rajyam, Na Swargam, Na Punarbhavam Kamye Dukhtaptanam,Praninam Artinashanam) (One should not desire for a kingdom nor the Heaven, nor freedom from rebirth. Let one desire for total freedom of the ailing creatures from sufferings and diseases.)

Supplement (Vol.41: 2021)- (57^th Issue)

Subject Index

((Editorial) COVID and Beyond – Dhanakar Thakur 1

Maharshi Charak Oath ।। महर्षिचरकशपथम् ।। 2

Medico legal Queries and Answers –M C Gupta, RK Shrama 5

Virus: ‘Poison Particl’ or Genesis of New Life– Dhanakar Thakur 3

NMO activities– Meruth’National Doctor’s Day,जस्टिस फॉर डॉक्टर अभिषेक,ऑनलाइन बैठक, 12

NMO.Ayodhya, मेरठ, Worlds AIDS Day,Praygraj, 15.11.2020_राष्ट्रिय स्वास्थ्य दिवस (NMO स्थापना दिवस),

J&K, rural bias ,Rashtriya Yuva Divas_ Vivekananda Jayanti(12.1.2-21),Bareilly ,RDA,Delhi,

NMOCON 2019 Mathura, Letter, NMO in History_ 24.11.2012

ABOUT THE INSIGNIA; Supplement (Vol.40: 2010), Form of Declaration cover ii

OBITURAY: DR. Ghanshyam Das,Dr. Baidya Nath Mishra, Ravindrenath R. Tongaokar cover iii

NMO for the Farmers’ Health on Delhi borders cover iv

Central Executive Committee of NMO (1.4.2020-31.3.2021) cover iv

Units of NMO, Membership of NMO cover iv

AUTHOR Index

Dhanakar Thakur- Editorial) COVID and Beyond ` 1

Virus: ‘Poison Particl’ or Genesis of New Life 2

M C Gupta- Medico legal Queries and Answers 5

RK Shrama- Medico legal Queries and Answers 5

————————————————————————————————————————————

Form of Declaration (Form 4, Rule 8)- Statement about ownership and other particulars about newspaper :

Name and address of Association who own the newspaper and partners and shareholders more than 1% of the total- National Medicos Organisation, D-234, Vive Vicar, New Delhi 110095 – 100%

I, Dr. Dhanakar Thakur, Publisher of Aayurvigyan Pragati, hereby declare that the particulars given above are true to the best of my knowledge and belief

Dated: 30.1.2022. (Sd/Dhanakar Thakur),Publisher (applied through SDO Press section ,Darbhanga for changes on 22.2.2121) आयुर्विज्ञान प्रगति Aayurvigyan Pragati 42;1:ii

National Medicos Organisation

इतिहास के पन्नों से । सेवा ही धर्मः।

स्वास्थ्य जीवन की एक महती आवष्यकता है, जो रोटी, कपड़ा, और मकान के सवाल का ही उपफल है। अन्य महत्वपूर्ण समस्याओं की तरह यह सार्वदेषिक ही नहीं अपितु सार्वभौमिक भी है। विज्ञान के अधुनातन विकास ने इस समस्या को घटाया ही नहीं, अपितु बढ़ाया भी है। महानगरों की अट्टालिकाएँ ही गन्दी बस्तियों के उद्गम स्रोत हैं। कारखानों की चिमनियाँ ही वायुमंडल के प्रदूशण के कारण हैं। जल-प्रदूशण से मनुश्य ही नहीं, वरन् जल-जन्तुओं पर भी विशम संकट आ गया है। विज्ञान के बहुआयामीय विकास के क्रम में आज एक चिकित्सक के हाथों में भी अनेक ब्रह्मास्त्र आ गये हैं। पर जीवन की विभिन्न सामाजिक एवं आर्थिक विशमताओं की तरह यहाँ भी दो मानव के बीच गहरी खाई है, जो दिन पर दिन बढ़ती ही जा रही है। एक ओर जहाँ चिकित्सा-विज्ञान हृदय-प्रतिरोपण और ‘डायलिसिस’ जैसी अत्याधुनिक चिकित्सा कुछ लोगों को दे रहा है, वहाँ बहुलांष को ‘सल्फाडायजिन’ की एक गोली भी नसीब नहीं हो पाती है। समस्या और भी जटिल हो जाती है जबकि हम अपनी नजरों को उन इलाकों तक ले जाने का कश्ट करते हैं – जहाँ अभी भी प्रगति के नाम पर बैलगाड़ी के पहिये भी मुष्किल से ही चल पाते हैं। यदि हम अपने ही देष की बात लें और उन करोड़ों हरिजनों, गन्दी बस्तियों में रहने वाले मजदूरों की बातें भी छोड़ दें, जिनके पास अस्पताल की कल्पना मात्र भी है, तो भी छोटानागपुर, नागा प्रदेष, बस्तर, अंडमान एवं कार-निकोबार एवं लक्षद्वीप जैसे दूर-दराज के इलाकों में रहने वाले उन करोड़ों गिरिवासी एवं वनवासी बन्धुओं के बारें में सोचें तो लगेगा कि वे आज भी जादू-मन्तर एवं टोने-टोटके के युग में ही रह रहे हैं, अभी तक ‘अलकेमी’ का युग भी उनके लिये नहीं आया है या नहीं आने दिया गया है। विज्ञान मुट्ठी भर लोगों का क्रीत-दास बन गया है एवं इसका प्रवेष इन क्षेत्रों में निशिद्ध-सा हो गया है।

निष्चय ही यह एक राजनैतिक, सामाजिक एवं आर्थिक समस्या है, पर सबके साथ-साथ हम चिकित्सकों के भी कुछ नैतिक दायित्व इनसे बंधे हैं। चाहे यह सत्य हो या मिथ्या पर चरक एवं सुश्रुत की भूमि पर चिकित्सकों की तुलना ‘षायलॉक’ से भी की जा रही है।

अतः आवष्यकता है कि हम खुले दिल से विचार करें और एक ऐसी स्वयंसेवी संस्था का निर्माण करें, जिसके सदस्य चिकित्सक एवं छात्र दोनों ही हों, क्योंकि आज के छात्र ही कल के चिकित्सक होने वाले हैं। एक प्रजातान्त्रिक देष में स्वयंसेवी संस्थाओं का राश्ट्रनिर्माण के कार्य में बहुत बड़ा महत्व होता है। सरकार से ही सब कुछ की अपेक्षा रखना, प्रगति को लोगों के पास पहुँचने देने से रोकना ही है।

यह सत्य है कि हमारी व्यावसायिक समस्याएं भी दिनानुदिन जटिल होती जा रही हैं, फिर भी यह स्पश्ट करना उचित होगा कि दधीचि के इस देष में हम इसकी बात न कर अपना अल्पतम सहयोग सेवा-भावना को ध्यान में रखते हुये ही करेंगे।

आयुर्वेद का एक ग्रन्थकार कहता है – “षिश्य ! तुम जो भी औशधि निर्माण करो, उसका चतुर्थ भाग ‘धन्वन्तरि भाग’ के रूप में निकाल कर दीनों की सेवा में लगाओ।“ आज के युग मे यह एक बहुत बड़ी बात होगी, पर यदि हममें ‘प्रत्येक छात्र एक पैसा प्रतिदिन और चिकित्सक दस पैसा प्रतिदिन’ इस पुनीत कार्य के लिये अर्पित कर सकें तो हमें विष्वास है कि चिकित्सा-विज्ञान की विद्युत-प्रतिभा से यदि इन दूरस्थ इलाकों को न आलोकित कर पाऐं तो कम-से -कम टॉर्च की एक बैटरी का प्रकाष निष्चय ही अपने ही इन बन्धुओं तक पहुँचाने में समर्थ होंगे।

( मा, गोविन्दाचार्य काा 8.8.1977 को दरभंगा स्टेषन पर मेडिकोज के अलग संगठन के लिये मैंने कहा। फिर यह प्रस्तावना मैंने 14. 8.1977 को अपने पैतृक गाँव समौल, मधुबनी, मिथिला में लिखी थी। उन दिनों मैं एम0 बी0 बी0 एस0,चतुर्थ वर्श का छात्र दरभंगा चिकित्सा महाविद्यालय, लहेरियासराय में था। इस प्रस्तावना एवं संगठन के उद्देष्य एवं स्वरूप के आधार पर मुम्बई में 25. 8.1977 एवं दरभंगा में 3.10.1977 को प्रारंभिक चर्चाओं के बाद वाराणसी में 5.11.1977 को ‘नेषनल मेडिकोज ऑरगेनाजेषन’ की स्थापना देष भर के मेडिकोज ने की।)

Later on in January 1978, I chosethe following shloka of Rantideva to be themotto of the nmo, part of which प्राणिनाम् आर्तिनाषनम्

is visible in the insignia of the NMO:

न त्वहं कामये राज्यम् न स्वर्गं नापुनर्भवम्। कामये दुःखतप्तानाम् प्राणिनाम् आर्तिनाषनम्

Later on in January 1978, I chosethe following shloka of Rantideva to be themotto of the nmo, part of which izkf.kuke~ vkfrZuk’kue~ is visible in the insignia of the NMO:

I do not desire the kingdom, nor the heaven, nor even the freedom from the rebirth, my desire is the total freedom of the ailing living creatures from sufferings and diseases)- Rantideva as described in the Upanishad, said thus when he was asked by the gods to ask any vara (divine promise) for anything he desired. Gods were pleased after rantideva donated his all worldly things; even food and water instead of saving his own life to the gods who had come to examine him successively as a Brahmin, a hungry and a thirsty). आयुर्विज्ञान प्रगति Aayurvigyan Pragati 42;1:iii

Regd. with the Registrar Newspapers for India आयुर्विज्ञान प्रगति R.N.39518/1981 AAYURVIGYAN PRAGATI

Dr.Kamleshwari Prasad Deo (5.2.1952-16.9.2018) MBBS (Ranchi)MS eye Darbhanga was a close associate of mine in initial NMO work when we both used to go to collect physician samples from doctors Bhikshukau gachhatah(two beggers are going)we used to joke.He was posted at Seetamarhi, the birthplace of mither Sita where I met him during May 14-15,2011 and 30.5.2015 .He was friend of Dr.Shanti Prakash at Ranchi and was called ‘captain’ due to a headgear(topi) he used to wear always .He was the man who once told me that for me as a teacher only Dr.K.K. Sinha wad fit I wrote him a letter and became very close by going RNchi to study neurology from him and later his assistant as a student and editor of several world-level neurology books I met his son and stayed with him in NNCH Patna also now in Delhi.He belonged to my native district of Araria and was married to a lady from nearby Nepal who was from his caste (such marriages are very common in my part as one country) who working as a teacher was sending money for his studies at Darbhanga; I met her when I visited Biratnagar for Maithili meeting I am sorry that even his death could be known after 4 years but am happy that his all children have reached the height of education.

Condolences…

—————————————————————————————————————

Published at Professor’s colony, Lalbagh, To:

Darbhanga, Printed at National Printers,

Ranchi 834010 by Dr. Dhanakar Thakur ——————————————————–

For the National Medicos Organisation

Editor: Dr. Dhanakar Thakur —————————————————–

c/o Ramnaresh Jha, Professor Colony

Opp.MRM College, ——————————————–

Darbhanga 846004Editorial*: Omicron and after; NMO Controversy- III (2002- )

*Dr. Dhanakar Thakur, Founder, NMO, 9843376861, dhanakar@gmail.com

The New Order of the World wants to destroy India and related countries. Whether this New Order is Right? No. However, in the new world health situation and spiritualism, Hindu Dharm is only a panacea. Dharm is the way of life and that is the answer in the health field too on which NMOCON 2022 was planned. India which was spending 14% on education now spends less than one per cent (0.76%). The spectrum of health is equally disastrous. Flowers were showered on us and now our young residents are lathi-charged and women medicos are the man (masculine) handled in a free democratic country! We have never been opposed to this government but we cannot be silent over the absurdities. It had no business in opening Pandora’s Box reservations in higher medical education or propagating ‘myopathy’.How one having an MBBS degree can be called socially or economically deprived or a BAMS can do modern surgery?

The dismissal of Dr. Harshwardhan was also surprising if India tackled Covid-19 better than other countries. He has been an active NMO member but let me affirm during his tenure I never even tried to talk (or with Ashwini Choubey and Ravishankar Prasad who have been equally my friends) for anything or for any personal gain or position and am happy to teach my MBBS/MD students and my Mithila and other works spread all over the country for different 67 social organizations founded by me(though ironically a big chunk of new NMO members have still no knowledge, “Dhanakar Thakur was the founder of NMO,” On 23.3.2007, Ma. Govindacharya incidentally met in Madhubani in his Alakh yatra and publically greeted me as the NMO founder; on 22.12.2005; he had cautioned in the NMO Conference at Agra not to forget the person who plants a tree; on 16.9.2019 and 30.11.2021 at Rashtriya Swabhiman meeting again at Delhi he publicly greeted me again as the founder of NMO. I talked to him seriously for the first time on 17.9.1973 when I went to Vijay Niketan RSS, Bihar Office, Patna, with my youngest brother Suman for his Netarhat School Entrance Examination and stayed there with him ( that Suman after Netarhat, St Xaviers’ Ranchi. IIT, Delhi, at JNU started ABVP with his Marathi friend; who Joined BARC, Mumbai and although the top water scientist in the world he succumbed to nosocomial infections at the Jashlok Hospital on the 10th postoperative day on 8.4. 2015).

In July 1977, from Laheriasarai Central Jail (protesting capitation-fee-based medical colleges), I wrote a letter to Ma. Madhusudan Gopal Deo, Bihar prant pracharak, RSS, for a separate medicos’ organisation, written in anguish that had Arun Jetali or Sudhil K Modi had been in Jails they would have reacted but I was a worker far from capital (for Darbhanga, Ganga was to be crossed by steamer and then overnight journey on a slow meter gauge train). He referred my letter to Ma. Govindacharya whom I asked on 8.8.1977 at Darbhanga station (after his program in the Marwadi college, on Ravindra Smriti Divas) while seeing him off at the gate. He asked me to write down my ideas which I wrote on August 14th,1977 at my village in Samaul of Madhubani district, the preamble of which is SEWA HI DHRAMAH ( cover iii) and the ABVP at Mumbai took a positive decision on the letter sent to Govindji (copy of which were also sent to Ma., Bala Saheb Deoras, and Ma. Eknath Ranade, whom I as Eklavya accepted as my organizational guide); on his instruction, I went to Varanasi, contacted tent to tent to assemble medicos to found NMO on 5.11.1977 but CRISIS I was created by an important person from the ABVP who did not like a separate organization of medicos which was solved on 26.11.1980 by Ma. Govindacharya.

CRISIS II was again in 1984 when the ABVP tried to withdraw NMO but it was over by Ma. Bala Saheb Deoras himself when he vetoed in July central meeting of RSS in favour of NMO (when one Sah prant pracharak said that Dhanakarji was organizing a national conference of the NMO at Jamshedpur on Dec 6-7,1986) “ madad kar sakte hain to kariye aaj vah Rashtriy sammelan kar raha hai kal antarrashtriya sammelan bhi karega.(if you can help him, help. Now he is organizing a national conference and in future will organize an international conference too).

However, CRISIS III was created by a coterie of five from within the NMO (from Patna, Ranchi, Agra, Ahmadabad and Udaipur) all of them I had elevated in the NMO, who influenced Margdarshak Ma. Bhaiyaji and grabbed NMO. What happened was just like any political drama. Ma. Bhaiyaji Joshi had called a secret core group committee meeting excluding me on 23.2.2003 in Mumbai attended by these conspirators amounting to my expulsion from the NMO without framing any charge or asking for explanations. Ma Bhaiyaji Joshi later informed me by a letter of the decision. A 47-year-old Dhanakar Thakur was never on any post so he could not be expelled but was excluded from the organisation he founded with his blood, sweat and tears, even his newly-wed wife had taken a divorce due to his involvement in the NMO-RSS.

At Agra in a hurriedly called conference on 22.12.2005, Dr. Madhup (who had organized the NMO conference, the first time out of Bihar, at Gwalior without lust of post) protested it severely. It cleaved the NMO and this crisis III will take a long to be over; morally I had to go with Madhup although I never obstructed anyway working of the opposite group (who had no legal registration with them) as being founder I wished NMO to run and when in 2007 it was known to me by Karnataka Prant Pracharak that they were instructed to send medicos to Arogya Bharati instead of NMO it sounded to me a repetition of CRISIS II and I insisted for running parallel NMo so that other group also worked and they worked well. Sadly, the opportunist coterie was shy to name me even on the website of NMO as its founder although traditionally founders of BJS, BMS, etc. are named.

NMO President Dr. H.P.Narayan sided with us and later Dr. S.Vivekananda, Dr. Manish (Madurai/ Delhi) and finally, Dr.Rajkumar Gupta organised the Bharat Sewa Conference of NMO at Agra with full honours to me which I deserved as the founder, later continued by scores of workers led by Dr.Prakash, Mohit, Dr Harsh, Dr.Pranjal, Dr.Ranu, Dr.Kritant, Dr.A.P. and many old workers who were pained to know the conspiracy that all was hatched to get some positions in various governmental posts which was not possible me being there as I was averse of any personal gains due to the organization and as an effect, the group could not protest the wrongs done by the government on ‘myxopathy’ or others which the team led by NMO secretary Dr. Prakash did marvellously and also helped the public during the Covid lockdown in various ways.

I lead the Mithila movement independently but made Mother Seeta the emblem there. Ma. Rajju Bhaiya had said that every Mithila work was Sangh’s work; Govindacharya on 15.9.1996 sent a letter to me as the Gen.Secy., BJP supporting the Mithila state movement by me and he also addressed at Jantar Mantar dharna for Mithila State on 10.12.2010.

I might have been justified for any Padma award for the NMO foundation and/or any political post in the Mithila region for my honest work, not connected with NMO but a Brahmin should not aspire for anything (although I am titled Thakur as happens in Mithila, many Khastriya- haters went against me and likewise many Maithil and Brahmin- haters too in the caste-sensitive areas!). Alas, values eroded and backbiters influenced.

There were 106 medical colleges in 1986 in the country, which all I toured, now 900 + medical and dental colleges, I could visit 200+. NMO needs honest workers, not posts/ pride seekers.

World Health and Spiritualism via Hindu Dharma

The life span of 300 years _ unimaginable looks but so declares the oldest book the RIGVEDA, TREENIMAYUSH and their time calculation was perfect as in the last Chapter it was mentioned that in the mother’s womb, a foetus is for ten months(lunar or 280 days is exactly as we know ) but such a life should be in good health one should see and speak clearly 100 years as was mentioned in many places of the same book, gives a scope of the longevity of 100 or 300 years but some 200 years is also documented in some French book on Pharmacy quoting in India in olden time there was also nursing system apart from a vaidya(doctor) and patients.

The system of Ayurveda had thrived in India which is scientific in many respects though I am a modern medicine postgraduate and a teacher, I feel the scope of research there remains unlimited.

The spiritual quest of a man is only possible in good health and India’s Hindu Dharm is exactly a way for that which can be taken up by any man of the globe and if he/she delves deep into it will find it is scientific and rational which I may contribute in succeeding days one by one which may be exciting for many.

World Health Day is celebrated on April 7 to recognize the widespread contributions of our medical faculty .

WORLD HEALTH DAY THEMES:2022-2002

2022 – ‘Our Planet, Our Health’.

2021 – “Building a fairer, healthier world for everyone”.

2020 – “Year of the Nurse and Midwife”

2019- Universal Health Coverage: Everyone, Everywhere

2019 – A repeat of the 2018 theme,

2018 – Universal health coverage

2017 – Depression

2016 – Diabetes

2015 – Food safety

2014 – Vector-borne diseases

2013 – Focus on high blood pressure

2012 – Active ageing: Good health adds life to years

2011 – Antibiotic resistance: No action today, no cure tomorrow

2010 – 1000 cities, 1000 lives

2009 – Save lives. Make hospitals safe in emergencies

2008 – Protecting health from climate change

2007 – Invest in health, build a safer future

2006 – Working together for health

2005 – Make every mother and child count

2004 – Road Safety

2003 – Healthy environments for children

2002 – Move for health

Rights of Doctors(as demanded by medico legal forum NMO support these).

1) Right to practice Profession; No person other than MBBS or an equivalent recognized Foreign Medical

qualification thereof (who has cleared the Foreign Medical Graduates exam or the Exit Exam) shall be allowed to practice modern scientific medicine or Allopathy.

a. Right to exclusive employment in Hospitals of Modern Scientific Medicine

(No AYUSH Resident Doctors)

b. Right to work without being exploited

i. In Corporate Hospitals

ii. In Government jobs as contractual employees

2) Right to choose whom he will serve.

a. Right to refuse abusive/aggressive/violent patients

b. Right to refuse High net worth individuals where a doctor feels that his

indemnity insurance will be inadequate to cover for ompensation that could be

awarded in case the patient ever went to court seeking compensation

c. Right to refuse patients if the physician does not have the infrastructure

and equipment necessary

d. Right to refuse patient when he/she is suffering from an ailment which is not within the range?

of experience of the treating physician

e. Right to refuse patient if the physician is himself ill or otherwise indisposed

3) Right to receive fair payment for services rendered

a. By Patient / Relatives

b. By the Government when services are provided in emergency

c. By the Government in cases of death and a relative’s refusal to pay the outstanding bill.

d. Right to receive a salary on time in service

4) Right to a safe working environment and refusal to work in the absence thereof

a. Safety from infections

b. Safety from radiation & other injuries

c. Safety from mental & physical violence

5) Right to life & Liberty

a. Right against wrongful incarceration

b. Right for no criminal prosecution without a medical Boards opinion in cases of

alleged criminal medical negligence

c. Right to a fair trial

d. Right to cross-examine

e. Right against multiple simultaneous prosecutions in multiple courts on the same facts with the

same party.

f. Right against a media trial/circus and extortion

6) Right to professional autonomy

individual physicians should have the freedom to exercise their professional judgment in the care and treatment of their patients without undue or inappropriate influence by outside parties or individuals.
To be free to treat as per their own professional opinion keeping in view educational & social

establishment.

c. To be granted immunity from prosecution when acting in good faith for benefit of the patient

d. To voluntarily create their own code of ethics and comply with the code by themselves.

7) Right to immunity from prosecution when involved in charitable activities and when acting as Good Samaritan

8) Right to self-defence

9) Right to protest

10) Right to ethical business practices (advertisement)

a. On starting practice.

b. On change of type of practice.

c. On changing address.

d. On temporary absence from duty.

e. On resumption of another practice.

f. On succeeding to another practice.

g. Public declaration of charges.

We hope you will support it.

Medico-legal Queries and Answers

*M C Gupta (MCG),**RK Sharma(RKS)

Queries — Additional signatures on a statutory consent form, doctors should have some basic legal knowledge, an official capacity, legal practice along with hospital work, ECG to some cardiologist, proper documentation, proper consent, the role of communication, surgical complications when law hold guilty of a doctor, examining a female patient, dead(not treated by us)can we issue a death certificate, Can General Practitioner refuse home visits, imposing costs, Drawing a parallel with respect to punishments in Criminal cases, don’t want MLC to be registered, upload pictures of surgeries for patients referred to Pvt hospitals, a general surgeon cannot perform Hysterectomy or LSCS, regarding MLCs, complication after surgery, is it mandatory for the surgeon to intimate his insurance company, India federal or unitary in nature?

QUESTION 1 — Do additional signatures on a statutory consent form that asked for make it invalid?

Tushar Nehete drtcnehete@gmail.com [medico-legal-queries] <medico-legal-queries@yahoogroups.co.in>

Wed, Oct 28, 2020, 9:05 PM to MedicoLegal Forum

1) Form C of the MTP Act, 1971 under rule 8 asks for only one signature i.e. of the patient. Will it be invalid by law if some additional signatures are taken on it like those of the husband or close relative and 2 independent witnesses etc.?

2) Or will it be a breach of secrecy under the act?

3) And for that matter does taking additional signatures or entering some additional information on any statutory consent form other than asking for make it invalid by law?

4) Form C under the MTP act has just too many flaws. It doesn’t fulfil most of the criteria of valid, informed consent. Law and courts expect so many other contents in a consent without which doctors are held guilty. Hence another detailed consent form is needed for the MTP procedure. What’s the use of such an incomplete form? How can a statutory format be so incomplete and useless? How can it be valid or admissible in a court of law without witnesses’ signatures? Can’t it be challenged by the opposite lawyer for many drawbacks and shortcomings? I always think so many legal stalwarts must have worked so hard while drafting this format. This form was unamended for almost 50 years. Is it perfect consent or was it left imperfect with some specific purpose?

5) Will it save a doctor without those additional contents just because it’s a statutory format?- without contents such as time, signatures of two independent witnesses, doctor’s signature( if consent is treated as a contract by courts), details of the surgery and anaesthesia including methods, possible complications, alternative treatment options etc.? – Dr. Tushar Nehete

——————————————

Ex-Prof. *M C Gupta, MD (Medicine), LLM, Advocate mcgupta44@gmail.com

medico-legal-queries-subscribe@yahoogroups.co.in

QUESTION 2— Why is it important that doctors should have some basic legal knowledge?

ANSWER:

1–It goes without saying that, by and large, the acts of a professional are guided by his knowledge. If the knowledge is lacking, there is a high chance that the acts/behaviour may be faulty. I joined the bar in the year 2001. During the last 19 years, I have observed that the legal knowledge of doctors is rather deficient. This is in spite of the fact that legally speaking, ignorance of the law is no excuse. In other words, everybody, including doctors, is supposed to know the basics of law. It is my observation that doctors, who are otherwise highly educated, often display a lack of basic knowledge of the law and a rational, legal attitude.

2–Let me illustrate my observation with the following examples:

i)—Cut / Commission Practice–I have been asked by doctors whether it is against law to accept cuts/commissions for referral to other doctors/hospitals/laboratories/imaging centres. The clear answer is that such practice is illegal. The surprising thing is that doctors should ask such a question at all. All doctors are supposed to have read the Code of Ethics Regulations, 2002. A declaration that they have read the same is given by them in writing before they are registered by the State Medical Council. Hence they are supposed to have read the following regulations:

“6.4.1 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 acts 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 another duly qualified person rendering medical care under his supervision.”

The very fact that they ask a question about the legality of the Cut / Commission Practice shows that they do not have even the basic legal knowledge that a doctor should have.

ii)—Simultaneous registration with SMC and MCI—There are some doctors who are primarily registered both with the SMC (State Medical Council) and the MCI. This is wrong in principle. The principle involved is that the MCI is an appellate authority if a doctor is aggrieved by the decision of the SMC in a complaint filed against him. The problem that may arise from simultaneous registration with both SMC and MCI is clear from the following example:

“A client of mine, a lady doctor with MD in Gyn-obs, conducted delivery but the patient died of PPH. The husband filed a complaint with the Delhi Medical Council as well as with the police. The DMC initiated an inquiry and the doctor submitted its reply to the DMC. The police wrote to MCI for opinion and the MCI, on finding that the doctor was registered with it, initiated its own inquiry and the doctor submitted its reply to the MCI also. The MCI found the doctor guilty and removed her name from the medical register for 2 months. She filed a writ petition against the MCI decision, saying the MCI was only an appellate authority and the inquiry should be held by the DMC. The HC set aside the order of the MCI and directed the DMC to complete the inquiry. The DMC also found her guilty and removed her name from the medical register for 3 months. Then I filed an appeal before the MCI against the DMC order and argued the case on her behalf. The MCI set aside the DMC order, saying there was no negligence on her part.”

The lesson here is that doctors should not get registered with both the SMC and the MCI. Those who are thus registered should get their primary registration with the MCI cancelled. In the case cited above, the doctor should not have sent a reply of defence to the MCI when she got a notice of inquiry from the MCI. She should have simply written to the MCI that the DMC was already conducting an inquiry. The MCI would not have then proceeded with the inquiry. It is obvious that the lady doctor was not aware of the basic legal principles:

a)—Two parallel inquiries, in general, are not permitted by law. Two concurrent inquiries on the same complaint by two different medical councils could not have taken place.

b)—An appellate authority cannot conduct the primary trial because, in that case, the accused doctor loses the opportunity for appeal.

19-07-2019 , (Ex)Prof. M C Gupta

QUESTION 3. — What does this entitle you to do in an official capacity?

>>> It entitles you to nothing.

NOTE–I rather encourage doctors to undertake a regular LLB course, often offered by evening law colleges. The course is simple and easy. It entitles doctors in many ways, including the entitlement to join the Bar.

–M C Gupta

===========================================

On Sat, 8 Feb 2020 at 21:06, Gladstone D’Costa <gladstonedcosta@gmail.com> wrote:

There is an emerging trend to do a certificate course conducted by some law colleges in medico-legal matters. What does this entitle you do in an official capacity?

QUESTION 4— I am a practicing Psychiatrist. I want to do LLB. Can I do legal practice along with my hospital work?

On Sat, 8 Feb 2020 at 20:40, Dr Rohit Bansal <rohitbansal76@gmail.com> wrote:

I am a practicing Psychiatrist in Barnala, Punjab. I want to do LLB.

Can I do legal practice along with my hospital work?

A—1—Please do your LL.B. Do not restrain your desire. You will never regret gaining an extra degree and knowledge.

2—You can do legal work without enrolling in the Bar. You can act as a medico-legal consultant, can draft pleadings for the court and, with the permission of the court, can even argue cases as an authorised representative. There are many doctors who do so. If the court does not permit, some lawyer friend of yours can argue the case.

3—You cannot enroll with the bar as an advocate without stopping your medical practice.

4– I invite you to join the MLQ (Medico-legal queries) group. It has 1033 members at present. This is a group devoted to the discussion of medico-legal issues. Here is how to join the MLQ group:

Click (send a blank mail):

medico-legal-queries-subscribe@yahoogroups.co.in

M C Gupta

QUESTION 5— ECG did in my hospital, sending this ECG to some cardiologist out of my state, who is not registered to my state medical council, and getting reported under MOU. Can we have such MOU legally? r. Sudhir Khunteta,

Director & Chief Intensivist, SHUBH HOSPITAL,

Gen. Secy. Transport Medicine Society,A-35, Vidhyut Nagar,Jaipur (2.8.2020)

MCG-A. There can be no legal bar even if you get it reported from the USA. The only legal precaution is that you should clearly write one of the following in the report—

A–You should tell the patient that the ECG will be reported by a cardiologist on your panel.

B–The report should clearly state that: ECG has done at….clinic and reported by Dr……………..

QUESTION 6 —What is the importance of proper documentation for a doctor/hospital?

MCG. A. If the records are proper, the law will hesitate to touch you. The aim of the law is to find what illegality has been committed. The finding has to come from medical records. Oral submissions have much less weight in law while possibilities and imaginations are considered not much better than conjectures. In this connection, I am immediately reminded of a case filed against an MD Gyne where the woman had died of PPH and the post-mortem finding, which was suspect, was that there was retained placenta. I had a lot of problems defending the doctor. Her defence could have been very simple if she had not slipped on a certain point while writing the case sheet. The delivery notes nowhere stated that a complete placenta was delivered though she assured me personally that it was so. Had she mentioned in the notes that the placenta as delivered was examined and found to be complete, the situation would have been easier.

Doctors often lose medical negligence cases because the medical record of the patient reflects poor documentation. They run into unnecessary problems just because they are too busy or careless to record essential details. This applies particularly to consent. Two cases come to my mind immediately:

i)—A doctor operated on a woman for ectopic pregnancy to remove the products of conception. Consent was taken for “uterine surgery”. On opening up, it was found that the site of the ectopic pregnancy was so close to the uterus that the removal of the uterus was necessary. The uterus was removed. No consent was taken for the hysterectomy. The woman, aged 30 years, sued. I had great difficulty defending the doctor.

ii)—An orthopaedic surgeon gave an injection of Depot Medrol epidurally for low backache… This is a common practice among orthopaedics even though this drug is not permitted for such use by the Drug Controller General of India and is contraindicated for such use by the manufacturer of the drug. The patient developed complications. While taking consent from the patient, it was not disclosed to him that the use of the drug is controversial. The patient filed a complaint with the DMC, which found no fault. The patient then filed an appeal before the MCI, which decided to reprimand the doctor and issue him a warning not to use drugs which are not recommended for a particular condition and are not recommended to be administered by a particular route. Had the orthopaedic surgeon disclosed in writing to the patient at the time of taking consent that the use of Depomedrol by epidermal injection, though often used by orthopaedics, is controversial and that the patient is giving consent in spite of knowing this, there would have been no case against the doctor.

QUESTION 7 — What is the role of proper consent in medical practice?

MCG A.–

It is surprising that doctors do not give much importance to consent. A doctor has no right to even touch a patient without his / her consent. There are many cases in courts where the issue is whether there was proper consent before treatment/surgery. In this connection, in order to explain the concept and importance of consent in medical practice, I am giving below a few examples from actual court cases:

1— The patient has a right to be informed. The Supreme Court observed as follows in Malay Kumar Ganguly … V. Dr. Sukumar Mukherjee and others, reported as (2009 SCC 9, 221)–

“142–The patients by and large are ignorant about the disease or side or adverse effect of a medicine. Ordinarily, the patients are to be informed about the admitted risk, if any. If some medicine has some adverse effect or some reaction is anticipated, he should be informed thereabout. It was not done in the instant case…..”

“143–The law on medical negligence also has to keep up with the advances in the medical science as to treatment as also diagnostics. Doctors increasingly must engage with patients during treatments especially when the line of treatment is a contested one and hazards are involved. Standard of care in such cases will involve the duty to disclose to patients about the risks of serious side effects or about alternative treatments. In the times to come, litigation may be based on the theory of lack of informed consent. ….”

3—In one of my own cases, where I argued for the doctor, the National Consumer Commission observed as follows:

“25. Let us turn to the point of the importance of obtaining informed consent.

OPs admitted that consent for the operation was not taken in this present case, because of an emergency. Counsel for OPs argued that it was a case of an emergency; also at that time, the complainant-1(husband of the patient) was not present and not traceable. The OPs performed operations to save the life of the patient. Such arguments are bereft of merits. The medical records show that OP-1 examined the patient at 10 am, and noted that, the patient had Continuous bouts of pain and vomiting. She advised for Laparotomy after lab reports, for relatives to be informed and for Consent.

26. The operation was conducted at 2 pm. There was a sufficient time of 4 hours, in between. The patient was conscious and she herself was able to give consent. Therefore, in our view, the OPs failed to take the consent, it is per se negligence. We place reliance upon Samira Kohli’s Case, in which the Hon’ble Supreme Court dealt extensively with the subject of Consent. Similarly, in this case, the patient was neither a minor nor mentally challenged or incapacitated. As the patient was a conscious and competent adult, there was no question of waiting for her husband or someone else, to give consent on her behalf.

27. Exceptions to the Informed Consent Doctrine, that The Courts have recognized four situations in which consent is required, but informed consent (that is adequate disclosure) is not necessarily required during (i) emergencies, (ii) the therapeutic privilege, (iii) patient waiver and (iv) treatment of criminal suspects or patients in custody. A right of action for lack of informed consent is limited to non-emergency treatment. An emergency situation has been defined as one when the patient is incapable of consenting and the harm from the failure to treat is greater than any harm posed by the treatment. The existence of emergency may be a question of fact.”

[Ref: Rajmal Singh & Ors. vs Dr. Madhu Gupta & Ors. on 8 May 2014, NCDRC]

3—The Supreme Court observed as follows regarding consent when there are practical difficulties in obtaining consent–

“135. Where it is not practicable for a medical practitioner to obtain consent for treatment and where the patient‘s life is in danger if appropriate treatment is not given, then the treatment may be administered without consent. This is justified by what is sometimes called the ―emergency principle‖ or ―the principle of necessity‖. Usually, the medical practitioner treats the patient in accordance with his clinical judgment of what is in the patient‘s best interests. Lord Goff of Chieveley has rightly pointed out in F v. West Berkshire Health Authority (supra) that for the principle of necessity to apply, two conditions must be met:-

(a) There must be ―a necessity to act when it is not practicable to communicate with the assisted person‖; and

(b) ―the action taken must be such as a reasonable person would in all the circumstances take, acting in the best interests of the assisted person.‖”

Ref: Common Cause v. Union of India, (2018) 5 SCC 1

QUESTION 8 — What is the role of communication in healthcare facilities?

MCG A.–Proper communication with the patient and his relatives is very important for establishing good patient-doctor interaction and preventing misunderstanding and misbehaviour/litigation/violence by the patients or relatives. The following points are important:

i)—When a patient is admitted to the hospital, one of the first communications is by way of seeking consent for treatment. This is a crucial occasion when the patient and his attendants deserve and want to know about the nature of the disease and the mode of treatment and the likely outcome. The fact is that in most hospitals, consent is treated merely as a formality and the patient’s signatures are taken on a blank form without explaining anything. Dissatisfaction and litigation start when the patient realises that the expectations that he had or was given were not fulfilled.

ii)—When there is an adverse outcome, for which the patient/attendants were not mentally prepared, they get agitated and even resort to violence. It is not to say that violence by patient’s attendants is defensible in any manner, but it is certainly a fact that proper communication, preferably by the treating doctor / a senior member of his team, spending sufficient time, would reduce the incidence of violence.

iii)—Patients resort to litigation only when they think that they have a genuine grievance. Nobody goes to a doctor to get treated first and then sue him. They sue the doctor because they think there was medical negligence/malpractice. They resort to litigation because there is no mechanism to redress their grievance. It is highly desirable and recommended that every hospital should have a Grievance Redressal Committee which can be approached by a patient or his relatives if they feel there are deficiencies in treatment. Such a committee should have, a few permanent members (physician, surgeon, hospital administrator, hospital advocate) while other members can be co-opted as necessary. This committee should grant an immediate hearing to the aggrieved party and should honestly and sincerely try to resolve the issue without appearing to favour the hospital/doctors. If such a Grievance Redressal Committee is established in a hospital, it will go a long way in reducing litigation.

QUESTION 9 — What happens if a surgical complication (like infection/ implant failure / cut through of implant etc) happens and the patient sues you in court? Does the law hold guilty of a doctor even if he has taken reasonable preventive steps to avoid that complication? (Asked by Prof Anil Arora, New Delhi)

RKS A.- Yes, it is true that all surgery carries risks and complications do happen in some cases and the doctor gets sued by the patient. In all such cases, the court views it as follows

1. Whether the doctor has explained to the patient all likely complications and taken proper consent or not.

2. Whether the doctor has applied reasonable care and skill.

3. Whether the doctor has followed standard protocol while handling complications.

4. Whether said complication is described in textbooks or journals or other authentic sources. If the court is satisfied that the doctor has followed the above, he will not be held guilty of negligence. But the doctor has to defend his case properly.

QUESTION 10 — What should be the priority of a witness while examining a female patient in a clinic? (21.8.2020)

RKS A.- The following priority is suggested.

1. Female relative or female attendant of the patient who has come with her

2. Her husband if she has come with him and no female relative or attendant is there.

3. Your female staff nurse or even computer operator if the patient has come alone.

4. If you do not have any female employees, ask any other female patient to come inside the examination room.

Avoid examination of the female patient alone when you are examining breasts, back or private parts.

QUESTION 11 — As a family physician many times we are called to visit a patient, on examination if we find him dead(not treated by us)can we issue a death certificate as demanded by relatives, if not then what should be the proper course of action, please guide- Dr Yudhvir Bansal , Rohini, Delhi, 19.7.2019

RKS Answers- You can always issue a death certificate but just examine the body for any injury present. Look for papers for an illness he was suffering from. If you are satisfied that death is natural, you can issue a death certificate. If not, refer the case to govt hospital.

ip- Maharashtra Consumer Commission – M. M. Abraham v/s. Dr. Yogendra Ravi & Ors

The patient who had undergone surgery developed a “foot drop” a known complication of that surgery. It was alleged that while taking consent this complication was not disclosed and a line was added subsequently at the bottom of the consent form. Fortunately, the court found that the patient’s wife’s signature appeared below the disputed sentence. Explain all complications in detail and get signatures at the end.

QUESTION 12 — Can General Practitioner refuse home visits? (Asked by Dr Anil Kumar Saini, 22.7.2019)

RKS A.- Yes, a general practitioner can refuse home visits. A notice to this effect may be put in a clinic so that your patients can understand this. You can mention it on your letterhead too. But on ethical grounds, in a life-threatening situation, the visit may be made as it is exceptional ground.

QUESTION 13 — What does imposing costs upon the parties generally mean?

On Tue, 2 Jun 2020 at 15:29, Aakash Sethi aakashsethirox@gmail.com asked :

MCG(29.7.2020)\>> Please view:http://www.legalservicesindia.com/article/480/Award-of-cost-under-cpc.html

2. Does imposing such a cost on the parties mean that compensation was awarded?

>>>No.

3. Why did the court explicitly mention that the petitioner has the liberty to get compensation via appropriate legal remedy? (para 29.1 and 29.2) what could be the result if such a point is not mentioned? Does the petitioner lose the ability to approach an appropriate forum?

>>> The court did so to avoid any confusion that the cost imposed was by way of compensation. Even without such mention by the HC, the complainant is at full liberty to approach a consumer court for compensation.

4. The court also said “28…..MCI must have a sentencing policy in place for the guidance of its Committees which are tasked with the job of returning recommendations both, on the guilt and punishment to be accorded to a delinquent doctor. The sentencing guidelines should take into account the aggravating and mitigating circumstances, including but not limited to whether or not the delinquent doctor is a first-time offender or a repeat offender”

QUESTION 14 —Drawing a parallel with respect to punishments in Criminal cases, do the courts have a definite guideline for awarding imprisonment sentences? If not, then does the court rely on a common law judge to sentence the convict? If yes, how strictly are the sentencing guidelines been followed generally by the trial courts?

i)–There is nothing wrong with “28…..MCI must have a sentencing policy in place for its Committees, tasked with returning recommendations on the guilt and punishment to be accorded to a delinquent doctor. The sentencing guidelines should take into account the aggravating and mitigating circumstances, including but not limited to whether or not the delinquent doctor is a first-time offender or a repeat offender”

ii)–MCI should have in place guidelines even without the need for courts to point out the need for the same. Without such guidelines, the punishment may be awarded arbitrarily.

QUESTION 15 —if the patient or his attendants give in writing that they don’t want MLC to be registered is it safe for the trauma attending surgeons to accept it or not? (Asked by Dr Sonia Kochhar)

RKS A..- In most cases, not making MLC on request of the patient or his attendants in trauma cases is safe for the attending surgeon. But he must use his wisdom if he finds something suspicious. The following cases require his judgment

1. If the injury does not correspond to the history and manner of injuries.

2. If the injury is sustained by a woman or small child and has some old injuries too. (Caution battered wife / battered child syndrome)

3. If the patient is not conscious and in-laws insist on not making MLC. Just wait for parents to come

. 4. Any unusual activity requiring suspicion to be raised.

QUESTION 16 — Recently Delhi Government has mandated it for Surgeons / Hospitals to upload pictures of surgeries for patients referred to Pvt hospitals under the Delhi Arogya Kosh ( DAK) scheme. This doesn’t fit within the legal ambit for disclosure to a court or academic purpose, nor has it been notified as a law. Kindly clarify whether the patient has a right to refuse especially in cases of urologic, gynae surgeries on genitalia or informed consent for the same is mandatory.

It is not a law as yet only govt circular.

Dr P Gulati, Senior Consult., Urologist

Medico-legal Tip of the day – 22nd July 2019

RKS A,- Please understand that govt circular is also a law. It is under administrative law. Govt have the power to issue circulars and we need to follow it. Under this circular, you are not uploading images for general people. It is selective and for govt reference only. It does not breach the confidentiality of the patient.

However, if somebody has issues, he can refuse and withdraw from the scheme. Nobody can be forced but he loses from govt scheme.

QUESTION 17 — There is a debate going on in the newspaper & the internet regarding the general surgeon that he cannot perform Hysterectomy or LSCS. (Asked by Dr. Manoj Garg, Morena, M.P.

RKS A. Answer- There is no doubt that a general surgeon is competent to do a hysterectomy or LSCS but it should be done only in case of emergency. I have observed that many surgeons are routinely doing LSCS at many nursing homes/hospitals, especially in small cities. Many such surgeons are doing these practices while assisting their wives in maternity nursing homes and some have no other surgical practice except LSCS routinely. In case of negligence, the court will take serious note of that as this practice is unusual for general surgeons as they have not been trained in performing LSCS in the course curriculum. The only justification is emergency when an obstetrician is not available

QUESTION 18 — I have queries regarding MLCs

1. If the case has been made MLC in the primary treated hospital, is it required to do one more MLC in the referred hospital / another hospital? as police will ask for the injury certificate from the second hospital?

2. Many times we come across cases of self-fall from the two-wheeler or self-fall at home. Is it required to make MLC in self-fall cases or not?

3. What is the legality of NIL MLC which is practiced in many hospitals? (Dr Kumar, Bangalore)

RKS A. A.1 If the case has been made MLC in the primary treated hospital, is it required to do one more MLC in the referred hospital / another hospital? as police will ask for the injury certificate from the second hospital?

No more MLC is required to be made if MLC has been made at the first hospital but label all documents as MLC and inform the police. An injury certificate can be issued.

2. Many times we come across cases of self-fall from the two-wheeler or self-fall at home. Is it required to make MLC in self-fall cases or not?

In case of a self-fall from a vehicle or at home, you need not make MLC if a person requests you not to make MLC. But if he is unconscious, make MLC.

3. What is the legality of NIL MLC which is practiced in many hospitals?

There is no standard term for NIL MLC. It is either MLC or Non-MLC

QUESTION 19 — If a patient develops some complication after surgery, is it mandatory for the surgeon to intimate his insurance company pre-emotively even before the patient files for litigation? Can the insurance company deny professional indemnity on the grounds that the doctor did not inform them prior to the filing of litigation by a patient who was ‘likely’ to have filed in the first place? (Dr. Yogesh K. Pithwa, Consultant Spine Surgeon)

RKS A.- No. it is not essential to inform the insurance company if you come to know that the patient had developed complications. Only when you receive legal notice either from a lawyer/ patient or court, it is essential to inform insurance companies.

Question – I am an owner of a small hospital. We have an x-ray machine but no radiologist on the hospital panel. Generally, x-rays advised by clinicians are examined by them. However, in Medico-legal cases, a formal report of a Radiologist is demanded by IO. My question is whether a non-radiology doctor (MBBS or PG) is legally authorised to generate a formal x-ray report under his signature. (Name withheld)

RKS Answer- Please note that all MLC x-rays are to be reported only by radiologists as the report goes to court. In non-MLC cases also, it is also essential that the report is signed by the radiologist. Clinicians are allowed to interpret x-rays while treating their own patients but cannot issue x-ray reports.

QUESTION 20 — Is India federal or unitary in nature?

ANSWER:

1– Indian constitution is federal in nature but unitary in the soul.

2– A unitary system is composed of one central government that holds all the power, but a federal system divides power between national and local forms of government.

India is a federal country. But not once in the constitution is the word “federation” ever mentioned. Instead, what is said is that India is a Union of States?.

–Federal features of the Indian constitution:

The Indian constitution is basically federal in nature and has the traditional characteristics of a federal system, as listed below:

i)—The Constitution is supreme.

ii)—There is a clear division of powers between the centre and the states. The Seventh Schedule of the Constitution contains three lists of subjects which show how the division of power is made between the two sets of government.

iii)-There is an independent judiciary to determine issues between the centre and the states and also between the states.

iv)—There is a rigid procedure for amendment of the Constitution as regards the powers of the centre and the states.

3–Unitary or Non-Federal Features of the Indian constitution:

i)–Single Constitution: There are no separate constitutions for the States. In a true federation, there are separate constitutions for the union and the States.

ii)–Centre’s control over States: The States have to respect the laws made by the central government and cannot make any law on matters on which there is already a central law.

iii)–Rajya Sabha does not represent the States’ equality: In a true federation, the upper house of the legislature has equal representation from the constituting units or the States.

iv)–The Existence of States depends on the Centre: The boundary of a State can be changed by carving out the existing States.

v)–Single citizenship: In a true federal state, citizens are given dual citizenship. In India however, the citizens enjoy single citizenship, i.e., Indian citizenship or citizenship of the country as a whole.

vi)–Unified judiciary: India has a unified or integrated judicial system. The Supreme Court is the highest court of justice in the country and all other subordinate courts are under it.

vii)–Proclamation of emergency: When the emergency is declared, the Union or Central governments become all-powerful and the State governments come under total control of it. The State governments lose their autonomy.

4–Following provisions prove that though India is federal in nature, its soul is unitary:

i)–In legislative matters, the Union Parliament is very powerful. It has not only exclusive control over the Union list and the residuary powers, but it has also dominance over the Concurrent list and the State list. This is of importance for the uniformity of laws in the country.

ii)–In administrative matters also, the Central government has been made more powerful than the States. The State governments have to work under the supervision and control of the Central government. The States should exercise their executive powers in accordance with the laws made by the Parliament. It can control the State governments by directing them to take necessary steps for the proper running of the administration. If the State fails to work properly or according to the Constitution, it can impose President’s rule there under Article 356 and take over its (the State’s) administration.

iii)—In Financial matters, the President of India has the power to make alterations in the distribution of revenues earned from income tax between the centre and the States. The Centre has also the power to grant loans and great-in-aid to the State governments. The Comptroller and Auditor General of India and the Finance Commission of India which are the central agencies also have control over the State finances.

NOTE— In 1983, the Sarkaria Commission emphasized cooperative federalism in India. It is a fact that India has a strong Central government but it should not always try to interfere in the matters of the States. Both governments should respect one another’s power or authority and work harmoniously.

—-Ex-Prof. M C Gupta, MD (Medicine), LLM, Advocate(with courtesy to <medico-legal-queries@yahoogroups.co.in>).

Central Executive Committee o NMO (1.4.2021-31.3.2022)

President: Dr. S.C. Rajput, N.Delhi ,Vice Presidents:Dr. Rajkumar Gupta, Agra,Dr. Shant Prakash,Ranchi, Dr.Satya Dev, Jammu, Dr.Ashok Goyal,Amritsar, Secretary : Dr. Prakash Pandey,. Hazaribagh,(resigned on 22.1.2022 ).Joint Secretary: Dr. Mohit ,Motihari ,Organising Secy.-cum- Treasurer-cum-editor AP: Dr. Dhanakar Thakur Darbhanga , Members-: Dr. Madhup Kumar, Gwalior, Dr. Niranjan, Bareilly,Dr. Manish Kumar. Samastipur/Delhi Dr. Harsh Kushwaha,Agra,Dr.Gaurishankar Krishna Gattapalli,AP

Nominations for the President and Secretary of NMO for year 2022-23 may be sent by 25.3.2022 on email nmocentral@rediffmail.com. Names can be withdrawn by 30.3.2022. If required election will be held as per NMO’s Constitution in GBM which will be notified to members.

12 जनवरी 2022 को स्वामी विवेकानंद जी की 158 वें जन्म दिवस के उपलक्ष में

नेशनल मेडिकोज आर्गेनाईजेशन द्वारा विभिन्न कार्यक्रम आयोजित किए गए, जिसमें सर्वप्रथम रोहिलखण्ड मेडिकल कॉलेज के केंद्रीय पुस्तकालय में छात्रों ने राष्ट्रीय युवा दिवस मनाया। प्रातः 9.30 पर स्वामीजी विवेकानंद के चित्र पर पुष्पांजलि कार्यक्रम को विधिवत रूप से आरंभ किया गया, उपस्थित सभी ने छत्रों ने दी, बाद में लड्डू का वितरण भी हुआ।

राष्ट्रीय युवा दिवस समारोह में बोलते हुए मेडिसिन के शिक्षक और नेशनल मेडिकोस आर्गेनाईजेशन के संस्थापक डॉ धनाकर ठकुर ने कहा की कहा कि भारत सरकार ने 12 जनवरी को राष्ट्रीय युवा दिवस के रूप में घोषित किया है। यह दिन युवाओं को प्रेरणा देता है क्योंकि स्वामीजी एक युवा थे जब उन्होंने पूरे देश की यात्रा की। वे विश्व धर्म सम्मेलन के बारे में जान गए और यूएसए चले गए। उनका भाषण भारत की पहचान के लिए एक महत्वपूर्ण मोड़ था। भारत के कई हिस्सों में मुसलमानों ने 600 वर्षों तक शासन किया जो लुटेरों के रूप में आए। उनमें से कुछ भारत में बस गए। पुर्तगाल, हॉलैंड, फ्रेंच और ब्रिटेन के यूरोपीय ईसाई यहां मसालों के कारोबार के साथ-साथ अपने धर्म का प्रचार-प्रसार करने आए थे। वे दूसरे को बदलने के लिए आपस में लड़े। उनमे फ्रेंच को छोड़कर सबने हिंदुओं पर अत्याचार किया। अंततः 1757 में अंग्रेजों के पास तत्कालीन बिहार, बंगाल और उड़ीसा की दीवानी चलीगयीजिसमें 30 मिलियन की आबादी और 25 लाख पाउंड का राजस्व प्रति वर्ष था। इतना बड़ा धन प्लासी में केवल 7 ब्रिटिश कीलड़ाईमेंमृत्युकापरिणाम था जो दुनिया के किसी भी युद्ध में नहीं हुआ है। स्वामी विवेकानंद ने मुस्लिम शासकों के उत्पीड़न के कारण हिंदुओं की सुप्तावस्था को समझा। उन्होंने हिंदुओं को विशेष रूप से युवाओं को जगाने के लिए उत्साहित किया और परिणाम शानदार रहे। 1905 तक कांग्रेस एक याचिकाकर्ता संगठनसे स्वतंत्रता के वाहन में बदल गया। चार दशकों में हमें अपनी मातृभूमि के विभाजन की कीमत पर आजादी मिली।युवाओं को सामाजिक कार्यों के माध्यम से खुद को संगठित करने की जरूरत है जो एनएमओ और एनईओ (नेशनलिस्ट इंजीनियर आर्गेनाईजेशन ) कर रहे हैं। जिसके उपरांत 10:00 बजे ऑनलाइन गोष्ठी का आयोजन किया गया जिसका विषय- हम अपने जीवन को विवेकानंद के विचारों के अनुसार कैसे सुखी बना सकते हैं, जिसकी अध्यक्षता डॉ धनाकर ठाकुर जी ने की एवं डॉ राजकुमार गुप्ता मुख्य वक्ता थे, उन्होंने विस्तार से से चर्चा की कि हम अपने जीवन को स्वामी विवेकानंद जी के आदर्शों और विचारों से अपने जीवन को सुखी किस प्रकार बना सकते हैं इस पर विस्तार से चर्चा ।इसी क्रम में सांय 6 बजे डेंटल मैनेजमेंट ऑफ स्लीप डिसऑर्डर विषय पर वेबीनार का आयोजन किया गया जिसकी अध्यक्षता डॉ प्रकाश कुमार पांडेय ने की, वेबीनार के वक्ता डॉ गौरी शंकर कृष्णा गट्टूपल्ली थे, डॉ गौरी शंकर ने सर्वप्रथम स्लीप डिसऑर्डर के बारे में विस्तार से चर्चा की एवं स्लीप डिसऑर्डर के उपचार के विषय में विस्तृत रूप से चर्चा की। आज के कार्यक्रम में डॉ धनाकर ठाकुर, डॉ राजकुमार गुप्ता ,डॉ प्रकाश कुमार पांडेय, डॉ हर्ष कुशवाहा ,डॉ प्रांजल माहेश्वरी, डॉ गौरी शंकर,मोहित सिंह, डॉ फेराज हसन ,डॉ रोनित शर्मा, डॉ सी एल वेंकट राव, डॉ चंद्रशेखर राव,डॉ अजय यादव, डॉ रोहित जैन, डॉ मुकेश थपक, डॉ लीना मुरकुटे, डॉ एम एन चेरी, डॉ विकास त्यागी, डॉ शहनवाज खान,डॉ सियाराम शर्मा, डॉ जी वी, डॉ जगदीश,डॉ एस एलिया, डॉ इंदिरा घई, डॉ अरघा चटर्जी, डॉ अभिनव गोयल, डॉ राहुल, डॉ पुष्पेंद्र, डॉ हिमांशु मित्तल, डॉ एस एच मेहंदी प्रमुख रूप से उपस्थित थे।

सन् १८९३ में शिकागो (अमेरिका) में

विश्व धर्म परिषद् में स्वामी विवेकानंद जी का भाषण–

अमेरिकी बहनों और भाइयों,

आपने जिस सौहार्द और स्नेह के साथ हम लोगों का स्वागत किया हैं,

उसके प्रति आभार प्रकट करने के निमित्त खड़े होते समय मेरा हृदय

अवर्णनीय हर्ष से पूर्ण हो रहा हैं। संसार में संन्यासियों की सब से

प्राचीन परम्परा की ओर से मैं आपको धन्यवाद देता हूँ;

धर्मों की माता की ओर से धन्यवाद देता हूँ; और सभी सम्प्रदायों एवं

मतों के कोटि कोटि हिन्दुओं की ओर से भी धन्यवाद देता हूँ। मैं इस मंच पर से बोलनेवाले उन कतिपय वक्ताओं के प्रति भी धन्यवाद ज्ञापित करता हूँ, जिन्होंने प्राची के प्रतिनिधियों का उल्लेख करते समय आपको यह बतलाया हैं कि सुदूर देशों के ये लोग सहिष्णुता का भाव विविध देशों में प्रचारित करने के गौरव का दावा कर सकते हैं। मैं एक ऐसे धर्म का अनुयायी होने में गर्व का अनुभव करता हूँ, जिसने संसार को सहिष्णुता तथा सार्वभौम स्वीकृति, दोनों की ही शिक्षा दी हैं। हम लोग सब धर्मों के प्रति केवल सहिष्णुता में ही विश्वास नहीं करते, वरन् समस्त धर्मों को सच्चा मान कर स्वीकार करते हैं। मुझे ऐसे देश का व्यक्ति होने का अभिमान हैं, जिसने इस पृथ्वी के समस्त धर्मों और देशों के उत्पीड़ितों और शरणार्थियों को आश्रय दिया हैं। मुझेआपको यह बतलाते हुए गर्व होता हैं कि हमने अपने वक्ष में यहूदियों केविशुद्धतम अवशिष्ट को स्थान दिया था, जिन्होंने दक्षिण भारत आकर उसी वर्षशरण ली थी, जिस वर्ष उनका पवित्र मन्दिर रोमन जाति के अत्याचार से धूल में मिला दिया गया था । ऐसे धर्म का अनुयायी होने में मैं गर्व का अनुभवकरता हूँ, जिसने महान् जरथुष्ट्र जाति के अवशिष्ट अंश को शरण दी और जिसका पालन वह अब तक कर रहा हैं। भाईयो, मैं आप लोगों को एक स्तोत्र की कुछ पंक्तियाँ सुनाता हूँ, जिसकी आवृति मैं बचपन से कर रहा हूँ और जिसकी आवृति प्रतिदिन लाखों मनुष्य किया करते हैं:

रुचिनां वैचित्र्यादृजुक ुटिलनानापथजुषाम ् । नृणामेको गम्यस्त्वमसि पयसामर्णव इव ।।

‘जैसे विभिन्न नदियाँ भिन्न भिन्न स्रोतों से निकलकर समुद्र में मिल जाती हैं, उसी प्रकार हे प्रभो! भिन्न भिन्न रुचि के अनुसार विभिन्न टेढ़े-मेढ़े अथवा सीधे रास्ते से जानेवाले लोग अन्त में तुझमें ही आकर मिल जाते हैं।’यह सभा, जो अभी तक आयोजित सर्वश्रेष्ठ पवित्र सम्मेलनों में से एक हैं, स्वतः ही गीता के इस अद्भुत उपदेश का प्रतिपादन एवं जगत् के प्रति उसकी घोषणा हैं:

ये यथा मां प्रपद्यन्ते तांस्तथैव भजाम्यहम् । मम वर्त्मानुवर्तन् ते मनुष्याः पार्थ सर्वशः ।।

– ‘ जो कोई मेरी ओर आता हैं – चाहे किसी प्रकार से हो – मैं उसको प्राप्त होता हूँ। लोग भिन्न मार्ग द्वारा प्रयत्न करते हुए अन्त में मेरी ही ओर आते हैं।’ साम्प्रदायिकता, हठधर्मिता और उनकी बीभत्स वंशधर धर्मान्धता इस सुन्दर पृथ्वी पर बहुत समय तक राज्य कर चुकी हैं। वे पृथ्वी को हिंसा से भरती रही हैं, उसको बारम्बार मानवता के रक्त से नहलाती रही हैं, सभ्यताओं को विध्वस्त करती और पूरे पूरे देशों को निराशा के गर्त में डालती रही हैं। यदि ये बीभत्स दानवी न होती, तो मानव समाज आज की अवस्था से कहीं अधिक उन्नत हो गया होता । पर अबउनका समय आ गया हैं, और मैं आन्तरिक रूप से आशा करता हूँ कि आज सुबह इस सभा के सम्मान में जो घण्टाध्वनि हुई हैं, वह समस्त धर्मान्धता का, तलवार या लेखनी के द्वारा होनेवाले सभी उत्पीड़नों का, तथा एक ही लक्ष्य की ओर अग्रसर होनेवाले मानवों की पारस्पारिक कटुता का मृत्युनिनाद सिद्ध हो।

Diet and Exercise relationship- MC Gupta 8

AUTHOR Index

Dhanakar Thakur – BMS (Bachelor in Medical Science) Equivalent to pre-Independence LMP \

be Started. (Editorial)- 1

1612–Can an anaesthetist hand over the case to another anaesthetist midway during an operation?

The black goat’s milk

The conflict of medical ethics and law

[medico-legal-forum] The Karnataka High Court has suggested that medical professionals should be protected from legal action just like public servants are protected against bonafide errors in their action.

medico-legal-forum] 1612–Can an anaesthetist hand over the case to another anaesthetist midway during an operation?

[medico-legal-forum] The black goat’s milk

(Editorial) 1 NMO in Controversy- III (2002-…) -Dhanakar Thakur, as the founder & Organiser 1

AUTHOR Index

(Editorial) 1 NMO in Controversy- III (2002-…) -Dhanakar Thakur, as the founder & Organiser 1

((Editorial) COVID and Beyond – Dhanakar Thakur 1

AUTHOR Index

M C Gupta- Medico legal Queries and Answers 5

RK Shrama- Medico legal Queries and Answers 5

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