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An analysis of Alternative Dispute Resolution and Healthcare in India

Healthcare workers face enormous problems as a result of the rapid advancement of technology and the rising demands of patients. On addition, patients are well-versed in their rights. Disputes and disagreements are commonplace in the medical field. Patients' dissatisfaction with their doctor or the consequences of their therapy is a typical source of conflict.

A formal complaint may be filed if a conflict cannot be resolved amicably at the nascent stage, however litigation is not always necessary. Under tort law, medical malpractice victims and their jurisdictions can seek compensation for their losses. A lawsuit for negligence, on the other hand, has a long and difficult path to success. The method appears to be time-consuming and expensive.

A fundamental principle of jurisprudence is that "justice delayed is justice denied." In any civilization, a speedy justice system needs to be a priority. Civil disagreements, commercial disputes, familial disputes, and so on are common in a culture like this. Approaching the courts is the best way to address these conflicts. Because of this, the number of instances in India is approximately 4.4 crores and has grown by 19 percent in the last year alone. The best approach, according to this theory, was to use an ADR process.

The blog focuses on healthcare concerns and disputes, as well as the Alternative Dispute Resolution (hereinafter, ADR) method plays a major role because of the doctor-patient dispute. Article begins with a brief introduction of ADR and medical procedures, then goes on to discuss the use of ADR and make a few allusions to court decisions. As a last point, it explains how the medical difficulties and ADR might be applied in practice.

Medical and ADR Issue

The continuing healthcare crisis in many countries, along with India, is the subject of constant debate. The healthcare system and the overall economy of a country are being impacted by this catastrophe. Patients' displeasure with the healthcare business is a direct result of these costs being passed on to them as a result.

Here, ADR, which is cost-effective and quick, plays a significant role. ADR can also be referred to as a settlement outside of court. It's a method of resolving a disagreement outside of court. ADR techniques, such as arbitration and mediation, are now being used by a wide range of healthcare providers to reduce the enormous legal costs.

Disputes between doctors and patients are common in the healthcare industry. Disputes in the healthcare industry are caused by cases of medical negligence or malpractice and confidence, pharmaceutical error, misdiagnosis, breach of trust infections, as well as many medical differences. Unexpected events and catastrophes occur at an alarming pace in the healthcare sector, some of which may be preventable and can be remedied, while others are the result of medical mistakes.

According to https://www.who.int/news-room/fact-sheets/detail/patient-safety, dangerous medical practices cause injury to millions of patients and the death of 2.6 million people each year. Unsafe medical care kills an average of five patients per minute worldwide. A dispute in the healthcare industry can result in a physician's licence being revoked or questioned, which could have a negative impact on the physician's ability to practise medicine. At a cost to both sides, it's an emotional roller coaster for everyone concerned.

When it comes to health care contracts, including such insurance policies, employment agreements, or disputes between payers and providers, the party who has been harmed by a breach of contract may pursue an in personam action even against party responsible. Arbitration can also be used to resolve healthcare contract disputes in which precise fulfilment of a contractual duty is required.

Depending on the severity of the fraud claims, malpractice cases in the medical industry may be mentioned to arbitration. Arbitration, it was found in the "A. Ayyasamy v. A. Paramasivam (2016)"[1] case, could only be used to settle minor claims or frivolous frauds. As a result, it is clear that the precise form of the serious worry claim cannot be resolved by arbitration and therefore must be referred to the court itself, because it has to be in the public realm as well as within the populace's concern.

The "Arbitration and Conciliation Act, 1996,"[2] governs arbitration. The antagonism is resolved by a neutral arbitrator who delivers an unprejudiced pre-arrangement in the disagreement in an irrevocable procedure. Arbitration can resolve certain healthcare conflicts, but it cannot resolve all of them. Physicians and hospital staff have a legal obligation to provide the best possible care to the patient.

In addition, "the doctor-patient relationship is an implied contract" because there are two parties involved, and the payment is in the form of compensation for the service, i.e. "treatment". It is composed of both contractual and tortious components.

In mediation, doctors are encouraged to take proper care, hospitals become better cautious, training programmes for the workforce are undertaken, enhanced as well as remedial therapy for the patient is offered. The process of mediation has been proven to be an effective means of resolving disagreements more quickly and amicably.

Medical Disputes and Permanent Lok Adalat

The Lok Adalat forum was developed by the Indian judicial system as an alternative dispute resolution (ADR) forum to lessen the burden on the court system and facilitate the resolution of disputes. Disputes in pre-litigation or litigation can also be addressed to Lok Adalat for out-of-court resolution and compromise, which really is a forum where even the parties can agree to compromise.

Under "Section 22A of the Legal Services Authority Act, 1987 (the PSU),"[3] a service at a hospital or dispensary can be considered a PSU, making it feasible for the Lok Adalat forum to hear and settle a medical dispute. While both parties have agreed to settle the case outside of court, the sitting judge might send the current medical disputes to the Permanent Lok Adalat.

"The medical sectoral disputes which can be resolved by the Permanent Lok Adalat include disputes ranging from medical negligence to Medi-claims insurance." Using Lok Adalats to resolve medical disputes saves time and money by avoiding the formality of going to court.

Because Lok Adalat has become so effective at resolving disagreements, it should be used regularly to settle medical disputes. This will reduce the effort of litigation while also allowing a huge number of medical disputes to be resolved swiftly.

Judicial Pronouncement

ADR does not have to be viewed as a panacea for resolving medical conflict; rather, it should be viewed as a venue for bringing the conflicting parties together and finding a cooperative solution early on. Adopting the ADR approach over litigation as a means of resolving conflicts has been recommended by the Supreme Court of India.

A Supreme Court ruling Food Corporation of India vs Joginderpal Mohinderpal (1989) [4] said that Arbitration has enormous urgency today when there has been an explosion of litigation in the Courts of law constituted by the sovereign powers.

In the case of Afcons Infrastructure v. Cherian Varkey Construction (2010) [5], the apex court emphasised the importance of mediation, especially in commercial matters, and observed that this type of ADR is ideal for parties facing complex issues that they are willing to resolve through negotiations. It will be difficult to change from litigation to ADR in the healthcare industry in India, due to cultural and linguistic differences, as well as a wide distribution of inequities.

Six flaws in court adjudication were recognised by Justice R V Raveendran:

  1. Delay in resolving the issue,
  2. uncertainty about the outcome,
  3. rigidity in the result/solution,
  4. high expense,
  5. difficulty enforcing, and hostile environment are all factors to be aware of.

Conclusion
According to Jimmy Carter, Unless both sides win, no agreement can be permanent. In the medical sector, ADR approaches can lead to a win-win situation in which both parties' interests are protected.

In light of our findings, we believe that ADR can serve as the most efficient and effective tool for resolving medical sector disputes in the present and the future, subject to the specifics of the claims and losses involved. The ADR method can be used to mediate disputes that take place in person. The medical system needs to develop a holistic approach to resolving disputes.

However, a shift in healthcare policy is needed so that hospitals are equipped with dispute resolution mechanisms and a grievance redressal unit to help resolve conflicts. There has been too much use of adversarial battle in conflicts between people and organisations. We can demonstrate that conflict can be addressed and justice served by healers and peacemakers through mediation.

End-Notes:
  1. https://indiankanoon.org/doc/180680303/
  2. https://www.indiacode.nic.in/handle/123456789/1978?sam_handle=123456789/1362
  3. https://indiankanoon.org/doc/96311964/#:~:text=(vi)%20insurance%20service%2C%20and,the%20purposes%20of%20this%20Chapter
  4. https://indiankanoon.org/doc/1337022/
  5. https://indiankanoon.org/doc/1875345/
Written By: Adv.Shashwata Sahu, LL.M. KIIT School of Law

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