Indian Journal of Legal Medicine

Purpose: This article clarifies the distinctions between Acts, Rules, Regulations, and Guidelines, which are often conflated in legal and organizational contexts. It aims to enhance understanding among non-legal professionals and institutional committees by providing practical examples and analyzing their roles in decisionmaking. Methodology: A descriptive analysis of legal definitions, hierarchical relationships, and case studies (e.g., the Consumer Protection Act, 2019) is conducted. Comparative tables and flowcharts are used to illustrate differences. Findings: Acts establish overarching legal frameworks, Rules operationalize procedures, Regulations enforce industry-specific standards, and Guidelines offer non-binding best practices. Documented guidelines, while promoting transparency, require flexibility to avoid rigidity. Implications: Clear differentiation of these terms ensures compliance, reduces ambiguity in decision-making, and balances adherence to legal frameworks with professional judgment. Conclusion: This article clarifies distinctions between Acts, Rules, Regulations, and Guidelines, underscoring their roles in governance. Acts establish laws, Rules operationalize procedures, Regulations enforce standards, and Guidelines advise best practices. Clear differentiation ensures compliance, reduces ambiguity, and balances legal rigor with professional judgment, empowering non-legal professionals in decision-making. Author.

Background: The judicial interpretation in V P Shantha (1995) extended the Consumer Protection Act (CPA), 1986, to medical services by distinguishing «contract of personal service» (excluded) from “contract for personal service» (included). Despite amendments in the CPA 2019 [Section 2(42)], this interpretation persists. This article challenges that stance using AI-assisted legal analysis, arguing that patient-tailored medical services constitute a «contract for personal service» and should be excluded from CPA 2019. Objective: To demonstrate that patient-specific medical treatments (e.g., surgeon-tailored surgery) fall under “contract for personal service as defined in CPA 2019, warranting exclusion from consumer law. Methods: • Legal Analysis: Scrutiny of Section 2(1)(o) (CPA 1986) and Section 2(42) (CPA 2019). • AI Inputs: Interrogation of AI tools to define "personal service" and its applicability to medical contexts. • Case Law Review: V P Shantha (1995), 1 parliamentary debate on CPA 2019, and Bar of Indian Lawyers v. D.K. Gandhi (2023).2 Results: 1. Contract Typology: • Contract for Personal Service: Relies on unique skills (e.g., surgeon’s expertise), autonomy in execution, and patient choice. • Contract of Personal Service: Employer-controlled labor (e.g., hospital staff) 2. Medical Services: Patient-tailored procedures (e.g., custom surgery) meet "contract for personal service" criteria due to individualized care, skill reliance, and consideration (payment). CPA 2019: Parliamentary intent and post-Shantha amendments support excluding such services. Conclusion: Patient-tailored medical services are “contracts for personal service" under Section 2(42) of CPA 2019 and must be excluded. Judicial recognition of this distinction aligns with legislative intent and modern medical practice.

Cause of action (CoA) is a foundational legal concept enabling plaintiffs to seek remedies for wrongful acts. Battery and assault, as intentional torts, represent critical CoAs in medicolegal contexts, particularly in cases of patient maltreatment, domestic violence, and institutional abuse. A narrative synthesis of legal literature, landmark case laws, and clinical guidelines was conducted, focusing on precedents from common law jurisdictions. Battery/assault claims require proof of intentional harm or threat without consent, distinct from negligence. Key issues include consent validity in medical settings, psychological trauma documentation, and overlapping criminal-civil proceedings. Landmark cases illustrate evolving standards for healthcare providers and institutions. Battery/assault CoAs are vital for victim redress but face evidentiary hurdles in medicolegal practice. Enhanced interdisciplinary coordination (legal-clinical) is recommended for robust claims adjudication. This review analyzes the medicolegal dimensions of battery/ assault as CoAs, including definitions, required elements, clinical relevance, and associated challenges in proving liability.

Background: The concept of “duty” in Indian jurisprudence spans constitutional, tort, administrative, and medicolegal contexts. In the medicolegal realm, defining a medical professional’s duty is critical to balancing patient rights and legal accountability. Objective: This literary review synthesizes judicial interpretations of “duty” in Indian medicolegal cases, focusing on negligence, liability standards, and the interplay between civil and criminal obligations. Methods: Analysis of landmark Supreme Court judgments, statutory provisions (e.g., Consumer Protection Act, 1986), and principles like the Bolam Test. Key Findings: 1. Courts define a doctor’s duty as adherence to “accepted medical standards” and “reasonable care” (Jacob Mathew v. State of Punjab, 2005). 2. Criminal liability requires “gross negligence” (Dr. Suresh Gupta v. GNCTD, 2004), while civil liability addresses compensation for deficient service (Indian Medical Association v. V.P. Shantha, 1995). 3. The Consumer Protection Act, 1986, holds doctors accountable for “deficiency in service”, emphasizing patient rights.

Background: The Bharatiya Nyaya Sanhita (BNS) redefines “injury” and “illegal” acts, creating ambiguity in medical negligence jurisprudence. This article examines whether harm caused by licensed physicians during treatment constitutes “illegally caused injury” under BNS. Methods: Doctrinal analysis of BNS Sections 2(14), 2(15), and 26; comparative review of IPC provisions, common law, and landmark case laws. Results: Liability hinges on breach of statutory duty (BNS 2(15), not mere harm. Deficient consent invalidates treatment legality but requires causal harm for negligence claims. Consumer law frames consent as contractual autonomy. Conclusion: BNS prioritizes legality of conduct over outcome. Harmonizing statutory “good faith” (Sec 26) with material risk disclosure prevents liability. The article underscores the classic legal dilemma between wrongful harm and privileged action under statutory license.

This case report highlights the significance of froth formation in the airways as a vital postmortem clue in burn-related deaths. A 38-year-old male was found unresponsive with partial-thickness burns covering 15–20% of his body, following a suspected fire incident in his residence. Although froth was not visible at the scene, white froth was noted oozing from the nose and mouth during autopsy. Internal examination revealed cherry-red, congested, and edematous lungs with petechial haemorrhages, and froth exuding on compression. Histopathological analysis confirmed interstitial haemorrhage and pulmonary edema. The presence of froth, coupled with respiratory tract findings, indicated ante-mortem inhalation of smoke or hot gases. Chronic smoking and acute alcohol intoxication were likely contributory factors, increasing susceptibility to inhalation injury and impairing protective reflexes. This case highlights that the absence of froth at the scene does not exclude inhalational injury, and that postmortem froth formation, although delayed, can be a crucial indicator of respiratory involvement. Thus, careful correlation of scene findings, autopsy observations, and histological evidence is essential for determining the exact cause of death in burn victims.

Background: A case of operative CBD injury is presented with its medical concerns, legal issues and key takeaways. A discussion of the legal defence taken and how it affected the decision of the courts is discussed, with case law supports. Clinical case Summary: A middle-aged woman was subjected to Laparoscopic Cholecystectomy by a surgeon in Hospital A. She developed problems soon after surgery. After observing for 2-3 days, she was referred to another hospital (Hospital B) in a different city at night. She was treated conservatively for another 2-3 days and then explored. At surgery she was found to have a CBD injury, a perforation in hepatic flexure of colon and faecal & biliary peritonitis. Closure of colon perforation, diversion ileostomy and peritoneal lavage & drainage was done. After a stormy post operative course, she died after 8 days. Litigation Summary: Complaint was filed in SCDRC against Hospital A and Hospital B for medical negligence and deficiency of service, by the family of the deceased. SCDRC decided against Hospital A but absolved Hospital B. Complainant as well as Hospital A preferred an appeal in NCDRC challenging this decision. NCDRC absolved Hospital A also, setting aside the SCDRC order qua Hospital A. The complainant approached the Supreme Court with a Revision Petition/SLP. It held the Hospital A negligent & enhanced the award of compensation from 16 L to 25 L while holding the Hospital B innocent. Conclusion: A known surgical complication, though unwelcome, cannot always be avoided. The current healthcare ecosystem often invites legal action against the doctors for adverse outcomes. This case brings out important medical & legal issues for discussion. The medicolegal lessons from the case are discussed for the readers to understand how the surgical complications and the possible litigation should be handled.