M Neelam Kachhap examines the field of diagnostic ultrasonography, ethical issues connected to this subject and the legal premise under which it is supposed to be practised
Medico-legal cases are on the rise in India. Although all fields of medicine attract medico-legal attention, recently, the field of diagnostic sonography has been in the public-eye. The medico-legal limelight is focussed on ultrasonography and sonologists, thanks to the recent media attention and celebrity talk show on female foeticide. Sex determination and subsequent female foeticide is an inhumane as well as illegal act. However, the issue of sex determination is only one of the many legalities associated with ultrasonography since it has vast applications in diagnostic imaging.
From soft tissue imaging to treatment of lesions, today ultrasonography is used for a variety of purposes in medicine. Thus a sonologist could face the court, not only for violating The Pre-conception and Pre-natal Diagnostic Techniques (PC/PNDT) Act but also for a lot of reasons like missed diagnosis, invented lesions, misreported lesions, etc.
Ignorance is not bliss
India has witnessed rapid developments in healthcare practice, with newer technologies and interventions promising better outcomes for patients. Informed patients are expecting more from doctors, leading to increasing dissatisfaction on the patients' part. In these times, where medico-legal cases against doctors are witnessing a sharp rise, being abreast of the fast changing laws has become even more important. Despite this, there are many sonologists who are not acquainted with the legalities of ultrasonography. "Most sonologists are unaware of the categories of litigation arising out of medico-legal issues in ultrasonography," says Dr Madhavan Unni, Professor and Consultant Radiologist, Kerala Institute of Medical Sciences (KIMS), Kerala. Seconding this, Dr Priya Chudgar, Senior Consultant Radiologist, Kohinoor Hospital, Mumbai avers, "To err is human and radiologists are also human beings. It is not uncommon in radiology practice to miss a diagnosis." Ignorance of law is not a defence. One cannot stand in court and say, 'I was unaware of the law'. It is upto the individual doctors to keep abreast of the rapidly changing laws and indemnify themselves. Like medicine, law also has its own language which needs to be comprehended by the doctors to fully understand the impact.
The most common complaint registered against a doctor is of medical negligence. But, does it apply to sonologists? Yes, it does! "A mistake committed by the sonologist during the course of his professional duty, could be considered as