Math Suresh Bada, Moirangthem Sydney, Kumar Naveen C, Nirmala Maria Christine
Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bengaluru 560029, Karnataka, India,
Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bengaluru 560029, Karnataka, India.
Natl Med J India. 2015 Nov-Dec;28(6):295-9.
Recent changes in policies allowing practitioners of Ayurveda, Yoga, Naturopathy, Unani, Siddha and Homoeopathy (AYUSH) to integrate into the mainstream of healthcare and also allowing practitioners of Ayurveda and Homoeopathy to perform medical termination of pregnancy (MTP) under the proposed amendment to the MTP bill have brought crosssystem practice into the limelight. We evaluate cross-system practice from its legal and ethical perspectives. Across judgments, the judiciary has held that cross-system practice is a form of medical negligence; however, it is permitted only in those states where the concerned governments have authorized it by a general or special order. Further, though a state government may authorize an alternative medicine doctor to prescribe allopathic medicines (or vice versa), it does not condone the prescription of wrong medicines or wrong diagnosis. Courts have also stated that prescribing allopathic medicines and misrepresenting these as traditional medicines is an unfair trade practice and not explaining the side-effects of a prescribed allopathic medicine amounts to medical negligence. Finally, the Supreme Court has cautioned that employing traditional medical practitioners who do not possess the required skill and competence to give allopathic treatment in hospitals and to let an emergency patient be treated by them is gross negligence. In the event of an unwanted outcome, the responsibility is completely on the hospital authorities. Therefore, there is an urgent need to abolish cross-system practice, invest in healthcare, and bring radical changes in health legislations to make right to healthcare a reality.
近期政策的变化允许阿育吠陀、瑜伽、自然疗法、尤那尼、悉达和顺势疗法（AYUSH）从业者融入医疗保健主流，并且根据《人工流产法案》的拟议修正案允许阿育吠陀和顺势疗法从业者进行人工流产，这使得跨系统执业成为焦点。我们从法律和伦理角度评估跨系统执业。在各项判决中，司法机构认为跨系统执业是医疗过失的一种形式；然而，只有在相关政府通过一般或特别命令授权的那些邦才被允许。此外，尽管邦政府可能授权替代医学医生开西药（反之亦然），但它不容忍开错药或误诊。法院还指出，开西药并将其伪称为传统药物是不公平的商业行为，不解释所开西药的副作用等同于医疗过失。最后，最高法院已告诫，在医院雇佣不具备进行西医治疗所需技能和能力的传统医学从业者并让急诊患者由他们治疗是严重过失。如果出现不良后果，责任完全在于医院当局。因此，迫切需要废除跨系统执业，投资于医疗保健，并对卫生立法进行彻底变革，以使医疗保健权成为现实。
