Theme: Health & Environment

Immunity for addicts volunteering for treatment

Trigger Warning: The following content contains information on drugs and narcotics which some readers may find disturbing. 

If an addict who is charged for consuming narcotic drugs or psychotropic substances or any other crime in relation to a small quantity of that drug or substance voluntarily seeks to undergo medical treatment for de-addiction, he will not be prosecuted. The law affords immunity to such persons who are looking to rehabilitate and treat themselves((  Section 64A, Narcotic Drugs and Psychotropic Substances Act, 1985))

This treatment must be done at: 

  • A hospital or institution maintained by the government 
  • A hospital or institution recognised by the government
  • A local authority as provided in the NDPS Act. 

It is important to note that this immunity can be withdrawn if the addict does not undergo the complete treatment for de-addiction(( Section 64A, Narcotic Drugs and Psychotropic Substances Act, 1985))

What is Covid-19 ?

Coronavirus disease (Covid-19) is an infectious disease caused by a newly discovered coronavirus i.e. severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). First identified in Wuhan, China, in December 2019, the World Health Organization (WHO) declared the outbreak to be a pandemic on 11 March, 2020.

Common Symptoms

According to the WHO, those infected with COVID can display any of the following symptoms: 

Most common Less common Serious
  • Fever
  • Dry cough
  • Tiredness
  • Aches and pains
  • Sore throat
  • Diarrhoea
  • Conjunctivitis
  • Headache
  • Loss of taste or smell
  • A rash on skin, or discolouration of fingers or toes
  • Difficulty breathing or shortness of breath
  • Chest pain or pressure
  • Loss of speech or movement


Prevention MethodsIt is also possible for a person to carry the infection without displaying any symptoms. This person can still transmit the disease to someone else.

According to the WHO, to prevent infection:

  • Wash hands regularly with soap and water, or clean them with alcohol-based hand rub.
  • Maintain at least 1 metre (3.2 feet) distance from people coughing or sneezing.
  • Avoid touching the face.
  • Cover the mouth and nose when coughing or sneezing.
  • Stay home if unwell.
  • Refrain from smoking and other activities that weaken the lungs.
  • Practice physical distancing by avoiding unnecessary travel and staying away from large groups of people.

Read our explainer to understand more on how Covid-19 is an epidemic as well as a notified disaster in India.

New strains of the Coronavirus(( Your Health, Covid-19, Centers for Disease Control and Prevention, accessed at https://www.cdc.gov/coronavirus/2019-ncov/transmission/variant.html))

Over time, multiple new variants of coronavirus have been identified in different parts of the world. These include:

  •  The B.1.1.7 variant in the United Kingdom
  •  The B. 1.351 variant in the South Africa 
  •  The P.1 variant in Brazil 

 

Emergency Treatment

Under the law, emergency treatment refers to any medical and mental health care treatment. It can be provided by a registered medical practitioner to a person with mental illness((Section 94(1),  the Mental Healthcare Act, 2017 )). For this, the consent of the nominated representative is required, if they are available.

The immediate treatment prevents((Section 94(1),  the Mental Healthcare Act, 2017. )):

  • The death or harm to the person
  • The person from inflicting serious harm to themselves and/or to others
  • The person from causing serious damage to their or others’ property

However, this does not allow the use of electroconvulsive therapy((Section 94(3),  the Mental Healthcare Act, 2017 )). Further, it does not allow to use any treatment not directly related to the criteria mentioned above((Section 94(2),  the Mental Healthcare Act, 2017 )).

In addition, this treatment is limited to 72 hours under normal circumstances or up to 7 days during an emergency((Section 94(4),  the Mental Healthcare Act, 2017 )).

Punishment for Noise Pollution

Causing noise pollution is a punishable offence under the law. The punishment is:

Causing Public Nuisance

Creating noise is considered to be a public nuisance when you cause any injury, danger or annoyance to the public((Section 268, Indian Penal Code, 1860 )). For example, if your neighbour plays a sound system at midnight very loudly, then this is a public nuisance.

The punishment for such nuisance is a fine up to Rs. 200.((Section 290, Indian Penal Code, 1860; Bhuban Ram and Ors. v. Bibhuti Bhushan Biswas AIR 1919 Cal 539 )) If you continue to make noise even after the Court directs you to stop the noise, the punishment is jail time up to 6 months along with a fine.((Section 291, Indian Penal Code, 1860 )).

Causing Environmental Pollution

Since noise pollution causes significant harm to the environment and surroundings, it is taken seriously under the law. For example, if the construction noise of a building is making it hard for you to live, then this is a form of noise pollution.

The punishment for this offence is jail time up to five years and/or a fine up to Rs. 1 Lakh.((Section 15, The Environment (Protection) Act, 1986. ))

If the noise pollution continues, then you may be punished with an additional fine of Rs. 5000 for every day the pollution happens. If the noise continues for more than a year despite orders to stop it, then you may be punished with jail time up to 7 years.((Section 15, The Environment (Protection) Act, 1986. ))

You have a right to complain about noise pollution and the authorities will take action against the responsible persons.

What are the rights of LGBTQ+ persons with respect to mental health?

Trigger Warning: The following content contains information on mental health issues which some readers may find disturbing.

Not being a straight person/cisgendered is not grounds for being diagnosed with a mental disorder. This means merely being a LGBTQ+ person does not make someone mentally ill.((National Legal Services Authority v. Union of India & Ors. (AIR 2014 SC 1863 )). However, when a person experience significant distress due to the difference between the gender  assigned at birth and gender that they identify with, they may be diagnosed with Gender Identity Disorder.((ICD.Codes, ICD-10-CM Code F64.8, https://icd.codes/icd10cm/F648; Section 2(s), Mental Healthcare Act, 2017 )).

In India, an LGBTQ+ have some rights with respect to mental health:

  • A person cannot be categorised as mentally ill merely if they do not conform to the moral, social, cultural, work or political values or religious beliefs of the community.((Section 3 (3), Mental Healthcare Act, 2017 )) For example, a person is not mentally ill just because they are gay.
  • A person has a right to mental healthcare services offered by mental healthcare establishments funded/run by the government((Section 18 (1), Mental Healthcare Act, 2017 )).
  • Healthcare services cannot be denied to anyone, as referred to above, on the basis of sex, gender or sexual orientation, etc.((Section 18 (2), Mental Healthcare Act, 2017 )).

If a person faces any discrimination while accessing medical or psychological healthcare, they can take action to alleviate the problem. Read for more options in our explainer “What are the options if there is discrimination and harassment by medical personnel against LGBTQ+ persons?“.

Who does this law apply to?

A pregnant woman can seek a legal abortion under two circumstances. First, to preserve the woman’s health, and second, in cases of fetal abnormality. However, in both these cases the doctor’s assessment for abortions is heavily relied on.

Woman’s Health

A doctor can perform an abortion only if in their medical opinion the abortion is necessary because(( Section 3(2), The Medical Termination Of Pregnancy Act, 1971.)):

  • The continuation of the pregnancy would be a risk to the life of the pregnant woman, or
  • The continuation of the pregnancy would cause her grave physical or mental injury.

To understand whether the health of the woman is going to be affected, the doctor is supposed to look at the environment she lived in before the abortion, and the environment she will likely live in after the abortion. The purpose of this is to assess the mental and physical health of the woman by understanding the social circumstances she will be subject to, and the repercussions she will have to face due to her decision to abort((

Section 3(3), The Medical Termination Of Pregnancy Act, 1971.))

The doctor must also consider the term of the pregnancy while assessing the abortion, unless it is an emergency abortion.

Fetal Abnormality

If there is a high chance that the child born would suffer from physical or mental abnormalities which would leave it seriously handicapped, then the doctor can decide to allow an abortion. These abnormalities include  severe cardiac problems, congenital disorders, brain anomalies and a scenario of multiple fetal abnormalities that leave the fetus with severe physical handicaps as well as fewer chances of survival(( Section 3(2), The Medical Termination Of Pregnancy Act, 1971.)).

Apart from these two circumstances, the law also has provisions for:

What are the rights a person has under this law?

The right to healthy environment(( Rural Litigation and Entitlement Kendra v. State of U.P, (1985) 2 SCC 431 : AIR 1985 SC 652.)) for all persons is a part of the Right to Life guaranteed by Article 21 of the Constitution of India. This includes the right to pollution free water(( A.P. Pollution Control Board v. M.V. Nayadu II, (1999) 2 SCC 247 : AIR 1999 SC 912; Mrs. Susetha v. State of T.N., (2006) 6 SCC 543; Narmada Bachao Andolan v. Union of India, (2000) 10 SCC 664; Subhash Kumar v. State of Bihar, (1991) 1 SCC 598 : AIR 1991 SC 420.))(( T. Damodhar Rao v. S.O. Municipal Board, AIR 1987 AP 171; Chhetriya Pradushan Mukti Sangarsh Samiti v. State of U.P., (1990) 4 SCC 449 : AIR 1990 SC 2060; T.N. Godavarnam Thirumalpad v. Union of India, (2002) 10 SCC 606.)).  People have a right to seek remedy for anything which endangers or impairs the quality of life under Article 21 i.e., interferes with the clean water or pollutes water, in violation of the laws,  under Article 32 of the Constitution(( Subhash Kumar v. State of Bihar , AIR 1991 SC 420.)).

Article 48A and Article 51A(g) of the Constitution of India, place a duty on the State as well as every citizen of India to improve and protect the environment including rivers and lakes from pollution.

What are the sources and effects of air pollution?

Air pollution is associated with many sectors, which include power, transport, industry, residential, construction, and agriculture.

Sources of Air Pollution

Burning of fossil fuels and emissions

The majority of air pollution comes from the use of energy like the burning of fossil fuels which releases toxic gases and chemicals into the air.(( National Clean Air Programme, Ministry of Environment, Forest and Climate Change, accessed at http://moef.gov.in/wp-content/uploads/2019/05/NCAP_Report.pdf.)) The two most common types of air pollution are smog and soot, caused by burning of fossil fuels like coal or natural gases. The small airborne particles present in soot or smog are extremely dangerous, as they enter lungs and blood and can lead to bronchitis and heart diseases which can be fatal. 

Other sources of harmful air pollutants are in the emissions from industry, vehicles, road dust, construction, garbage burning, domestic households and diesel generator sets.(( National Clean Air Programme, Ministry of Environment, Forest and Climate Change, accessed at http://moef.gov.in/wp-content/uploads/2019/05/NCAP_Report.pdf.))

Use of Air Conditioners

Increased use of air conditioners leads to a direct increase in the demand for electricity. This demand for electricity consequently increases the dependence on fossil fuels to meet the collective energy needs. The electricity sector, thus, is the largest source of polluting greenhouse gas emissions. Increased levels of greenhouse gas emissions are responsible for climate change and air pollution. Therefore, increased usage of air conditioners is one of the causes of air pollution and is a threat to public health.(( National Research Development Corporation, accessed at: https://www.nrdc.org/experts/vijay-limaye/ac-cools-us-warmer-world-dirties-air-harms-health.))

However, a case cannot be filed against any single individual for such an act, as no one person is solely responsible for the increased demand of energy or air pollution. It is a result of increased use of air conditioners as a community which leads to these harmful effects of air pollution.

Vehicular Pollution

Emissions from vehicles are the source of 60-70% of overall air pollution. The Government is trying to control such emissions through measures like stricter mass emission standards and protocols, phasing out of old vehicles,(( Report of Working Group on Environment and Environmental Regulatory Mechanisms, NITI AAYOG, accessed at: https://niti.gov.in/planningcommission.gov.in/docs/aboutus/committee/wrkgrp11/wg_envtal.pdf.)) increased awareness about vehicle maintenance and lane discipline, revised fuel efficiency norms like use of alternative fuel programmes and blending of biofuels, promotion of electric or hybrid vehicles and increased use of public transport like metros, e-rickshaws.(( Reference Note, Vehicular Pollution in India, Lok Sabha, accessed at: https://niti.gov.in/planningcommission.gov.in/docs/aboutus/committee/wrkgrp11/wg_envtal.pdf.))

Effects of Air Pollution

Climate Change 

Air pollution is both the cause as well as an effect of climate change. The emissions of carbon dioxide and methane raise the earth’s temperature. Consequently, increased heat leads to smog (smoke and fog) and increased UV radiation.(( Air Pollution, National Research Development Corporation, accessed at: https://www.nrdc.org/stories/air-pollution-everything-you-need-know#sec1.))

Health Impacts 

Air pollution is extremely concerning due to its life-threatening health impacts. However, the impact of air pollution is not limited to health but extends to agriculture and the general well-being of human, plant and animal life. Other effects of air pollution can be irritation of the eyes and throat, damage to the lungs and can trigger allergies and asthma attacks.(( National Clean Air Programme, Ministry of Environment, Forest and Climate Change, accessed at http://moef.gov.in/wp-content/uploads/2019/05/NCAP_Report.pdf.)) Long term exposure to polluted air may also cause skin problems, harm to liver and reproductive organs. Presence of hazardous chemicals, like lead and mercury, in the air can damage children’s brain function.(( Air Pollution, National Research Development Corporation, accessed at: https://www.nrdc.org/stories/air-pollution-everything-you-need-know#sec1.)) Patients with lung or heart ailments are more vulnerable to the effects of air pollution.

 

 

Obtaining Information About Medical Records or Reports

Patients have the right to obtain authentic information regarding their medical condition or ailment, method of treatment and options for treatment(( Annexure 8, Clinical Establishments Act (Standards for Hospital Level 1A & 1B), 2010)). Patients have to be provided:

  • Adequate information so that they can make an educated decision, give consent or withdraw consent for treatment.
  • Medical information in a language that the patient understands, communicated to them in a manner that is not overly technical.
  • Information regarding costs/additional cost of treatment or diagnosis at the completion of treatment. The patient or his caretaker has the right to receive an itemised receipt.(( Charter of Patient Rights, Ministry of Health and Family Welfare.))
  •  Basic details of the doctors and medical staff treating the patient, including the identities,  qualifications and name of the primary treating doctor/consultant.

Doctors are required to maintain the records of patients they treat for 3 years from the date of starting the treatment(( Section 1.3.1, Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations, 2002)), in a format prescribed by the Indian Medical Council.(( Appendix 3, Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations, 2002))

Asking for Medical Records or Reports

Patients and their caregivers also have the right to ask for medical records and reports(( Nisha Priya Bhatia v. Institute of Human Behavior & Allied Sciences 2014 SCC OnLine CIC 5092)) of their case, which should be provided to them within 3 days.(( Section 1.3.2, Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations, 2002))

Hospital authorities have a duty to provide such information under the law.(( Right to Information Act, 2005; Consumer Protection Act, 1986 (now repealed by Consumer Protection Act, 2019); The India Medical Council Act, 1965; World Medical Ethics, World Medical Association )).Not maintaining such records or not complying with the patient’s request for records in the stipulated time will amount to professional misconduct.(( Section 7.2, Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations, 2002)). Further, the doctor shall be liable to disciplinary action.

The following documents can be obtained by the patient from the hospital(( Charter of Patient Rights, Ministry of Health and Family Welfare)):

  • Originals and copies of case papers.
  • Indoor patient record. For instance, this includes a repository of medical information and history of a patient.
  • Investigation reports. For instance, this includes details of the methods including  tests and scans done to help with the diagnosis or management of a disease.
  • Discharge summary. This is a document prepared by the attending physician detailing the diagnosis, course of treatment and follow-up (if any) of a patient when he is  discharged from the doctor’s care.
  • Death summary, which is given to the caregiver in case of death of the patient.

Filing an RTI Application (Right to Information)

To obtain some of the information given above, you can file an RTI application to both government and private hospitals. Some examples of when you can file an RTI are:

  • To claim related documents
  • To get COVID-19(( Mr.Venkatesh Nayak vs. CPIO & CMO(EMR), Ministry of Health & Family Welfare and Ors. CIC/MOHFW/C/2020/668909-BJ)) related information such as treatment facilities.
  • To access medical records of patients.(( Shri Prabhat Kumar v. Directorate of Health Services GNCTD 2015 SCC OnLine CIC 2742))

If you require any assistance on filing an RTI application to ask for medical records or information, then you can check out the Right to Information topic for further clarification.

Cigarettes and Tobacco Products

Under the law, tobacco products refer to(( Schedule I, the Cigarettes and Other Tobacco Products (Prohibition of Advertisement and Regulation of Trade and Commerce, Production, Supply and Distribution) Act, 2003.[↩])) products like:

  • Cigarettes
  • Cigars
  • Cheroots (a cigar which is open on both ends)
  • Beedis
  • Chewing Tobacco
  • Snuff
  • Cigarette tobacco, pipe tobacco and hookah tobacco
  • Pan masala
  • Gutka
  • Tooth Powder containing Tobacco

A cigarette is a roll of tobacco wrapped in paper or in any other material. However, under the law beedis, cheroots and cigars are tobacco products, not cigarettes(( Section 3(b), the Cigarettes and Other Tobacco Products (Prohibition of Advertisement and Regulation of Trade and Commerce, Production, Supply and Distribution) Act, 2003.[↩])).

Indian law, governs the production, sale, distribution, consumption of advertisement of cigarettes and tobacco products. For example, smoking in a public place is not allowed, as is sale to a minor person and advertisement of tobacco products.