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About the Author:
Ashish Anshu is an Advocate with 28 years of experience in diverse practice areas. Having started with his own practice in the year 1996 at the Patna High Court, Ashish moved on to be part of corporate law firms, Dua Associate, Advocates and Tatva Legal, Advocates. He is the Founding President of the Indian Lawyers Association, Telangana Chapter.
Ashish has been ranked by Chambers and Partners Asia-Pacific Guide consecutively for five (5) years 2019, 2020, 2021, 2022 and 2023, and by Legal 500 for the year 2021.
Ashish has been enlisted in Forbes Legal Powerlist 2021 as Top Individual Lawyer (Above 10 years’ experience) for Real Estate and Construction.
Ashish presently is a ‘Legal Volunteer’ at the Art of Living International Centre, Bangalore.
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In India, the relationship between nurses and law is essential to maintaining professional standards in healthcare while ensuring patient safety and the well-being of nurses themselves.
The legal framework governing nursing in India includes several laws, regulations, and guidelines aimed at protecting the rights of patients and the professional integrity of nurses.
Below are the key aspects of nursing practice and its relationship with the nurses and the legal framework in India:
1. Nursing Practice Act:
In India, the legal regulation of nursing practice falls under various State and Central government regulations. The Indian Nursing Council (INC), established under the Indian Nursing Council Act, 1947, is the statutory body responsible for overseeing nursing education and practice across the country. It sets the standards for nursing education, the qualifications required for nursing practice, and the codes of ethics nurses must follow.
Although India does not have a singular ‘Nurse Practice Act’ like some other countries, the Indian Nursing Council framework, along with state-level legislation, defines the scope and responsibilities of nurses.
2. Registration and License:
The Indian Nursing Council (INC) sets the minimum educational qualifications and training requirements for nurses in India. To practice as a registered nurse, an individual must complete a recognized nursing program (such as General Nursing and Midwifery (GNM) or Bachelor of Science in Nursing (BSc Nursing)) and obtain a license from the State Nursing Council.
Each state in India has its own Nursing Council, responsible for maintaining the nurse registry, issuing licenses, and monitoring professional conduct. Nurses must adhere to the professional codes of conduct and ethical standards set forth by both the INC and State Nursing Councils to avoid legal consequences.
3. Legal Issues in Nursing Practice:
• Nursing Malpractice and Negligence: Just like in other parts of the world, Indian nurses are legally responsible for providing care according to accepted professional standards. If a nurse fails to provide adequate care and it results in patient harm, the nurse may face legal action for malpractice or negligence. Malpractice in nursing can include medication errors, failure to monitor a patient’s condition, or failure to follow medical orders. Nurses may be held legally accountable if their actions result in harm to a patient.
• Patient Rights and Informed Consent: Nurses in India must ensure that patients understand their treatment options and give informed consent before undergoing medical procedures. Though informed consent is a fundamental principle, it is often under-emphasized in some healthcare settings. Nurses must be aware of their legal responsibilities in obtaining informed consent and in ensuring patients’ rights to privacy and dignity are respected.
• Nurse-Patient Confidentiality: Confidentiality is a legal obligation under Indian law, especially concerning patient records and personal health information. Under the Indian Penal Code (IPC), nurses can face legal consequences if they breach patient confidentiality. Additionally, the Information Technology Act, 2000includes provisions for data protection in healthcare.
4. Role of Nurses in Legal Proceedings:
• Expert Witnesses: Nurses in India may be called upon as expert witnesses in legal proceedings, particularly in cases involving medical malpractice or negligence. An expert nurse witness may testify on the standard of care, medical procedures, and ethical considerations in a case.
• Legal Nurse Consultants: Some nurses in India may pursue additional training to become legal nurse consultants. These professionals work with lawyers, advising on medical-legal cases by interpreting medical records, providing insight into healthcare practices, and helping to understand medical terminology in legal contexts.
5. Ethical and Legal Dilemmas:
Nurses in India, like their counterparts globally, face ethical dilemmas, especially in areas like end-of-life care, abortion, and religious or cultural considerations. For example, India has laws regulating abortion (Medical Termination of Pregnancy Act, 1971), and nurses are involved in ensuring that patients’ rights and the legal framework are respected in such cases. Nurses are required to act within the boundaries of Indian law while ensuring compassionate care, even when personal or cultural beliefs may differ.
Similarly, organ donation and transplantation laws (Transplantation of Human Organs Act, 1994) present legal and ethical challenges for nurses, particularly in ensuring patient consent and compliance with regulations.
6. Workplace Legal Issues:
• Nurses’ Employment Rights: Nurses in India, like other healthcare workers, are entitled to certain labor rights. These include protection from exploitation, unsafe working conditions, and unfair termination. The Indian Labor Law provides guidelines on working hours, wages, and conditions. Nurses who work in government or private hospitals are entitled to labor protections under these laws.
• Workplace Safety and Protection: Nurses are exposed to workplace hazards, including exposure to infections, chemicals, and physical injuries. The Factories Act, 1948 and the Occupational Safety, Health, and Working Conditions Code, 2020 provide guidelines on workplace safety, including the provision of protective equipment and safe working environments.
• Sexual Harassment in the Workplace: The Sexual Harassment of Women at Workplace (Prevention, Prohibition, and Redressal) Act, 2013 protects nurses (especially female nurses) from harassment in healthcare settings. Hospitals and healthcare institutions are legally required to form internal committees to address sexual harassment complaints.
7. Legal Rights of Nurses in India:
• Right to Professional Autonomy: Nurses in India are entitled to exercise their professional judgment while providing care, as long as they adhere to legal and ethical standards. This autonomy is crucial for ensuring that nurses can act in the best interests of patients while maintaining professional integrity.
• Right to Protection: Nurses have the legal right to protection from physical violence, especially in situations where they are exposed to aggression or threats from patients or their families. Healthcare facilities are responsible for creating a safe work environment and offering support to nurses.
Conclusion:
The relationship between nursing practice, nurses, and laws in India is complex, requiring nurses to navigate various legal and ethical challenges in their daily practice. By understanding relevant laws, such as those governing nursing registration, patient care, informed consent, confidentiality, and workplace safety, nurses can protect their professional reputation and ensure the best possible care for patients. Nurses must continue to educate themselves on legal updates and ensure compliance with Indian healthcare laws to safeguard both their patients and their own professional integrity.