Theme: Health & Environment

Do I need my parent’s permission to get an abortion?

If you are above 18 years, you do not need to get your parent’s permission under the law. You do not even need to tell your parents. Some hospitals and clinics do insist on obtaining your parent’s permission if you are unmarried. However, this is not required by the law.

Can I get an abortion if I am in my second trimester of pregnancy?

If you have been pregnant for less than 20 weeks, you can get an abortion if the doctor agrees that the required conditions have been fulfilled. At any point of time after 20 weeks, the doctor can perform an abortion only if it is immediately required to save your life.

What are mental healthcare establishments?

Mental health establishments are(( Section 2(p), Mental Healthcare Act, 2017)) any health establishments funded or run by the government, and meant for the care of people who are suffering from mental illnesses or where such people reside, temporarily or not, for treatment and rehabilitation.  These include establishments for Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homoeopathy and any general hospital/nursing home, run or funded by the government. However, this does not include a family residential place where a person with mental illness resides with his relatives or friends. 

What are mental healthcare services?

Mental healthcare services refer to analysis and diagnosis of someone’s mental condition including treatment, care and rehabilitation(( Section 2(o), Mental Healthcare Act, 2017)).

Guide to Accessing Safe Abortions

How can the guide help you?

The Nyaaya Guide to Accessing Safe Abortions aims to highlight the rights available to women accessing abortions and the processes to be followed for a safe and legal abortion.

What are the laws being discussed in the guide?

The primary law being dealt with is the Medical Termination of Pregnancy Act, 1971 (MTP Act), and the associated Rules and Regulations. We have also referred to the Constitution of India, 1950 and the Indian Penal Code, 1960.

As per the 2018 national Sample Registration System data, the total estimate of maternity-related deaths in the country was around 26,437. While the exact percentage of this number contributed by complications from unsafe abortions is difficult to pinpoint, it is an undisputed factor contributing to this death rate. The aim of this guide is to make you aware of your reproductive rights and various processes under Indian law, and to deter women from accessing unsafe abortions and avoiding complications like maternal and infant mortalities and related morbidities.

Data on Maternal Deaths:

 

17 2500 7363
Number of points Maternal Mortality Ratio (MMR) has declined by Additional mothers saved annually Estimated Annual Maternal Deaths avoided

 

Are abortions legal in India?

Yes, abortions, or medical terminations of pregnancy, are legal in India. However, there are certain conditions prescribed for going ahead with an abortion.

‘Abortion’ is not the term used in law. While ‘abortion’ is the colloquially used term, the law refers to the process as a ‘medical termination of pregnancy’.

In practice, this includes two methods – medical terminations and surgical terminations, which the World Health Organization recognized as the two safe methods of terminating a pregnancy. The Medical Termination of Pregnancy (Amendment) Bill, 2020, proposes to include a definition for the term ‘medical termination of pregnancy’ to include these two methods. However, the Bill is yet to become a law.

 

Do you have the right to demand an abortion?

While in principle you have a fundamental right to make reproductive choices, the final decision to grant you the abortion will depend upon the satisfaction of the authorised doctor.

Courts have linked the right to access abortions and other reproductive health services to the right to life and personal liberty under Article 21 of the Constitution, including the right to decisional privacy. However, doctors can only conduct an abortion if they are of the opinion that a case/request falls under one of the grounds listed in the law.

TWO DIFFERENT KINDS OF ABORTIONS

Doctors can perform two different kinds of abortions:

  • Medical abortions
  • Surgical abortions.

When you approach a doctor for an abortion, the first step is to do an ultrasound to ensure that the foetus is inside the uterus. Many times, it can be outside the uterus, for instance, in the fallopian tube. A pregnancy in the fallopian tube can cause a medical emergency and needs an operation.

What happens in a medical abortion?

  • A medical abortion is done before 9 weeks of pregnancy by administering two kinds of pills, Mifepristone and Misoprostol.
  • After the doctor has conducted your ultrasound and ensured that you are eligible for a medical abortion, the first type of pill, Mifepristone, will be given to you at the clinic. This pill acts against the progesterone in your body, i.e. cuts off the nutrition to the foetus.
  • The second type of pill, Misoprostol, makes your cervix soft to ensure everything comes out like a period.
  • The pills must be administered within 24 to 72 hours of each other. This is different depending on which doctor you go to. They can also be taken at home.
  • You must visit the doctor again after taking all the medication to check that the abortion has been successfully carried out.
  • These pills are only available with a doctor’s prescription and should not be taken without consulting a doctor.
  • It is also illegal for the pharmacist to sell these pills without prescription. It is a jailable offence.

What happens in surgical abortions?

  • Surgical abortions are done after 9 weeks of pregnancy.
  • As the name suggests, a surgical abortion is a surgical procedure that an authorised and experienced doctor conducts on you.
  • In this procedure, the doctor will give you a medicine that softens your cervix along with some anesthetic or sedative. Sedation or anesthesia is used to reduce pain and/or trauma during the procedure.
  • Doctors use vacuum aspiration and go in through the vagina (outside of the vulva) and suck the contents of the uterus out.
  • This is a very safe procedure but it must be done by someone with experience. If inexperienced persons do this, there can be complications like infertility in the long run.

WHEN CAN AN ABORTION BE PERFORMED?

A woman can medically terminate her pregnancy if she is:

  • Up to 12 weeks pregnant, with the permission of one registered medical practitioner.
  • From 12 to 20 weeks, with the permission of two registered medical practitioners.
  • Post 20 weeks, registered medical practitioners can terminate a pregnancy if they deem that the abortion is necessary to save the life of the pregnant woman.
Requesting an abortion after finding out the sex of the fetus is illegal in India. The law punishes those who request such abortions as well as medical practitioners partaking in identification of sex of the fetus. The punishment for both is jail time upto three years, along with a fine up to Rs. 50,000.

 

For a doctor to legally terminate a pregnancy, they must believe that there is:

  • A risk to the life of the pregnant woman, or grave injury to her physical or mental health.
  • A significant risk that if the abortion is not carried out, the child so born would suffer from physical or mental abnormalities and be seriously handicapped.
A pregnancy is considered injurious to the woman’s mental health if it is caused by:

  • Rape.
  • Failure of contraceptives or preventive methods. This is applicable only to unwanted pregnancies of married women. Presently, there is a Bill pending before Parliament that seeks to make this provision available to both married and unmarried women. Until then, this presumption only applies to married women.

 

The doctor will consider the pregnant woman’s actual and reasonably foreseeable environment while deciding whether continuation of a pregnancy would affect her mental or physical health.

WHO CAN PERFORM AN ABORTION?

Only doctors who are Registered Medical Practitioners can administer abortions via the pill or surgery.

Abortions conducted by unregistered or unauthorised practitioners or clinics can be unsafe for the woman and can cause severe medical complications contributing to maternal mortality and/or morbidities. Before approaching a clinic or a doctor, it is advisable to find out if they are registered as per law.

If you have reason to believe that the doctor who conducted your abortion or the clinic where it was performed was not authorised, please visit another doctor and/or hospital. You can file a complaint to the police and report such unauthorised persons or clinics as well. You can find the punishments for unauthorised persons and clinics conducting abortions here.

 

Don’t worry! The police and/or courts will not punish you for approaching an unregistered practitioner or an unauthorised clinic if you did not know that they were not authorised at the time of the abortion.

Do make sure you visit an authorised doctor at the earliest and get yourself checked. Medical complications from an unsafe abortion can be severe and cause further problems to your health.

REMEMBER: It is important to complain about such persons and/or clinics to prevent unsafe abortions.

 

In emergency situations, where a doctor who is not a registered medical practitioner needs to conduct an abortion to save the life of the pregnant woman,  they can do so in good faith.

WHOSE CONSENT IS NEEDED FOR AN ABORTION?

A woman above the age of 18 seeking an abortion does not require anyone else’s consent or permission to obtain it. Only her consent is required. To ensure proper consent is taken, the doctor/clinic will make the woman requesting an abortion sign Form C.

Consent form to be signed by woman requesting abortion

Some doctors will require another person to be there with you during and after the procedure. Having an abortion can be a traumatic experience, both physically and mentally. You need someone to help you as the effects of anesthesia take some time to wear off, and to be there for you in case you face anxiety or need any other form of support.

In case a pregnancy is requested for a minor, the consent of her parent or guardian is required. In cases of abortions requested for mentally ill persons, the consent of the guardian is required.

REMEMBER: Married women do not need the consent of their partner before terminating their pregnancy. Only the woman’s consent is required. Doctors are not required to ask women to furnish their marriage certificate to conduct an abortion.

 

Abortion for Minors

All doctors are legally obligated to report a pregnancy of a minor in India. This is because the age of consent in India is 18 years, and a pregnancy of a woman below this age is considered a result of rape.

This is a mandatory requirement for all doctors, not just the ones conducting abortions. For instance, an ophthalmologist who conducted an eye exam on a pregnant minor was arrested for not reporting such a pregnancy.

This duty to report applies in cases of married minors too.

WHERE CAN AN ABORTION BE CONDUCTED?

All hospitals established/maintained by the Government or hospitals approved by the Government to perform abortions are allowed to carry out procedures to terminate pregnancies.

As for private facilities, only those with a certificate granted by a District Level Committee can perform abortions.

 

SAFE ABORTION UNSAFE ABORTION
Govt authorized hospitals and private facilities with a certificate to perform abortions Illegal vans with mobile ultrasound units

 

There have been recent cases of illegal abortions being conducted in vans with mobile ultrasound units. According to rules under the PCPNDT Act, your ultrasound machine has to be registered, and remain in the authorised place and cannot be moved. In Uttar Pradesh, tracking devices are now being added to ultrasound machines so every single ultrasound you do will be tracked.

Would you be punished for availing an abortion from an unauthorised place?

If the pregnancy is causing significant distress to your mental health, the MTP Act protects you from punishment in such a case.

How can you ensure the clinic or the doctor conducting your abortion is authorised to do so?

  • You must ensure that the doctor conducting the abortion has an MBBS degree. Doctors with BAMS, BMS, BHMS degrees are not legally authorised to perform abortions.
  • You can also check if your doctor has a postgraduate degree after the MBBS degree, such as an MS degree, in the field of gynaecology or obstetrics, but this is not an essential requirement. However you must ensure that they have a certification of a 6 months authorised course from a government approved centre.
  • There is no combined list of authorised centres online, but you can check if you are at an authorised clinic  by checking if the doctor is an MBBS doctor working in a gynaecology and obstetrics related setting.
  • In a village or a rural area, ensure that the doctor has at least an MBBS degree, because even medical abortions can be life threatening.

WHAT QUESTIONS CAN THE DOCTOR ASK YOU BEFORE CONDUCTING AN ABORTION?

 

The doctor will ask you for the following details (probably as a form to be filled):

  • Your age
  • Your consent (Note: Nobody else’s consent is required here)
  • Previous medical condition, if any – like bleeding disorder, etc.
  • Any previous children
  • Any previous medical or surgical abortions conducted
  • Any allergies to any of the medications they will administer during an abortion
  • Date of your last period to calculate the age of the pregnancy.

Things that you don’t need for an abortion:

  • Disclosure of your marital status – If the pregnancy is having a significant impact on your mental health, you are within your rights to seek an abortion.
  • Anybody else’s consent – If you are above the age of 18 years and of sound mind, you do not need your partner’s or parent/guardian’s consent to get an abortion.

In some cases, the hospital/clinic may ask you to bring someone along with you for support after the abortion is done. This does not mean that their consent is required for the procedure.

Will the clinic keep your information private?

Yes, the head of the hospital will keep information related to the termination of pregnancy (including the consent form) in safe custody.

An admission register will contain the serial number given to the patient for the termination of pregnancy, and the register will be kept secret as well. The clinic will keep this register for 5 years, after which it will be destroyed. The details about the pregnant woman will not be disclosed to anybody, including family members, police or specific authorities mentioned in law.

The Court can request to see this register in medico legal cases. In such cases, only the Court will have access to copies of the register and no one else

Even where your doctor refers you to another doctor for a treatment related to your abortion, the details of your abortion must be kept private.

Can you get medical leave from work after an abortion?

Yes, if the woman asks for a certificate, the doctor can grant a certificate to the woman upon termination of her pregnancy for her to get medical leave from work. Once a certificate is submitted to the employer, they are prohibited from disclosing these details to anybody.

At some workplaces, you can take a paid leave if you have an illness arising out of the abortion procedure you underwent. Such leave can be availed under the maternity benefits law. To check if your workplace is covered under this law, read this explainer.

The Court can request to see this register in medico legal cases. In such cases, only the Court will have access to copies of the register and no one else

Even where your doctor refers you to another doctor for a treatment related to your abortion, the details of your abortion must be kept private.

MYTHS AROUND MEDICAL ABORTIONS

 

 

MYTH FACT
Abortions cause infertility.  If performed correctly, abortions will not make you infertile. However, if you are given an abortion when you have had an ectopic pregnancy that causes you to lose one of your fallopian tubes, it will impair your fertility (it still won’t make you infertile).
Abortion causes PCOS or breast cancer. No, abortions don’t cause either.
Safe abortions done by doctors do not cause any damage to the uterus.  If you get an abortion from an untrained doctor, there could be chances of complications. 

 

RESOURCES

 

The medical information on abortions in this guide has been provided by Dr Tanaya Narendra, also popularly known as Dr. Cuterus. More information on reproductive rights and sexual health can be found on her handle here.

Legislation:

Medical Termination of Pregnancy Act, 1971

Medical Termination of Pregnancy Rules, 2003

Medical Termination of Pregnancy Regulations, 2003

The Pre-conception and Pre-natal Diagnostic Techniques (Prohibition of Sex Selection) Act, 1994

Guidelines:

Safe Abortions: Technical and Police Guidance for Safe Abortions, World Health Organisation

 

Case law:

Suchita Srivastava & Anr vs Chandigarh Administration

Devika Biswas vs. Union of India

 

Checklists

  • Ensure you visit a doctor and have an ultrasound done before getting an abortion.
  • Ensure the place or the doctor you are visiting to have the abortion is registered and authorised under law.
  • Ensure you read Form C carefully before signing it. As an adult woman, only your consent is needed for the procedure.
  • If someone is forcing you to get an abortion, please file an FIR with the police.

Sample Forms

Consent form to be signed by woman requesting abortion

Form C

(See rule 8)

I ________________ daughter/wife of_______________ aged about _____ years of __ (here state the permanent address) __ at present residing at _____________________________

do hereby give my consent to the termination of my pregnancy at ___(State the name of place where the pregnancy is to be terminated)__Place:

Date:

Signature(To be filled in by guardian where the woman is a mentally ill person or minor)

I_________________________son/daughter/wife of__________________ aged about __________ years of _____________________at present residing at __(Permanent address ) ____ do hereby give my consent to the termination of the pregnancy of my ward ______________________ who is a minor/lunatic at ____(place of termination of my pregnancy)__.

Place:

Date:

 

Certificate Issued to Clinic/Hospital authorised to conduct abortions

 

Form B

(See sub-rule (6) of rule 5)

Certificate of approval.

The place described below is hereby approved for the purpose of the Medical termination of Pregnancy Act, 1971 ( 34 of 1971).

AS READ WITH IN UPTO ————-WEEKS

Name of the Place

Address and other descriptions

Name of the owner

Place:

Date:

to the Government of the ________________

 

Form available at

https://main.mohfw.gov.in/acts-rules-and-standards-health-sector/acts/mtp-rules

Health Laws

There are certain laws that relate to your legal rights as a patient and your fundamental rights around the medical  care you are entitled to. Watch our video interviews, where experts in these fields explain the laws and your rights in a simple, actionable manner.

Self-Declaration for Travelling During Covid

How can the guide help you?

This guide by Nyaaya and Ungender helps those who have faced sexual harassment at the workplace to navigate the legal process in such situations. The guide clarifies legal aspects including what constitutes sexual harassment, remedies or safeguards available to the survivor, investigation procedure, punishments, etc.

The guide’s objective is to help survivors of sexual harassment secure a safe work environment and enable them to take action against sexual harassment by a colleague, visitor, or anyone else at a workplace.

 

sample (1)

What is Noise Pollution?

Noise is common in everyday life, but when it goes above a certain limit, it is considered to be pollution1 as well as a public nuisance1. Noise at such levels may be injurious to human beings, living creatures, plants, property and the environment2

The law known as the Noise Pollution (Regulation And Control) Rules, 2000 regulates and controls noise in India.

Right to Live in Peace without Noise

Everyone has the right under Article 21 of the Constitution of India, 1950 to live in peace, comfort and quiet within their house and has a right to prevent the noise from reaching them3. No one can claim a right to create noise even in their own premises which would travel beyond their precincts and cause nuisance to neighbours or others. That’s why any noise which affects the ordinary comforts of life of a person is also considered to be a nuisance4.

Meaning of Noise

The word noise is not explained in any law but noise is considered to be an environmental pollutant1 in India. It is one of the main causes of environmental pollution.

Noise derives its meaning from the Latin term ‘nausea’. Courts have defined noise as ‘unwanted sound, a potential hazard to health and communication dumped into the environment with regard to the adverse effect it may have on unwilling ears4. For example, a blaring horn causes unwanted noise but the sound which pleases the listeners is music and is not considered to be noise4.

Causing Noise Pollution

Decibel is the unit of measurement of noise. There are noise limits that you will have to follow depending on the area you live in. However, since measuring noise requires scientific instruments (such as a sound level meter), you may not always know if you are exceeding the noise limits for a particular area. In such cases, you should:

  • Make sure that regardless of what you do or which equipment you use, it does not turn out to be noisy and a disturbance for others. For example, if you are playing music during a party, try to keep the volume down at night time while people are sleeping.

  • Don’t wait for your neighbours or people around you to file a complaint to the police. If they mention that you are making noise that is disturbing them, try to reduce the noise.

Please note that it does not matter whether you made the noise unintentionally or intentionally; all that matters is whether you have created too much noise.

Complaining against Noise Pollution

If any noise causes you annoyance, discomfort or any injury, then you can file a complaint with the police or your State’s Pollution Control Board. Otherwise, you can also complain if you know that the noise5. level is disturbing you or it happens at night between 10:00 pm and 6:00 am.

  1. Section 2 (a) of the Air (Prevention and Control of Pollution) Act, 1981. [↩] [↩] [↩]
  2. Central Pollution Control Board, WHO Guidelines for Noise Quality, https://cpcb.nic.in/who-guidelines-for-noise-quality/Some common sources of noise pollution are industrial activity, construction activity, generator sets, etc.(Preamble, Noise Pollution (Control and Regulation) Rules, 2000). [↩]
  3. Burrabazar Fireworks Dealers Association v. Commissioner of Police, Calcutta AIR 1998 Cal 121 [↩]
  4. Noise Pollution (V), In re, (2005) 5 SCC 733 [↩] [↩] [↩]
  5. Rule 7, Noise Pollution (Control and Regulation) Rules, 2000. [↩]

What is the need for LGBTQ+ specific healthcare?

LGBTQ+ persons might have healthcare needs that are specific and unique to their experiences. Some of the common healthcare issues are:

There may also be a social bias present, which may make accessing adequate healthcare difficult. For example, a therapist may refuse to treat someone because they are gay or a transgender person.  This may result in people avoiding treatment in a timely manner, or may result in a person not disclosing their true gender/sexual identity, which may lead to added complications. This is why it is important for to understand your rights while accessing healthcare.

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?“.

What is Mental Illness?

Mental illness is a health condition1 which involves substantial disorder of thinking, mood, perception and orientation or memory. This may lead to gross impairment of judgment, behaviour, capacity to recognise reality or ability to meet the ordinary demands of life. Abuse of drugs or alcohol may also result in a mental condition. Some examples of mental illness are substance abuse disorder, bipolar disorder, etc. This does not include mental retardation i.e. incomplete intellectual development. Persons with mental illness also have rights under the law including the right to confidentiality, right to treatment, etc. 

Determination of Mental Illness

To determine whether one has a mental illness it must be determined according to nationally/internationally accepted medical standards, like the International Classification of Disease of the World Health Organisation.2 

These reasons cannot determine whether a person is mentally ill3:

  • Past treatment for a mental illness4
  • Political, economic or social status
  • Belonging to a cultural, racial or religious group, or for any other reason not directly relevant to mental health status of the person; 
  • Refusal to conform to moral, social, cultural, work, political, or religious values prevalent in one’s community.

Please note that one cannot be considered as a person of unsound mind, merely because they have a mental illness. Only a Court can declare a person to be of unsound mind5. 

Capacity to Make Treatment Decisions

The capacity to make mental healthcare-related decisions depends on the conditions given above6 :

  • The ability to understand relevant information on mental healthcare related issues, such as admission, personal assistance or treatment. Please note the information given to the person has to be comprehensible. For example, Ram cannot hear properly. The information given to him will be using means that will enable him to understand it7. 
  • The ability to understand the consequences of a decision on the treatment, admission or personal assistance
  • The ability to communicate the formed decision through speech, expression, gesture, etc. 

If one takes a decision that others think is incorrect or inappropriate, that solely will not mean that one does not have the capacity to make such a decision8. For example, against the wishes of his parents, Ram decides not to go to a mental health establishment. The sole fact that Ram’s parents think that a decision is inappropriate does not mean they do not have the capacity to make such a decision.

  1. Section 2(s), the Mental Healthcare Act, 2017. [↩]
  2. Section 3(1), the Mental Healthcare Act, 2017. [↩]
  3. Section 3(3),  the Mental Healthcare Act, 2017. [↩]
  4. Section 3(4),  the Mental Healthcare Act, 2017. [↩]
  5. Section 3(5),  the Mental Healthcare Act, 2017. [↩]
  6. Section 4(1),  the Mental Healthcare Act, 2017. [↩]
  7. Section 4(2),  the Mental Healthcare Act, 2017. [↩]
  8. Section 4(3),  the Mental Healthcare Act, 2017. [↩]

What is water pollution?

Water pollution is the contamination of water, i.e. changing of the physical, chemical or biological properties of water or the emission of sewage or industrial discharge. It includes the introduction of any solid, liquid or gaseous pollutant into water (either directly or indirectly) which would make water toxic and injurious to the health of the public or for domestic, commercial, agricultural or other important purposes or be unsafe and harmful to the life and health of plants, animals and aquatic organisms1.

Causes of water pollution include:

i. Solid water pollutant. For example, plastic waste, metals, food and animal remains.

ii. Liquid water pollutant. For example, sewage, human waste and industrial waste water.

iii. Gaseous water pollutant. For example, methane, carbon dioxide, sulphur dioxide, nitrogen oxide.

  1. Section 2(e), The Water (Prevention and Control of Pollution) Act, 1974. [↩]

What is Air Pollution?

Air pollution is the presence of dust, fumes, gas, mist, odor, smoke or vapour, in the atmosphere, in quantities that can cause injury to human, plant or animal life or harm the environment.1 The Air Quality Index (AQI) measures the quantities of these pollutants in the atmosphere in an area. The causes of air pollution include:2

  • Solid Air Pollutant. For example, burning of solid fuels such as firewood, crop residue, cow dung cakes, coal, lignite and charcoal.3
  • Liquid Air Pollutant. For example, use of gasoline, kerosene and diesel in households. 
  • Gaseous Air Pollutant. For example, sulphur dioxide, carbon monoxide and nitrogen. 
  • Noise Pollutant. For example, harsh sounds from traffic, engines, generators and fireworks.

The National Ambient Air Quality Standards, set by the Central Pollution Control Board, lay down the permissible limits of twelve pollutants like sulphur dioxide, nitrogen dioxide, trioxygen, lead, carbon monoxide, ammonia, benzene, arsenic, nickel and particulate matter. These limits differ for industrial, residential, rural, ecologically sensitive areas and other areas created by the Central Government.4

 

Right to Clean Environment

The right to a clean environment is a right available to all citizens in India.5 Article 21 of the Constitution of India, 1950 lays down the right to life and personal liberty, which includes the right to pollution-free air6 and a clean environment. Art. 51A(g) of the Constitution also creates a duty upon every citizen to protect and preserve the environment.7

If a person is suffering from health issues, due to air pollution, they have a right to complain under the law. Read more in our explainer “Who can you complain to regarding a grievance under the law?”

  1. Expert Committee of The Central Pollution Control Board (‘CPCB’); UPADHYAY S. & UPADHYAY V, HANDBOOK ON ENVIRONMENTAL LAW: WATER LAWS, AIR WILDLIFE LAWS AND THE ENVIRONMENT (VOL. II), 2002. [↩]
  2. Section 2(a), Air (Prevention and Control of Pollution) Act, 1981. [↩]
  3. Indicators of Social Consumption, Ministry of Statistics and Program Implementation, accessed at: http://mospi.nic.in/sites/default/files/publication_reports/Report_585_75th_round_Education_final_1507_0.pdf. [↩]
  4. National Ambient Air Quality Standards and Trends 2019, cpcb.nic.in, accessed  at: https://cpcb.nic.in/upload/NAAQS_2019.pdf. [↩]
  5. Shri. Sachidanand Pandey v. State of West Bengal, AIR 1987 SC 1109. [↩]
  6. Subhash Kumar v. State of Bihar, AIR  (1991) 1 SCC 598; M.C. Mehta v. Union of India (Aravalli Mining case) (2004) 12 SCC 118. [↩]
  7. Article 51A(g), The Constitution of India, 1950. [↩]

Patient Rights in India

The word ‘patient’ has not been defined anywhere under Indian Law. However, the term covers those people who receive healthcare services by doctors or medical professionals. The Government including state governments have a duty to provide healthcare services and improving public health1.

Laws governing Patient Rights

The laws governing rights of  people who approach healthcare establishments or medical professionals in India include:

  • The Constitution of India, 1950
  • Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations, 2002
  • Drugs and Cosmetics Act, 1940
  • Clinical Establishment(Registration and Regulation) Act, 2010
  • Indian Penal Code, 1860 and Code of Criminal Procedure, 1973.

These laws guide medical health professionals in maintaining a standard of care and treatment of patients. Since there is no specific legislation covering patient rights in India, the Ministry of Health and Family Welfare, and the National Human Rights Commission released the Charter of Patient Rights. Further, this contains the rights protecting patients who access medical care. These include:

List of Patient Rights in India

The Ministry of Health and Family Welfare and National Human Rights Commission released the Charter of Patient Rights. It enumerates 17 rights that all patients in India are entitled to. These include:

Right to Information

A patient has the right to obtain authentic information regarding their medical condition or ailment, method and options for treatment.

Right to records and reports

Hospital authorities have a duty to provide medical records and reports to all patients or their caregivers.

Right to emergency medical care

No patient can be turned away from receiving emergency medical care from a government or private hospital.

Right to informed consent

A medical professional should obtain the consent of the patient or their caregiver, spouse or guardian (in case of a minor) in writing, before performing an operation.

Right to confidentiality, privacy and dignity

All medical professionals have to maintain the highest level of confidentiality regarding the private details of the patient.

Right to second opinion

A patient is free to go for a second opinion for any doctor of his or her choice.

Right to transparency in rates

All costs that are levied on patients for services, tests and treatments rendered by medical establishments have to be made available to the public.

Right to non-discrimination

Doctors and medical personnel cannot refuse treatment to patients on the grounds of gender, sexuality, caste, religion, race, place of birth or illnesses.

Right to safety and quality care according to standards

It is the duty of medical establishments to provide a safe and clean environment for treatment. 

Right to choose alternative treatment options if available

Once a patient or their caregiver are informed of their treatment options, they are free to choose the course ahead. They cannot be compelled to follow a certain treatment without their will, even if the doctor deems it necessary. 

Right to choose source for obtaining medicines and tests

When medicines or tests are prescribed to a patient, it is up to them to decide where they want to purchase it from. It is guaranteed as their right as a consumer to have access to a variety of goods or services at competitive prices. 

Right to proper referral and transfer, which is free from perverse commercial influence

All patients have a right to receive seamless service and quality of care being upheld when the patient is referred to a different doctor or the patient is  transferred to a different facility. 

Right to protection for patients involved in clinical trials

Participants of all clinical trials in India have rights such as claiming compensation in case of trial-related injury or death, confidentiality of personal information etc.

Right to protection of participants involved in biomedical and health research

The National Ethical Guidelines for Biomedical and Health Research Involving Human Participants have to be followed to ensure rights are given to the participants.

Right to take discharge of patient, or body of deceased from the hospital

During any point in the treatment, a patient is free to take discharge or leave from the hospital. They cannot be held without their will or kept in the hospital by force. Similarly, caretakers of a deceased patient have the right to receive their body from the hospital.

Right to patient education

Patients have the right to receive education about the facts relevant to their condition and healthy living practices.

Right to be heard and seek redressal

If a patient or their caregiver have a grievance against a doctor or the hospital administration regarding the quality of treatment provided, they have a right to seek redressal for the same.

  1. Article 42, Constitution of India, 1950; Entry 6, List II, Schedule VII, Constitution of India, 1950. [↩]

Duties of Educational Institutes

The owner/manager of an education institute must ensure that a board is displayed at a conspicuous place outside the institute, which states the following:1

  • The sale of cigarettes and other tobacco products is strictly prohibited within 100 yards of the institute. The distance measured radially from the outer boundary of the institute.
  • The punishment2 is a fine of Rs. 200. 

Punishment

You cannot sell tobacco products within 100 yards of an educational institute. The punishment is a fine of Rs. 200.3

  1. Section 3, the Cigarettes and Other Tobacco Products (Display of Board by Educational Institutions) Rules, 2009.[ [↩]
  2. Section 24 of the Cigarettes and Other Tobacco Products (Prohibition of Advertisement and Regulation of Trade and Commerce, Production, Supply and Distribution) Act, 2003. [↩]
  3. Section 24, the Cigarettes and Other Tobacco Products (Prohibition of Advertisement and Regulation of Trade and Commerce, Production, Supply and Distribution) Act, 2003. [↩]

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 themselves1

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.2

  1. Section 64A, Narcotic Drugs and Psychotropic Substances Act, 1985. [↩]
  2. 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.

 

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 illness1. For this, the consent of the nominated representative is required, if they are available.

The immediate treatment prevents2:

  • 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 therapy3. Further, it does not allow to use any treatment not directly related to the criteria mentioned above4.

In addition, this treatment is limited to 72 hours under normal circumstances or up to 7 days during an emergency5.

  1. Section 94(1),  the Mental Healthcare Act, 2017. [↩]
  2. Section 94(1),  the Mental Healthcare Act, 2017. [↩]
  3. Section 94(3),  the Mental Healthcare Act, 2017. [↩]
  4. Section 94(2),  the Mental Healthcare Act, 2017. [↩]
  5. 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 public1. 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. 200.2 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.3.

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.4

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.5

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

  1. Section 268, Indian Penal Code, 1860. [↩]
  2. Section 290, Indian Penal Code, 1860; Bhuban Ram and Ors. v. Bibhuti Bhushan Biswas AIR 1919 Cal 539 [↩]
  3. Section 291, Indian Penal Code, 1860. [↩]
  4. Section 15, The Environment (Protection) Act, 1986. [↩]
  5. Section 15, The Environment (Protection) Act, 1986. [↩]

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.1. 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.2.

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.3 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 government4.
  • Healthcare services cannot be denied to anyone, as referred to above, on the basis of sex, gender or sexual orientation, etc.5.

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?“.

  1. National Legal Services Authority v. Union of India & Ors. (AIR 2014 SC 1863 [↩]
  2. ICD.Codes, ICD-10-CM Code F64.8, https://icd.codes/icd10cm/F648; Section 2(s), Mental Healthcare Act, 2017. [↩]
  3. Section 3 (3), Mental Healthcare Act, 2017. [↩]
  4. Section 18 (1), Mental Healthcare Act, 2017. [↩]
  5. Section 18 (2), Mental Healthcare Act, 2017. [↩]

What are the rights a person has under this law?

The right to healthy environment1 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 water2.  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 Constitution3.

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.

  1. Rural Litigation and Entitlement Kendra v. State of U.P, (1985) 2 SCC 431 : AIR 1985 SC 652. [↩]
  2. 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. [↩]
  3. Subhash Kumar v. State of Bihar , AIR 1991 SC 420. [↩]