The recent case of the rape and murder of a 31-year trainee doctor in the state-run KG Medical College and Hospital has outraged the nation. The female doctor had gone to the seminar hall to rest, due to lack of properly designated on-duty space, after 36 hours of grueling work.
On 9 August 2024, her semi-naked body, with multiple injuries and signs of sexual assault and torture was found. The inquest report, on August 10, pointed to the 10 injuries on the victim’s body including bleeding from the vagina, both eyes and mouth, and injuries on the face, neck, nails, right hand, left leg, and stomach.
Nearly 51 years before, a junior nurse named Arun Shaubaug was sexually assaulted in 1973. She was attacked and choked with a dog chain and was raped in the basement of Mumbai’s King Edward Memorial Hospital. The strangulation with a dog chain cut off her oxygen supply and rendered her in a vegetative stage for life.
Multiple cases of sexual assault in the hospital have time and again have indicated the lack of proper safety protocols for women and doctors in the hospital spaces. The lack of appropriate CCTV, failure to screen visitors, and unavailability of separate restrooms for female doctors, have indicated that hospitals remain unsafe for doctors. In fact, there have also been frequent cases of mob fury from the patient’s families and relatives, after death of a patient or for demanding immediate healthcare services.
As per the data from the National Crime Record Bureau, India has reported more than 400 cases of sexual harassment in the workplace from 2018 to 2022. The data has also shown that Himachal Pradesh is on the top with 97 cases of sexual harassment in the workplace. In contrast, West Bengal which witnessed the brutality of the rape and murder of the female doctors only had 1 case recorded, highlighting the challenge of under-reporting and registration of such cases with the legal system.
According to a 2015 IMA survey, 75 percent of doctors have faced some kind of violence at the workplace. It is important to recognize that women make up nearly 30 percent of Indian doctors and 80 percent of the nursing staff, and therefore ensuring their safety should be a top priority.
While 26 states have already passed legislation protecting healthcare workers, a gap in implementation and the need for a consolidated law from the center for uniform protection of doctors across all the states and union territories remain major concerns. The Union health minister had previously held that, as per the constitutional provisions, ‘health’ and ‘law and order’ remain a state’s responsibility.
Following the recent case, the Supreme Court set up a National Task Force, to prepare a plan to prevent gender-based violence against medical professionals and a national protocol for workplace safety of healthcare professionals.
Below listed are some existing legal provisions and statutes that aim to prevent violence against health professionals.
The Epidemic Disease Act 1897, was an act to prevent the spread of dangerous epidemic diseases. An ordinance to this act came in 2020 to protect the doctors during covid 19. The ordinance protects healthcare personnel combating epidemic diseases and expands the power of the central government to prevent the spread of these diseases.
An act of violence includes any of the following acts committed against a healthcare service personnel
(i) Harassment impacting living or working conditions
(ii) harm, injury, hurt, or danger to life
(iii) obstruction in discharge of his duties, and
(iv) loss or damage to the property or documents of the healthcare service personnel.
Property is defined to include a: clinical establishment, quarantine facility, mobile medical unit, and other property in which a healthcare service personnel has a direct interest, to the epidemic.
The act further specifies that if an act of violence against healthcare service personnel causes grievous harm, the person committing the offense will be punishable with imprisonment between six months and seven years, and a fine between one lakh and five lakh rupees. These offenses are highlighted as cognizable and non-bailable.
While a central law has not been enacted due to the reasoning that public health is a state subject, discussion on the 2019 Prevention of Violence Against Doctors Medical Professionals and Medical Institutions Act has not moved forward in Parliament.
Under this bill, violence against health professionals and damage to property would be punishable with imprisonment between six months and five years, and a fine between Rs 50,000 and Rs 5 lakh. In case of “grievous hurt”, the punishment will be 3-10 years in jail and Rs. 2-10 lakh fine.
The R.G. Kar Hospital case has reignited the debate on whether it is time for India to have a centralized law to prevent violence against doctors or not.
Majorly, the state acts have defined healthcare service personnel as doctors, nurses, medical and nursing students, and paramedical staff.
Violence in these acts has been defined as activities that cause harm, injury, endangering life, intimidation, obstruction to the ability of a healthcare service person to discharge their duty and loss or damage to property in a healthcare institute.
Apart from the legislative measures, there are also several initiatives brought in by the states to ensure security. These include installing CCTV cameras, deployment of additional security personnel, and establishment of police outposts in larger hospitals.
The Maharashtra Medicare Service Persons and Medicare Service Institutions (Prevention of Violence and Damage or Loss to Property) Act: This law by the Maharashtra Government clearly states that any offender who is involved in any act of violence against a Medicare Service Person shall be punished with imprisonment which may extend to three years and with a fine, which may extend to fifty thousand rupees.
The Kerala Healthcare Service Persons and Healthcare Service Institutions (Prevention of Violence and Damage to property) Amendment Act of 2023, was enacted after a junior doctor named Vandana Das was killed on duty in Kerala after she was stabbed 11 times in the chest by a drunk school teacher.
This act by the Kerala State government protects a wide range of healthcare workers, including doctors, nurses, paramedics, nurses, pharmacists, lab technicians, clerks, ministerial staff and security guards. The Act makes any kind of violence against healthcare workers a non-bailable offense.
As per the act, the FIR has to be filed within one hour after the incidence of violence. The inspector must complete an investigation into the offense within sixty days of filing an FIR. The act calls for the investigation of the victims on consecutive days.
After the recommendations made by the Karnataka Law Commission, Karnataka passed “The Karnataka Medical Registration and Certain Other Law (Amendment) Bill of 2024”, amending the Karnataka Medical Registration Act, 1961, and the Karnataka Prohibition of Violence Against Medicare Service Personnel and Damage to Property in Medicare Services Institutions Act, 2009.
It calls for the addition of a new section, prohibiting the insult of medicare service personnel in a medicare service institution. Additionally, any person who commits any such insults would be punished with a period of not less than three years and with a fine of not less than twenty-five thousand rupees.
The Andhra Pradesh Medicare Service Persons and Medicare Service Institutions (Prevention of Violence and Damage to Property) Act, 2008, was established to safeguard medicare service personnel and protect healthcare institutions. The law intends to protect healthcare professionals, including doctors, nurses, and other medical personnel, from acts of violence and aggression while they are performing their duties.
Recently, the Andhra Pradesh Government decided to amend the Medicare Personnel (Protection against Violence) Act, making offenses under it non-bailable, aiming to deter violence.
Assam Medicare Service Persons and Medicare Service Institutions (Prevention of Violence and Damage to Property) Act, 2011: Under this act, any violence against a Medicare Service Person shall be punished with imprisonment for a term which may extend to three years and with a fine which may extend to fifty thousand rupees. This offense would thereby be cognizable and non-bailable.
The West Bengal Clinical Establishments (Registration, Regulation and Transparency) Act, contains provisions aimed at protecting doctors and healthcare workers from violence. The act calls for imposing penalties and fines on the offenders.
| Title of the Law | State | Year | Punishment |
| The Maharashtra Medicare Service Persons and Medicare Service Institutions (Prevention of Violence and Damage or Loss to Property) Act | Maharashtra | 2010 | Imprisonment which may extend to three years and fine which may extend to fifty thousand rupees |
| Kerala Healthcare Service Persons and Healthcare Service Institutions (Prevention of Violence and Damage to property) Amendment Act of 2023 | Kerala | 2023 | Any kind of violence is a non-bailable offense. Punishment of imprisonment of not less than one year and with a fine of not less than one lakh rupees. |
| The Karnataka Medical Registration and Certain Other Law (Amendment) Bill of 2024 | Karnataka | 2024 | Punishment with a period of not less than three years and with a fine of not less than twenty-five thousand rupees. |
| Andhra Pradesh Medicare Service Persons and Medicare Service Institutions (Prevention of Violence and Damage to Property) Act, 2008 | Andhra Pradesh | 2008 | Imprisonment of three years and a fine which may extend to fifty thousand rupees. |
| Assam Medicare Service Persons and Medicare Service Institutions (Prevention of Violence and Damage to Property) Act, 2011 | Assam | 2011 | |
| West Bengal Clinical Establishments (Registration, Regulation and Transparency) Act | West Bengal | 2017 | The act calls for imposing penalties and fines on the offenders. |
Durrain Desnavi is pursuing a Masters in Development from Azim Premji University, Bangalore. She is currently a Research Intern with TA.
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