BNS 26 and BNS 106 Explained

Till 1994 Doctors can be punished by 1. Medical Council - Only for Gross Issues 2. Employer (Private Hospital or Govt) No other person can enquire or punish This was the situation

So There were no cases filed under 304 A for what happened during treatment But The Inclusion under consumer courts opened flood gates Once it was told that consumer court can enquire, Police also too the power to enquire and filed under 304 A Till that time There were no arrests / remand for 304A Even Drivers used to be booked and then let out in "Station Bail" (Court Bail was not even needed) Only after then started arresting doctors under 304 A, they started arresting drivers too -- So When we demanded to exclude healthcare from consumer courts Union Govt accepted They even proposed the draft bill But it was opposed by few perverts They said when there is criminal liability, how can you remove consumer liability So The to Excluse Medical Treatment from Consumer Courts, you need to exclude Medical Management from Police Stations too To Exclude Medical Treatment from 304A You need to differentiate between Medical Treatment and other Issues So They have differentiated in New Law 106 This is the first step Section 106 of The Bharatiya Nyaya Sanhita (BNS): Causing death by negligence. (1) Whoever causes death of any person by doing any rash or negligent act not amounting to culpable homicide, shall be punished with imprisonment of either description for a term which may extend to five years, and shall also be liable to fine; and if such act is done by a registered medical practitioner while performing medical procedure, he shall be punished with imprisonment of either description for a term which may extend to two years, and shall also be liable to fine. Explanation.— For the purposes of this sub-section, “registered medical practitioner” means a medical practitioner who possesses any medical qualification recognised under the National Medical Commission Act, 2019 and whose name has been entered in the National Medical Register or a State Medical Register under that Act. (2) Whoever causes death of any person by rash and negligent driving of vehicle not amounting to culpable homicide, and escapes without reporting it to a police officer or a Magistrate soon after the incident, shall be punished with imprisonment of either description of a term which may extend to ten years, and shall also be liable to fine. There are lots more steps involved, and next, 106 will be amended to remove the punishment clause Next Doctors will be excluded from Consumer Courts. Supreme Court has already asked for review of the old judgement (please see https://www.livelaw.in/supreme-court/judgment-bringing-doctors-under-consumer-protection-act-requires-reconsideration-supreme-court-257852 ) Please remember that this mess has been created over 3 decades and cannot by undone on one day. We need to untie each knot one by one Please also look at BNS 26. Act not intended to cause death, done by consent in good faith for person's benefit. Nothing, which is not intended to cause death, is an offence by reason of any harm which it may cause, or be intended by the doer to cause, or be known by the doer to be likely to cause, to any person for whose benefit it is done in good faith, and who has given a consent, whether express or implied, to suffer that harm, or to take the risk of that harm. Illustration : A, a surgeon, knowing that a particular operation is likely to cause the death of Z, who suffers under the painful complaint, but not intending to cause Z’s death, and intending, in good faith, Z’s benefit, performs that operation on Z, with Z’s consent. A has committed no offence So Doctors, Be Calm. Your Protection has been already included in Black and White As long there is a consent, Section 26 of BNS Applies. Article 106 is only when there is no consent So There is no point in shouting against Union Govt All you need to do is to Ask your state Governments to order the DGP to write to Police to invoke BNS Sec 26 whenever there is a consent. And Read BNS 26 again, the consent may be express or implied Tagging @bijlanirajesh sir and @DrDhruvchauhan Sir who have been discussing this Also Tagging @docbhooshan sir for his efforts earlier regarding this issue.

How is should a doctor explain to a patient

http://www.thehindu.com/news/cities/Delhi/consumer-panel-orders-hospital-to-pay-5-lakh-for-medical-negligence/article23497338.ece Consumer panel orders hospital to pay ₹5 lakh for medical negligence Commission says ‘informed consent’ to proposed treatment mandatory The State Consumer Disputes Redressal Commission in Delhi has directed Indraprastha Apollo Hospitals to pay ₹5 lakh as compensation to a petitioner for alleged medical negligence. Directing the hospital and the treating doctor to jointly pay the sum, the commission held that “informed consent [to proposed treatment] is mandatory”, which the hospital failed to do. The petitioner, challenging a district forum order that held the hospital guilty of “deficiency in services and not medical negligence”, had sought compensation of ₹50 lakh. The petitioner said that his 23-year-old daughter was admitted to the hospital in 2004 after a severe bout of diarrhoea but was diagnosed with an autoimmune disease, where healthy tissues are mistakenly attacked by the immune system, four days later. In the complaint against the hospital, the petitioner alleged that his daughter died after the hospital carried out a blood transfusion despite the “patient being in good condition”. ‘Overdose of steroids’ “The complainant levelled allegations that transfusion of blood to the patient resulted in an overdose of steroids. The complainant further submitted that the patient was absolutely fit when he requested the doctors to discharge her. Contention of the complainant is that further transfusion of blood led to unconsciousness from which the patient never recovered,” read the allegations as noted by the State commission. Complicated case Contending allegations that the hospital had tried to “grab money”, the respondents, including the doctor who treated the patient, argued that “it was a complicated disease and could not have an on-spot diagnosis without referring to a stringent battery of tests. There was no contradiction to blood transfusion. Her condition warranted life-saving measures and steroids needed to be given”. Referring to the report submitted by an expert committee, which spoke of a “communication gap between the hospital and the petitioner”, the State Consumer Disputes Redressal Commission held: “No record shows whether the patient or her attendants were disclosed information related to diagnosis of the disease, nature of proposed treatment, potential risk of the treatment and consequences of the patient refusing the suggested line of treatment. All these things are fundamental requirement of law.”

Eye Surgeon Punished for No Fault of his

1 (FA/14/59) STATE CONSUMER DISPUTES REDRESSAL COMMISSION MAHARASHTRA, MUMBAI FIRST APPEAL NO.FA/14/59 (Arisen out of Judgment and order dated 27/08/2013 passed by Ld. Addl.Mumbai Suburban District in consumer complaint No.531 of 2006) Shri.Gopal Joshi R/at-Jeevaram bhawan, 4 th floor, B/46, R.R.T Road, Mulund (W), Mumbai 400 080. Appellant(s) Versus 1.Dr.Ashlesha Gala Netra Jyot, Eye Care Centre, 206, Jai Commercial Complex, At the Junction of M.G.Road & S.L.Road, Opp.Hotel Gurukrupa, Mulund (W), Mumbai 400 081. 2.Dr.Hemant Thakkar 1 st Navghar Lane, Mulund (E), Mumbai 400 081. Respondent(s) BEFORE: Hon’ble Mr.Justice A.P.Bhangale, President Hon’ble Dr.S.K.Kakade, Member PRESENT: For the Appellant(s): Advocate Shri.T.S.Shilotri is present with authority letter from Advocate Shri.Mangesh D.Nalavade For the Respondent(e) : Advocate Shri.Ajay Pawar is present for respondent No.1. None present for respondent No.2. ORDER Per: Hon’ble Mr.Justice A.P.Bhangale, President [1] Heard submissions. By present appeal, appellant has challenged validity and legality of the impugned Judgment and Order dated 27/08/2013 2 (FA/14/59) passed by Ld. Addl. Mumbai Suburban District in consumer complaint No.531 of 2006 whereby the consumer complaint was dismissed. Brief facts appears as underThe complainant is resident of Jeevram Bhavan, 4th floor, B/46, R.R.T.Road, Mulund (W), Mumbai 400 080 had approached his family doctor, Dr.Hemant Thakkar due to problem in his eye. According to Dr.Thakkar complainant need to undergo Cataract operation. He advised him to approach Dr.A.M. Gala who at Netrajyot Eye Care Centre, 206, Jai Commercial Complex, Mulund (W), Mumbai 400 080. Thus, on 09/08/2005 Dr.Gala had advised the complainant to undergo Cataract operation. He was initially examined and it was decided to hold operation on 12/08/2005 at 8 a.m. The eye operation was conducted and the patient was discharged at evening on the same day. The complainant thereafter complained of cornea swelling to his left eye and ultimately lost his eye sight of left eye. Though the complainant had used eye drops as prescribed he was referred to Dr.Nikunj Shah and Dr.Nikhil Gokhale by Dr.Gala. The two doctors to whom patient was referred opined that there was injury to retina of the complainant and complainant had to undergo another operation on left eye on 02/09/2005. According to the complainant, the operation had failed and complainant lost his eye sight of left eye. Further according to complainant Dr.Gala ought not to have referred the complainant to Dr.Nikunj Shah and Dr.Vatsal Parekh. Complainant alleged that there was medical negligence by Dr.Gala and Dr.Thakkar as well. [2] According to opponent No.1-Dr.Gala, patient had undergone operation at the hands of Dr.Parekh regarding injury to cornea and therefore he is not concerned with that operation. He also disputed his liability about the cataract operation or failure thereof. According to Dr.Gala it was a minor operation and was performed successfully and later on when injury to 3 (FA/14/59) cornea was complained of he had referred the patient to the competent doctors. [3] We have considered the reasons stated by the Ld.Forum below in details regarding the observations as to the facts and medical negligence including the ruling of Hon’ble Supreme Court in Civil Appeal No.3541 of Martin F. D' Souza vs Mohd. Ishfaq on 17 February, 2009 2009 CPJ page 32 (SC. [4] It is true that medical practitioner would fail below the standard of his reasonable competency conduct if there are want of precautions to perform the operation or surgery. In the present case, we do not find any evidence from the opponent No.1 i.e. Dr.Gala as to his initial observation of the patient (complainant). Standard of reasonable care and precaution on the part of surgeon before performing operation necessarily and ought to be supported by documents such as Fitness Certificate of the patient to undergo surgery or operation and Consent Form at pre-operative stage indicating that the patient had given his free consent for undergoing the surgery. If according to Dr.Gala Cataract surgery was minor operation he should have taken precaution that patient is advised preliminary medical examination indicating that patient did not suffer from ailments like high B/P, Diabetes etc. or if he is suffering the necessary medical test to be performed and it ought to be ensured from the competent examining doctor that the patient is fit for undergoing surgery as contemplated in the case of complainant. We do not find any evidence in this regard nor we find that Ld.District Forum performed its duty to enquire as to whether surgeon concerned had insisted upon Fitness Certificate of the patient or whether patient had given his free consent to undergo the surgical operation. Apart from this, considering the judicial precedent relied upon on behalf of the opponent in First Appeal No.956 of 2006 decided by the State Consumer Disputes Redressal Commission, Rajasthan, Jaipur between Mrs.Damayanti Devi v/s. 4 (FA/14/59) Dr.Indu Arora decided on 05/06/2009 and the principles of medical negligence, we are not questioning the requisite professional skill of Dr.Gala nor we impute professional negligence upon him on account of performance of operation in the facts of the case as he is post graduate in surgery and experienced Ophthalmologist. Our observations are limited to failure to take precautions on account of not insisting upon Fitness Certificate or Consent Form in writing from the patient at pre-operative stage since in the present case patient had approached Dr.Gala on 09/08/2005 and was called on 12/08/2005 at 8 a.m. for operation of the cataract. There was sufficient time gap during which complainant could have been medially examined in respect of ailments which he suffered and regarding fitness of the complainant to undergo the surgical operation in respect of cataract of his left eye. In our view, had these precautions been taken by Dr.Gala then he may have been exonerated from the liability. In absence of these precautions Ld.District Forum failed in its duty to address itself on these questions and simply considering the other facts proceeded to dismiss the complaint. Our attention is also invited to the Article -‘Medical tests before eye surgery- when you need them – and when you don’t ’ published by American Academy of Ophthalmology in the year 2017 in the periodical ‘Choosing wisely (an initiative of the ABIM Foundation). It cannot be disputed that cataract surgery in modern days is low risk eye surgery as it is usually done with local anesthesia to numb the eye and then medicines are prescribed for relaxation of the patient. However, observation is mentioned as, ‘Even though eye surgery is very low risk, many healthy people get a routine set of tests before their surgery. In these cases, the tests don’t change the surgery or make it safer.’ The article further reads as, ‘You may need an EKG if you have heart disease or symptoms such as chest pain or shortness of breath. If you have diabetes, you will probably need a blood test to make sure it is under control.’ These observations are clearly indicative of precautions that need to be taken before any eye 5 (FA/14/59) surgery is performed in cases of patient suffering from ailments such as hypertension or diabetes. Necessary medical tests are necessary so that the competent doctor examining can certify that patient is fit for surgery. Furthermore, surgeon shall also take precaution to obtain free consent of the patient or close relative in writing before he can be subjected to surgery. For want of these precautions only we partly allow this appeal irrespective of the failure of the surgery. We direct the appellant Dr.Ashlesh M.Gala to pay sum of Rs.25,000/-(Rupees Twenty Five Thousand only) as compensation inclusive of charges for surgery to be refunded in the sum of Rs.15,000/- (Rupees Fifteen Thousand only). We also direct litigation costs in the sum of Rs.5000/- (Rupees Five Thousand only) shall be paid to the complainant. The amount shall be paid within one month from the date of this order failing which it shall carry interest @ 9% p.a. from the date of order till realization. Impugned order is set aside. Appeal is partly allowed accordingly. Certified copy of this order be supplied to both the parties. Pronounced on 23 rd March, 2018. [JUSTICE A.P.BHANGALE] PRESIDENT [Dr.S.K.KAKADE] MEMBER rsc --

http://www.dnaindia.com/mumbai/report-doctor-penalised-for-improper-eye-surgery-2602557 The Maharashtra Consumer Dispute Redressal Commission has recently pulled up a Mulund-based ophthalmologist, Dr Ashlesh Gala, for a botched up cataract surgery which resulted in the loss of vision for one of his patient. The forum held that the doctor failed to take the preliminary precautions of conducting the mandatory medical tests for the consumer which resulted in vision-loss in one eye. The commission has asked the doctor to pay a penalty amount of Rs 45,000 toward the complainant for his mistake. However, the patient, Gopal Joshi, is unhappy with the order and has decided to take the matter to the National Commission. The commision's order read,"It cannot be disputed that the cataract surgery in modern day is a low-risk eye surgery as it is usually done with local anesthesia to numb the eye and then medicines are prescribed for relaxation of the patient. However, even though eye surgery has very low risk, many healthy people get a routine set of tests done before the surgey is conducted. In these cases, the tests don't change or make it safer but helps controlling blood pressure and sugar during the time of the surgery." Meanwhile, Joshi's lawyer, Mangesh Nalawade, while speaking to DNA said, "Our plea was on the grounds of negligence as the medical papers say that there was a cornea tear of my client which lead to loss of his vision in one eye. But, the aspect of negligence was not considered by the Commission. We are definitely approaching the National Consumer Dispute Redressal Commission and filing an appeal." -- http://www.choosingwisely.org/patient-resources/medical-tests-before-eye-surgery/ If you’re going to have cataract surgery or another eye surgery, you may be given some medical tests first. For example, you may have an electrocardiogram (EKG) to check your heart, or a complete blood count (CBC) to check for anemia, a low amount of red blood cells. These tests may make surgery safer. For example, they may find medical problems that lead to a delay or change in your surgery. But most people don’t need these tests before eye surgery. Here’s why: The tests usually aren’t helpful for low-risk surgery. Generally, cataract and other eye surgeries have very low risks of complications or problems, such as heart attacks. There really isn’t anything doctors can do to lower the risk any further. Eye surgeries do not take long, and they use only a local anesthetic to numb the eye, often with a medicine to relax you. Even so, many healthy people get a routine set of tests before eye surgery. In these cases, the tests don’t change the surgery or make it safer. They can lead to more tests. The tests themselves are very safe, but they can cause false alarms. This can lead to anxiety and more tests. And they can needlessly delay your sur­gery. For example, one test may be followed up with a repeat test, an ultrasound, a biopsy, or a test that exposes you to radiation, such as an X-ray or CT scan. The costs can add up. Your health plan may not pay for the tests if you do not have a specific medical need for them. If this happens, you may need to pay for them. It could cost between $25 and $50 per test, according to HealthcareBlueBook.com. So when are the tests needed? You may need the tests if you have certain kinds of health conditions or illnesses. For example, you may need an EKG if you have heart disease or symptoms such as chest pain or shortness of breath. If you have diabetes, you will probably need a blood test to make sure it is under control. Based on the test results, your doctor may need to change your surgery or anesthesia. You may need special care during or after the surgery. Or you may need to postpone the surgery until the problem is treated or controlled. This report is for you to use when talking with your health-care provider. It is not a substitute for medical advice and treatment. Use of this report is at your own risk. © 2013 Consumer Reports. Developed in cooperation with the American Academy of Ophthalmology. 04/2013

PGI Chandigarh: doctors told to summon security before announcing patient's death

From https://www.nyoooz.com/news/chandigarh/1066322/chandigarh-pgi-doctors-told-to-summon-security-before-announcing-patients-dea/ Taking strict note of manhandling of doctors at its emergency wing, Post-Graduate Institute of Medical Education and Research (PGIMER) director has told resident doctors to inform security personnel first before breaking the news of a patient’s death to attendants. Dr Jagat Ram has also ordered a quick-response team (QRT) of 12 security guards to keep an eye on untoward incidents threatening the safety of doctors in the emergency wing. “Next week a meeting of resident doctors, representatives of hospital administration and security wing will be called to finalise the new measures,” a senior administrative officer, not wishing to be named, said. The child died on Wednesday night, following which his family started hurling abuses at the female doctor and broke a machine,” said Dr Sandeep Tula, vice-president, Association of Resident Doctors (ARD). We have filed a police complaint against the family.”“For their safety, I have told all resident doctors working in the emergency to inform the QRT before informing attendants about the death of a patient. Taking strict note of manhandling of doctors at its emergency wing, Post-Graduate Institute of Medical Education and Research (PGIMER) director has told resident doctors to inform security personnel first before breaking the news of a patient’s death to attendants. Dr Jagat Ram has also ordered a quick-response team (QRT) of 12 security guards to keep an eye on untoward incidents threatening the safety of doctors in the emergency wing. This team will be in addition to the 40-odd security guards posted in the ward. On the night of March 21, attendants of a 13-year-old critically ill boy created ruckus inside the emergency, hurled abuses at a female doctor and broke a dialysis machine costing Rs 21 lakh, after the doctors could not save the child. “The boy had end-stage cancer. For three days, the doctors had been informing the father that bone marrow transplant was the only solution, but his family could not afford the expenses. The child died on Wednesday night, following which his family started hurling abuses at the female doctor and broke a machine,” said Dr Sandeep Tula, vice-president, Association of Resident Doctors (ARD). Attacks on doctors March 21: Attendants hurled abuses, threatened a resident doctor after she could not save a child suffering from end-stage blood cancer May 2017: A resident doctor was slapped by a patient’s attendant in the emergency medical OPD as the doctor failed to save the patient August 2016: A resident doctor was manhandled by a patient’s attendant in emergency Dr Jagat Ram said, “This behaviour is highly inappropriate and will not be tolerated. The doctors give their best to save lives and do not deserve this treatment by attendants.

Court Fined Doctors Rs. 40 Lakhs for Conservative Management

If Doctor wants to try non surgical methods, but if patient develops complications, Consumer Courts Fine Doctors

All those who say that doctors are operating without waiting, please read this 

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உடனடியாக அறுவை சிகிச்சை செய்யாமல், நோயாளிக்கு பிரச்சனை வந்தால் நுகர்வோர் நீதிமன்றங்கள் மருத்துவருக்கு 40 லட்சம் அபராதம் விதிக்கின்றன

மருத்துவர்கள் தேவையில்லாமல் அறுவை சிகிச்சை செய்கிறார்கள் என்று கூறுபவர்களின் பணிவான கவனத்திற்கு 

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The Delay in diagnosis and treatment made the patient to lose her life, which in turn costed Doctors and Hospital hefty sum of Rs.25 lakhs towards compensation + Rs.15 lakhs towards mental pain & agony, totalling to Rs.40 lakhs with interest !!!

The commission gave an interesting example to explain the issue of 1 % risk of serious harm.
“suppose that, an aeroplane on a long-haul flight developed engine trouble while in mid-air, this gave rise to a one percent risk that the plane would crash and that risk would not increase for the next 12 hours but remain constant”.
“A reasonable pilot, knowing this, would not wait for 12 hours to expire but would land his plane as soon as reasonably practicable.”

(MRS.) MANIKA ROY & ANR V/s. DR. B.L. CHITLANGRA, Bombay Hospital & ors. CC no.42/2003, decided on 5th January, 2016, by the National Commission.

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Facts in nutshell:
Ms. Kaberi Roy, 29, (since deceased, referred herein as a “patient”), daughter of complainants was initially diagnosed by their family physician as the patient of ‘acute appendicitis’ and advised her for immediate surgery and therefore the complainants admitted her in Bombay Hospital at 10.30 PM 0n 27.06.2002.The casualty Medical Officer examined her and diagnosed it as a case of acute appendicitis. The routine check-up also indicated severity of appendicitis and possibility of perforation (leucocytes count (17700 per cmm). The Neutrophils were 87%). It was alleged by the Complainants that the Opponent Doctors, senior surgeons failed in their duty to examine the patient immediately during emergency as Doctors came to examine the patient on next day i.e. 28.06.2002 at 11 AM. I.e. almost after more than twelve hours of her emergency admission. The Surgery turned to not fruitful and it was alleged that the no proper surgical procedure was selected, there was septicaemia, no post-iop proper treatment and as a result patient died within two days of hospitalization, and within 36 hours of her operation.

Court Fined Doctors Rs. 40 Lakhs for Delay in Patient Diagnosis and Treatment

The Commission heard the parties at length, studied the medical records and medical literature…
The commission found discrepancy in Medical Record and the statements of Doctors especially regarding removal of Gangrenous fluid. It further observed that the departures of the Opp. Doctors individually and together in the treatment and diagnosis of the patient led to a delay in the patient’s surgery, and were a proximate cause or substantial cause contributing to the septic emic shock and death. The patient was admitted in late night, thus emergency USG scan should have been sought on an urgent basis to rule out the causes of acute abdomen. The opponent Hospital is one of tertiary care hospital and the highest care is expected than from other hospitals & had the USG scan been obtained and interpreted promptly, these complications might have been avoided. If that had happened, patient could have been operated expeditiously as an emergency basis, further observed by the commission. It also held that an appropriate standard of care had not been met as surgery took place after 17 hours.

Court Fined Doctors Rs. 40 Lakhs for Delay in Patient Diagnosis and Treatment

IT relied by the Landmark judgment of Apex court of Dr. Laxman Balakrishna Joshi Vs. Dr. Trimbak Bapu Godbole AIR 1969 SC 128, which laid down that a doctor when consulted by a patient, owes him certain duties, namely,
(a) a duty of care in deciding whether to undertake the case;
(b) a duty of care in deciding what treatment to give; and
(c) a duty of care in the administration of that treatment. A breach of any of these duties gives a cause of action for negligence to the patient.

Court Fined Doctors Rs. 40 Lakhs for Delay in Patient Diagnosis and Treatment

This may be the first case of this year wherein the Doctors and Hospital were held negligent and ordered to pay such heavy compensation!! To learn from the mistakes of others, is the crux of this case!!

http://desimedicos.com/court-fined-rs-40-lakhs-for/
https://www.facebook.com/spine.brain.surgeon/posts/10153949284609828

Define Medical Negligence

From https://www.facebook.com/spine.brain.surgeon/posts/10153919623829828 << "What I think is that the ambit and scope of term 'medical negligence' should be defined properly. Complications are inherent to the science of medicine also, as it's not a 100 per cent fool-proof science," Dr Mundada said adding that inability to make the patient well is not and should not be made equivalent to medical negligence. >> http://www.newindianexpress.com/nation/Eyebrows-Raised-Over-NHRC-Hearing-on-Medical-Negligence-Cases/2016/01/07/article3216077.ece

Medical officer gets jail over waste disposal

From http://www.asianage.com/india/ex-medical-officer-gets-jail-over-waste-disposal-005 In a landmark judgment, the sub-divisional judicial magistrate court Jagatsinghpur on Wednesday awarded six-month imprisonment to former additional district medical officer Nityananda Panda for failure in disposal of hospital waste and violation of Environment (Protection) Act, 1986. In his verdict on Tuesday, the SDJM Alekh Kumar Pradhan also imposed a penalty of `50,000 on Panda and further one-month in prison in case he fails to deposit the penalty. Besides, the court also slapped a penalty of `50,000 on the authorities of the district headquarters hospital. The directive of the court came at the end of hearing in a criminal case filed by the Orissa State Pollution Control Board against Dr Panda. It may be mentioned that the Orissa high court in 2009 had asked the OSPCB to register criminal cases against the medical authorities for improper waste disposal management in gross violation of Environment (Protection) Rules. Acting on the directive of the court, the board had given provisional authorisation for one year to the Jagatsinghpur hospital for disposal of waste. However, the board during its inspection of the hospital on April 4, 2010, found gross irregularities in waste management by the hospital authorities. Taking strong exception to the lackadaisical attitude of the hospital authorities, the board had issued a show cause notice to them on May 1, 2010.

Private college hospitals can do autopsies, says court

http://www.deccanchronicle.com/141102/nation-current-affairs/article/private-college-hospitals-can-do-autopsies-says-court Chennai: The Madras high court has suggested to the state government to explore the feasibility of permitting private medical college hospitals to perform autopsies on unidentified bodies, which will relieve the congestion in mortuaries in government hospitals. A division bench comprising Justices S. Rajeswaran and P. N. Prakash gave the suggestion while issuing a set of directions to authorities relating to man missing cases and unidentified bodies. Citing an order of the Karnataka government relating to conducting of post-mortem, the bench said, “Due to paucity of post-mortem doctors in government hospitals, post-mortem on unidentified bodies is not done immediately and preference is given only to murder cases, accident cases and in cases where the body is identified. In our opinion, a solution to this problem can be found, if private medical college hospitals in the state are given permission to conduct post-mortem as done in the state of Karnataka”. In Tamil Nadu, there were 19 government medical colleges and 26 private medical colleges, of which 11 were deemed universities. At present, students studying in these private medical colleges were sent to the government medical college hospitals for getting training in autopsy, the bench pointed out. To begin with, on a trial basis, if the government grants permission to these private medical colleges to perform autopsies on unidentified bodies, it will relieve the congestion in the mortuaries in the government hospitals. The orthodox may raise their eyebrows and ask anxiously “Will not these private doctors become amenable to influence and issue bogus post-mortem certificates?” But, the situation seems no better in the government hospitals either. “If videography of all post-mortems, whether done in government hospital or private hospital is made compulsory, such misadventures can be curtailed”, the bench added. The bench said an apprehension was voiced that the state will not be able to take any action against a doctor of a private medical college, if the post-mortem certificate given by him was found to be bogus. It cited various sections under the Indian Penal Code dealing with furnishing false information and causing disappearance of evidence, among others that are to prosecute the doctor. The legislature can also bring in an amendment to the definition of “public servant” found in section 21 of IPC and in section 2 © of the Prevention of Corruption Act, by including “The doctors who perform autopsy at the request of a police officer” so that the doctor can be prosecuted even under the Prevention of Corruption Act, the bench added.

Penalised for Not Giving Doc Rural Service Marks

From http://m.newindianexpress.com/tamil-nadu/369689

MADURAI:

Pulling up the State Health Secretary and the Secretary of the Medical Selection Committee for not awarding marks to a young doctor for her rural service, thereby denying her an opportunity to pursue postgraduate specialisation course, the Madras High Court bench here imposed a fine of `1 lakh on each of them.

The doctor J Mercy Rumya Florence, an assistant surgeon, was temporarily appointed at a primary health centre in Thulukarapatti in Tirunelveli where she worked for two years and four months. Later, she appeared for an entrance exam in 2012-13, for pursuing postgraduate degree course and scored 63.36 marks. As per the prospectus she was eligible to be awarded one mark for each completed year of Compulsory Rotatory Residential Internship (CRRI) in rural area. However, she was not given the marks on the grounds that it is awarded only for doctors who are in regular service. Justice S Nagamuthu said that due to the careless attitude of the respondents, the petitioner had lost her right to acquire a PG seat and she deserved to be compensated for it.

Letter 3655 dated 27.03.2014 : Permission for 10 A 1 Doctors : Leave Regularised

GO No 254 dated 30.10.2013 : Time Bound Promotion in Tamil Nadu Medical Services

Govternmen Doctor to Pay Rs 5,000 for Illegal Aid to Police

By T S Sekaran - CHENNAI

Published: 24th January 2014 08:49 AM

Last Updated: 24th January 2014 08:49 AM

Dr S Rajendran, presently working As Chief Medical Officer, Government Hospital in Jayankondam in Ariyalur district, is directed by the TN State Human Rights Commission to pay a compensation of Rs5,000, for assisting the local police to build up a false case against a villager.

SHRC Acting chairperson Jayanthi, IAS (retired), who gave the direction on Thursday, also directed Kosalraman, presently working as SI, Intelligence section, Tiruchy, to pay Rs25,000 to Abhimannan of Chettithirukonam village in Ariyalur district, for violating his human rights. The State government should pay the entire amount of Rs30,000 to Abhimannan within four weeks and recover the same from the SI and the doctor, the commission said.

According to Abhimannan, one Malar of the village filed a civil suit against him over a property and the same was pending before the Civil Court in Ariyalur. While so, he was picked up by cops on September 28, 2004 and taken to Vikramangalam police station, where he was directed to pay Rs5,000 to settle the dues of the station personnel due to a nearby hotel to favourably settle the civil case. He was abused with filthy language and severely attacked, when he refused to oblige. A false case was registered against him, produced before the local magistrate belatedly and remanded in custody. Abhimannan moved the SHRC with the present complaint.

Passing orders on it, the SHRC observed that the evidence available in the case, coupled with the documents, would show that the complainant was picked up by Kosalraman on September 28, 2004 from his house and was taken to the Vikramangalam Police Station, where he was illegally detained and was shown as arrested only at 2 pm on that day and that he was brutally assaulted by the SI. The doctor has extended all his illegal assistance by filing a false medical certificate.
From http://www.newindianexpress.com/states/tamil_nadu/Govternmen-Doctor-to-Pay-Rs-5000-for-Illegal-Aid-to-Police/2014/01/24/article2016899.ece

Detention of Mentally Ill People in Hospitals - Guidelines for Doctors and Magistrates

Nathalie Vandenbyvanghe vs The State Of Tamil Nadu on 19 September, 2008 Dated :19..09..2008 C O R A M The Honourable Mrs. Justice Prabha Sridevan and The Honourable Mr. Justice V. Periya Karuppiah Habeas Corpus Petition No.1041 of 2008 Nathalie Vandenbyvanghe .. Petitioner versus 1. The State of Tamil Nadu, Rep. by its Secretary to Government, Home Department, Fort St. George, Chennai-9. 2. The Commissioner of Police, Chennai City, Chennai. 3. Institute of Mental Health, Rep. by its Director, Kilpauk, Chennai-10. 4. The Inspector of Police, Kottur Police Station. 5. Inspector of Police, Nesamony Nagar Police Station, Kanyakumari District at Nagercoil. .. Respondents - - - - - PRAYER : Petition under Article 226 of the Constitution of India seeking to issue a writ of habeas corpus directing the 3rd respondent to set Mr. Roger Vandenbyvange, a French National, aged about 61 years, at liberty forthwith. - - - - - For Petitioner : Mr. T.R. Rajagopalan, Senior Counsel for Mrs. Pushpa Sathyanarayana. For Respondents : Mr. P. Kumaresan, Addl. Public Prosecutor. - - - - - O R D E R Prabha Sridevan, J. A foreign national came to our country as a tourist, he lost his passport, he could not speak English. He has no mental illness, yet, he was rounded up along with more than 100 persons, and was issued reception orders under the Mental Health Act, 1987. Disturbed that he did not return to his homeland, his daughter filed this habeas corpus petition. 2. The facts are these : The father of the petitioner herein, one Roger Vandenbyvanghe, aged about 61 years, was visiting India to seek the blessings of Matha Amritandamayi. He had a valid passport and visa. His visa was valid upto 8.6.2008. He lost his passport and other travel documents along with his personal belongings, including his clothes. He knew only French language and no other language. He was also unable to communicate with anybody. He was wandering on the roads in Kanyakumari District. He had no money and he had to live seeking alms and that is how he made his survival. When he did not return to his home country beyond the date of expiry of his visa, his daughter was alarmed. When she enquired with the French Embassy, she was informed that her father had been admitted into the Mental Health Institute, Chennai. It came as a rude shock to the petitioner since her father was not a mentally ill person. Therefore, she came to Chennai to take her father back. She made a request to the hospital authorities to discharge her father, but they refused to do so. Her complaint was that her father, was illegally kept in the custody of the hospital authorities. Therefore, she filed this habeas corpus petition. 3. On 21.7.2008, this Court passed an order in this petition and the relevant portions of the said order are extracted below, since we feel it is necessary : "This habeas corpus petition portrays a sad state of affair in handling a foreign national by name Roger Vandenbyvanghe, aged 61 years, who could not have dreamt when he came to India and landed during January, 2008 that his life is going to be miserable at the hands of the police. ... On 9.7.2008, the Inspector of Police, Kottar Police Station surrounded 50 male persons and the Inspector of Police, Nesamony Nagar Police Station surrounded 45 male persons as well as 20 female persons totalling 115 persons and resorted to invoke the provisions of Section 23 of the Mental Health Act, 1987 and a case in Cr.No.800 of 2008 was registered. They made all of them appear before a team of doctors consisting of Dr.Y.Arul Prakash, Assistant Surgeon, Government Medical College & Hospital, Nagercoil and Dr.P.Natarajan, Tutor in Psychiatry, Kanyakumari Government Medical College & Hospital, Nagercoil at Asaripallam on the same day. The French national in question was one among the 115 persons who was produced before the above team of doctors and was certified to be suffering from Bipolar disorder mania and a certificate to this effect was issued by the team of doctors. Likewise, similar certificates were also issued in respect of the remaining 114 persons as well. On the strength of the above certificates, the Inspectors of Police of Kottar & Nesamony Nagar Police Stations made applications before the learned Judicial Magistrate No.II in-charge, Nagercoil, Kanyakumari District to pass reception orders authorising the detention of the French national and other 114 persons as in-patients in the Institute of Mental Health, Kilpauk, Chennai. The said applications were ordered again on the very same day and the reception orders were also served in Form-5. Based on the said reception orders, all 115 persons were brought to Chennai and were admitted in the Institute of Mental Health, Kilpauk, Chennai for further treatment. ... They were brought to Chennai and were admitted in the Institute of Mental Health. The detenu was put on observation for a period of ten days. Ultimately, the Institute of Mental Health found that Mr.Roger Vandenbyvanghe does not exhibit any abnormality or psychopathology during the entire period of ten days observation and the observation report of the Institute of Mental Health, Chennai-10 dated 19.7.2008 reads as under:- "Name Mr.Roger Vawdew Vaughe Age 60 Sex Male IP No.2132/2008 DOA 10.7.2008 Mr.Roger Vawdew Vaughe 60 years old male was admitted in Institute of Mental Health, Chennai-10 along with the group of totally 115 persons through reception order issued by the Judicial Magistrate II, Nagercoil I/c, Kanyakumari District on 10.7.2008. On admission, Mr. Roger Vawdew Vaughe was unclean, untidy, and having an infected ulcer on the outer aspect of the left forearm. Mr. Roger Vandew Vaughe has been under observation for the past 10 days. Detailed Physically examination, mental status examination, blood investigation and psychological testing was carried out. During his stay in the last 10 days Mr. Roger Vawdew Vaughe is behaving well, and he has proper sleep and eats sufficiently. Based on the ward behaviour, physical and mental status examination and investigations, it is opined that Mr. Roger Vawdew Vaughe does not exhibit any abnormality or psychopathology during this period of observation." The manner in which this foreign national had been treated by the police is really disturbing. It is difficult to understand how a prima facie satisfaction could be arrived at by the officers in respect of 115 persons en masse at the same time : "This exposes the psycho-fever of the police to proceed against those who are wandering in the streets to be treated as mentally ill persons disregard of their actual physical and mental condition. We must express our total dissatisfaction over the way by which the entire matter had been handled not only by the police, but also at the level of the doctors and the learned Judicial Magistrate as well." (vide order dated 21.7.2008) The approach of the doctors who were called upon to certify whether these 115 persons deserve to be detained is equally inexplicable : "When 115 persons were surrounded by the police and were produced enmasse to a team of doctors, it is hard to believe whether the doctors have discharged their noble duty by examining all the 115 persons individually and arrived at the conclusion that they are mentally ill persons to be dealt under the provisions of the Mental Health Act. The examination of all the 115 persons and to certify them to be mentally ill persons at a stretch and by issuing a printed form of certificate is either humanly impossible or would be the result of callousness shown against those persons by the doctors." (vide order dated 21.7.2008) The reception orders were passed by the learned Judicial Magistrate en masse too : "On perusal of the records, it is seen that the Magistrate before whom all the 115 persons were produced, at a single stretch, has exercised the power under Section 24 and issued the reception orders. The satisfaction of the Magistrate, in our view, is only mechanical and she has not properly applied her judicial mind to the provisions of the Act." (vide order dated 21.7.2008) In view of the prima facie opinion arrived at with regard to these 115 persons, directions were issued to the Director, Institute of Mental Health, Kilpauk, Chennai to submit a detailed report regarding them. 4. The Additional Public Prosecutor produced the status report filed by the Deputy Superintendent of Police, Nagercoil. According to this, several representations had been received from various social organisations that more than 100 mentally ill persons were wandering in Nagercoil and that their condition was pitiable. Therefore, the District Administration took joint action to produce them before the Judicial Magistrate's Court as per law. It appears that cases were registered based on the representations of the social organisations in Crime No.800 of 2008 under Section 23(3) of the Mental Health Act, 1982 by the Kottar Police Station against 50 male mentally ill persons; in Crime No.405 of 2008 under the same section on the file of the Nesamony Nagar Police Station against 45 mentally ill persons; and in Crime No.18 of 2008 under the same section on the file of the All Women Police Station against 20 female mentally ill persons. The District Administration, therefore, apparently had made arrangements to trim their hair and give them bath and also to provide them new clothes. 125 persons were caught and produced for medical examination based on the order of the Judicial Magistrate. According to the status report, 12 doctors from Kanyakumari Medical College comprising a team evaluated these mentally ill persons and rejected 10 persons as beggars and certified the remaining 115 persons as suffering from mental illness. The status report records that the doctors had to work overtime since they had to examine a large number of persons. It is only after observing the due process of law that they had been transferred to the Institute of Mental Health, Kilpauk, Chennai. According to the status report, the petitioner's father was diagnosed as suffering from Bipolar Disorder Mania. He had escaped from the ward twice and thereafter, he was asserted for mental illness. According to the status report, the said person was inadequately dressed, shabby, talking irrelevantly and was in an abnormal, elevated state of mind with absence of insight. 5. It was repeatedly urged by the learned Additional Public Prosecutor that the reception orders were passed only after due examination of the persons. 6. We are not able to accept this submission. Strictly speaking, when the petitioner's father was restored to her, no further orders were necessary. But, we felt that the treatment of mentally ill persons by the police, doctors and court left much to be desired. That is why the medical report was called for from the Isstitute of Mental health at Chennai.As a sample, we will take the case of the petitioner's father itself. According to the police status report, he was admitted by one Manikandan, Director of a Non Governmental Organisation on 27.5.2008. He absconded, was again admitted by the same person and again he absconded, but subsequently the diagnosis was made that he was suffering from bipolar disorder mania as seen above on 27.6.2008. The medical record of the petitioner's father had been produced and the observation report made on admission by the Civil Assistant Surgeon at the Institute of Mental Health, Chennai would show that the petitioner's father was unclean, untidy and having an infected ulcer on his left forearm. The doctor certified that a detailed physical examination, mental status examination, blood investigation and psychological testing of the said person had been carried out and he was behaving well, "he has proper sleep and eats sufficiently". Based on the ward behaviour, physical and mental status examination and investigations, the doctor at the Institute of Mental Health, Chennai certified that the petitioner's father does not exhibit any abnormality or psychopathology during this period of observation. The psychological report shows that a psycho-diagnostic assessment was made and he talked relevantly and coherently. His attention could be aroused and sustained and there was no evidence of psychosis. Therefore, it is evident that the original assessment diagnosing the petitioner's father with Bipolar Disorder Mania is not supported by the subsequent assessment made. We are not giving any finding on the professional capacity of the doctors at Kanyakumari who diagnosed the petitioner's father as being mentally ill. But, we cannot ignore the manner in which it was done. 125 persons were examined virtually on a single day and therefore, the diagnosis was not the result of a proper psycho-assessment. The reception order passed on such an assessment cannot be a valid one. 7. The Director of the Institute of Mental Health was present in Court on one of the days of hearing and we requested him to furnish information with regard to the number of days taken by the team at the Institute for assessing the mental capacities of the 115 persons who were sent to them and the report filed by him reads as follows : "Submitted by Dr. R. Sathianathan, Director, The Institute of Mental Health, Chennai-10. With reference to the information sought by the Honourable High Court Bench A total number of 115 persons (95 males & 20 females) were admitted at the Institute of Mental Health on 10th July, 2008 though the Reception Order from The Honourable Judicial Magistrate No.II i/c., Nagercoil Kanyakumari District, under Section 23, 24 of Mental Health Act, 1987. At the Institute of Mental Health, a team was constituted comprising of 10 Psychiatrists, 2 Psychologists, 6 Social Workers, 6 Staff Nurses and other Para Medical Staff. The team identified the referred persons based on their identification marks as also examined and screened for physical illnesses such as hypertension, cellulites, ulcers, fractures, leprosy etc. On the subsequent day, a detailed laboratory investigation like blood test, X-ray, ECG, HIV Screening, were carried out. Persons with physical illnesses were referred to other hospitals for appropriate treatment. Simultaneously a detailed Mental Status Examination was carried out over a period of 10 days. These persons were given customized care, following which their personal details were solicited. With the information sought, few of the person's relatives were contacted by the social workers. Out of the 115 persons admitted, a French National was discharged as per the instructions of the Honourable High Court. Another 7 persons were (6 males & 1 female) found to have no gross psychopathology during the observation period. These seven persons were further observed for 10 more days for their ward behaviour and subsequently psychological assessments were done. After an intensive observation and investigation these 7 persons were certified that they did not have any abnormality. The efforts are being taken to reintegrate them back to community through the N.G.O's. The rest of the 107 persons are still under observation and treatment. All the 114 person were placed before the Vistors Committee on 30th July, 2008. Dr. R. Sathianathan, 16 August, 2008." Therefore, over a span of ten days, the persons were kept under observation and a mental status examination was done and out of these 115 persons, seven were certified as not having any abnormality and other 107 persons are still under observation. The Director IMH Chennai, told us that a minimum period of 10 days is required to make a mental status examination. 8. Now, we come to the question that disturbs us. It is seen from the records produced before us that the District Collector, Nagercoil had called for a meeting when it was brought to her notice that mentally affected persons are seen in railway stations and bus stands and that proper reception orders are to be obtained. At the meeting, a plan was drawn up : "In the meeting, it was unanimously resolved to send the Mentally affected persons who are seen in Nagercoil Town and Kanyakumari Township to the Institute of Mental Health, Ayanavaram, Chennai in a safety manner. At the first instance, necessary steps would be initiated to identify the Mentally affected persons so as to hand over to the Government Institute of Mental Health, Chennai, for which, the following arrangements to be made by the Officers concerned. It was further planned to commence this exercise by 9th itself and before this end of next week, all the identified patients should be sent to the Institute by getting proper Reception Order from the Judicial Magistrate, as required by the Institute." On 9.7.2008, learned Judicial Magistrate No.II had sent all the 115 persons for assessment of their mental condition as per Section 24 of the Mental Health Act. On 10.7.2008, reception orders had been issued. Though it was submitted by the learned Additional Public Prosecutor that there was no short-circuiting in the process of assessment of the mental condition and that a team of doctors worked, and that all the mentally ill persons were distributed amongst the team and evaluation was done properly, the facts indicate the contrary. We find that the evaluation report had been signed only by two doctors. For that, some explanation is given, which were are not willing to accept. It is clear that 115 persons were treated as mere chattels, rounded up, their hair trimmed, given a bath, sent to doctors, who "duly certified them as mentally ill" and reception orders had been issued. 9. We are also not happy about the manner in which reception orders had been issued by the learned Judicial Magistrate. Of course, we are not here to examine the correctness of the reception orders, that falls beyond the scope of this habeas corpus petition. But, it is apparent the learned Judicial Magistrate not have been really "satisfied" that reception orders ought to be issued in respect of these 115 persons? Mentally ill persons are entitled to the right of life with dignity and they have the Fundamental Rights same as others. Junior level officers of the judiciary are perhaps under the misapprehension that in their Courts, procedural law alone has to be followed. They should change their mindsets. They are equally charged with the obligation of protecting the fundamental rights of the litigants. The work they do day after day cannot run afoul of the Constitutional Obligations. 10. We are concerned with the manner in which the police, the doctors and the learned judicial magistrate have dealt with this group which, on the face of it, is a group without power; but nonetheless a group of persons entitled to protection of human rights. Their autonomy is violated and they have been treated as though they have no rights of their own. "By rights, I mean those fundamental expectations that govern the relationship between individuals and societies. In modern, western societies, rights of individuals are conceptualised as protections against arbitrary so that individuals retain personal choice and decision-making. ... The right of the individual to be free from arbitrary exercise of state power is perhaps the key difference between the democratic nations of the world and those that operate under other systems. Their cross-cultural value is recognized by documents such as the Universal Declaration of Human Rights, which hold that all adults, anywhere in the world, should be free to make basic life choices for themselves. Involuntary commitment, forced treatment, and psychiatric control over decision-making are really not complicated issues, despite the efforts to make them seem so. The fundamental question is this: why do we take one group of people, those labelled "mentally ill", and deny them basic rights? The ethical system (if I can call it that) that drives the involuntary treatment system is paternalism, the idea that one group (the one in power, not oddly) knows what is best for another group (which lacks power). The history of civilisation is in part, the struggle against paternalism and for self-determination. People in power are always saying that they know what is best for those they rule over, even if those poor unfortunate individuals think they know best what they want. The powerful seldom cast their own motives in anything but benevolent terms. Rulers and slave masters like to think (or pretend) that their subjects love them and are grateful to them often having to ignore much evidence to the contrary. The struggle for freedom has always been seen by the powerful as a denial of the obvious truth of the superiority of the rulers. It is clear that we cannot leave our fate in the hands of lawyers, judges, and psychiatrists, who seem quite willing to sacrifice our freedom in the name of benevolent paternalism. Not too many years ago, former patients were not invited to speak at conferences like these. Today, our participation is welcomed, our opinions are solicited, our voices being heard. But the continued existence of involuntary commitment, of prison-like mental institutions, of discrimination and seggregation, shows how far we still have to go to reach our goals: full citizenship, equality, and human dignity".1 11. In his Article2, Kevin Wadzuk of the American University, Washington DC writes : "The United States Constitution is the document upon which the country was founded. It outlines the powers and procedures of the government as well as its duties to protect personal liberties. There is no mention in the Constitution that the rights guaranteed to citizens are limited to those citizens who are of sound mind. ... After consideration of the abuses of the mentally ill, one might question the rationale of society, through its representatives, in these actions. Thomas Szasz (1963) suggests that social disturbance is the issue resolved by this process. If a person asserts ideas, beliefs, or sensations that threaten society, a social disturbance is created. Thus, the deprivation of liberty of a person for mental health reasons is based on the person s thoughts and behavior, not criminal actions. This is an important distinction to make because it leads to the violation of one the basic constitutional rights. Perhaps what is more disturbing is that these persons are not criminals; they are rejects from society. Society has deemed the behaviors of these people as unacceptable and developed a process to remove them from sight and consideration. However, these persons do not disappear; they spend years of there lives in mental institutions, such as St. Elizabeth s Hospital. It is extremely saddening and distinctly outrageous that a minority group could be so blatantly abused." 12. With these voices in the background, we go to the Act. Section 24 of the Mental Health Act reads as follows : "24. Procedure on production of mentally ill person. (1) If a person is produced before a Magistrate under sub-section (3) of section 23, and, if in his opinion, there are sufficient grounds for proceeding further, the Magistrate shall- (a) examine the person to assess his capacity to understand, (b) cause him to be examined by a medical officer, and (c) make such inquiries in relation to such person as he may deem necessary. (2) After the completion of the proceedings under sub-section (1), the Magistrate may pass a reception order authorising the detention of the said as an inpatient in a psychiatric hospital or psychiatric nursing home,- (a) if the medical officer certifies such person to be a mentally ill person, and (b) if the Magistrate is satisfied that the said person is a mentally ill person and that in the interest of the health and personal safety of that person or for the protection of others, it is necessary to pass such order: Provided that if any relative or friend of the mentally ill person desires that the mentally ill person be sent to any particular licensed psychiatric hospital or psychiatric nursing home for treatment therein and undertakes in writing to the satisfaction of the Magistrate to pay the cost of maintenance of the mentally ill person in such hospital or nursing home, the magistrate shall, if the medical officer in charge of such hospital or nursing home consents, make a reception order for the admission of the mentally ill person into that hospital or nursing home and detention therein: Provided further that if any relative or friend of the mentally ill person enters into a bond, with or without sureties for such amount as the Magistrate may determine, undertaking that such mentally ill person will be properly taken care of and shall be prevented from doing any injury to himself or to others, the Magistrate may, instead of making a reception order, hand him over to the care of such relative or friend." The Statement of Objects and Reasons of the Mental Health Act shows the transformation in the attitude of people when compared to the Act that was repealed, namely the Lunacy Act. Even the nomenclature given to the mental condition, to which the Act is addressed, has undergone a sea change. Where originally the word used was "lunacy", now the words used are "mental health". 13. It is evident that on the part of Judicial Magistrate No.II, Nagercoil, he has not applied his mind to examine the persons produced before him under Section 24 of the Mental Health Act, 1987, but had mechanically passed the reception orders. As we have already observed our unhappiness about the manner in which the 115 persons were produced by the police before the Judicial Magistrate No: II, Nagercoil at Kanyakumari District, and the disposal of those persons in granting the reception orders by the learned Judicial Magistrate, it has become necessary for us to give suitable directions to the executive authorities concerned as well as the Judicial Magistrates, who have to deal with the persons who are supposed to be mentally ill, so that they may act in accordance with The Mental Health Act, 1987 and to follow the guidelines issued by this Court as well as the Supreme Court in the various pronouncements. The Supreme Court had bestowed its hope on judicial Magistrates rather than the executive Magistrates to pass reception orders as per provisions of The Mental Health Act, 1987. 14. Mentally ill persons are not criminals, they have not committed any offence. Then, is it necessary that for their protection, action should commence with a First Information Report? The law makers should seriously consider an alternative procedure by which reception orders can be issued without a "police complaint". 15. Justice Claire L'Heureux Dube, Supreme Court of Canada (Retired) would say that one must walk in the person's shoes if one has to understand where a person who complains of violation of rights comes from. I quote : "It is important to walk a mile in another person's shoes. As it is possible to grow up in the same family, neighbourhood, school..... And yet, have totally different experiences depending on whether you are a man or a woman. The way to resolve differences therefore is not to suppress those who are different, but to notice them and not try to see our reflection in them." It would be better, in fact imperative, that the police, the doctors and the judicial officers put themselves in the shoes of these marginalized groups of persons who are treated as if they are non-persons before they deal with their rights. 16. Every person wandering on the street is not mentally ill. The police should not "round up" people as if they were stray cattle and deal with them as such. Each individual should be dealt with as a separate case, he/she shall be treated as a human being with all the Constitutional rights. This will be possible if the police/NGO or any other person bring up each case individually as and when it arises. 17. The police need not wait to reach such a huge number in order to produce such persons before the Judicial Magistrate concerned. They shall act promptly as and when they happen to see an abandoned or destitute or mentally affected or suspected ill persons wandering in the public places. When such mentally ill persons are handled by the police, they are to be treated with humanity and dignity and they should not be treated as chattel. The police officers who are actually executing the work of taking cognizance of the mentally ill persons who are roaming in the streets and other public places shall deal with them as per Section 23 of the Mental Health Act, 1987. 18. It is also apparent that the medical officers have not given the due care and caution before certifying a person as mentally ill. This has several serious legal consequences, depriving them of many rights. For example a mentally unsound person cannot contest an election. There are so many disqualifications that attend a person with mental unsoundness. In this case, the petitioner's father has been certified as suffering from bipolar disorder without justification. He is as healthy as the person who first examined him, as the certificate from the Institute of Mental Health, Chennai would show. The doctors cannot mindlessly certify a person as mentally ill. If they need time for examination, they shall insist on that time being given. Importantly, a person does not deserve any less attention than another merely because he/she is found on the street or is poor or is a beggar. The doctors shall also attend immediately to any physical injury that is found on the said person. 19. The trust and hope laid on the Judicial Magistrates in Sheela Barse vs. Union of India, (1993) 4 S.C.C. 204 should have been fulfilled by the Judicial Magistrates by observing and enforcing the provisions of the Mental Health Act, 1987, strictly when the suspected mentally ill persons are produced before them. The Judicial Magistrates concerned should have examined the persons to assess their capacity to understand and cause him to be examined by the Medical Officer and to make such enquiries in relation to such person whenever necessary. It is humanly impossible to "examine" 115 persons, as has been done in this case. Any deviation of Section 24 of the Act is not only harmful to the persons concerned but will also affect the society at large. Under these circumstances, the Judicial Magistrates of this State of Tamil Nadu as well as the State of Puducherry are to be instructed that they should follow the procedures mentioned in Section 24 of the Mental Health Act, 1897 in letter and spirit and to see that justice is done to the persons concerned. The mentally ill persons shall not be made to wait unduly long before reception orders are issued. The Magistrates shall remember the trust and faith reposed on them while they discharge their duty under this Act. What happened in this case must not ever recur. 20. By an order dated 21.07.2008, this Court had set at liberty the detenu Mr. Roger Vandenbyvanghe, already, and therefore, this habeas corpus petition is disposed of with the aforesaid directions. 21. The Registry is directed to circulate this order to all the Judicial Magistrates concerned in Tamil Nadu and Puducherry through the Principal District Judge of the respective Districts for strict observance. The Registry shall also communicate this order to the Director General of Police, Tamil Nadu, and Director General of Police, Puducherry, to circulate the instructions and observations to all the police stations. (P.S.D., J.) (V.P.K., J.) ab 19..09..2008 Index : Yes Website : Yes To 1. The State of Tamil Nadu, Rep. by its Secretary to Government, Home Department, Fort St. George, Chennai-9. 2. The Commissioner of Police, Chennai City, Chennai. 3. Institute of Mental Health, Rep. by its Director, Kilpauk, Chennai-10. 4. The Inspector of Police, Kottur Police Station. 5. Inspector of Police, Nesamony Nagar Police Station, Kanyakumari District at Nagercoil. ab Prabha Sridevan, J. and V. Periya Karuppiah, J. Pre-delivery Order in H.C.P. No.1041 of 2008 Delivered on

Siddha Doctors and use of Modern Scientific Medicine Drugs

From http://indiankanoon.org/doc/1519022/ BEFORE THE MADURAI BENCH OF MADRAS HIGH COURT DATED: 11/02/2011 CORAM THE HONOURBLE MR.JUSTICE K.CHANDRU W.P.(MD)NO.7678 of 2010 W.P.(MD)NO.4463 of 2007 W.P.(MD)NO.8907 to 8909 of 2009 W.P.(MD)NO.2244, 5851, 6276, 6277, 8051, 8233 and 12561 of 2010 and M.P.(MD)Nos.1 of 2007, 1,1 and 1 of 2009, 1,1,1,1,1,1,2,1,1 and 2 of 2010 W.P.(MD)No.7678 of 2010 Tamilnadu Siddha Medical Graduates Association, Reg. No.105/2000, rep by Dr.M.Selvin Innocent Dhas, MD(s), President, Tamilnadu Siddha Medical Graduates Association, Kanyakumari Chapter:3-2, Muthalakurichy, Thuckalay Post, Kanyakumari District. .. Petitioner vs 1.Indian Medical Association, rep by Dr.K.Prakasam, Chairman, IMA Quackery Eradication Committee, Tamilnadu State Branch, Chennai. 2.State of Tamilnadu, rep by its Secretary to Government, Department of Health and Family welfare, Fort St. George, Chennai-9. 3.The Director, Public Health and Preventive Medicine, DMS Complex, Teynampet, Chennai-18. 4.The Director General of Police, Chennai-4. 5.The District Collector, Nagercoil, Kanyakumari District. 6.The Superintendent of Police, Nagercoil, Kanyakumari District. 7.Tamil Nadu Medical Council, rep by its Registrar Mr.S.Kandasamy, D Block, First Floor, TNHB Complex, Jawaharlal Nehru Salai, 100 feet Inner Ring Road, Vadapalani, Chennai-26. (R-7 impleaded as a party respondent as per order dt.31.8.2010 in MP(MD)No.2 of 2010) .. Respondents W.P.(MD)No.4463 of 2007 Dr.Jillus .. Petitioner vs 1.The Superintendent of Police, Kanyakumari District at Nagercoil. 2.The Inspector of Police, Colachel Police Station, Kanyakumari District. .. Respondents W.P.(MD)Nos.8907 to 8909 of 2009 Dr.N.Vivekanandham .. Petitioner in WP(MD)No.8907 of 2009 Dr.N.Sornappan .. Petitioner in WP(MD)No.8908 of 2009 Dr.N.Selvam .. Petitioner in WP(MD)No.8909 of 2009 vs 1.The Joint Director, Public Health Department, Kottar, Nagerkovil, Kanyakumari District. 2.The Deputy Director, Public Health Department, Krishnankovil, Vadaseri, Nagercoil, Kanakumari District. 3.The Superintendent of Police, Kanyakumari District, Nagerkovil, Kanyakumari. .. Respondents in all three writ petitions W.P.(MD)No.2244 of 2010 Tamizhaga Homeopathy and Siddha (Ayush) Doctors Association, Registered No.2 rep by State General Secretary Dr.K.Chinnaiyan Registered office at No.15,Baloba Nanthavanam, North Vasal Street, Thanjavur. .. Petitioner Vs 1.The Secretary, Department of Health, Indian Medicine and Homeopathy and Family Welfare Department, Fort St. George, Chennai-600 009. 2.State of Tamil Nadu, rep by Special Secretary, Home Department, Fort St. George, Madras-600 009. 3.The Director General of Police, Kamarajar Salai, Madras-600 004. 4.The Superintendent of Police, Thanjavur District, Thanjavur. 5.The Superintendent of Police, Pudukkottai District, Pudukkottai. 6.The Drug Controller, Arulananda Nagar, Thanjavur. .. Respondents W.P.(MD)Nos.5851, 6276 and 6277 of 2010 Rural Medical Private Practitioners' Associations, Regd. No.312/1994 Kodairoad Main Road, Pudur, Kodairaod, Dindigul District-624 006 rep by its President, Dr.S.Belavandran .. Petitioner in W.P.(MD)No.5851 of 2010 Dr.S.Palanimuthu .. Petitioner in W.P.(MD)No.6276 of 2010 Dr.R.Murugesan .. Petitioner in W.P.(MD)No.6277 of 2010 vs 1.The State of Tamilnadu, rep by its Chief Secretary, Secretariat, Chennai. 2.The State of Tamilnadu, rep by its Secretary to Government, Health & Family Welfare Department, Secretariat, Chennai. 3.The State of Tamilnadu, rep by its Secretary to Government, Home Department, Secretariat, Chennai. 4.The Director General of Police, Santhome, Chennai-6. 5.The Inspector General of Police, South Zone, Alagar Kovil Road, Madurai-2. 6.The District Collector, Dindigul District, Dindigul. 7.The Superintendent of Police, Dindigul District, Dindigul. .. Respondents in all the three writ petitions W.P.(MD)No.8051 of 2010 L.Arivazhagan .. Petitioner Vs 1.The State of Tamil Nadu, rep by its Secretary to Government, Health & Family Welfare Department, Fort St George, Chennai-9. 2.The District Collector, Dindigul, Dindigul District. 3.The Superintendent of Police, Dindigul, Dindigul District. .. Respondents W.P.(MD)No.8233 of 2010 : Karikalan .. Petitioner Vs 1.The Joint Director of Medicines, Sivagangai 2.The Superintendent of Police, Sivagangai. .. Respondents W.P.(MD)No.12561 of 2010 Dr.S.Selvaraj .. Petitioner Vs 1.The State of Tamilnadu, rep by Commissioner and Secretary to Government, Health and Family Department, Secretariat, Chennai-600 009. 2.The Deputy Director, Public Health Department, Meenakshi Nayakkan Patti Post, Dindigul District. 3.The District Collector, Office of the Collectorate, Dindigul. 4.The Superintendent of Police, District Police Office, Dindigul. 5.The Inspector of Police, Chanarpatti Police Station, Dindigul District .. Respondents W.P.(MD)No.7678 of 2010 has been preferred under Article 226 of the Constitution of India praying for the issue of a writ of mandamus to forbear the respondents and their men not to interfere with the professional practice of the members of the petitioner association and taking action in the name of Anti-quackery action against the members of the petitioner's association who are practicing their profession as per the Regulations passed by the Central Council of Indian Medicine, New Delhi and as per the Indian Medical Degrees (Madras Amendment) Act, 1940. W.P.(MD)No.4463 of 2007 has been preferred under Article 226 of the Constitution of India praying for the issue of a writ of mandamus forbearing the respondents from interfering with the practice of the petitioner as Homeopathy Doctor in St. Mary's Hospital, Beach Junction, Colachel, Kanyakumar District. W.P.(MD)Nos.8907 to 8909 of 2009 have been preferred under Article 226 of the Constitution of India praying for the issue of a writ of mandamus forbearing the respondents herein from in any way interfering the Siddha and Ayurvedic medical practice in the petitioners' clinic M/s.Nambirajan Siddha Clinic at Nangai Nagar, Akkarai Cape Road, Suseendhiram and also at Register Office Road, Edalakudi, Nagerkovil, Kanyakumari District, M/s.Sorna Clninic at 11/48, main Road, Kulasekaranpudhur, Kanyakumari District and M/s.Selvam Clinic at Kheezhur, Thirupathi Saaram, Kanyakumari District without following due process of law. W.P.(MD)No.2244 of 2010 has been preferred under Article 226 of the Constitution of India praying for the issue of a writ of mandamus to direct the respondents not to take any penal action against the members of the petitioner's association except complaint from the competent persons under the provisions of Tamil Nadu Homeopathy System of Medicine and Practitioners of Homeopathy Act and Tamil Nadu Council of Indian Medicine to enable the members of the petitioner's association to practice in the system of Homeopathy and Siddha Medicine without any interruption from respondents 2 and 6. W.P.(MD)Nos.5851, 6276 and 6277 of 2010 have been preferred under Article 226 of the Constitution of India praying for the issue of a writ of mandamus to forbear the respondents from interfering with the day today practice of Indian system of medicines, viz., Siddha, Unani, Ayurvedha and Homeopathy by the members of the petitioner association within a period that may be stipulated by the court. W.P.(MD)No.8051 of 2010 has been preferred under Article 226 of the Constitution of India praying for the issue of a writ of mandamus to direct the respondents to break open the seal of the petitioner premises situated in D.No.1/111, Therodum Veethi, Sempatti, Dindigul District and consequently to forbear the respondents herein in any way interfering with the petitioner's day today practice in Indian System of Siddha Medicine and Homeopathy. W.P.(MD)No.8233 of 2010 has been preferred under Article 226 of the Constitution of India praying for the issue of a writ of mandamus to forbear the respondents and their subordinates from interfering with the peaceful and lawful practice of the petitioner in the field of Siddha, Herbal Medicine, Herbal Physiotherapy and Acupuncture. W.P.(MD)No.12561 of 2010 has been preferred under Article 226 of the Constitution of India praying for the issue of a writ of mandamus to forbear the respondents herein from in any way interfering with the petitioner's Siddha, Ayurvedic and Homeo Medical practice in the petitioner's clinic without following due process of law. !For Petitioners ... Ms.Victoria Gowri Mr.K.Sellathurai Mr.M.Ajmal Khan Mr.K.Gokul Mr.M.Ramaratnam Mr.P.Ganapathi Subramani Mr.N.Anandhakumar Mr.C.K.M.Appaji ^For Respondents ... Mrs.V.Chellammal Murthy, AAG-V assisted by Mr.S.C.Herold Singh, GA Mr.Veerakathiravan Mr.C.Karthick Mr.B.Cheran - - - - :COMMON ORDER In W.P.(MD)No.7678 of 2010, the petitioner is the Tamilnadu Siddha Medical Graduates Association represented by its President. In that writ petition, they seek writ in the nature of mandamus to forbear the respondents from interfering with the professional practice of the members of the petitioner association and from taking action in the name of Anti-quackery action against the members of the petitioner's association who are practicing their profession as per the Regulations passed by the Central Council of Indian Medicine, New Delhi and as per the Indian Medical Degrees (Madras Amendment) Act, 1940. 2.The writ petition was admitted on 18.6.2010. Pending the writ petition, an interim injunction was granted against fourth and sixth respondents, i.e. Director General of Police, Chennai and the Superintendent of Police, Nagercoil, Kanyakumari District from interfering with the professional practice of the members of the petitioner association who hold valid registration certificate issued by the Tamilnadu Siddha Medical Council, even if they practice their respective system with modern scientific medicines including Surgery and Gynecology, Obstetrics, Anesthesiology, ENT, Ophthalmology based on the training and teaching they had during the course of their study. But, it was made clear that they are not entitled to practice exclusively Allopathy medicine. Subsequently, the Tamil Nadu Medical Council represented by its Registrar was impleaded as the 7th respondent in that writ petition. 3.Even before filing of the said writ petition, a writ petition was filed by one Dr..Jillus in the year 2007 in W.P.(MD)No.4463 of 2007 seeking to forbear the respondents, i.e. Superintendent of Police, Kanyakumari District and his subordinates from interfering with the practice of the petitioner as Homeopathy Doctor in St. Mary's Hospital, Beach Junction, Colachel, Kanyakumar District. In that writ petition, notice of motion was ordered. Pending notice of motion, no interim relief was granted. It was directed to be listed along with other batch of cases relating to Homeopathy Doctors. 4.Thereafter, 10 other writ petitions were filed. W.P.(MD)No.2244 of 2010 is filed by the Tamizhaga Homeopathy and Siddha (Ayush) Doctors Association, functioning from Thanjavur seeking for a direction to the respondents not to take any penal action against the members of the petitioner's association except complaint from the competent persons under the provisions of Tamil Nadu Homeopathy System of Medicine and Practitioners of Homeopathy Act and Tamil Nadu Council of Indian Medicine to enable the members of the petitioner's association to practice in the system of Homeopathy and Siddha Medicine without any interruption. That writ petition was admitted on 25.2.2010. Pending the writ petition, an interim injunction was granted. In that case, the fifth respondent, i.e. Superintendent of Police, Pudukkottai had filed a counter affidavit, dated 20.4.2010. It was claimed that the police have no reason to harass the Homeopathy and Siddha Doctors. Section 15 of the Indian Medical Council Act, 1956 bars the Homeopathy and Siddha Doctors from using Allopathy medicines. They were acting upon the complaints received from the Allopathy doctors. A Siddha or Homeopathy Doctor cannot be let off without prosecution if they impersonated as Allopathy Doctor. They have been dealt with under the provisions of the IPC and as per the Indian Homeopathy Council Act. 5.W.P.(MD)No.5851 of 2010 was filed by the Rural Medical Private Practitioners' Association represented by its President. The prayer in that writ petition was to forbear the respondents from interfering with the day today practice of Indian system of medicines, viz., Siddha, Unani, Ayurvedha and Homeopathy by the members of the petitioner association. In that writ petition, notice was taken by the Government Pleader. An interim injunction was also granted provided the members of the petitioner association do not use, prescribe Allopathic medicines or perform surgery or any other activity which is unknown to Indian medicine and homeopathy. 6.In W.P.(MD)Nos.6276 and 6277 of 2010, the two petitioners who are Doctors in Dindigul District sought for the prayer against the official respondents including the State and the Police Officers from interfering with the day today practice of Indian medicine, i.e Siddha by the petitioners. In those two writ petitions, notice regarding admission was granted on 29.4.2010. An interim prayer as made in W.P.(MD)No.5851 of 2010 was granted by this court. 7.In W.P.(MD)No.8051 of 2010, again the petitioner was a Doctor in Dindigul District practicing Siddha medicine, who had registered with Tamil Nadu Siddha Medical Council. He prayed for a direction to respondents to break open the seal of the petitioner premises situated in Door no.1/111, Therodum Veethi, Sempatti, Dindigul District and to forbear the respondents from in any way interfering with the petitioner' day today practice in Indian System of Siddha medicine and Homeopathy. That writ petition was not admitted till date. 8.In W.P.(MD)No.8233 of 2010, the petitioner had claimed that he had underwent self employment course for youth conducted by the Madurai Kamaraj University in Herbal Education. He had undergone training in Acupuncture Theraphy conducted by the Department of Adult Continuing Education and Extension, Madurai Kamaraj University. He is having diploma in Acupuncture and Herbal Physiotherapy as well as holding diploma in Siddha Medicine. He is also practicing an alternate medicine of Acupuncture, Herbal and Siddha Medicine. He seeks for a direction to the respondent police at Sivagangai to forbear them from interfering with the peaceful and lawful practice of the petitioner in the field of Siddha, Herbal Medicine, Herbal Physiotherapy and Acupuncture. When that writ petition came up for hearing, the learned Government Pleader took notice. No interim order was granted by this court. 9.In W.P.(MD)Nos.8907 to 8909 of 2009, the three writ petitioners who are residents of Kanyakumari District and are registered Ayurvedic and Siddha Medical practitioners. They sought for direction to the respondent police to forbear them from interfering with the Siddha and Aurvedic medical practice in their respective clinics at various places as found in the prayer portion. In these three writ petitions, notice of motion was ordered on 8.9.2009. No interim order was granted by this court. 10.In W.P.(MD)No.12561 of 2010, the petitioner who is a registered Ayurvedic, Siddha and Homeopathy medical practitioner, seeks for a direction to forbear the respondents from in any way interfering with the petitioner's right to practice Indian medicine except following due process of law. When that writ petition came up on 02.11.2010, this court directed the third respondent, i.e. District Collector, Dindigul to remove the seal in the office of the petitioner at Athikaripatti. The third respondent was also given liberty to take an inventory of all items found in the clinic for the purpose of further investigation and prosecution of cases registered against the petitioner. He was also given liberty to seize the goods which are necessary to be used as material evidence in the prosecution. In that case, notice was taken by the learned Government Advocate. 11.It is unnecessary to deal with the facts of the individual cases filed by certain medical practitioners of Indian Medicine. It is agreed between the parties that W.P.(MD)No.7678 of 2010 which was filed by the Tamil Nadu Siddha Medical Graduates Association can be taken as a representative case and that the contentions raised therein if answered will dispose of all other individual cases. Apart from that W.P.(MD)Nos.2244 of 2010 and 5851 of 2010 were also filed by two associations representing different sections. 12.Heard the arguments of Mrs.Victoria Gowri, learned counsel for petitioners, Mrs.Chellammal Murthy, learned Additional Advocate General-V, leading Mr.S.C.Herold Singh, learned Government Advocate appearing for respondent State and Police, Mr.Veerakathiravan, learned counsel appearing for the Tamil Nadu Medical Council and Mr.C.Karthik and Dr.B.Cheran for the first respondent Indian Medical Association. 13.Before proceeding to deal with the rival contentions in all these writ petitions, it is necessary that the Tamil Nadu Government by G.O.Ms.No.248, Health and Family Welfare Department, dated 8.9.2010 had issued a notification in the Government Gazette under Rule 2(ee)(iii) of the Drugs and Cosmetics Rules, 1945. It is necessary to set out the entire notification, which reads as follows: "WHEREAS, the rights of practitioners of Indian System of Medicine are protected under section 17(3)(b) of the indian Medicine Central Council Act, 1970 (Central Act 48 of 1970); AND WHEREAS, as per section 2(1)(e) of the said Act, "Indian Medicine" means the system of Indian Medicine commonly known as Ashtang Ayurveda, Siddha or Unani Tibb whether supplemented or not by such modern advances, as the Central Council of Indian Medicine may declare by notification from time to time; AND WHEREAS, the Central Council of Indian Medicine in its Notification F.No.28- 5/2004-AY.(MM), dated the 19th May 2004, has clarified that the word "Modern Advances " in clause (e) of Section 2(1) of the said Act as advances made in the various branches of modern scientific medicine in all its branches of internal medicine, surgery, gynaecology and obstetrics, anesthesiology, diagnostic procedures and other technological innovation made from time to time and declare that the courses and curriculum conducted and recognized by the Central Council of Indian Medicine are supplemented with such modern advances; AND WHEREAS, the Central Council of Indian Medicine has improved and strengthened the syllabus of Indian Medicine by including subjects with regard to National Programmes like National Malaria Eradication programmes, Tuberculosis, Leprosy, Family Welfare Programme, Reproductive and Child Health Programme, Immunisation Programme, AIDS, Cancer etc : Now, THEREFORE, under sub-clause (iii) of clause (ee) of rule 2 of the Drugs and Cosmetics Rules, 1945 the Governor of Tamil Nadu hereby declares every registered medical practitioner holding the qualifications specified in the second, third or fourth Schedule to the Indian Medicine Central Council Act, 1970 (Central Act 48 of 1970) and Part III of the Schedule to the Tamil Nadu Siddha System of Medicine (Development and Registration of Practitioners) Act, 1997 (Tamil Nadu Act 34 of 1997) and registered in the Medical Register of State maintained under the aforesaid Acts, as a person practicing the modern scientific system of medicine for the purposes of the Drugs and Cosmetics Act, 1940 (Central Act 23 of 1940.)" 14.It is claimed that the said notification is the subject matter of challenge by the Indian Medical Association, the first respondent, in W.P.No.23783 of 2010 before the Principal Bench. They had obtained an interim stay and the same is pending. It is the case of the petitioner that the Principal Bench in W.P.No.22155 of 2009 passed an interim order on 5.1.2010, seeking for a direction to the petitioner association to furnish to the respondents the names of such persons who are allegedly practicing medicine without valid licence. The respondents 2 to 4 in that writ petition were directed to take an action against those persons on receiving any such information. 15.The Indian Medical Association had earlier filed W.P.No.30259 of 2008 before the Principal Bench, seeking for a direction to consider their representations, dated 15.5.2008 and 14.6.2008 and to initiate an appropriate criminal prosecution against the paramedical technicians, paramedical practitioners and Physiotherapists, who are practicing Allopathic medicine and doing Allopathy treatment by using the prefix Doctor before their names in the prescriptions and advertisements within the State of Tamil Nadu. In that writ petition, the Principal Bench on 23.2.2010 had directed the first respondent to take an action against persons who pose themselves as Doctors or persons who are qualified otherwise than Doctors prefixing the title Doctor before their names in the prescriptions and advertisements. The Association was also directed to give the names of such persons who according to them were illegally practicing, before the Superintendent of Police of the respective districts as well as to the District Medical Officer. 16.In the light of these two orders of the High Court, the first respondent Association made a representation to the District Collector of all Districts in the name of Anti-quackery action at the District level. As per the directions of this court in those two writ petitions, they had furnished a list of the alleged quack Doctors in every District and a consolidated list of 2000 quacks was handed over to the Director General of Police. The first respondent Association themselves made a definition as to who is quack so as to include even the names of Doctors who are practicing over the system of medicine in the list of quacks which are beyond the scope of the order passed by this court. While no doubt the practice of unqualified quacks will have to be checked, but the first respondent cannot use those two orders as a mean to eliminate the other Doctors who are practicing the other systems of medicine. Therefore, the petitioner association made a representation to the District Collector, Kanyakumari District to convene a meeting for proper identification of quacks. Therefore, it is claimed that their right to practice any system of medicine is derived from the Act under which the medical practitioner is registered. The members of the petitioner association were governed by the provision of the Indian Medical Degree (Madras Amendment) Act, 1940, Indian Medicine Central Council Act, 1970, The Tamilnadu Siddha System of Medicine (Development and Registration of Practitioners) Act, 1997, The Drugs and Cosmetics Act 1940, The Drugs and Cosmetics Rules, 1945 and the Indian Medical Practitioners Professional Conduct Etiquette and Code of Ethics Regulations. 17.The respondent police on the basis of the list furnished by the first respondent had arrested many members of the petitioner association and remanded them to custody under various provisions of the IPC read with Section 15(2) of the Indian Medical Council Act, 1956. But, already this court in the year 2006 had granted an interim injunction restraining the police from interfering with the professional practice of such of those members of the petitioner association having a valid registration certificate issued by the Tamil Nadu Siddha Medical Council. As long as their registration holds good, they should not be disturbed. In the light of the constant pressure by the first respondent and various cases filed by the police, the association has filed the present writ petition so as to save their members from the harassment faced at the hands of the respondents. 18.The case of the petitioner association with reference to their right to practice the Indian medicine in their affidavit stated as follows: "c.The members of the petitioner-association studied in approved institutions, obtained their professional degrees from Universities and enrolled as Siddha Practitioner in the State register maintained by the Tamilnadu Siddha Medical Council. d.The members of the petitioner-association are qualified B.S.M.S. (Bachelor of Indian Medicine and Surgery) which is placed under the second schedule of the IMCC Act, 1970 and it is a recognized medical qualification for practicing Indian Medicine. e.The duration of the courses like B.A.M.S. (Bachelor of Ayurveda Medicine and Surgery) and B.S.M.S. (Bachelor of Siddha Medicine and Surgery) is equal to the duration of the course for M.B.B.S. (Bachelor of Medicine and Bachelor of Surgery) and all these three courses are involving five years period of study and a six months house surgeon period. Thus the scheme of study of Indian Medicine and English Medicine are similar. f.Sec.2(1)(e) of the IMCC Act says that "Indian Medicine" means the system of Indian Medicine commonly knows as Ashtang Ayurveda, Siddha, and Unani Tibb whether supplemented or not by such modern advances as the Central Council may declare by notifications from time to time. Thus the three types of practice of Indian Medicine namely Ayurveda, Siddha and Unani Tibb also includes the practices of modern advances as the Central Council constituted u/s.3 of IMCC Act may declare by notifications from time to time. g.The Central Council of Indian Medicine issued a notification in No:8-5-96- Ay.(MM) dated 30.10.96 and notified that "Institutionally qualified practitioners of India Systems of Medicine (Ayurveda, Siddha & Unani) are eligible to practice Indian Systems of Medicine and Modern Medicine including Surgery, Gynecology, Obstetrics based on their training and teaching which are included in the syllabi of via courses of Indian System of Medicine prescribed by Central Council of Indian Medicine after approval of the Govt. of India. h.It was further clarified in the said notification that the rights of practitioners of Indian system of Medicine to practice modern scientific system of Medicine (Allopathic Medicine) are protected under Section 17 of the Indian Medicine Central Council Act, 1970. j.The members of the petitioner-association are doctors by profession and holders of Medical Degree as recognized by the Union and State Governments of India. l.The respondents ought to have taken into consideration, that the members of the petitioner-association are holders of medical degrees under the Indian Medical Degrees (Madras Amendment) Act, 1940 and are registered medical practitioners according to section 2(ee)(iii) of the Drugs and Cosmetic Rules, 1945 and legally qualified medical practitioners under Section 25 of The Tamilnadu Siddha System of Medicine (Development and Practitioners) Act, 1997. m.The respondents failed to honour the constitutional validity of the Tamilnadu Siddha System of Medicine (Development and Registration of Practitioners) Act, 1997 and failed to appreciate the provisions regarding professional misconduct or infamous conduct in any professional respect as explained in Section 30(1) stating, "No court shall take cognizance of any offence punishable under this Act except on complaint in writing made by the Registrar of any officer authorized by him in this behalf." n.The respondents failed to appreciate the Indian Medical Practitioners Professional Conduct, Etiquette and Code of Ethics Regulations enacted by the exercise of the powers conferred by clause (1) of (2) of section 26 of the Indian Medicine Central Council Act, 1970, by the Central Council of Indian Medicine, with the previous sanction of the Central Government. o.The respondents failed to understand that except on complaint in writing by the registrar of Indian Medicine or any officer authorized by him in this behalf, the 4th respondent could not take action against the members of the petitioner-association for professional misconduct or infamous conduct in any professional aspect. p.The 1st respondent-association has prepared the list of quacks with the malafide intention to defame and demean the professional good will of the members of the petitioner-association, by including the names of the petitioner- association who are practicing their system of medicine within the scope of the Central and State Acts under which they have registered their medical degrees. r.The respondents have violated the fundamental right to practice any profession of the members of the petitioner-association as guaranteed by Article 19(g) of the Constitution of India, and the 4th respondent ought to have appreciated the order dated 13.10.2009 bearing No:K.Dis.No:70/TNBIM/2009 passed by Tamilnadu Board of Indian Medicine." 19.In the typed set filed by the petitioner association, they have enclosed various registration certificates obtained by them under the Tamil Nadu Siddha Medical Counsel to show that they are not quacks so as to be harassed by the respondent. 20.Ms.Victora Gowri, the learned counsel also referred to the following judgments in support of her submissions. She referred to a judgment of the Supreme Court in Dr.Mukhtiar Chand and others Vs. State of Punjab and others reported in 1998 (7) SCC 579 with reference to right of guarantee under Article 19(1)(g) of the Constitution of India to carry on any occupation. In paragraph 35, the Supreme Court had observed as follows: "35.Points 2 and 3 have some overlapping so it will be convenient to discuss them together. The right to practise any profession or to carry on any occupation, trade or business is no doubt a fundamental right guaranteed under Article 19(1)(g) of the Constitution of India. But that right is subject to any law relating to the professional or technical qualifications necessary for practising any profession or carrying on any occupation or trade or business enacted under clause (6) of Article 19. The regulatory measures on the exercise of this right both with regard to the standard of professional qualifications and professional conduct have been applied keeping in view not only the right of the medical practitioners but also the right to life and proper health care of persons who need medical care and treatment. There can, therefore, be no compromise on the professional standards of medical practitioners. With regard to ensuring professional standards required to practise allopathic medicine, the 1956 Act was passed which deals also with reconstitution of the Medical Council of India and maintenance of an Indian Medical Register. Thus, for the first time, an Indian Medical Register for the whole of India came to be maintained from 1956. In the 1956 Act, Section 2(f) defines "medicine" to mean "modern scientific medicine" in all its branches and includes surgery and obstetrics, but does not include veterinary medicine and surgery and the expression "recognised medical qualification" is defined in Section 2(h) to mean any of the medical qualifications included in the Schedules to the Act." 21.With reference to Doctors practicing Indian System of Medicine using Allopathy, in paragraph 27, it was observed as follows: "27.The learned counsel argued at length on the question whether clause (iii) is also intended for left-out qualified allopathic doctors. But if that interpretation is accepted, the said clause will become redundant as admittedly clauses (i) and (ii) exhaust all categories of practitioners entitled to practise in allopathic medicine. It was conceded at the end of the day and, in our view rightly, that the clause takes in medical practitioners other than qualified practitioners entitled to practise allopathic medicine. And as practitioners of homoeopathic medicine are specifically excluded, it becomes evident that this category comprises practitioners who are enrolled in a Medical Register of a State and though not answering the description of clauses (i) and (ii), are de facto practising modern system of medicine (allopathic) and those facts are declared by the State Government concerned. By this sub-clause, a de facto practitioner of modern scientific medicine (allopathic) is recognized as a registered medical practitioner and is enabled to prescribe drugs covered by the Drugs Act." 22.Similarly, in paragraph 40, the Supreme Court had observed as follows: "40.We have perused the Bombay Medical Act, 1912, the Bihar and Orissa Medical Act, 1916, the Punjab Medical Registration Act, 1916, the Rajasthan Medical Act, 1952 and the Maharashtra Medical Council Act, 1965 which regulate maintenance of registers of medical practitioners and the entitlement to practise allopathic medicine. Under those Acts, State Medical Registers are maintained. Section 7(3) of the Bombay Act of 1912 enabled the Provincial Government, after consulting the State Medical Council, to permit the registration of any person who was actually practising medicine in the Bombay Presidency before 25-6-1912; this seems to be the only case of registration without the requisite qualification. Further, persons possessing Ayurvidya Visharad of the Tilak Maharashtra Vidyapeeth of Poona, obtained during the years 1921-1935 (which was included in the Schedule to that Act on 30-9-1939 pursuant to Notification No. 3020/33 dated 12-9-1939) were entitled to be registered in the State Medical Register; this is the only ayurvedic qualification on the basis of which persons were eligible to be registered on the State Medical Register in Maharashtra; further with regard to rural areas, the prohibition to practise allopathic medicine under that Act did not apply provided a person had commenced practice in any village in the rural area prior to 1912. None of the petitioners has claimed benefit of these exceptions. We could not find any other provision which enables a person, other than those possessing the qualification prescribed in the Schedules to the Acts, to be registered in the State Medical Register to practise allopathic medicine. So it can be observed that if any State law relating to registration of medical practitioners permits practise of allopathic medicine on the basis of a degree in integrated medicines, the bar in Section 15(2)(b) of the 1956 Act will not apply." 23.With reference to the provisions of the Drugs and Cosmetics Act and the right to use such Allopathy medicines by such Doctors, in paragraph 41, it was observed as follows: "41.Rule 2(ee), as noted above, has been inserted in the Drugs Rules with effect from 14-5-1960. Section 15 of the 1956 Act, as it then stood, only provided that the medical qualifications in the Schedule shall be sufficient qualification for enrolment on any State Medical Register and so there was no inconsistency between the section and the Rule when it was brought into force. But after sub- section (2) of Section 15 was inserted in the 1956 Act, with effect from 15-9- 1964, which, inter alia, provides that no person other than a medical practitioner enrolled on a "State Medical Register" shall practise modern scientific medicine in any State, the right of non-allopathic doctors to prescribe drugs by virtue of the declaration issued under the said Drugs Rules, by implication, got obliterated. However, this does not debar them from prescribing or administering allopathic drugs sold across the counter for common ailments." 24.It was further stated that if the State law provides registration of Indian medicine practitioners, then the notification issued under the Central Act will be available in their favour. In paragraph 49, the Supreme Court had stated as follows: "49.The upshot of the above discussion is that Rule 2(ee)(iii) as effected from 14-5-1960 is valid and does not suffer from the vice of want of legislative competence and the notifications issued by the State Governments thereunder are not ultra vires the said Rule and are legal. However, after sub-section (2) in Section 15 of the 1956 Act occupied the field vide Central Act 24 of 1964 with effect from 16-6-1964, the benefit of the said Rule and the notifications issued thereunder would be available only in those States where the privilege of such right to practise any system of medicine is conferred by the State law under which practitioners of Indian medicine are registered in the State, which is for the time being in force. The position with regard to medical practitioners of Indian medicine holding degrees in integrated courses is on the same plane inasmuch as if any State Act recognizes their qualification as sufficient for registration in the State Medical Register, the prohibition contained in Section 15(2)(b) of the 1956 Act will not apply." 25.The learned counsel also submitted that the petitioner association had filed W.P.No.9648 of 2006 before the Principal bench. Despite the interim order since the respondents were taking action flouting those orders, the association was constrained to file a contempt petition being Contempt Petition No.775 of 2010 before the Principal Bench against the Director General of Police. In that contempt petition, a learned Judge of this Court by his order, dated 23.7.2010 which was subsequently reported in 2010 (4) CTC 798, after referring to the submissions made by the parties, in paragraph 4 had observed as follows: "4....it is imperative that no proceedings can be initiated against any of those registered practitioners in Siddha, Ayurveda, Homeopathy and Unani, who are eligible to practice irrespective of the respective system also with Modern Scientific Medicine including Surgery and Gynecology Obstetrics, Anesthesiology, ENT, Opthalmology, etc. Such registration of the medical practitioners with Tamil Nadu Siddha Medical Council, Tamil Nadu Board of Indian Medicine and Tamil Nadu Homeopathy Medical Council as well as such of those qualified doctors who were recognised as such by the Madurai Kamaraj University and Tamil Nadu Dr. MGR Medical University who have been qualified respectively in the system of bachelor of Siddha Medicine and Surgery. If any action had been taken against such of those medical practitioners referred to above, it is needless to state that, such action should be dropped forthwith pending further orders in the Writ Petition." 26.Thereafter, pains were taken to explain the various provisions of relevant enactments including the import of the Drugs and Cosmetics Act and the usage of medicine therein. It was also stated that the course undergone by them during the degree including Pharmacology as well as surgery. Therefore, it is too late for them to call the Siddha practitioners as quacks. It was also claimed that there are many of Siddha and Ayurvedic preparations were prescribed by Allopathy Doctors. Therefore, there is no legal bar for the Siddha Doctors prescribing Allopathy medicines. Both systems are based upon modern medicines. The syllabus and question papers that were issued during the course undergone by the petitioner were also referred to as well as various articles were also referred to. 27.The counsel also referred to the order passed by this court in Crl.O.P.(MD)No.11994 of 2010 and batch cases, dated 2.11.2010, wherein a learned Judge quashed the FIR registered against the members of the petitioner association. The learned counsel also referred to a circular issued by the State Government, dated 15.6.2010 by the Health and Family Welfare Department to the Director General of Police, wherein after referring to the cases earlier filed by the petitioner association, the Director General of Police was directed as follows: "I am therefore to request you to instruct the police officers in the Districts not to intervene with the Practice of Registered Practitioners of Siddha, Ayurveda, Unani and Naturopathy who are registered in the Tamilnadu Siddha Medical Council and Tamilnadu Board of Indian Medicine. If any of these ISM Doctors are exclusively doing practice in Allopathy medicine, names of these Doctors may be intimated to the Council and the Government for taking action against them under the Tamilnadu Siddha System of Medicine (Development and Registration of Practitioners) Act, 1997 and Tamilnadu Board of Indian Medicine Rules. The cases of the Doctors who are already under arrest may be reviewed with reference to the above clarifications." 28.They also submitted that the State Government had issued G.O.Ms.No.248, Health and Family Welfare Department, dated 8.9.2010 under the Drugs and Cosmetics Rules, allowing to register the medical practitioners under the Indian Medical Central Council Act in the II, III and IV schedule and Tamilnadu Siddha System of Medicine (Development and Registration of Practitioners) Act, 1997 registered under the III Schedule and registered in the Medical Register of the State maintained under various Acts practicing the modern scientific system of medicine for the purpose of Drugs and Cosmetics Act. Therefore, merely because they are prescribing Allopathy medicine as a part of their treatment procedure, they cannot be prosecuted. 29.Unfortunately, the official respondents have not filed any counter affidavit. It is the first respondent who has filed a counter affidavit. The first respondent had stated that the term of quack is defined by the Supreme Court in Poonam Verma Vs. Ashwin Patel reported in 1996 (4) SCC 332. It means a person who does not have knowledge of a particular system of medicine but practices in that system is a Quack and a mere pretender to medical knoweldge or skill or to put it differently as charlatan. 30.It was submitted that in W.P.No.1598 of 2001, dated 19.8.2008, this court in paragraph 7 had observed as follows: "7.It is also seen that the Government of Tamilnadu had taken a policy decision not to regularise the practice of unqualified medical practitioners, considering the public welfare and in view of the fact that adequate number of registered medical practitioners in Modern Medicine, Indian Medicine, Homeopathy, etc., are available to cater to the needs of the public. Regulating the practice of unqualified medical practitioners would result in the loss of precious human lives and it will also pose various health hazards. Unless the members of the petitioner Association are possessing the required qualifications, as prescribed by the recognised University and unless they are registered in their respective Medical Councils they cannot be permitted to practice." 31.Thereafter, in W.P(MD).No.2267 of 2009, dated 24.8.2009, this court after referring to Dr.Mukhtiar Chand case and Poonam Verma's case (cited supra), in paragraph 8 had observed as follows: "8.The petitioner has filed the Chart of duties and responsibilities of Pharmacists in the typed set of papers. Even under the said chart a pharmacist is only entitled to dispense with the drugs and he shall not do so without prescription by the medical officer. Therefore, merely because the petitioner possessing a Diploma in pharmacy and stated to be running a medical shop, he is not entitled to dispense drugs without a prescription from an authorised medical officer. Further the petitioner has stated in the affidavit that he is assisting the patients by administering injunction and taking blood samples, at no stretch of imagination the petitioner shall go on with such activities in his medical shop on the strength of having studied such procedure in his diploma course. The Chart of duties also placed an embargo on the petitioner that he should not on any account prescribe medicine for patient on his own. An inclusion of a particular subject or a nature of studies in the curriculum of a course, cannot be used by the petitioner to state that he is entitled to practise the same. If such interpretation is given, then the very purpose of enacting the Indian Medical Council Act and maintaining the list of registered practitioner would be an empty formality. It is needless to state that as long as the petitioner confines himself to the sphere of activity for which he is authorised and for which purpose he holds the qualification, he cannot apprehend of any harassment in the hands of the police. Further in the event of a complaint being lodged with the jurisdictional police, the petitioner cannot seek for a blanket order that such complaint cannot be investigated." 32.Subsequently in Dr.K.Abdul Muneer and another Vs. The State of Tamil Nadu and others reported in 2010 (4) CTC 88, vide judgment, dated 12.2.2010, a learned Judge after referring to Dr.Mukhtiar Chand case and Poonam Verma's case (cited supra) and Yash Ahuja Vs. Medical Council of India reported in 2009 (12) Scale 687 in paragraphs 30 and 31 had observed as follows: "30.The grievance of the Petitioners are on account of the raid conducted by the Police Authorities in their clinic on account of their practice in Allopathic Medicine along with Unani Medicine. The Director of Medical Sciences in his counter affidavit has categorically stated that the Unani Practitioners like the petitioners are not entitled to practice in the system of Allopathic Medicine. The petitioners have also no case that they are qualified in the Allopathic system of medicine. The Petitioners are taking shelter under the brief training given to them during their internship. The training which the Petitioners have undergone during the time of house surgeoncy was only for the purpose of completing the course as per the Regulations. During that particular period of six months, the petitioners were given training in as many as seven departments viz., Obstetrics, Gynecology, Medicine, Surgery, Pediatrics, E.N.T. and Ophthalmology. The training for a brief period given to the petitioners were not for the purpose of practicing in the system of Allpathic Medicine or to administer modern medicine. It was only as part of their curriculum to get the degree in BUMS they have undergone such training. The training received by the Petitioners in the Government Hospital will not qualify them to practice in the Allopathic system of medicine. So long as there is no entry of the Petitioners name in the State Register maintained by the statutory authorities under the Indian Medical Council Act, 1956, it is not open to them to practice in the Allopathic Medicine. 31.There is no dispute that Ayurveda, Siddha, Unani and allopathic and homeopathic system of medicines have got their own history, heritage, advantages and importance. It is not possible to ignore our traditional, indigenous system of medicine and the service rendered by the Medical practitioners of Indian Medicine for the cause of public health. There is no restriction for practicing the Indian Medicine by the qualified practitioners. The problem would arise only when they attempt to practice the allopathic system of medicine without a Degree and training in the modern system of medicine." 33.Further, the matter was taken on appeal in W.A.No.755 of 2010. A division bench of this court by its judgment, dated 8.6.2010 dismissed the writ appeal. In paragraph 6, the division bench had observed as follows: "6.Taking clue from the last paragraph of the said circular, learned senior counsel submitted that the appellants have already undergone training, which is evident from page No.17 of the typed set of papers viz., the completion certificate issued by the Government Royapettah Hospital, Chennai-14 in respect of the appellants for the period of training undergone by them from 01.07.1990 to 16.07.1990; therefore they are entitled for practising in the Indian Medicine and the learned Single Judge should have considered the same and allowed the appellants to practice in Allopathic medicine. Once again, we went through the entire materials available on record and we are of the considered opinion that the appellants have undergone training in Indian Medicine only for a period of 15 days, which is not sufficient for allowing the appellants to practice in Allopathic Medicine. Further, the circular issued by the Central Council of Indian Medicine on 19.05.2004 is prospective in operation and unless it is specifically stated in the said circular that it must be given retrospective effect, the appellants cannot be allowed to practice Allopathic Medicine based on the said circular. As held by the Hon'ble Supreme Court of India in the case reported in (1998) 7 SCC Pg.579 referred to supra, a harmonious reading of section 15 of the 1956 Act and Section 17 of the 1970 Act leads to the conclusion that there is no scope for a person enrolled on the State Register of Indian Medicine or the Central Register of Indian Medicine to practise modern scientific medicine in any of its branches unless that person is also enrolled on a State Medical Register within the meaning of the 1956 Act. In the case on hand, the qualification of the appellants are not registered in the State Medical Register and therefore, they are not entitled to practice Allopathic medicine. Moreover, in the definition of "Indian medicine" given in the circular dated 19.05.2004, nothing is stated about the registration." 34.In W.P.No.2722 of 2010, dated 30.3.2010, another learned Judge of this court after referring to all previous cases held that omnibus prayer of the petitioner association cannot be granted. But if any member is individually aggrieved by any action taken, they can challenge it before the competent court and no blanket order can be granted. Further, the State Government had taken a policy decision not to regularise the practice of an unqualified medical practitioners. Considering the public welfare and unless the member of the petitioner association possesses required qualification as prescribed by the recognized University and unless they have registered with respective medical council, they cannot be permitted to practice. 35.In the light of the judgments of this court, the petitioners contended that any Doctor who has registered under the Siddha system of medicine, if he violates any condition, he can be punishable under the Indian Medical Council Act. Likewise, the Indian Medicine Central Council Act, 1970 is to regularize the practice of Siddha medicine by enrolling the members of the council. Therefore, the members who have registered under various councils can practice only the system of medicines for which they were qualified. Likewise if they are not registered themselves in the State register under the Indian Medical Council Act, 1950 cannot practice Allopathy. Both the Indian Medical Council Act and the Indian Medicine Central Council Act though they are statutory bodies, the members registered under each of the council can only practice for which they have been licensed. The Central Council of Indian Medicine had issued a notification, dated 19.5.2004 permitting the qualified practitioners of Ayurvedic, Siddha, Unani Tibb are eligible to practice respective systems with modern Scientific medicine including Surgery, Gynecology, Obstetrics, Anesthesiology, ENT, Ophthalmology, etc based on the training and teching. 36.But the Medical Council of India had issued a notification on 11.3.2002 and published in the Gazette dated 6.4.2002 in the following lines: "No person other than a doctor having qualification recognized by Medical Council of India and registered with Medical Council of India / State Medical Council(s) is allowed to practice Modern system of Medicine or Surgery. A person obtaining qualification in any other system of medicine is not allowed to practice Modern system of Medicine in any form." 37.It was contended that the notification issued by the Central Council of Indian Medicine was beyond its power, but the syllabus, curriculum and training in the two systems are different. Dr.Muthtiar Chand case (cited supra) do not help the case of the petitioners. On the other hand, it only strengthens the stand of the respondents. An harmonious reading of the Medical Council Act, 1956 and the Central Council of Indian Medicine Act was only mean a person enrolls either under the State register of Indian Medicine or the Central register of Indian Medicine can practice modern scientific medicine in any of its branches unless that person is also enrolled under the State Medical Register of 1956 Act. Thereafter, it was argued that the syllabus between the two courses are different and what the Doctor under the Indian medicine system had is only the birds eye view of the subject and not enough to practice Allopathy medicine. 38.Further, a reference was also made to a judgment of the Supreme Court in Yash Ahuja and others Vs. Medical Council of India and others reported in 2009 (12) Scale 687 to contend that under the Indian Medical Council Act even medical degrees from other countries were not recognised directly and those Doctors will have to undergo screening test. Each system, i.e. Ayurvedic, Siddha, Unani, Allopathy and Homeopathy have got their own history, heritage, advantages and importance and so long as they are practicing within their system, there will be no difficulty, but if they transgressed their limits, certainly, they are liable for an action. While Ayurvedic medicines are derived from Herbs, Siddha medicine is developed from plants and metals and Allopathy medicines are made from chemicals. Though they are dealing with common patient, each system has got its own regime of treatment. Therefore, it was stated that the petitioners cannot be allowed to treat any patient with Allopathy medicine and that will be a clear case of transgression of their limits. 39.A reference was made to a latest judgment of the Supreme Court in Rajasthan Pradesh V.S.Sardarshahar and another Vs. Union of India and others reported in 2010 (6) MLJ 82 (SC), wherein the Supreme Court in paragraph 42 had observed as follows: "42.In view of the above, it is evident that right to practice under Article 19(1)(g) of the Constitution is not absolute. By virtue of the provisions of Clause (6) to Article 19 reasonable restrictions can be imposed. The Court has a duty to strike a balance between the right of a Vaidya to practice, particularly, when he does not possess the requisite qualification and the right of a "little Indian" guaranteed under Article 21 of the Constitution which includes the protection and safeguarding the health and life of a public at large from mal-medical treatment. An unqualified, unregistered and unauthorized medical practitioner possessing no valid qualification, degree or diploma cannot be permitted to exploit the poor Indians on the basis of a certificate granted by an institution without any enrolment of students or imparting any education or having any affiliation or recognition and that too without knowing the basic qualification of the candidates. Question of entertaining the issue of validity of Entry No.105 to the Second schedule to the Act 1970 i.e. "to 1967" does not arise as it is not a cut-off date fixed by the Statutory Authority rather a date, after which the qualification in question was not recognised. Hindi Sahitya Sammelan itself admitted tht the Society was not imparting any education. It had no affiliated colleges. It merely conducts the test. The Society never submitted any application after 1967 before the Statutory Authority to accord recognition and modify the Entry No.105 to Part I of Schedule II to the Act 1970. Submissions to the effect that 1953 Act conferred privileges upon the Vaidyas in exceptional circumstances to practice and any restriction to practice unless the names are entered in the Central Register is arbitrary and violative of statutory provisions of the State Act, are preposterous for the reason that such privileges, if are repugnant to the provisions of Act 1970, cannot be availed by operation of the provisions contained in Article 254 of the Constitution. Thus, such a restriction cannot be held violative of equality clause enshrined in Article 14 of the Constitution." In the context of the above, the first respondent had contended that the petitioner's association writ petition should be dismissed. The earlier order having become final, they will operate as res judicata against the contentions raised by the petitioner. 40.In the light of the rival pleadings, two questions arise for consideration. The first was whether the first respondent association can be given a carte blanche to find out as to who are all practicing quackery and on that basis, the police can be directed to proceed against those individuals in a criminal court. But, if such a power is given to the practitioners of one system, it will naturally result in witch hunting of others who did not have licence to practice in Allopathic system of medicine. A reading of all the earlier orders did not indicate that if a person is having licence to practice under a particular system of medicine and registered under the respective council, he can be simply proceeded for the alleged transgression of their limits. If a person who did not have any degree under any system and if he practices any form of medicine, they can be easily identified as a quack and can be proceeded on a complaint even under the provisions of IPC. In respect of violation of any professional conduct or ethics under each system for which separate registration under a council is provided. Hence each council will be the only authority to deal with those persons who violate their professional ethics and conduct. Even in those cases, there is no difficulty because each of the councils were empowered by a Central enactment and fully geared to deal with such contingencies. 41.A further question will arise that if a Doctor under the system of Indian medicine prescribed Allopathic drugs, whether it would amount to violation of Indian Medicine Council Act? In fact, the Government Order issued by the State Government in G.O.Ms.No.248, Health and Family Welfare Department, dated 8.9.2010 permits such of those practitioners to be brought under the registered practitioner in terms of Rule 2(ee)(iii). It is the statutory order that takes out the taboo of such of those Indian medicine doctors prescribing even Allopathy medicine. In the judgment in Dr.Muthtiar Chand's case (cited supra), the said issue has been dealt with and the term modern medicine has been defined. There is lot of misconception about the Doctors who are qualified under the Indian medicine and having valid degree as well as registration under the statutory council being dealt with by the police solely at the instance of the first respondent association and treating them as criminals. If allowed it will certainly bring disrepute to them in the eye of public and will make it appear that the system of Indian medicine comprises of only quacks or non professionals. Such can never be the stand of any Government. The issues to merit and demerits of each system has to be scientifically established. Ultimately, it is for the people to apt for a particular system of treatment. The faith of the people matters more than any other criteria. The legal interpretation given by the court can only ultimately guide to deal with complaints of malpraxix. But certainly the police cannot be allowed to take an initiative in such matters. 42.Even in cases of medical negligence, the Supreme Court had laid down several restrictions. In many cases, the complaints of medical negligence before the Consumer forum or criminal courts have been found fault with. In matters of criminal negligence, the Supreme Court has now held that such conduct must first be enquired into by experts in the field and then only the criminal court can deal with such matters. 43.While talking about the system of medicine and denial of access by poor to this institution, the Supreme Court in Samira Kohli Vs. Dr.Prabha Manchanda and another reported in 2008 (2) SCC 1 in paragraphs 38, 39, 40 and 43 had observed as follows: "38.In India, majority of citizens requiring medical care and treatment fall below the poverty line. Most of them are illiterate or semi-literate. They cannot comprehend medical terms, concepts, and treatment procedures. They cannot understand the functions of various organs or the effect of removal of such organs. They do not have access to effective but costly diagnostic procedures. Poor patients lying in the corridors of hospitals after admission for want of beds or patients waiting for days on the roadside for an admission or a mere examination, is a common sight. For them, any treatment with reference to rough and ready diagnosis based on their outward symptoms and doctor's experience or intuition is acceptable and welcome so long as it is free or cheap; and whatever the doctor decides as being in their interest, is usually unquestioningly accepted. They are a passive, ignorant and uninvolved in treatment procedures. 39.The poor and needy face a hostile medical environment - inadequacy in the number of hospitals and beds, non-availability of adequate treatment facilities, utter lack of qualitative treatment, corruption, callousness and apathy. Many poor patients with serious ailments (e.g. heart patients and cancer patients) have to wait for months for their turn even for diagnosis, and due to limited treatment facilities, many die even before their turn comes for treatment. What choice do these poor patients have? Any treatment of whatever degree, is a boon or a favour, for them. The stark reality is that for a vast majority in the country, the concepts of informed consent or any form of consent, and choice in treatment, have no meaning or relevance. 40.The position of doctors in government and charitable hospitals, who treat them, is also unenviable. They are overworked, understaffed, with little or no diagnostic or surgical facilities and limited choice of medicines and treatment procedures. They have to improvise with virtual non-existent facilities and limited dubious medicines. They are required to be committed, service oriented and non-commercial in outlook. What choice of treatment can these doctors give to the poor patients? What informed consent can they take from them? 43.Health care (like education) can thrive in the hands of charitable institutions. It also requires more serious attention from the State. In a developing country like ours where teeming millions of poor, downtrodden and illiterate cry out for health care, there is a desperate need for making health care easily accessible and affordable. Remarkable developments in the field of medicine might have revolutionalised health care. But they cannot be afforded by the common man. The woes of non-affording patients have in no way decreased. Gone are the days when any patient could go to a neighbourhood general practitioner or a family doctor and get affordable treatment at a very reasonable cost, with affection, care and concern. Their noble tribe is dwindling. Every doctor wants to be a specialist. The proliferation of specialists and super specialists, have exhausted many a patient both financially and physically, by having to move from doctor to doctor, in search of the appropriate specialist who can identify the problem and provide treatment. What used to be competent treatment by one general practitioner has now become multi-pronged treatment by several specialists." 44.In fact, anticipating that there may be large scale of complaints against medical professionals from the aggrieved patients and others, the Supreme Court had warned Courts and the Consumer forums to keep several factors in mind in cases relating to medical negligence and not to take a view which would have in fact disservice to the public vide its judgment in Martin F. D.'Souza Vs. Mohd. Ishfaq reported in 2009 (3) SCC 1. Thereafter, the Supreme Court held that in such a case, the following safeguards should be provided to Doctors at paragraph 106 which reads as follows: "106.We, therefore, direct that whenever a complaint is received against a doctor or hospital by the Consumer Fora (whether District, State or National) or by the criminal court then before issuing notice to the doctor or hospital against whom the complaint was made the Consumer Forum or the criminal court should first refer the matter to a competent doctor or committee of doctors, specialised in the field relating to which the medical negligence is attributed, and only after that doctor or committee reports that there is a prima facie case of medical negligence should notice be then issued to the doctor/hospital concerned. This is necessary to avoid harassment to doctors who may not be ultimately found to be negligent. We further warn the police officials not to arrest or harass doctors unless the facts clearly come within the parameters laid down in Jacob Mathew case1, otherwise the policemen will themselves have to face legal action." Therefore, as apprehended by the Supreme Court that leaving the choice to the policemen to be let loose on the Doctors who are actually having qualified medical degrees will not only be undesirable but will be disservice to the public. 45.Once again reiterating the principles laid down in Jacob Mathew Vs. State of Punjab reported in 2005 (6) SCC 1, the Supreme Court in INS.Malhotra (Ms) Vs. Dr.A.Kriplani and others reported in 2009 (4) SCC 705, in paragraph 49 had observed as follows: "49.Again, it has been held that indiscriminate prosecution of medical professionals for criminal medical negligence is counterproductive and does no service or good to the society. "28. A medical practitioner faced with an emergency ordinarily tries his best to redeem the patient out of his suffering. He does not gain anything by acting with negligence or by omitting to do an act. Obviously, therefore, it will be for the complainant to clearly make out a case of negligence before a medical practitioner is charged with or proceeded against criminally. A surgeon with shaky hands under fear of legal action cannot perform a successful operation and a quivering physician cannot administer the end-dose of medicine to his patient. 29. If the hands be trembling with the dangling fear of facing a criminal prosecution in the event of failure for whatever reason-whether attributable to himself or not, neither can a surgeon successfully wield his life-saving scalpel to perform an essential surgery, nor can a physician successfully administer the life-saving dose of medicine. Discretion being the better part of valour, a medical professional would feel better advised to leave a terminal patient to his own fate in the case of emergency where the chance of success may be 10% (or so), rather than taking the risk of making a last ditch effort towards saving the subject and facing a criminal prosecution if his effort fails. Such timidity forced upon a doctor would be a disservice to society." (Jacob Mathew case2, SCC pp.22-23, paras 28-29)" 46.The principles laid down in Jacob Mathew's case (cited supra) once again was reiterated and followed in Nizam's Institute of Medical Sciences Vs. Prasanth S.Dhananka and others reported in 2009 (6) SCC 1. 47.In the light of the above, if it is seen the Supreme Court is of the opinion that medical professionals must be saved from unjust complaints of negligence or malpraxis and safeguards should be made. No blanket permission can be issued to the police to arrest or to prosecute the so-called quacks identified by the respondent Indian Medical Association. If the IMA as a guild association of Allopathic medical practitioners are aggrieved by any misconduct committed by other medical professionals governed by other systems of medicines, they can make complaints to their professional bodies under which those professionals are registered as they have valid licence and can find remedies. It is only in case where they are able to establish that there persons masquerading as Doctors, then the question of pressing into service anti quackery act will come into play. It will enable them to take that person to be prosecuted by legal methods. 48.The State Government realizing the difficulties faced by such practitioners had issued a circular, dated 15.6.2010, wherein an aggrieved individual was directed to approach the respective council and the Government for taking an appropriate action. Since each of the council is established by the Parliament and having a statutory body to deal with such misconducts, it is appropriate that those councils should be approached in case of any deviation in the licence to practice. The respective councils can also decide whether the members registered under the respective council had transgressed their limits under the licence conditions which were issued under a particular Act of the Parliament. But at no point of time, a person who is having a valid degree and having registered under an enactment can be directed to be proceeded by the police by registering a criminal case against them in a criminal court and that too at the instance of an Association like the first respondent which is not even a statutory body, but a mere association of Doctors practicing under Allopathy System of medicine. 49.In the light of the above, this court is of the view that the order passed by this court in 2010 (4) CTC 798 is held to be a correct position of law. For the sake of repetition, it is observed as follows: "4....it is imperative that no proceedings can be initiated against any of those registered practitioners in Siddha, Ayurveda, Homeopathy and Unani, who are eligible to practice irrespective of the respective system also with Modern Scientific Medicine including Surgery and Gynecology Obstetrics, Anesthesiology, ENT, Opthalmology, etc. Such registration of the medical practitioners with Tamil Nadu Siddha Medical Council, Tamil Nadu Board of Indian Medicine and Tamil Nadu Homeopathy Medical Council as well as such of those qualified doctors who were recognised as such by the Madurai Kamaraj University and Tamil Nadu Dr. MGR Medical University who have been qualified respectively in the system of bachelor of Siddha Medicine and Surgery. If any action had been taken against such of those medical practitioners referred to above, it is needless to state that, such action should be dropped forthwith pending further orders in the Writ Petition." 50.In the light of the above, the writ petition in W.P.(MD)No.7678 of 2010 is disposed of with the above directions. Since all the issues have been decided in W.P.(MD)No.7678 of 2010, the other writ petitions as they do not raise similar contentions must necessarily fail. Hence all the other writ petitions will stand dismissed. In individual cases, where actions have been already initiated (which are now under challenge) and if it is pending before any forum, it is open to the petitioners to approach those forums and take such defences that are open to them. However, there will be no order as to costs. Consequently, connected miscellaneous petitions will stand closed. vvk To 1.The Superintendent of Police, Kanyakumari District at Nagercoil. 2.The Inspector of Police, Colachel Police Station, Kanyakumari District. 3.The Joint Director, Public Health Department, Kottar, Nagerkovil, Kanyakumari District. 4.The Deputy Director, Public Health Department, Krishnankovil, Vadaseri, Nagercoil, Kanakumari District. 5.The Secretary, Department of Health, Indian Medicine and Homeopathy and Family Welfare Department, Fort St. George, Chennai-600 009. 6.The Special Secretary, State of Tamil Nadu, Home Department, Fort St. George, Madras-600 009. 7.The Director General of Police, Kamarajar Salai, Madras-600 004. 8.The Superintendent of Police, Thanjavur District, Thanjavur. 9.The Superintendent of Police, Pudukkottai District, Pudukkottai. 10.The Drug Controller, Arulananda Nagar, Thanjavur. 11.The Chief Secretary, The State of Tamilnadu, Secretariat, Chennai. 12.The Secretary to Government, The State of Tamilnadu, Health & Family Welfare Department, Secretariat, Chennai. 13.The Secretary to Government, The State of Tamilnadu, Home Department, Secretariat, Chennai. 14.The Inspector General of Police, South Zone, Alagar Kovil Road, Madurai-2. 15.The District Collector, Dindigul District, Dindigul. 16.The Superintendent of Police, Dindigul District, Dindigul. 17.The Director, Public Health and Preventive Medicine, DMS Complex, Teynampet, Chennai-18. 18.The District Collector, Nagercoil, Kanyakumari District. 19.The Joint Director of Medicines, Sivagangai 20.The Superintendent of Police, Sivagangai. 21.The Commissioner and Secretary to Government, The State of Tamilnadu, Health and Family Department, Secretariat, Chennai-600 009. 22.The Deputy Director, Public Health Department, Meenakshi Nayakkan Patti Post, Dindigul District. 23.The Inspector of Police, Chanarpatti Police Station, Dindigul District