Introduction

Charaks’s oath (1000 B.C) and Hippocratic oath (460 B.C.) illustrates the duties and responsibilities of the persons who adopt the Noble profession of Medicine. “However, the events, which have been taking place in recent times, have raised doubts in the minds of members of society on the sincerity and commitment of those in the profession to adhere to the Hippocratic oath (460 B.C.).” In fact, medical negligence is a matter of major concern today not only in India but all over the world. For instance, malpractice litigation has become rampant in the U.S.A. with colossal damages being awarded. AT the standards in the medical profession are deteriorating.? Pursuits of money rather than the pursuit of excellence appears to be the most important motive force in patient care (Desh Pande, 1992).

Doctors are liable under the prevailing laws such as Civil Penal Code, Indian Penal Code, Law of Contractors, Sale of Goods Act, Law of Torts and other specific Legislation.? Under S\section 304-A of the Indian Penal Code (IPC), the doctor who committee criminal liability is punishable with imprisonment for a term which may extend upto two years, or with a fine, or both. Civil liability arises in case of medical service rendered on payment of fee, under section 73 and 74 of the Indian Contract Act (L.D. Lele, 1992). Under the Law of Torts (a wrong that is independent of contract) civil liability is applicable to doctors of all categories, that is whether they provide their service for a fee or as charity without doctors committing professional misconduct and it can direct the removal of the name of any person enrolled on a State Medical Register on the Grounds of professional misconduct.? the above mentioned laws have some drawbacks such as:-

1. Delay in Justice?
2. Huge legal fee
3. Limited access to the courts
4. Difficulties involved in proving both negligence and cause
5. Deficiency in IMC Act; Such as:
   1. Lack of Provision to receive complaints from patients.
   2. to award any compensation when negligence

Every profession has its guidelines and needs a scrutiny. Every professional body should ideally scrutinize whether their members are following the principles and practices as laid down by their ethics. Unfortunately MCI and other Associations have not been efficient, the only alternative is CPA 1986.

The CPA was passed by the Indian Parliament to safeguard and protection the interest of consumers. CPA aims at simplification of procedures for seeking redressal of grievances of patients or their relatives. The process can be initiated without any cost or without any court fee.

The principle of consumer protection is essentially the protection of the unwary customer against the trader, who might be unscrupulous in the quality of the saleable material to get rid off or the dictum of Cavest Emptor-Let buyer beware.

Who is liable:

1. Doctors with independent practice rendering only free services.
2. Private hospitals charging all.
3. All hospital having free as well as paying patients, they are liable to both.
4. Doctors/hospitals paid by an Insurance firm for treatment of a client or an employer for the treatment of an employee.

Who is not liable:

1. Doctors in hospitals which do not charge of their patients.
2. Hospitals offering free services to all patients.

Strength. weaknesses, opportunities & threats (swot) analysis of CPA:

SWOT analysis is the situational analysis in terms of strengths, weakness, opportunities and threats that can be studied for any questions has given ample scope for identifying, diagnosing and assessing the situation in the form of strengths, weakness, environmental threats and opportunities.

Swot Analysis of CPA

Strengths

Weaknesses

Valued as noble profession Professional pride that doctors have Giant strides in the medical profession Significant proportion of doctors government commitment to protect the Rights of the Consumers. Strong consumer movement in the country. Influence of international consumer Movement. The Hippocratic Oath that doctors Take at the time of Graduation. Vigilant press.

Highly technical orientation of the Medical field Declining credibility of medical Profession. Highly prevalent professional jealousy. Lack of objectivity and empirical Nature of several regimens Growing commercialisation of medical profession. Inept medical record keeping Lack of sufficient staff in the consumer Forums. Attitude of lawyers in frequently asking for adjournments. Huge back log in clearing medical cases in consumer forums.

Opportunities	Threats
Growing patient consciousness for quality care. Successful application of the CPA to other services/goods. Possibility of introducing medical audit has made. Possibility of strengthening of MCI Agreeing to the application of CPA Realisation of need for regular CME programmes. Proven instances of medical negligence.	Low level of awareness Among patient. Illiteracy and low socio-economic Status of patients. Exaggerated claims encouraged by mercenary type lawyers. Tendency of insurance companies to opt for out of court settlements. Strong opposition extended by the IMA. Growing urge to practice defensive medicine

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