Law and Medicine Questions 1 to 20 (3 Marks)

Law > Medical Jurisprudence > Duties of Medical Practitioner

Q1A. Any two medical specialists (Write any Two)

Pediatrician: Pediatrician is a medical doctor who manages the physical, behavioral, and mental care for children from birth until age 18. A pediatrician is trained to diagnose and treat a broad range of childhood illnesses, from minor health problems to serious diseases. They focus on the prevention, detection and management of physical, behavioral, developmental and social problems that affect children. They work to diagnose and treat infections, injuries, and many types of organic disease and dysfunction and bring about improvement in the life of children with chronic problems.
Cardiologist: Cardiologists are qualified to treat heart attacks, heart failure, heart valve disease, arrhythmia, and high blood pressure. He may collaborate with cardiac surgeons to decide the course of treatment for his patients. Cardiology is a specialty, which has many subspecialties like interventional cardiology, nuclear cardiology, electro physiology, or echocardiography, which help in making diagnostic studies.
Gynecologist: A gynecologist is a doctor who specializes in female reproductive health. They diagnose and treat issues related to the female reproductive tract. This includes the uterus, fallopian tubes, and ovaries and breasts. They diagnose and treat reproductive system disorders such as endometriosis, infertility, ovarian cysts, and pelvic pain. They may also care for people with ovarian, cervical, and other reproductive cancers.
Orthopedic Surgeon: An orthopedic surgeon is qualified to diagnose orthopedic problems, perform or prescribe treatments, and assist with rehabilitation. They also help to develop long-term strategies to treat illnesses, disorders, and issues relating to bones, joints, ligaments, tendons, and muscles. These specialists help treat broken bones, joint problems, like arthritis, and degenerative conditions, like osteoporosis. In addition orthopedic doctors treat sports injuries, infections or congenital conditions related to, and tumors in the bones.

Q1B. Any two varieties of medical profession (Write any Two)

Ayurveda

Ayurveda often referred as “the mother of all healing”, is an ancient Indian system of healing. It is 5000 to 10000 years old. Reference of this system can be seen in the Rigveda and the Atharva Veda. “Ayur” means life and veda means “knowledge”, thus “Ayurveda” means knowledge of life. The medicines are mainly plant based.

Diagnosis in Ayurveda takes in the form of general physical examination, involving examination of the pulse, tongue, eyes, vein sans faeces. Regulation of diet as a therapy plays an important role in Ayurvedic treatment.

Major books on this system are Charak Sanhita and Sushruta Sanhita. This system has holistic approach of treating the patient. “Charak Sanhita” is a massive compilation containing several chapters on therapeutic and internal medicine. It contains reference to more than six hundred types of medications of plant, animal, and mineral origin. “Sushrut Sanhita” is an ancient scholarly work dedicated to surgery. In the whole world this is the oldest compilation on surgery. The book is written in the sixth century B.C. by an ancient Ayurvedic scholar “Sushruta”. The book contains descriptions of surgical procedures which are relevant even today.

Doctrine of Ayurveda:

Body is made up of Pancha Mahabhootas: Prithvi (earth), Jal (water), Agni (fire), Vayu (air) and Akash (ether). There are three doshas in the body: Tridosha: The Vata (ether + air), Pitta (fire) and Kapha (earth + water) and Trigunas: the Satva, Rajas and Tamas, which are the psychological properties

Any imbalance in above factors due to internal and external factors causes disease and restoring equilibrium through various techniques, procedures, regimes, diet and medicine constitute treatment. Over the years, Kshar Sutra and Panchakarma therapies of Ayurveda have become very popular among the public.

2) Homeopathy:

The systematic foundation of Homeopathic techniques was made by German physician Dr, Samuel Hahnemann. The word homeopathy is derived from two greek words, ‘homois’ means similar and ‘pathos’ means sufferings. Homeopathy is based on following three principles:

The Law of Similars: Main principle is Similia Similibus Curantur meaning likes are cure by likes or likes be treated by likes.
The Law of Minimum Dosage: In Homeopathy patient is given minimum dose so that toxic effect of dose can be eliminated. The dose is to stimulate internal immune system.
The Law of Single Remedy: Homeopathy will try to treat patient by using single remedy, which is the most similar to the symptoms shown by the patient.

Homeopathy adopts holistic approach towards the patient. Hence Homeopathy may give two different medicines to two different patients suffering from the same problem. Homeopathy uses animal, plant, mineral and synthetic substances in the preparation of medicines.

3) Allopathy:

The system of medical practice which treats disease by the use of remedies which produce effects different from those produced by the disease under treatment. The term “allopathy” was coined in 1842 by C.F.S. Hahnemann to designate the usual practice of medicine (allopathy) as opposed to homeopathy, the system of therapy that he founded based on the concept that disease can be treated with drugs (in minute doses) thought capable of producing the same symptoms in healthy people as the disease itself.

Allopathy is also known as Biomedicine or Western Medicine. Treatment is done by medication, surgery, radiation, or and other therapies and procedures. The criticism to the system is that allopathic medicines like pills and injection do not cure disease, they merely mask the symptoms of disease.

Doctrine of Allopathy

It believes that germs, bacteria, and viruses that causes disease are destroyed when drugs and chemical agents are administered in the patient. Modern diagnostic methods like X-rays, sonography, ECG, instruments and techniques like use of radioisotopes are used. Millions of dollars are spent annually on research and development of allopathic drugs. Main drugs used include, antipyretics, antibiotics, antifungal, antibacterial, antihistamine, antifertility, narcotics, sulpha drugs, etc. Allopathy has had the most evidence-based scientific research, data collection, and drug testing. It’s also the most regulated by a neutral party like the Food and Drug Administration (FDA) or the Indian Medical Association.

4) Siddha Therapy:

It is 5000 year old system of medicines. It is based on the similar principles of Ayurveda. The word “siddha” means “achievement” and practitioner of this system of treatment were called “Siddhars”. This system is said to be developed by many Siddhars. Agatsya was the first Siddhar. It is mostly practiced in South India, particularly in Tamil Nadu. April 14 is celebrated as World Siddha Day.

This system treats the individual as a microcosm of the universe. It believes that the human body is made up of five tatvas or elements namely: earth, water, air, fire, and space. It considers food as basic building block of human body, which gets processed into humors, tissues and waste matter. The equilibrium of humors contribute to the health of a person and its imbalance or disturbance leads to disease. It puts emphasis on the body, mind, and spirit and work for harmony of the human body. It is particularly effective in allergy, skin problems, arthritis, and general debility.

The Siddha system of Medicine emphasizes on the patient, environment, age, sex, race, habits, mental frame work, habitat, diet, appetite, physical condition, physiological constitution of the diseases for its treatment which is individualistic in nature Diagnosis of diseases are done through examination of pulse, urine, stool, eyes, skin, study of voice, colour of body, tongue and status of the digestion of individual patients.

5) Yoga:

Derived from the Sanskrit word ‘yuj’ which means ‘to unite or integrate’, yoga is a 5,000-year-old Indian body of knowledge. Yoga is all about harmonizing the body with the mind and breath through the means of various breathing exercises, yoga poses (asanas), mudras (hand positions) and meditation (dhyana).

There are eight limbs of yoga namely, Yam, Niyam, Asana, Pranayama, Pratyahara, Dhara, Dhyana, Samadhi. Maharishi Patanjali who is regarded as the Father of Yoga, compiled in his book called “Patanjali Yog Sutra”. Most of the Asnas work on the principle of stretching a body. June, 21 every year is celebrated as the International Yoga day

Yoga is an Art and Science of healthy living. It is a spiritual discipline based on an extremely subtle science, which focuses on bringing harmony between mind and body. The holistic approach of Yoga is well established and it brings harmony in all walks of life and thus, known for disease prevention, promotion of health and management of many lifestyle –related disorders. Today, Yoga is popular across the globe, not just because of its efficacy in the management of some diseases, but also of its strength in providing relief to the practitioner, from mental and emotional distress and providing a feeling of well-being. Hence, now-a-days Yoga is being practiced as part of healthy life style across the globe.

Q2. Informed consent:

Informed consent is defined as voluntary acceptance by a competent patient of a plan for medical care after physician adequately discloses the proposed plan, its risks and benefits, and alternative approaches. This requires a process of effective communication and education between the physician and patient. Informed consent is a process with the elements of autonomous authorization, free from coercion or manipulation, decision-making capacity, disclosures to the patients, and comprehension.

There are four major components of informed consent:

That the patient has the capacity to make the decision.
The medical provider discloses information on the treatment, test, or procedure in question. This includes explaining the expected benefits and risks, as well as the probability of these benefits and risks occurring.
The patient must comprehend the information told to them.
The patient must voluntarily give their consent, without any coercion from the healthcare professional.

The informed consent may be express or implied. Before the procedure, the patient / patient’s next keen has to complete and sign a consent form. This form is a legal document that shows their participation in the decision and your agreement to have the procedure done. In emergencies, when a decision must be made urgently, the patient is not able to participate in decision making, and the patient’s next keen is not available, physicians may initiate treatment without prior informed consent. In such situations, the physician should inform the patient/the next keen at the earliest opportunity and obtain consent for ongoing treatment in keeping with these guidelines.

Q3. Privileged Communication

A privileged communication is a conversation between two parties that is legally classified as a private discussion. This discussion is legally protected, and so cannot be disclosed to third parties. The concept is most commonly associated with a discussion between a doctor and a patient. It is called so because whatever information that is disclosed in this kind of setting is protected i.e., the courts cannot force the individual to disclose the details of such communication.

Sections 122 to 129 of the Indian Evidence Act, 1872 contain provisions related to privileged communication. These provisions deal with what is called absolute privilege, and apply only to the specific instances covered by the sections. Communication between a doctor and his patient does not enjoy absolute privilege, but can be said to have relative privilege. The communication between a doctor and his patient can be communicated to other only in bona fide manner and abiding the rules of confidentiality and exceptions to it.

If doctor is sued for medical negligence by the patient, then the doctor may disclose information to the Court similarly if a doctor sues patient for non-payment of fees, the patient can disclose information to the Court. If Court orders to produce medical reports containing confidential information, then the doctor is supposed to submit it to the Court.

In Mr. X v. Hospital Z, AIR 1999 SC 495 case, the apex court when commenting on infectious diseases held that in special circumstances, public interest would override the duty of confidentiality, as where there is an immediate or future health risk to the community or to a specific person.

Q4. Res ipsa loquitur

Res ipsa loquitur is a Latin maxim whose meaning is “the thing tells its own story”. It is important on the part of the plaintiff that he/she did not contribute to the cause. In general, it is the plaintiff’s responsibility to produce necessary evidence against the defendant to have the judgment in his favour. The legal doctrine of res ipsa loquitur relieves a plaintiff of his burden of proving any specific act of negligence on the part of the defendant.

The doctrine of Res Ipsa Loquitur has three elements:

the injury that had occurred under the circumstances must be explicit and can only occur due to someone’s negligence and it cannot occur in the ordinary situations.
the injury caused by the defendant to the plaintiff must have been done with the use of some instrument which was exclusively under the control of the defendant.
the injury caused to the plaintiff must be under the scope of the defendant’s duty and it must not be due to the voluntary act or the contribution from the plaintiff’s side.

The first condition of doctrine is technical in nature and is difficult to prove plaintiff being the layman in respect to medical science cannot prove the medical negligence based on his/her common knowledge.

In Jaspal Singh v. Post Graduate Institute of Medical Education and Research 2000 (2) CPR 300 case, the patient, blood group was A+ was give n B+ blood on two different fays, and he died soon thereafter. Here medical negligence is clearly seen and in such case the maxim “Res ipsa loquitur” is applicable.

Q5. Right to health under Constitution of India

According to Article 21 of the Constitution of India “no person shall be deprived of his/her life or personal liberty except according to the procedure established by law. Right to life under Article 21 of the Constitution has been generously deciphered to mean something more than only human presence and incorporates the right to live with nobility and conventionality. The use of word ‘Life’ in Article 21 of the Constitution has a lot more extensive importance which includes human nobility, the right to livelihood, right to health, right to pollution free air, and so forth.

In the State of Punjab v. M.S. Chawla, it has been held that-the right to life ensured under Article 21 incorporates inside its ambit the right to health and clinical consideration.

The Supreme Court in Vincent v. Union of India, held that a healthy body is the very establishment of all human activities. Article 47, a Directive Principle of State Policy in such manner lays pressure on the improvement of general health and denial of medications harmful to health as one of the essential obligations of the state.

Right to health should be considered with the right to medical care and the right to clean and pollution free environment.

Q6. Right to self determination

Article 21 of the Constitution is the basis of right of self-determination of patient. An adult patient who suffers from no mental incapacity has an absolute right to choose whether to consent to medical treatment. The protection of patient self-determination entails the following elements: (a) recognition of, and respect for, the patient’s right to decide what treatment to have or not to have; (b) provision of an enabling climate for the patient to make self-determined choices (ensuring effective communication and building trust); and (c) having regard for the context (social, cultural, emotional, etc.) in which the patient has to make his or her decision. The right of self-determination of the patient ought to be respected.

Two conditions are ordinarily required before applying the right of self determination. The individual has to have the relevant internal capacities for self-government and has to be free from external constraints. In a medical context, a decision is ordinarily regarded as autonomous where the individual has the capacity to make the relevant decision, has sufficient information to make the decision and does so voluntarily.

Where patients lack the capacity to make a decision, it follows necessarily that decisions must be made on their behalf. Very young children ordinarily have the majority of decisions made by parents and guardians. Where adults lack capacity, health care decisions are ordinarily made by the health professional in overall charge of their care, although adults can appoint someone to make decisions on their behalf.

Q7. Duties of medical practitioner

Chapter I of the Code of Ethics Regulation Rules, 2002 gives general responsibilities of the Medical Practitioner.

A physician shall uphold the dignity and honour of his profession.
The Principal objective of the medical profession is to render service to humanity with full respect for the dignity of profession and man.
Physicians should try continuously to improve medical knowledge and skills and should make available to their patients and colleagues the benefits of their professional attainments.
The physician should practice methods of healing founded on scientific basis and should not associate professionally with anyone who violates this principle.
he should be modest, sober, patient, prompt in discharging his duty without anxiety; conducting himself with propriety in his profession and in all the actions of his life.
Every physician shall maintain the medical records pertaining to his / her indoor patients for a period of 3 years from the date of commencement of the treatment in a standard proforma laid down by the Medical Council of India and attached as Appendix 3
No person other than a doctor having qualification recognised by Medical Council of India and registered with Medical Council of India/State Medical Council (s) is allowed to practice Modern system of Medicine or Surgery.
Physicians should merit the confidence of patients entrusted to their care, rendering to each a full measure of service and devotion.

Q8. Kinds of disaster:

A disaster is an unexpected accident that can inflict significant damage and maybe death. A disaster is defined as a disruption on a massive scale, either natural or man-made, occurring in short or long periods. Disasters can lead to human, material, economic or environmental hardships, which can be beyond the bearable capacity of the affected society. There are two kinds of disasters:

Natural Disaster: A natural disaster is described as a major event caused by Earth’s natural processes that result in significant environmental harm and loss of life. Natural disasters are dictated by natural forces that people have little to no influence over. These are the disasters people learn to prepare for and survive because very little can be done to prevent them. Examples are earthquakes, tsunamis, tornados, cyclones, floods, avalanches, landslides, draughts, forest fires.
Man-made Disaster: Man-made disasters have an element of human intent, negligence, or error involving a failure of a man-made system. Man-made disasters are difficult to predict, however they are preventable. With a little vigilance, they shouldn’t occur in the first place. Examples: gas leaks, oil spills, nuclear meltdowns, and industrial fires due to human error.

Q9. Medical negligence

A tort is a residuary civil wrong. Duties in tort are fixed by the law and such duties are owed in rem or to the people at large generally. Such wrongs can be remedied by filing for unliquidated damages. Negligence is a tort. A negligence is the omission to do something which a reasonable man, guided by those considerations which ordinarily regulate the conduct of human affairs, would do or doing something which a prudent and reasonable man would not do.

Medical Negligence basically is the misconduct by a medical practitioner or doctor by not providing enough care resulting in breach of their duties and harming the patients which are their consumers. Medical negligence has caused many deaths as well as adverse results to the patient’s health. Some examples of medical negligence are as follows:

improper administration of medicines.
performing the wrong or inappropriate type of surgery.
not giving proper medical advice.
leaving any foreign object in the body of the patient such as a sponge or bandage, etc. after the surgery.

Q10. Medical negligence and consumer protection Act any two case

Consumer Protection (Mediation) Rules 2020 dictates under Rule (4) that matters relating to proceedings in respect of medical negligence resulting in grievous injury or death should not be referred to the mediation cell. This is because medical negligence comes under the ambit of the Consumer Protection Act.

In Indian Medical Association v V.P Shantha, 1995 (6) SCC 651 case, the Supreme Court bought medical profession within the ambit of the Consumer Protection act, 1986. The apex court said the relationship between patient and medical professional is contractual. A Consumer who has been offered a service has the right to approach court if there is sufficient evidence that there was breach of duty, medical negligence, a consumer has the right to move to the consumer dispute redressal forum.

In Poonam Verma v. Ashwin Patel 1996 (4) SCC case, Pramod Verma, husband of the appellant, Mrs. Poonam Verma fell ill and complained of fever and so, Ashwin Patel, who was an authorized Homeopathic kept him under mediation and gave him some allopathic medicines for viral fever for two days. But even after these medications the condition of Ashwin Patel didn’t improve so Ashwin Patel shifted the medications from viral fever to Typhoid Fever because according to Ashwin Patel these two diseases were prevalent in the locality. But even then the condition of Pramod Verma deteriorated and so Ashwin Patel asked the appellant to shift Pramod Verma to Sanjeevani Maternity and General Nursing Home under Dr. Rajeev Warty. Then Pramod Verma was shifted to Hinduja Hospital in an unconscious state where, after four and a half-hour of admission, he died. The Appellant therefore filed a petition before the National Consumer Disputes Redressal Commission, New Delhi. The issue was whether there was a breach of duty of care by Ashwin Patel in the treatment of Pramod Verma and whether this will amount to actionable negligence. The honourable Court found Ashwin Patel guilty for negligence and was made to pay compensation.

Q11. Define Magic Remedy under DMR(OA) Act, 1954

According to Section 2(c) of theDrugs and Magic Remedies (Objectionable Advertisements) Act, 1954, magic remedy‟ includes a talisman, mantra, kavacha, and any other charm of any kind which is alleged to possess miraculous powers for or in the diagnosis, cure, mitigation, treatment or prevention of any disease in human beings or animals or for affecting or influencing in any way the structure or any organic function of the body of human beings or animals.

Q12. Give two Examples of Medico Legal Case

All cases of accidents, burns, assaults, alleged suicide or homicide, poisoning, road traffic accident, rape, drowning, etc shall be registered as medico legal cases (MLC).

Road Accident:

A traffic or road accident is defined as an accident involving at least one vehicle on a road open to public traffic in which at least one person is injured or killed. The main cause of accidents and crashes are due to human errors. Most of the road users are quite well aware of the general rules and safety measures while using roads but it is only the laxity on part of road users, which cause accidents and crashes.

The Investigation of the accident must be done as soon as possible after it occurs because it helps in observing the conditions as they were at the time of the accident. Investigation officer may take help from an automobile expert and a medical expert. Establishment of facts includes visiting site of accident, examination of mechanical damages. If the driver of the vehicle is survived, his medical examination is mandatory. It should be ascertained if he was under the influence of alcohol or drugs at the time of accident. Medical examination of the victims must be conducted immediately. Medical examination includes noting of injuries suffered, place, angle, extent, and depth of injury. It also includes noting of blood stains on body, tears, grease marks, mud and soil stains, etc.

In case of accidental death, an autopsy (post mortem) is often performed to ascertain the cause of death. An autopsy or post-mortem is a surgical procedure involving a thorough examination of the corpse by dissection to determine the cause and manner of death. The procedure is performed by specialist pathologists.

2) Rape:

Section 375 of IPC defines the term “Rape”.

A man is said to commit “rape” who, except in the case hereinafter excepted, has sexual intercourse with a woman under circumstances falling under any of the six following descriptions:—

(First) — Against her will.

(Secondly) —Without her consent.

(Thirdly) — With her consent, when her consent has been obtained by putting her or any person in whom she is interested in fear of death or of hurt.

(Fourthly) —With her consent, when the man knows that he is not her husband, and that her consent is given because she believes that he is another man to whom she is or believes herself to be lawfully married.

(Fifthly) — With her consent, when, at the time of giving such consent, by reason of unsoundness of mind or intoxication or the administration by him personally or through another of any stupefying or unwholesome substance, she is unable to understand the nature and consequences of that to which she gives consent.

(Sixthly) — With or without her consent, when she is under sixteen years of age.

Explanation: Penetration is sufficient to constitute the sexual intercourse necessary to the offence of rape.

Exception: Sexual intercourse by a man with his own wife, the wife not being under fifteen years of age, is not rape.

Section 53(5) of the CrPC talks about examination of a female victim, which should be done by or under the supervision of a female doctor. Section 53A of the CrPC provides for a detailed medical examination of a person accused of an offence of rape or an attempt to commit rape.

A detailed medical examination is to be carried out by a registered medical practitioner employed in a hospital run by government or local authority without delay. A “reasoned” report be prepared recording the name and address of the accused, the person by whom he was brought, the age of the accused, marks of injury if any, a description of materials collected from the accused for DNA profiling, etc.

Section 164(A) CrPC explains the legal requirements for medical examination of a victim of rape. One of the main elements of this is that the consent of the victim is mandatory and should be part of the report. It provides for a medical examination of the victim of rape by a registered medical practitioner preferably woman within 24 hours of incidence of assault.

Q13. Write Short Note – Female Foeticide

Female foeticide is the procedure of abortion to terminate a female foetus from the womb of the mother before taking birth after the sex recognition tests like an ultrasound scan. The census figures not only indicate the imbalance in the sex ratio, but it also indicates, the casual approach of society to all women. It is the cruellest on the part of society not to allow a female child to be born.

Major Reasons for Female Foeticide:

Patrilineal line of succession
Dowry system, violence against women
Low status of women
Preference for son due to financial security
Small family norm
Religious and social taboos
Misuse of diagnostic techniques.

Impact of Female Foeticide:

The sex ratio denotes the ratio of females to males in a specific region. As per the decennial Indian census, the Sex Ratio of India is 107.48. It means 107.48 males per 100 females in 2019.
It increases number of crimes against women

Q14. Define Donor under TOHO Act 1994.

Section 2(f) of the Transplantation of Human Organs and Tissues (TOHO) Act, 1994, defines donor as ““donor” means any person, not less than eighteen years of age, who voluntarily authorises the removal of any of his human organs for therapeutic purposes under sub-section (1) or sub-section (2) of section 3 of the Act”.

Q15. What is meant by “privileged communication‟?

If doctor is sued for medical negligence by the patient, then the doctor may disclose information to the Court similarly if a doctor sues patient for non-payment of fees, the doctor can disclose information to the Court. If Court orders to produce medical reports containing confidential information, then the doctor is supposed to submit it to the Court.

16. What is meant by a patient’s rights to self-determination?

Q17. Define “Genetic Counselling Centre‟ according to PCPNDT Act, 1994

According to Section 2(c) of the the Pre-conception and Pre-natal Diagnostic Techniques (Prohibition of Sex Selection) Act, 1994, “Genetic Counselling Centre” means an institute, hospital, nursing home or any place, by whatever name called, which provides for genetic counselling to patients.

Q18. State any three important provisions of Helsinki Declaration with respect to human experimentation of drugs.

Medical research in humans depends on important ethical considerations to ensure the protection of the research subjects. The Helsinki Declaration is a statement outlining the ethical principles for medical research involving human subjects that was initially adopted by the 18th Assembly of the World Medical Association in Helsinki, Finland in June 1964.It was developed from 10 principles first stated in 1947 in the Nuremberg Code and further incorporated elements from the Declaration of Geneva (made in 1948), a statement of the ethical duties of physicians.

“The health of my patient will be my first consideration,” and the International Code of Medical Ethics declares that, “A physician shall act in the patient’s best interest when providing medical care.”
It is the duty of the physician to promote and safeguard the health, well-being and rights of patients, including those who are involved in medical research. The physician’s knowledge and conscience are dedicated to the fulfilment of this duty.
he primary purpose of medical research involving human subjects is to understand the causes, development and effects of diseases and improve preventive, diagnostic and therapeutic interventions (methods, procedures and treatments). Even the best proven interventions must be evaluated continually through research for their safety, effectiveness, efficiency, accessibility and quality.
Medical research is subject to ethical standards that promote and ensure respect for all human subjects and protect their health and rights.
While the primary purpose of medical research is to generate new knowledge, this goal can never take precedence over the rights and interests of individual research subjects.

Q19. What is the difference between ECG and EEG?

An electrocardiogram (ECG or EKG) is a medical test that detects heart problems by measuring the electrical activity generated by the heart as it contracts. Each beat of the heart is triggered by an electrical impulse generated from special cells in upper right chamber of heart. An electrocardiogram is a painless, non-invasive way to help diagnose many common heart problems in people of all ages. It is used to determine or detect:

Abnormal heart rhythm (arrhythmias)
If blocked or narrowed arteries in your heart (coronary artery disease) are causing chest pain or a heart attack
Whether you have had a previous heart attack
How well certain heart disease treatments, such as a pacemaker, are working

An electroencephalogram (EEG) is a test that detects electrical activity in human brain using small, metal discs (electrodes) attached to his scalp. The brain cells communicate via electrical impulses and are active all the time, even when asleep. This activity shows up as wavy lines on an EEG recording. An EEG is one of the main diagnostic tests for epilepsy. An EEG can also play a role in diagnosing other brain disorders.

Q20. Write Short Note – Brain Stem Death

Brain stem is the “stalk of the brain” which connects the spinal cord to various parts of the brain. It sends messages to the rest of your body to regulate balance, breathing, heart rate and more. It is very vital part of the body. Section 2(d) of the Transplantation of Human Organs and Tissues Act, 1994, defines brainstem death as ““brain-stem death” means the stage at which all functions of the brain-stem have permanently and irreversibly ceased and is so certified under sub-section (6) of section 3 of the Act.”

Identification of brain stem death carries important prognosis for the survival of the patient, because the heart may keep on beating for few days after brain stem death, or even for weeks if the patient is in the Intensive Care Unit of hospital with all forms of medical and cardiac support. The person cannot perform fundamental work of an organism. The person is practically dead but may have heart beat and such person may still able to breathe. Such brain stem death must be certified by a Board of Medical Expert referred to in Section 3(6) of the Act. The Board should contain

the registered medical practitioner in charge of the hospital in which brain-stem death has occurred;
an independent registered medical practitioner, being a specialist, to be nominated by the registered medical practitioner specified in clause (i), from the panel of names approved by the Appropriate Authority;
a neurologist or a neurosurgeon to be nominated by the registered medical practitioner specified in clause (i), from the panel of names approved by the Appropriate Authority: Provided that where a neurologist or a neurosurgeon is not available, the registered medical practitioner may nominate an independent registered medical practitioner, being a surgeon or a physician and an anaesthetist or intensivist subject to the condition that they are not members of the transplantation team for the concerned recipient and to such conditions as may be prescribed;
the registered medical practitioner treating the person whose brain-stem death has occurred.

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