Tuesday 23 February 2010

Fundamental rights. Module 1

The Constitution of India guarantee civil liberties such that all Indians can lead their lives in peace and harmony as citizens of India. These include individual rights common to most liberal democracies, such as equality before law, freedom of speech and expression, freedom of association and peaceful assembly, freedom to practice religion, and the right to constitutional remedies for the protection of civil rights by means of writs such as habeas corpus. Violations of these rights result in punishments as prescribed in the Indian Penal Code, subject to discretion of the judiciary. The Fundamental Rights are defined as basic human freedoms which every Indian citizen has the right to enjoy for a proper and harmonious development of personality. These rights universally apply to all citizens, irrespective of race, place of birth, religion, caste, creed, colour or sex. They are enforceable by the courts, subject to certain restrictions. The Rights have their origins in many sources, including England's Bill of Rights, the United States Bill of Rights and France's Declaration of the Rights of Man.

The six fundamental rights are:

Right to equality
Right to freedom
Right against exploitation
Right to freedom of religion
Cultural and educational rights
Right to constitutional remedies


Rights literally mean those freedoms which are essential for personal good as well as the good of the community. The rights guaranteed under the Constitution of India are fundamental as they have been incorporated into the Fundamental Law of the Land and are enforceable in a court of law. However, this does not mean that they are absolute or that they are immune from Constitutional amendment.

Fundamental rights for Indians have also been aimed at overturning the inequalities of pre-independence social practices. Specifically, they have also been used to abolish untouchability and hence prohibit discrimination on the grounds of religion, race, caste, sex, or place of birth. They also forbid trafficking of human beings and forced labour. They also protect cultural and educational rights of ethnic and religious minorities by allowing them to preserve their languages and also establish and administer their own education institutions.

Significance and characteristics

The Fundamental Rights were included in the constitution because they were considered essential for the development of the personality of every individual and to preserve human dignity. The writers of the constitution regarded democracy of no avail if civil liberties, like freedom of speech and religion were not recognized and protected by the State. According to them, "democracy" is, in essence, a government by opinion and therefore, the means of formulating public opinion should be secured to the people of a democratic nation. For this purpose, the constitution guaranteed to all the citizens of India the freedom of speech and expression and various other freedoms in the form of the Fundamental Rights.

All people, irrespective of race, religion, caste or sex, have been given the right to move the Supreme Court and the High Courts for the enforcement of their Fundamental Rights. It is not necessary that the aggrieved party has to be the one to do so. Poverty stricken people may not have the means to do so and therefore, in the public interest, anyone can commence litigation in the court on their behalf. This is known as "Public interest litigation". In some cases, High Court judges have acted on their own on the basis of newspaper reports.

These Fundamental Rights help not only in protection but also the prevention of gross violations of human rights. They emphasize on the fundamental unity of India by guaranteeing to all citizens the access and use of the same facilities, irrespective of background. Some Fundamental Rights apply for persons of any nationality whereas others are available only to the citizens of India. The right to life and personal liberty is available to all people and so is the right to freedom of religion. On the other hand, freedoms of speech and expression and freedom to reside and settle in any part of the country are reserved to citizens alone, including non-resident Indian citizens. The right to equality in matters of public employment cannot be conferred to overseas citizens of India.

Fundamental rights primarily protect individuals from any arbitrary state actions, but some rights are enforceable against individuals. For instance, the Constitution abolishes untouchability and also prohibits begar. These provisions act as a check both on state action as well as the action of private individuals. However, these rights are not absolute or uncontrolled and are subject to reasonable restrictions as necessary for the protection of general welfare. They can also be selectively curtailed. The Supreme Court has ruled that all provisions of the Constitution, including Fundamental Rights can be amended. However, the Parliament cannot alter the basic structure of the constitution. Features such as secularism and democracy fall under this category. Since the Fundamental Rights can only be altered by a constitutional amendment, their inclusion is a check not only on the executive branch, but also on the Parliament and state legislatures.

A state of national emergency has an adverse effect on these rights. Under such a state, the rights conferred by Article 19 (freedoms of speech, assembly and movement, etc.) remain suspended. Hence, in such a situation, the legislature may make laws which go against the rights given in Article 19. Also, the President may by order suspend the right to move court for the enforcement of other rights as well.

Right to equality

Right to equality is an important right provided for in Articles 14, 15, 16, 17 and 18 of the constitution. It is the principal foundation of all other rights and liberties, and guarantees the following:

Equality before law: Article 14 of the constitution guarantees that all citizens shall be equally protected by the laws of the country. It means that the State[5] cannot discriminate against a citizen on the basis of caste, creed, colour, sex, religion or place of birth.[13] According to the Electricity Act of 26 January 2003 the Parliament has the power to create special courts[14] for the speedy trial of offences committed by persons holding high offices. Creation of special courts is not a violation of this right.
Social equality and equal access to public areas: Article 15 of the constitution states that no person shall be discriminated on the basis of caste, colour, language etc. Every person shall have equal access to public places like public parks, museums, wells, bathing ghats and temples etc. However, the State may make any special provision for women and children. Special provisions may be made for the advancements of any socially or educationally backward class or scheduled castes or scheduled tribes.

Equality in matters of public employment: Article 16 of the constitution lays down that the State cannot discriminate against anyone in the matters of employment. All citizens can apply for government jobs. There are some exceptions. The Parliament may enact a law stating that certain jobs can only be filled by applicants who are domiciled in the area. This may be meant for posts that require knowledge of the locality and language of the area. The State may also reserve posts for members of backward classes, scheduled castes or scheduled tribes which are not adequately represented in the services under the State to bring up the weaker sections of the society. Also, there a law may be passed which requires that the holder of an office of any religious institution shall also be a person professing that particular religion. According to the Citizenship (Amendment) Bill, 2003, this right shall not be conferred to Overseas citizens of India.

Abolition of untouchability: Article 17 of the constitution abolishes the practice of untouchability. Practice of untouchability is an offense and anyone doing so is punishable by law. The Untouchability Offences Act of 1955 (renamed to Protection of Civil Rights Act in 1976) provided penalties for preventing a person from entering a place of worship or from taking water from a tank or well.

Abolition of Titles: Article 18 of the constitution prohibits the State from conferring any titles. Citizens of India cannot accept titles from a foreign State. The British government had created an aristocratic class known as Rai Bahadurs and Khan Bahadurs in India — these titles were also abolished. However, Military and academic distinctions can be conferred on the citizens of India. The awards of Bharat Ratna and Padma Vibhushan cannot be used by the recipient as a title and do not, accordingly, come within the constitutional prohibition". The Supreme Court, on 15 December 1995, upheld the validity of such awards.

Right to freedom

The Constitution of India contains the right to freedom, given in articles 19, 20, 21 and 22, with the view of guaranteeing individual rights that were considered vital by the framers of the constitution. The right to freedom in Article 19 guarantees the following six freedoms:[20]

Freedom of speech and expression, which enable an individual to participate in public activities. The phrase, "freedom of press" has not been used in Article 19, but freedom of expression includes freedom of press. Reasonable restrictions can be imposed in the interest of public order, security of State, decency or morality.
Freedom to assemble peacefully without arms, on which the State can impose reasonable restrictions in the interest of public order and the sovereignty and integrity of India.
Freedom to form associations or unions on which the State can impose reasonable restrictions on this freedom in the interest of public order, morality and the sovereignty and integrity of India.
Freedom to move freely throughout the territory of India though reasonable restrictions can be imposed on this right in the interest of the general public, for example, restrictions may be imposed on movement and travelling, so as to control epidemics.
Freedom to reside and settle in any part of the territory of India which is also subject to reasonable restrictions by the State in the interest of the general public or for the protection of the scheduled tribes because certain safeguards as are envisaged here seem to be justified to protect indigenous and tribal peoples from exploitation and coercion.
Freedom to practice any profession or to carry on any occupation, trade or business on which the State may impose reasonable restrictions in the interest of the general public. Thus, there is no right to carry on a business which is dangerous or immoral. Also, professional or technical qualifications may be prescribed for practicing any profession or carrying on any trade.
The constitution also guarantees the right to life and personal liberty, which in turn cites specific provisions in which these rights are applied and enforced:

Protection with respect to conviction for offences is guaranteed in the right to life and personal liberty. According to Article 20, no one can be awarded punishment which is more than what the law of the land prescribes at that time. This legal axiom is based on the principle that no criminal law can be made retrospective, that is, for an act to become an offence, the essential condition is that it should have been an offence legally at the time of committing it. Moreover, no person accused of any offence shall be compelled to be a witness against himself. "Compulsion" in this article refers to what in law is called "Duress" (injury, beating or unlawful imprisonment to make a person do something that he does not want to do). This article is known as a safeguard against self incrimination. The other principle enshrined in this article is known as the principle of double jeopardy, that is, no person can be convicted twice for the same offence, which has been derived from Anglo Saxon law. This principle was first established in the Magna Carta.

Protection of life and personal liberty is also stated under right to life and personal liberty. Article 21 declares that no citizen can be denied his life and liberty except by law. This means that a person's life and personal liberty can only be disputed if that person has committed a crime. However, the right to life does not include the right to die, and hence, suicide or an attempt thereof, is an offence. (Attempted suicide being interpreted as a crime has seen many debates. The Supreme Court of India gave a landmark ruling in the year 1994. The court repealed section 309 of the Indian penal code, under which people attempting suicide could face prosecution and prison terms of up to one year. In the year 1996 however another Supreme Court ruling nullified the earlier one) "Personal liberty" includes all the freedoms which are not included in Article 19 (that is, the six freedoms). The right to travel abroad is also covered under "personal liberty" in Article 21.

Critical analysis

The Fundamental Rights have been criticised for many reasons. Political groups have demanded that the right to work, the right to economic assistance in case of unemployment, old age, and similar rights be enshrined as constitutional guarantees to address issues of poverty and economic insecurity, though these provisions have been enshrined in the Directive Principles of state policy. The right to freedom and personal liberty has a number of limiting clauses, and thus have been criticized for failing to check the sanctioning of powers often deemed "excessive". There is also the provision of preventive detention and suspension of Fundamental Rights in times of Emergency. The provisions of acts like MISA (Maintenance of Internal Security Act) and NSA (National Security Act) are a means of countering the fundamental rights, because they sanction excessive powers with the aim of fighting internal and cross-border terrorism and political violence, without safeguards for civil rights. The phrases "security of State", "public order" and "morality" are of wide implication. The meaning of phrases like "reasonable restrictions" and "the interest of public order" have not been explicitly stated in the constitution, and this ambiguity leads to unnecessary litigation. The freedom to assemble peacably and without arms is exercised, but in some cases, these meetings are broken up by the police through the use of non-fatal methods.

"Freedom of press" has not been included in the right to freedom, which is necessary for formulating public opinion and to make freedom of expression more legitimate. Employment of child labour in hazardous job environments has been reduced, but their employment even in non-hazardous jobs, including their prevalent employment as domestic help violates the spirit and ideals of the constitution. More than 16.5 million children are employed and working in India. India was ranked 88 out of 159 in 2005, according to the degree to which corruption is perceived to exist among public officials and politicians worldwide. The right to equality in matters regarding public employment shall not be conferred to Overseas citizens of India, according to the Citizenship (Amendment) Bill, 2003.

Privileges are benefits enjoyed by an employee because of certain criteria, pending approval from higher management. i.e. Privileges are things to which one has a just claim ….BUT ..

[Privileges + Approval from Authority ≈ Rights]

Rights are the legal or moral entitlement to do or refrain from doing something or to obtain or refrain from obtaining an action, thing or recognition in civil society. Most modern concepts of rights are universalist and egalitarian, i.e. equal rights are granted to all people.

There are two kinds of rights: natural rights (certain list of rights enshrined in nature that cannot be legitimately modified by any human power) and legal rights (rights that are human constructs, created by society, enforced by governments and subject to change).

[Rights ≈ Privileges enjoyed Irrespective of Approval]
Eligibility is defined as condition(s)/requirement(s)/criteria that must be met/fulfilled in order to participate in a plan. An individual has to apply for the entitlements if all the required eligibility criteria are fulfilled.

Entitlement is a guarantee of access to benefits because of rights, or by agreement through law. It can also refer, in a more casual sense to someone's belief that he/she is deserving of some particular reward or benefit.

[Eligibility for Privileges → Fulfilment of Eligibility Criteria → Entitlement]

1. Privileges


2. Request/Apply for Entitlement


3. Eligibility


4. Approval from Authority


5. Entitlement GRANTED for Privileges


3.4. Defining Entitlement and Eligibility

Some key concepts must be defined early in the planning process to establish criteria of eligibility and entitlement for APs. This will reduce confusion in data collection and facilitate delivery of support and services to the entitled persons.

Affected Persons
APs are defined as those who stand to lose, as a consequence of the project, all or part of their physical and non-physical assets, including homes, communities, productive lands, resources such as forests, range lands, fishing areas, or important cultural sites, commercial properties, tenancy, income-earning opportunities, and social and cultural networks and activities. Such impacts may be permanent or temporary. This most often occurs through land expropriation, using eminent domain or other regulatory measures. They have no option but to reestablish elsewhere. People can also be affected through exposure to health and safety hazards which then force them to relocate.

Unit of Entitlement
The unit of entitlement may be an individual, a household, a family or a community. Bank policy recognizes the concept of household as a unit for data collection and impact assessment. As a rule, the unit of loss should determine the unit of entitlement. However, if more than one person has customary rights to a resource (for example, common property), the compensation may be shared by all. Households headed by women are to be recognized and compensated equally with households headed by men. Widowed women or divorcees living within male-headed households and having no legal rights to land may be considered as separate units for relocation purposes. Usually, major children within the household are not eligible for full entitlements, but are compensated for any lost assets and assisted to restore any lost livelihoods.

Loss and Eligible Impact
Defining loss and eligible impact is important because some losses are more visible or tangible than others. For example, loss of agricultural land, structures, or loss of crops do not require any definitions. Other losses, such as access to livelihood sources (for example, tenant or sharecroppers losing 'user rights' to land or wage laborers losing opportunities to work on land), require investigation to establish resettlement effects.

Establishing Eligibility Criteria for Resettlement
The three important elements of involuntary resettlement are : (i) compensation for lost assets, incomes, and livelihoods; (ii) assistance for relocation; and (iii) assistance for rehabilitation to achieve at least the same level of well-being with the project as without it. Bank policy requires analysis of the losses experienced for each case through census and survey. This is often subject to a "cut-off" date used to minimize fraudulent practices. In situations where APs are left with non-viable farm-holdings, project management should always allow income restoration and resettlement eligibility.

Valuation of entitlements and grievance methods
The Bank policy has no reference for valuating entitlements except for the general principle that APs should be at least as well off after the project as before it. In other words, valuation of their property and assets should be at the replacement value. Bank's practices also recognize this principle to ensure protection of interests and the well-being of the APs. In the case of non-inclusion in the APs list or inadequate compensation, an AP must have recourse to established dispute resolution and grievance procedures.

Compensation options
The Bank's policy refers to compensation, relocation of APs, and rehabilitation. There is no discussion of cash as a mode of compensation. However, Bank practices discourage cash compensation for land, except in cases with limited impact only, such as a strip of land required for a right of way that does not threaten livelihoods. Replacement land, "topping up" or additional cash grants to purchase land, job creation and employment, and often a mix of these options have been applied in many projects. APs should be offered multiple options, from which to choose to restore livelihood.

Income restoration programs
Income restoration programs should include both land-based and nonland-based options depending on the pre-project income-generating activities of APs. See Chapter 7 for a greater discussion of income restoration.

Rights vs. Privilege

Too often, people misconstrue the nature of rights and privilege. In the context of unionized labor forces, this confusion is widespread and apparent: unions couch employment in terms of one's "right" to work, while in more efficient, non-unionized workforces, employment is rightly seen as a privilege granted to the employee by the company for which he works.

Not for nothing are companies with non-unionized workforces (generally) performing better than companies with unionized workforces.

Similarly, the difference between privately-funded education and publicly-funded education can be seen in terms of the right vs. privilege dichotomy: private schools educate their children well because their employees understand they work not because of a contractual right to work, but because they are being given the privilege to teach young children and cultivate their minds.

Nowhere are the perverse incentives of the employment-is-a-right thinking more apparent than in this anecdote:

It was only the first day ofschool, and already Christyn Pope was in trouble. Pope, the principal at Chavez Elementary School in the Southcrest section of San Diego, gave a television news interview in which she happened tomention the fact that the school lawn had turned brown overthe summer and that the weeds were out of control. But that wasn't what landed Pope in hot water....

What got Pope in trouble that day was when she let slip the factthat some parents were interested in volunteering their time to pull the weeds and to fix broken sprinkler heads for the lawn. She had forgotten that the unionized landscapers had a right todo the work, and if they couldn't do it,no one was allowed to make sure the weeds were cut. "The union called me right away, and told me what I said was illegal," Pope told the San Diego Union Tribune, referring to the California School Employees Association, the union that represented the laid-off grounds keepers.

Note the odd language Pope chooses to use: "what I said was illegal." This is a strange inversion of the normal logic we Americans operate under: on the one hand, the unionized employees had a "right" to work, but, because their right was contractually protected, Pope's right to free speech--the parents want to help curtail weed growth--had been restricted

http://en.wikipedia.org/wiki/Entitlement

Entitlement

Entitlement is a guarantee of access to benefits because of rights, or by agreement through law. It can also refer, in a more casual sense to someone's belief that he/she is deserving of some particular reward or benefit.[1] It is often used as a negative term in popular parlance (i.e. a 'sense of entitlement'). The legal term, however, carries no value judgment: it simply denotes a right granted. It was issued in 1965 by President Johnson's administration.

In 2007, approximately 2/3 of the United States Federal budget consisted of entitlement payments.

In computer security, it can also refer to access control.

http://www.isixsigma.com/dictionary/Entitlement-236.htm

As good as a process can get without capital investment. Alt. A perceived "right to demand." Opposite of a gift, in that it is without appreciation. A "you owe me" obligation for which, I owe nothing in return.

http://en.wikipedia.org/wiki/Right

Right
In jurisprudence and law, a right is the legal or moral entitlement to do or refrain from doing something or to obtain or refrain from obtaining an action, thing or recognition in civil society. Compare with privilege, or a thing to which one has a just claim. Rights serve as rules of interaction between people, and, as such, they place constraints and obligations upon the actions of individuals or groups (for example, if one has a right to life, this means that others do not have the liberty to murder him).

Most modern conceptions of rights are universalist and egalitarian - in other words, equal rights are granted to all people. There are two main modern conceptions of rights: on the one hand, the idea of natural rights holds that there is a certain list of rights enshrined in nature that cannot be legitimately modified by any human power. On the other hand, the idea of legal rights holds that rights are human constructs, created by society, enforced by governments and subject to change.

By contrast, most pre-modern conceptions of rights were hierarchical, with different people being granted different rights, and some having more rights than others. For instance, the rights of a father to be respected by his son did not indicate a duty upon the father to return that respect, and the divine right of kings to hold absolute power over their subjects did not leave room for many rights to be granted to the subjects themselves. The concept of natural right developed in the School of Salamanca in the late 16th century, and first gained widespread acceptance nearly 200 years later, during the Age of Enlightenment.

It is not generally considered necessary that a right should be understood by the holder of that right; thus rights may be recognized on behalf of another, such as children's rights or the rights of people declared mentally incompetent to understand their rights. However, rights must be understood by someone in order to have legal existence, so the understanding of rights is a social prerequisite for the existence of rights. Therefore, educational opportunities within society have a close bearing upon the people's ability to erect adequate rights structures.

There are two fundamental controversies surrounding the notion of rights: First, there is the question of the basis for rights (on what basis rights can be said to exist). Second, there is the question of the content of rights (what the rights of a person actually are).

Types of rights

In modern English and European systems of jurisprudence and law, a right is the legal or moral entitlement to do or refrain from doing something or to obtain or refrain from obtaining an action, thing or recognition in civil society. Compare with duty, referring to behaviour that is expected or required of the citizen, and with privilege, referring to something that can be conferred and revoked.

The specific enumeration of rights accorded to citizens has historically differed greatly from one century to the next, and from one regime to the next, but nowadays is normally addressed by the constitutions of the respective nations. Generally speaking (within the English and European systems) a right corresponds with a complementary obligation that others have on the same object or realm; for instance if someone has a right on a thing, simultaneously another party or parties have an obligation to do something (or to abstain from doing something) in order to respect that right or to give concrete execution to that right.

Property rights provide a good example: society recognizes that individuals have title to particular property as defined by the transaction by which they acquired the property granting the individual free use and possession of the property. In many cases, especially regarding ideological and similar rights, the obligation depends on the legal system in its entirety, or on the state, or on the generical universality of other subjects submitted to the law.

Societal rights or civil rights are bestowed to its citizenry by society and are a set of obligations that are purported as a social contract. Societal rights are a privilege of membership and the benefits are limited to its members though may be extended to temporary guests. Access to societal rights are dependent government grants and on the citizen fulfilling their obligations e.g. complying with laws and paying taxes.

The right can therefore be a faculty of doing something, of omitting or refusing to do something or of claiming something. Some interpretations express a typical form of right in the faculty of using something, and this is more often related to the right of ownership of property. The faculty (in all the above mentioned senses) can be originated by a (generical or specific) law, or by a private contract (which is sometimes exactly defined as a specific law between or among volunteer parties).

Other interpretations consider the right as a sort of freedom of something or as the object of justice. One of the definitions of justice is in fact the obligation that the legal system has toward the individual or toward the collectivity to grant respect or execution to his/her/its right, ordinarily with no need of explicit claim.

Aristotle, in the Nicomachean Ethics (book five), claims that there is a large difference between written (generalized) justice and what is actually right for the (specific) individual.

(10-3) "But what obscures the matter is that though what is equitable is just, it is not identical with, but a correction of, that which is just according to law."

(10-4) "The reason of this is that every law is laid down in general terms, while there are matters about which it is impossible to speak correctly in general terms. Where, then, it is necessary to speak in general terms, but impossible to do so correctly, the legislator lays down that which holds good for the majority of cases, being quite aware that it does not hold good for all."

"The law, indeed, is none the less correctly laid down because of this defect; for the defect lies not in the law, nor in the lawgiver, but in the nature of the subject-matter, being necessarily involved in the very conditions of human action."

Rights can be divided into individual rights, that are held by citizens as individuals (or corporations) recognised by the legal system, and collective rights, held by an ensemble of citizens or a subgroup of citizens who have a certain characteristic in common. In some cases there can be an amount of tension between individual and collective rights. In other cases, the view of collective and individual rights held by one group can come into sharp and bitter conflict with the view of rights held by another group. For instance compare Manifest destiny with Trail of Tears.

With reference to the object of the right, a common general distinction is among:

Intellectual rights, which include:
Civil rights
Religious rights
Rights of opinion
Real rights (from the Latin word "res", thing), which include:
Property rights
Rights of use
Liberties
Personal rights, as a credit.
See also: human rights, exclusive rights, negative and positive rights, natural rights, civil rights, legal rights, contractual rights.

Important documents

Magna Carta (1215; England)
Required the king of England to renounce certain rights and respect certain legal procedures, and to accept that the will of the king could be bound by law.
Bill of Rights 1689 (England)
Declared that Englishmen, as embodied by Parliament, possess certain civil and political rights that can not be taken away.
Declaration of the Rights of Man and of the Citizen (1789; France)
One of the fundamental documents of the French Revolution, defining a set of individual rights and collective rights of the people.
United States Bill of Rights (1789/1791)
The first ten amendments of the United States Constitution.
Universal Declaration of Human Rights (1948)
An over-arching set of standards by which Governments, organisations and individuals would measure their behaviour towards each other. The preamble declares that the
"...recognition of the inherent dignity and of the equal and inalienable rights of all members of the human family is the foundation of freedom, justice and peace in the world..."

Other general Declarations from the UN have followed, notably the UN Convention on the Rights of the Child, 1989 [1].
European Convention on Human Rights (1950)
Adopted under the auspices of the Council of Europe to protect human rights and fundamental freedoms.
Canadian Charter of Rights and Freedoms (1982)
Its purpose is to protect rights of Canadian citizens from actions and policies of all levels of government.
Charter of Fundamental Rights of the European Union (2000)

Individual rights

"Individual rights" represent the moral rights of individuals in society prior to government. Individual rights are principles that identify and sanction certain interactions between individuals in a society while excluding others. For some theorists, individual rights delimit how the individual may use force in defense of person and property. Other theorists consider individual rights as describing the limits to which collective interests may be imposed on individuals.

Individual rights are distinct from civil or legal rights as these are rights granted by government to citizens and will vary with the organization and administration of governments. Individual rights identify a boundary of just social interactions in presence or absence of government.

Individual rights are sometimes held to be distinct from human rights, because human rights often references a basket of civil and individual rights. The former class of rights is often considered to include human goods and benefits (positive rights) rather than rights proper (negative rights.) Individual rights are an individual's moral claim to freedom of action. Such rights may be respected or recognized by others for reasons of reciprocity, contract, pragmatism, or as a moral imperative. Also some theorists believe an individual can forfeit their rights if that individual does not exercise reciprocal respect and restraint.

Social Control and Individual Rights

In Western discourse, individual rights are commonly assumed to be inversely related to social control. By contrast, much of the recent political discourse on individual rights in the People's Republic of China, particularly with respect to due process rights and rule of law, has focused on how protection of individual rights actually makes social control by the government more effective. For example, it has been argued that the people are less likely to violate the law if they believe that the legal system is likely to punish them if they actually violated the law and not punish them if they did not violate the law. By contrast, if the legal system is arbitrary then an individual has no incentive to actually follow the law.

People who argue that individual rights are more important than social control are called "individual rights advocates". Advocates tend to argue for increased civil rights. This is traditionally associated with liberalism.

Role of Government

Individual rights are often codified into law so that they may be protected by impartial third parties such as the government. Governments that respect individual rights often provide for systemic controls that protect individual rights such as a system of "due process" in criminal justice. These systems give rise to such civil rights as are necessary for the governemnt to administer justice. With respect to individual rights the role of the government is as a third party protecting, identifying and enforcing the rights of the individual while attempting to assure just remedies for transgressions. Police states are generally considered to be oppressive because they do not respect individual rights.

Rights are significant only where corresponding duties and responsibilities exist and people have the ability to enforce them - because society and individual survival depend on people relying on their ability to enforce rights people must be able to enforce those obligations where there is an absence or a betrayal of trust. Obligations are enforced by individuals and societal expectations and norms, but ultimately may require the ability or the actual enforcement by a government. The absence of a firm ability to enforce rights increases the risks associated with entering agreements and relying on rights, which limits individuals and societies ability to operate co-operatively.

The definition and upholding of individual rights is the core responsibility of any modern government.

In the United States, the Constitution outlines individual rights within the Bill of Rights. In Canada, the Canadian Charter of Rights and Freedoms serves the same function. One of the key differences between the two documents is that some rights in the Canadian Charter can be overridden by governments if they deliberately do so and "the resulting balance of individual rights and social rights remains appropriate to a free and democratic society" after the change. In practice, no Canadian government has ever chosen to face the political consequences of actually overriding the Charter. In contrast, in the United States, no such override exists (not even in theory, as is the case in Canada), and judicial activism has been the norm in the interpretation of the Bill of Rights; even a constitutional amendment could not remove these rights entirely, as they are considered inalienable under the natural rights principles the Constitution is founded upon.

What Rights

The idea of individual rights is closely related to the idea of individual capital in some theories of political economy, in which the individual enhances his or her own creative capacities (as opposed to measurable productive capacities, which is usually called the theory of human capital), and must remain free to do so in any way she or he sees fit. The most prominent advocate of this approach, called "development as freedom", is economist Amartya Sen. In this view, individual rights have the economic purpose of enabling each individual to optimize his or her capacity to make a unique contribution others cannot make.

More recent human development theory combines this view with a more rigorous ecological economics and means of measuring well-being. Individual rights such as "freedom from toxins" or "freedom to garden", e.g. cultivating hemp, assume a central role in most such theories, and have indeed been upheld in some countries, e.g. Canada, in which the individual is recognized as having a right to plant native plants in defiance of any social control, as part of the existing "right of free expression" and "freedom of conscience".

Some claim the Universal Declaration of Human Rights, 1948, and subsequent declarations, established individual rights, in theory, as the basis of international legal norms. Others claim exactly the opposite, that Declaration destroys individual rights rather than establishing them.

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Many thinkers dispute the validity of the distinction between negative and positive rights, which they see as being purely a matter of semantics. It can be said that any negative right involves an entitlement to protection against some form of abuse, and is therefore just as "positive" as a positive right. Others would counter that the exercise of negative rights doesn't require any action on the parts of others or the government (e.g., you could conceivably exercise free speech without anyone else acting to help you, whereas free health care cannot happen without actions from others).

Amendments

Changes in Fundamental Rights require a Constitutional amendment which has to be passed by a special majority of both houses of the Parliament. This means that an amendment requires the approval of two-thirds of the members present and voting. However, the number of members voting should not be less than the simple majority of the house — whether the Lok Sabha or Rajya Sabha.

The right to property was originally included as a fundamental right. However, the 44th Amendment passed in 1978, revised the status of property rights by stating that "No person shall be deprived of his property save by authority of law" to further the goals of socialism.[38]
The right to education at elementary level has been made one of the Fundamental Rights under right to life and personal liberty by the 86th constitutional amendment of 2002.[28]

Salient features of Allopathy and Homeopathy as system of medicine. Module 1

Allopathy is a term coined in the early 19th century by , Samuel Hahnemann, the founder of homeopathy, as a synonym for mainstream medicine. It was used by homeopaths to highlight the difference they perceived between homeopathy and conventional medicine, and its use remains common among homeopaths. The term derives from the Greek , állos, other, different + , páthos, suffering. The distinction comes from the use in homeopathy of substances that cause similar effects as the symptoms of a disease to treat patients (homeo - meaning similar). The term allopathy was meant to contrast the homeopathic approach with those conventional medical treatments that are different from or which directly counter a patient's symptoms; hence the terms allopathic and antipathic. Homeopaths saw such symptomatic treatments as "opposites treating opposites". However, many conventional medical treatments do not fit this definition of allopathy, as they seek to prevent illness, or remove the cause of an illness by acting on theetiology of disease.

As used by homeopaths, the term allopathy has always referred to the principle of curing disease by administering substances that produce other symptoms (when given to a healthy human) than the symptoms produced by a disease. For example, part of an allopathic treatment for fever may include the use of a drug which reduces the fever, while also including a drug (such as an antibiotic) that attacks the cause of the fever (such as a bacterial infection). A homeopathic treatment for fever, by contrast, is one that uses a diluted and succussed dosage of a substance that in an undiluted and unsuccussed form would induce fever in a healthy person. Hahnemann used this term to distinguish medicine as practiced in his time from his use of infinitesimally small doses of substances to treat the spiritual causes of illness.

Maharasthra is the only state in India which allows homeopaths to presecribe allopathic medicines. Chief Minister Narayan Rane said there was a long pending demand in this regard from the medical fraternity and government took the decision after giving a detailed thought. ``Homeopaths who completed their degree/diploma after taking admissions to the medical colleges before or during the period 1992-93 would have to undergo a special 6-month long course to learn necessary allopathic techniques. They will be allowed to prescribe allopathic medicines after succeeding in the course,'' said Rane.
Stating that there were about 29,000 homeopaths in the State, the CM said that the government's decision would not violate a Supreme Court judgement preventing homeopahts from practising allopathy.

Homeopathy is form of alternative medicine formulated by Samuel Hahnemann by which a disease is treated by prescribing the lowest possible dose which causes symptoms similar to disease.

Strengths and Weaknesses of Allopathy and Homeopathy

HomeopathyAllopathy
StrengthsIt is useful for chronic diseases which have no cure

Negligible costs,

fast acting,

best for viral infections,

most potent in long-term use,

suited for chronic diseases,

tones up the immune and the nervous systems when used judiciously,

attempts to cure rather than control.

It is very useful for acute condition and surgical problems

Fast acting.

Best for any crisis situation.

Surgery is a major plus and has made impressive advances.

Ease of diagnosis and medicine-selection. Highly trained and qualified doctors; especially effective in the short run for bacterial infections.

Allopathy is well-supported by scientific research

WeaknessesHomeopathy is unsupported by modern scientific research

Very difficult medicine-selection, can have a lot of side-effects if the correct medicine/ potency/dose-frequency is not chosen,

poor quality of doctors who attempt to use short-cuts with damaging consequences,

hardest to master and administer among all therapies.

The most ‘unnatural’ of all therapies. Depresses the immune system.

Full of side-effects.

Emphasis on short-term symptomatic relief rather than on permanent cure.

Highly expensive, system-invasive drugs and procedures.


Monday 15 February 2010

Arrest. Module 4

An arrest is the act of depriving a person of his or her liberty usually in relation to the investigation and prevention of crime.

The term is Anglo-Norman in origin and is related to the French word arrêt, meaning "stop".



Blood Bank. Module 4

Blood Bank

A place where blood is collected from donors, typed, separated into components, stored, and prepared for transfusion to recipients.

A blood bank may be a separate free-standing facility or part of a larger laboratory in a hospital.




Drugs and Cosmetics Rules, 1945, in Schedule K

Drugs and Cosmetics ( 10th Amendment) Rules, 2001

Class of Drugs "5B. Whole Human Blood I.P. and / or its components stored for transfusion by a First Referral Unit, Community Health Centre, Primary Health Centre and a Hospital

Ethical issues in transfusion medicine

The practice of transfusion medicine involves a number of ethical issues because blood comes from human beings and is a precious resource with a limited shelf life. In 1980 the International Society of Blood Transfusion endorsed its first formal code of ethics, which was adopted by the World Health Organisation and the League of Red Crescent Societies. A revised code of ethics for donation and transfusion was endorsed in 2000.

Blood donation as a gift, donor confidentiality, donor notification and donor consent, consent for transfusion, the right to refuse blood transfusion, the right to be informed if harmed, and ethical principles for establishments, are discussed in the international and Indian contexts.

Ethics is basically a set of moral values or a code of conduct. The role of ethics in developing clinical practice guidelines and recommendations for health-care providers is to ensure that values that may not be adequately incorporated into the law are given reasonable consideration. The framers and the users of guidelines must be aware of the potential ethical conflicts inherent in many medical decisions, and the guidelines must reflect a thoughtful consideration and balancing of issues.

The practice of transfusion medicine involves a number of ethical issues because blood comes from human beings and is a precious resource with a limited shelf life. It involves a moral responsibility towards both donors and patients. Decisions must be based on four principles: respect for individuals and their worth, protection of individuals' rights and well being, avoidance of exploitation, and the Hippocratic principle of primum non nocere or "first do no harm".

History of transfusion ethics

Ethics is a dynamic process in relation to the state of scientific knowledge, public awareness and the local laws, at any given
time and place. This is clear when we review the history of transfusion ethics (1). The earliest mention of human transfusion, in 1492, describes efforts to save the life of Pope Innocent VIII. Blood was extracted from three 10-year-old boys and transfused to the Pope. All three boys and the Pope died. Some two centuries later transfusion was attempted again. In 1667, Dr Richard Lower transfused sheep's blood to a mentally-ill man to cure him. The patient was given 20 shillings to undergo this experiment. The same year a 34-year-old man underwent repeat transfusions of calf's blood. This resulted in a classical haemolytic transfusion reaction and the court banned future transfusions.

Human-to-human transfusion was resurrected by James Blundell, a London obstetrician, to save the lives of women with obstetric haemorrhage. By the early twentieth century, a number of advances had been made in transfusion medicine, in the form of the discovery of blood groups and preservation, making transfusion safer. HIV brought transfusion safety into public awareness. It also brought up ethical issues in relation to both donors and patients.

After approximately 1,000 transfusion/fraction-transmitted HIV infection cases occurred in 1982-83, in 1992 the Krever Enquiry (2) ruled that the Canadian Red Cross (CRC) erred in not barring gay men from donating blood when it was known that AIDS was almost exclusively a disease of gay men, and the American Association of Blood Banks had debarred them from donating blood. The CRC replied that it was trying not to discriminate against gay people. The court upheld that "public rights are higher than the individual's right".

ISBT code of ethics

In 1980 the International Society of Blood Transfusion (ISBT) endorsed its first formal code of ethics. It was later also endorsed and adopted by the World Health Organisation and the League of Red Crescent Societies. A revised code of ethics for blood donation and transfusion was endorsed in 2000, with inputs from various concerned organisations. It gave recommendations regarding the ethical responsibilities of the donor, the collection agency and the prescribing authority toward the well being
of the recipient and the community at large (3). This code is reproduced below:

A code of ethics for blood donation and transfusion

The objective of this code is to define the ethical principles and rules to be observed in the field of transfusion medicine.

1. Blood donation, including haematopoietic tissues for transplantation shall, in all circumstances, be voluntary and non-remunerated; no coercion should be brought to bear upon the donor. The donor should provide informed consent to the donation of blood or blood components and to the subsequent (legitimate) use of the blood by the transfusion service.

2. Patients should be informed of the known risks and benefits of blood transfusion and/or alternative therapies and have the right to accept or refuse the procedure. Any valid advance directive should be respected.

3. In the event that the patient is unable to give prior informed consent, the basis for treatment by transfusion must be in the best interests of the patient.

4. A profit motive should not be the basis for the establishment and running of a blood service.

5. The donor should be advised of the risks connected with the procedure; the donor's health and safety must be protected. Any procedures relating to the administration to a donor of any substance for increasing the concentration of specific blood components should be in compliance with internationally accepted standards.

6. Anonymity between donor and recipient must be ensured except in special situations and the confidentiality of donor information assured.

7. The donor should understand the risks to others of donating infected blood and his or her ethical responsibility to the recipient.

8. Blood donation must be based on regularly reviewed medical selection criteria and not entail discrimination of any kind, including gender, race, nationality or religion. Neither donor nor potential recipient has the right to require that any such discrimination be practised.

9. Blood must be collected under the overall responsibility of a suitably qualified, registered medical practitioner.

10. All matters related to whole blood donation and haemapheresis should be in compliance with appropriately defined and internationally accepted standards.

11. Donors and recipients should be informed if they have been harmed.

12. Transfusion therapy must be given under the overall responsibility of a registered medical practitioner.

13. Genuine clinical need should be the only basis for transfusion therapy.

14. There should be no financial incentive to prescribe a blood transfusion.

15. Blood is a public resource and access should not be restricted.

16. As far as possible the patient should receive only those particular components (cells, plasma, or plasma derivatives) that are clinically appropriate and afford optimal safety.

17. Wastage should be avoided in order to safeguard the interests of all potential recipients and the donor.

18. Blood transfusion practices established by national or international health bodies and other agencies competent and authorised to do so should be in compliance with this code of ethics.

Some important issues are being highlighted:

Ethical issues related to donors

Blood donation as a gift: The WHO recommends that national blood services should be based on voluntary, non-remunerated blood donation. No one should be forced to donate, for family or economic or any other reason. The trade of human blood and body parts is unethical. "The dignity and worth of the human being should be respected." (4)

Non-remunerated blood donation is considered a gift and the blood centre has a right to accept or defer it if unacceptable. Donor deferral might appear as discrimination and a violation of a human right, but the patient's right to safer blood is more important than the donor's right to not to discriminated against, as blood centres are made to help patients and not donors.

Donor confidentiality, donor notification and donor consent: Donor confidentiality is an important issue. Personal information disclosed by the blood donor during the course of a pre-donation interview and information obtained from the various tests performed on the donated component, are expected to be held in confidence by the donor centre (4).

Donor screening and testing used to be simple. Today's donors are asked intimate questions about their lifestyles and put through a battery of laboratory tests. This has had significant repercussions for the relationships between blood centres, blood donors, physicians and patients. The blood donor, an ostensibly healthy individual until notified of an abnormal result by the blood centre, may seek a physician's advice and doubt the creditability of the testing procedure and deferral policies. A more specific test might turn out to be negative and the donor may be labelled as healthy. This donor might return to the blood centre asking for compensation for the unnecessary mental anguish and the expenses incurred and might never donate again.

The donor room personnel and the donor may have misunderstandings about confidentiality. There is often a tension in donor centres between the need to keep the donor information confidential and the need to disclose relevant information to third parties such as family members, employers, public health authorities and police officers.

Blood safety depends partly on the information provided by the donor and it is also the donor's ethical duty to provide truthful information. It is unethical to wilfully conceal information about high-risk behaviour or medical history.

Ethical issues related to patients

Ethical issues related to patients include access to risk-free safe blood free of charge or need of replacement, informed consent for transfusion, the right to refuse the transfusion, and the right to be informed if harmed.

Consent for transfusion: Consent for transfusion has to be informed consent (5). The patient should be informed of the known risks and benefits of transfusion, and alternative therapies such as autologous transfusion or erythropoietin. Only then should the consent be documented. If the patient is unable to give prior informed consent, the basis of treatment by transfusion should be in the best interests of the patient.

Right to refusal: The patient's right to refuse blood transfusion should be respected (6). Some religious sects such as Jehovah's Witnesses do not accept blood transfusions (7). Followers of this belief live in India as well and there have been instances of blood refusal here.

Right to be informed if harmed: If the patient has been transfused blood and components that were not intended for him/her, whether harmed or not, he/she has the right to be informed (6, 8). Similarly a patient who has inadvertently received blood positive for a transfusion transmissible marker has a right to be informed and given due compensation.

Ethical principles for blood establishments: A profit motive should not be the basis of establishing and running blood transfusion services. Wastage should be avoided to safeguard the interests of all potential donors and recipients (3).

The situation in India

With the rising awareness of ethical issues in every field of medical care and research in India, awareness is growing in the field of transfusion medicine as well. But we are nowhere near the international code of ethics.

In the 1990s, in response to a public interest litigation a Supreme Court order banned professional blood sellers and directed the government to formulate a national blood policy. The National Blood Transfusion Council, with the National Blood Policy as a tool, and the Drugs Controller, with the help of the Drugs and Cosmetics Act, now aim to ensure blood safety and ethical transfusion practices in India.

Currently under the Drugs and Cosmetics Act it is mandatory to test blood for anti-HIV 1 and 2, anti-HCV, HBsAg and RPR for syphilis (9). Consent for testing is taken and the donor is given the option of receiving the results – this is mandatory in some countries such as the US and UK.

Until recently donors were not informed because specific consent for testing was not taken (10), and the screening tests had relatively high false positive rates, which could cause panic. No confirmatory tests were required. So the donation system was projected as anonymous and unlinked and adequate counselling was not available. The National Blood Policy of 2002 has addressed this gap (11).

The Code of Medical Ethics, that is binding on doctors, honours confidentiality. However, in a court of law in India, this privilege is not absolute but qualified. Doctors can reveal information in the interest of individual or general welfare of society and when there is no mal-intention.

Ethical issues are mostly violated in relation to the patient in India. Patients all over the country do not have access to safe blood, free of charge, or the option of giving consent and choosing safer alternatives. With the National Blood Policy, a decision was taken to improve transfusion services all over the country and create greater awareness about transfusion issues. The policy must also address all the other issues in the international code of ethics for blood donation and transfusion to make India achieve international standards.

References

1. Rossi EC, Simon TL. Transfusion in the new millennium. In: Simon TL, Dzik WH, Snyder EL, Stowell CP, Strauss RG, editors. Rossi's principles of transfusion medicine. 3rd ed. Philadelphia: Lippinkott William and Wilkins; 2002. p 1-13.

2. Hoey J. Human rights, ethics and the Krever enquiry. CMAJ 1997; 157: 1231.

3. International Society of Blood Transfusion [homepage on the Internet]. A code of ethics for blood donation and blood transfusion. [cited 2006 June 15]. Available from: http://www.isbt-web.org/files/documentation/code_of_ethics.pdf

4. Macpherson CR, Domen RE, Perlin T, editors. Ethical issues in transfusion medicine. Bethesda: American Association of Blood Banks Press; 2000.

5. Stowell C, editor. Informed consent for blood transfusion. Bethesda: American Association of Blood Banks Press; 1997.

6. Macpherson JL, Mansfield EM. Medicolegal aspects of blood transfusion. In: Simon TL, Dzik WH, Snyder EL, Stowell CP, Strauss RG, editors. Rossi's principles of transfusion medicine. 3rd ed. Philadelphia: Lippinkott William and Wilkins; 2002. p 927-39.

7. Muramato O. Bioethical aspects of recent changes in the policy of refusal of blood by Jehovah's witnesses. BMJ 2001; 322: 37-39.

8. Mann JM. Medicine and public health, ethics and human rights. Hastings Cent Rep 1997; 27(3): 6-13.

9. Government of India. Drugs and Cosmetics Rules, 1945 (amended till 30th June 2005). [cited 2006 July 20]. Available from: http://www.cdsco.nic.in/html/Drugs&CosmeticAct.pdf

10. Watwe JM. Disclosure of confidential medical information. Issues Med Ethics 1998; 6: 56-7.

Ministry of Health and Family Welfare. National Blood Policy. National AIDS Control Organization, Government of India 2002. [cited 2006 July 20]. Available from: http://www.nacoonline.org/prog_policyblood.htm

32 out of 36 errors in 'Clinical Pathology' occur in the 'Blood bank'.

Wednesday 10 February 2010

Patient's Rights. Module 4

14 Rights of Patients

1. Right to Preventive Measures
Every individual has the right to a proper service in order to prevent illness.

2. Right to Access
Every individual has the right of access to the health services that his or her health needs require. The health services must guarantee equal access to everyone, without discriminating on the basis of financial resources, place of residence, kind of illness or time of access to services.

3. Right to Information
Every individual has the right to access to all kind of information regarding their state of health, the health services and how to use them, and all that scientific research and technological innovation makes available.

4-Right to Consent
Every individual has the right of access to all information that might enable him or her to actively participate in the decisions regarding his or her health; this information is a prerequisite for any procedure and treatment, including the participation in scientific research.

5-Right to Free Choice
Each individual has the right to freely choose from among different treatment procedures and providers on the basis of adequate information.

6-Right to Privacy and Confidentiality
Every individual has the right to the confidentiality of personal information, including information regarding his or her state of health and potential diagnostic or therapeutic
procedures, as well as the protection of his or her privacy during the performance of diagnostic exams, specialist visits, and medical/surgical treatments in general.

7-Right to Respect of Patients’ Time
Each individual has the right to receive necessary treatment within a swift and predetermined period of time. This right applies at each phase of the treatment.

8-Right to the Observance of Quality Standards
Each individual has the right of access to high quality health services on the basis of the specification and observance of precise standards.

9-Right to Safety
Each individual has the right to be free from harm caused by the poor functioning of health services, medical malpractice and errors, and the right of access to health services and treatments that meet high safety standards.

10-Right to Innovation
Each individual has the right of access to innovative procedures, including diagnostic procedures, according to international standards and independently of economic or financial considerations.

11-Right to Avoid Unnecessary Suffering and Pain
Each individual has the right to avoid as much suffering and pain as possible, in each phase of his or her illness.

12-Right to Personalized Treatment
Each individual has the right to diagnostic or therapeutic programmes tailored as much as possible to his or her personal needs.

13-Right to Complain
Each individual has the right to complain whenever he or she has suffered a harm and the right to receive a response or other feedback.

14-Right to Compensation
Each individual has the right to receive sufficient compensation within a reasonably short time whenever he or she has suffered physical or moral and psychological harm caused by a health service treatment.

------------------------------------------------
Basic rights of patients —
right to access healthcare,
right to emergency care,
right to information,
right to privacy,
right to autonomy and decision making,
right to quality care and
right to seek redressal.




THE CONSUMER PROTECTION ACT ENSHRINES THE FOLLOWING RIGHTS OF CONSUMER:
Right to be protected from hazardous goods and services
Right to be informed about the quality and performance of goods and services
Rights to free choice of goods and services
Right to be heard in decision making process concerning consumer interests
Right to redressal if consumer rights are infringed
Right to consumer education

THE PATIENT AS A CONSUMER

Traditionally, patients in India have unquestioning trust in their doctors. Most doctors deserve it. But in some cases, medical negligence has resulted in severe harm physical, mental and financial . In addition, Unqualified practitioners have brought suffering to gullible patients. Doctors have been liable to prosecution in civil court, but few malpractice victims sue for compensation, fearing years (even decades) of costly litigation. Fortunately, in 1995 the Supreme Court decreed the medical profession to be a "service" under the Consumer Protection Act, 1986.It set aside a writ Petition challenging the same by the Indian medical Association.

WHAT IS MEDICAL NEGLIGENCE?

Medical negligence is defined as a failure to exercise reasonable skill and care in diagnosis and treatment as per the prevalent standards as that particular point of time. An aggrieved patient who believes that he is a victim of medical negligence can now approach the Consumer Courts for fair compensation, and expect results in a relatively shorter period of two to three years. The procedure is comparatively simple and inexpensive.

THE PATIENT'S RIGHTS

In the interest of a healthy doctorpatient relationship, A patient should Know his rights as a consumer:

1. You have a right to be told all the facts about your illness; to have your medical records explained to you; and to be made aware of risks and side effects, if any, of the treatment prescribed for you do not hesitate to question your doctor about any of these aspects.
2. When you are being given a physical examination, you have a right to be handled with consideration and due regard for your modesty.
3. You have a right to know your doctor's qualifications. If you cannot evaluate them yourself, do not hesitate to ask someone who can.
4. You have a right to complete confidentiality regarding your illness.
5. If you are doubtful about the treatment prescribed and especially an operation suggested, you have a right to get a second opinion from any specialist.
6. You have a right to be told in advance what an operation is for and the possible risks invoved. If this is not possible because of your being unconscious or for some other reasons, your nearest relatives must be told before they consent to the operation.
7. If you are to be discharged or moved to another hospital, you have a right to be informed in advance and to make your own choice of hospital of nursing home, in consultation with the doctor.
8. You have a right to get your case papers upon request.

A PATIENT'S PRECAUTIONS UNDERGOING OR PLANNING MEDICAL TREATMENT

1. Make sure you have told all relevant facts to the doctor before deciding any treatment.
2. Unless it is a life threatening emergency, the final decision about the treatment should be taken after proper deliberation and/or second opinion.
3. Please seek clarification for all the doubts regarding diagnosis/treatment/investigation.
4. Discuss with your doctor the cost of the treatment. Please make sure the cost includes possible complications.
5. During the treatment, If you are not satisfied with any aspect and/or have doubts, seek clarification from the doctor.
6. Keep all receipts/prescriptions/reports/discharge cards safely and keep extra photo copies.
7. After treatment clarify all doubts regarding bills/payments etc before discharge.
8. Involve your family physician in the discussion with the specialist doctor.
9. In case of a deth during the treatment, if you are not satisfied with the cause of death, demand a post mortem examination and get copies of the entire Indoor Case Record. This is the right of every patient/legal heir.
10. It is necessary and correct to discuss with the concerned doctor all the doubts before resorting to any legal action. Many of the complications/delays/mishaps in any medical treatment can be genuine.
11. In case you require expert medical advice regarding the legitimacy of your complaint about medical malpractice or deficiency in service you may approch the Association for Consumer Action on Safety and Health (ACASH) or any similar organisation.

CPA AND MEDICAL NEGLIGENCE

The Consumer protection Act 1986 (CPA) is a unique legislation which provides for speedy and economical redressal in a simple manner. It has been held in a number of cases under CPA that instances of medical negligence are covered by CPA. Given below is a brief of the provisions under CPA.
Those unfortunate enough to experience gross malpractice may approach (in writing or in person) the District Consumer Disputes Redressal Forum when the compensation claims amount to less than Rs.5 Lakhs. Claims between Rs.5 Lakhs and Rs.20 Lakhs may be taken to the State Consumer Dispute Commission. Claims above Rs.20 Lakhs may be placed before the National Consumer Disputes Redressal Commission. The addresses of the above bodies may be obtained from your local consumer organisation. All complaints must be endored by the written opinion of two expert specialists in the medical field.

CHECK IF YOUR COMPLAINT COVERS THE FOLLOWING POINTS

1. Name and Address of the complainant in full.
2. Name and Address of the opposite parties.
3. When and where cause of the complaint arose.
4. Particulars of the complaint in detail along with supporting documents as exhibits.
5. Relief prayed. such as replacement/removal of defect or return of price/compensation for expenses incurred & physical/mental torture, if any. While asking for claims the amount should be within reasonable limits and justifiable.
6. The entire set of papers regarding the complaint, along with exhibits, is to be given in 1+3 sets and one set each for every aditional opposite party.

INSTRUCTIONS

1. The relief claimed by you should be in clear word.
2. The complaint can be sent in Marathi,Hindi or English. If the company's office is in another State, it is better to make the complaints in English.
3. The complaint should not be on a post card.
4. Three copies of the complaint, together with all the annexures for the Forum and extra sets for each of the opponents should be filed, together with the above three copies.
5. The complaint can be sent by post.
6. Complaints of a representative nature may be filed by registered Consumer Organisations Like Consumer Guidance Society of India.

Suspension of HIV positive person's Right to marriage. Module 4

The suspension of the legal right to marry of people living with HIV/AIDS - Child's rights.

Issues involved:
Right to health
Universal Declaration of Human Rights (Article 25)
Article12.1 International Covenant on Economic, Social and Cultural Rights
Concept of discrimination Article 14,15,16 of Constitution of India
Fundamental Rights Chapter (Part III) of the Constitution
Article 21 Right to Health
Article 27
Vincent Parikulangara v Union of India 1987 (2) SCC 165 AIR 1987 SC 990

Supreme Court of India delivered a judgement in Sept 98 that the law imposes a duty on a person living with HIV/AIDS effect of spreading the infection of his own discease, which is obviously dangerous to life, to the woman he marries.

Supreme Court of India - Right to Marry

Mr. X v. Hospital Z (1998) 8 SCC 296, AIR 1998 SCW 3662 -- Supreme Court of India (Right to Marry)

MR. X (The Appellant) obtained the Degree of MBBS in 1987. In June, 1990 he joined a state Government's state medical and health service as Assistant Surgeon Grade-I. In September, 1991 he joined the further course of Diploma in Opthamalogy which he completed in April, 1993. In August, 1993 he resumed his duties in the State Health service as Assistant Surgeon Grade - I.

Mr. X's uncle who was a minister in the state government was ailing from a disease which was provisionally diagnosed as Aortic Anuerism. He was advised to go to the 'Z' Hospital and Mr. X was directed by the Government of the State to accompany the said patient to the South of India for treatment. He was posted for surgery on May 31, 1995 which, however, was cancelled due to shortage of blood. On June 1, 1995 Mr. X and his driver were asked to donate blood for the operation. Their blood samples were taken and the result showed that Mr. X's blood group was A(+ve). However, Mr. X was not disclosed the result of his tests at all.

In August 1995 the appellant proposed marriage to one Ms. 'Y' which was accepted and the marriage was proposed to be held on December 12, 1995. In the meantime the Hospital informed the minister that Mr. X's blood had tested positive for HIV. When he came to know of this Mr. X himself called of the marriage. The appellant went again to the respondents' hospital where several tests were conducted and he was confirmed HIV(+ve). Since the marriage had been settled but was subsequently called off, several people including the members of the appellant's family and persons belonging to his community became aware of the appellant's HIV(+ve) status. This resulted in severe criticism of the appellant and he was ostracized by the community. The appellant left his State around November 26, 1995.

The appellant then approached the National Consumer Disputes Redressal Commission for damages against the respondents, on the ground that the information which was required to be kept confidential at common law and under medical ethics was disclosed illegally and, therefore, the respondents were liable to pay damages. The Commission dismissed the Petition summarily by its order dated 3rd July 1998 on the ground that the appellant may seek his remedy in the civil court.

Mr. X therefore approached the Supreme Court. The question of law before the court was whether the National Consumer Forum had the jurisdiction to entertain a case in which the plaintiff was HIV positive and whose status was disclosed by the hospital to 3rd parties. The Supreme Court, however, chose to pass a judgment on merits of the issues and held:

a. Although the doctor-patient confidentiality was important and part of the medical ethics incorporated by the then Medical Council Act, a patient's right to confidentiality was not enforceable in a situation where the patient is HIV positive, if he stood the risk of spreading it to his prospective spouse.

b. Since HIV is fatal and the life of the spouse has to be saved, the right to privacy of the patient is not absolute in this situation and may be restricted. There is nothing wrong, therefore, in Hospital informing the prospective spouse of Mr. X's HIV status.

c. Since Indian matrimonial laws provide venereal disease as a ground for divorce, a person suffering from a VD has no right to get married till s/he is fully cured and such right must be treated as a 'suspended right'.

d. Since acts likely to spread communicable diseases is a crime under the Indian Penal Code, the failure of the hospital to inform the spouse of the disease would make them participant criminals.

e. Patients suffering from 'AIDS' deserve full sympathy; they are entitled to all respects as human beings. They must have their avocation and jobs etc. cannot be denied to them.

Against this Judgement application were filed to review and clarify.




Do HIV positive patients have a right to marry?

Prof Gopinath N Shenoy

A very interesting issue recently came up before the Hon’ble Supreme Court of India. The issue was to decide whether an HIV positive patient has a right to marry! Justice S Saghir Ahmad, decided this issue along with many other issues and said that every young man or, for that matter, a woman’s right to marry cannot be accepted in the absolute terms in which it is being contended. With regard to age and biological needs, a person may have a right to marry but this right is not without a duty.

Ifa person is suffering from any communicable venereal disease or is impotent so that the marriage has a chance of resulting in a complete failure or that his wife would seek divorce from him on that ground, that person is under a moral, as also a legal duty to inform the woman with whom the marriage is proposed that he was not physically healthy and that he was suffering from a disease which was likely to be communicated to her.

Marriage is the sacred union of two healthy bodies of opposite sexes, legally permissible. It has to be mental, psychological and a physical union. When two souls thus unite, a new soul comes into existence. That is how, the life goes on, on this planet.

Mental and physical health is of prime importance in a marriage, as one of the objects of the marriage is the procreation of equally healthy children. That is why, in every system of matrimonial law, it has been provided that if a person was found to be suffering from any venereal disease in a communicable form, it will be open to the other partner in the marriage to seek divorce. Reference can be made to Section 13(i)(v) of the Hindu Marriage Act, 1955 which provides that any marriage solemnised, whether before or after the commencement of the Act, may on a petition presented by either the husband or the wife, be dissolved by a decree of divorce on the ground that the other party has been suffering from venereal disease in a communicable form.

Section 2 of the Dissolution of Muslim Marriages Act, 1939 sets out that if the husband is suffering from a virulent venereal disease, a woman married under Muslim Law to such person shall be entitled to obtain a decree for dissolution of her marriage.

Under the Parsi Marriage and Divorce Act, 1936, one of the grounds for divorce set out in Section 32 is that the defendant has, since the marriage, infected the plaintiff with venereal disease.

Under the Indian Divorce Act, 1869, the grounds for dissolution of a marriage have been set out in Section 10 which provides that a wife may petition for dissolution if her husband was guilty of incestous adultery, bigamy with adultery or of rape, sodomy or bestiality.

Under Section 27 of the Special Marriage Act, the party to a marriage has been given the right to obtain divorce if the other party to whom he or she was married was suffering from venereal disease in a communicable form. The emphasis, therefore, in practically all systems of marriage is on a healthy body with moral ethics. Once the law provides the “venereal disease” as a ground for divorce to either husband or wife, such a person who was suffering from that disease, even prior to the marriage cannot be said to have any right to marry so long as he is not fully cured of the disease.

If the disease, with which he was suffering, would constitute a valid ground for divorce, was concealed by him and he entered into marital ties with a woman who did not know that the person with whom she was being married was suffering from a virulent venereal disease, that person must be injuncted from entering into marital ties so as to prevent him from spoiling the health and, consequently, the life of an innocent woman.

In this situation, the right to marry and duty to inform about his ailment are vested in the same person. Moreover, so long as the person is not cured of the communicable venereal disease or impotency, the right to marry cannot be enforced through a court of law and shall be treated to be a ‘Suspended Right’.

Learned Justice Sagir Ahmed expressed another aspect of this matter as well. Sections 269 of the Indian Penal Code provided that whoever unlawfully or negligently does any act which is, and which he knows or has reason to believe to be, likely to spread the infection of any disease dangerous to life, shall be punished with imprisonment of either description for a term which may extend to six months, or with fine, or with both (negligent act likely to spread infection of disease dangerous to life).

Section 270 of the Indian Penal Code also states whoever malignantly does any act which is, and which he knows or has reason to believe to be, likely to spread the infection of any disease dangerous to life, shall be punished with imprisonment of either description for a term which may extend to two years, or with fine, or with both (malignant act likely to spread infection of disease dangerous to life).

These two sections spell out two separate and distinct offences by providing that if a person, negligently or unlawfully, does an act which he knew was likely to spread the infection of a disease, dangerous to life, to another person, then the former would be guilty of an offence, punishable with imprisonment for the term indicated therein. Therefore, if a person suffering from the dreadful disease Aids, knowingly marries a woman and thereby transmits infection to that woman, he would be guilty of offences indicated in Sections 269 and 270 of the Indian Penal Code.

Learned Justice Sagir Ahmed was of the opinion that the above statutory provisions thus impose a duty upon the infected person not to marry as the marriage would have the effect of spreading the infection of his own disease, which obviously is dangerous to humanity,

apart from the woman whom he marries. Aids is the product of undisciplined sexual impulse. This impulse, being the notorious human failing if not disciplined, can afflict and overtake anyone how high so ever or, for that matter, how low he may be in the social strata.

The patients suffering from the dreadful disease Aids deserve full sympathy. They are entitled to all respects as human beings. Their society cannot, and should not be avoided, which otherwise, would have bad psychological impact upon them. They have to have their avocation. Government jobs or service cannot be denied to them as has been laid down in some American decisions (School Board of Nassau Country, Florida vs. Airline (1987) 107 S Ct 1123; Chalk vs USDC CD of Cal (9th Circuit 1988) 840 2F 2d 701; Shuttleworth vs Broward Cty (SDA Fla 1986) 639 F Supp 654; Raytheon vs Fair Employment and Housing Commission, Estate of Chadbourne (1989) 261 Cal Reporter 197). But, sex with them or possibility thereof has to be avoided as otherwise they would infect and communicate the dreadful disease to others. The Court cannot assist that person to achieve that object.

Infringement of ’Suspended Right to Marry’ could not be legally compensated by damages either in torts or common law. Subsequent to this ruling of the Hon’ble Supreme Court another petition was filed before a three-Judge-Bench of the same Court. The issue to be decided was whether it was right and proper to demolish the right to marry in all HIV patients. The issue was also whether an HIV positive patient could marry an infected or an uninfected person after disclosing that he suffered from the dreadful disease.

The three-Judge-Bench decided that the decision supra was decided by learned Justice Sagir Ahmed without hearing all concerned groups (especially the NGOs) who are active in this field. Therefore the learned three-judge-bench was pleased to expunge the observation made by Justice Sagir Ahmed in this regards thus restoring the rights of an HIV infected person to marry.
http://www.expresshealthcaremgmt.com/20040115/legalities01.shtml


Ghandikota P, Johari V; International Conference on AIDS.

Int Conf AIDS. 2000 Jul 9-14; 13: abstract no. WePpE1349.
P. Ghandikota, 7/10 Botawala Building 2nd Floor Horniman Circle, Fort, Mumbai 400023, India, Tel.: +91 22 267 6213/ 267 6219, Fax: +91 22 270 25 63, E-mail: aidslaw@vsnl.com

Issue: The position of protecting the rights of the unborn child, whose parents are both HIV-positive, by legally suspending the right to marriage of PLWHAs in India, relies on hypothetical scenarios and presupposed notions that cannot ethically or legally justify the suspension of the fundamental right to marriage by a court of law.


Description: It is possible for discordant couples or couples wherein both partners are HIV-positive to live healthy marital lives, which includes the possibility of bearing HIV-negative children. Specifically, the risk of transmission of the HIV-virus from mother to child can now be reduced to a negligible amount with appropriate medical intervention, such as AZT treatment. Furthermore, the couple may choose to adopt a child. From a legal standpoint and under common law, the court does not have right to intervene on behalf of the unborn child.

Conclusion: The reliance on notions of self versus other further marginalises people living with HIV/AIDS. The solution to preventing the spread of the virus to vulnerable groups, including children of HIV-positive parents, should be centered on creating an affirmative and enabling environment whereby positive persons and their families are able to access the proper social and medical services available.


Protest against ruling on HIV marriage
Lawyer Anand Grover called for public protest against the Supreme Court ruling suspending the AIDS-affected person's right to marry. He said the right to marry is a fundamental right and no court of law can 'suspend' it. The apex court did not take cognisance of the fact that HIV-positive people get married with full, free and informed consent of their partner who may or may not have HIV positive status. "The restriction on the marriages of HIV- infected persons can have serious repercussions. The isolation of such persons will drive the epidemic underground, as doctors and hospitals will not maintain confidentiality with regard to their HIV status," he said. He said the apex court was right in making it a moral and legal right for an HIV-positive person to disclose his/her status to the prospective spouse.

Lawyer calls for protest on SC ruling in HIV marriage case. Indian Express, September 5,1999.

Paper in:
June 2000