Annals of Indian Academy of Neurology
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FOREWARD
Year : 2016  |  Volume : 19  |  Issue : 5  |  Page : 2
 

Foreword


Professor of Law and Registrar, The National Law School of India University, Bengaluru, Karnataka, India

Date of Submission05-Oct-2016
Date of Decision05-Oct-2016
Date of Acceptance05-Oct-2016
Date of Web Publication24-Oct-2016

Correspondence Address:
Omprakash V Nandimath
The National Law School of India University, Bengaluru, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0972-2327.192892

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How to cite this article:
Nandimath OV. Foreword. Ann Indian Acad Neurol 2016;19, Suppl S1:2

How to cite this URL:
Nandimath OV. Foreword. Ann Indian Acad Neurol [serial online] 2016 [cited 2017 Mar 23];19, Suppl S1:2. Available from: http://www.annalsofian.org/text.asp?2016/19/5/2/192892


The World Health Organization in its seminal report on neurological disability titled, “Neurological Disorders, Public Health Challenges”, states that, about 1 billion people worldwide, suffer from various kinds of neurological disorders and 6.8 million people die annually from these disorders. Neurological disorders have emerged as priority health problems worldwide. Neurological illness not only contribute to mortality but also to huge morbidity because of their unique characteristics such as chronicity, progressive degeneration and limited therapeutic options. The severity of neurological disorders is dependent upon, the type of illness as well as the specific area of the nervous system affected. In addition to the physical disability they are also known to have comorbid emotional difficulties adding to the suffering. Neurological illnesses not only affect patients but also their families and caregivers, they also have an enormous emotional turmoil, economic impact, care-givers burden and lost productivity. Considering these challenges, neurological illnesses plausibly are prone to medical negligence cases.

In light of the recent Supreme Court judgments offering large compensation amounts in medical negligence cases may signal the beginning of increasing medical negligence litigation and the practice of defensive medicine in India. Further, the lack of uniform, reliable and consistent way of assessing and awarding compensation has been a matter of grave concern across the courts. Neurological illnesses pose various challenges such as, varying course, difficulty in diagnosis, few treatment options, challenges in quantifying disability and unable to predict the prognosis. These difficulties have been clearly depicted in the assessment of neurological disability. Hence, there is an urgent need for collaborative discussion with legal, neurological, neuro-surgical and physiatrists professional bodies to arrive at consensus.

The World Health Organization has emphasized on increased road traffic accidents which have resulted in more number of traumatic brain and spinal cord injuries raising this to a critical public health problem that deserves the attention of the world's health community. The traumatic brain injury usually requires long-term care and disability incurring a huge economic cost to the health care systems. Further, litigation, insurance claim and disability benefits have highlighted the enormous burden on the society.

People with certain neurological disorders like dementia, delirium, severe head injury etc., often become incapacitated to the level that important decision-making relating to an individual's property, financial affairs, and health and social care are lost. The law needs to take proactive steps to protect the rights of the persons with neurological disorders, who are incapacitated. Unfortunately, there are no explicit provisions to protect the rights of the persons with neurological disorders in the existing legal framework. There are several shortcomings in the Rights of the Persons with the Disability Bill, 2014 (RPWD Bill, 2014) from the persons with neurological disability. If it is passed in the present form, it would be against the spirit of UNCRPD. There is an urgent need to amend the Clause 13 of the RPWD Bill, 2014 so that the persons with neurological disability also do get the benefit.

There are many instances of mercy killing petition by patients suffering from various neurological illnesses. The issue of whether or not euthanasia should be made legal, has created a lot of controversies. However, the Supreme Court in Aruna Shanbaug's case, mentions about passive euthanasia under exceptional circumstances, which needs further amplification. The Advanced Directives document in Mental Health Care Bill, 2016, gives 'legal validity' to one's preferences for end-of-life care. However, this issue comes with the whole gamut of litigations adding burden to the existing judiciary.

Thus, it is believed that, this special issue on “Medico-Legal Issues in Neurological Practices” would ignite the much needed spark towards good collaborative debate across the stakeholder communities.




 

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