Health officials across the globe are racing against time to contain the spread of the deadly novel coronavirus (2019-nCoV), which has claimed over 300 lives and globally affected more than 14,000 people so far. Given the exigency of the pandemic, the Indian government has asked its citizens and foreign nationals coming from China — where the new strain of coronavirus erupted in Wuhan in late December 2019 — to approach health officials, get themselves checked to ensure they are not infected and then to remain quarantined at home.
Despite the advisories, some who returned from China refused to seek medical consultation. In one case, a family of five in Bengaluru was unwilling to meet the doctors from the Health and Family Welfare Department. They shut the doors on the team of doctors, who arrived after the neighbours alerted the officials that the family had recently returned from China. The following day, the family agreed to test for the virus after an ambulance arrived at the premises.
In another case from Kerala, a 23-year-old MBBS final-year student who recently arrived from China, refused to meet health officials or take tests citing religious beliefs.
In this case, taking into account the public safety, the officials had to warn the woman and her family that the police would arrest and forcefully admit them to the hospital if they refused to take treatment, sources in the Health Department told TNM.
But can a state government arrest a person if he/she is suspected of carrying a viral infection and refuses or obstructs officials from following the quarantine and treatment protocols?
Can officials arrest if a person refuses the test?
In the case of the woman from Kerala, she returned along with the female student who is the first confirmed case of coronavirus in Kerala. As part of tracking travellers from China, the health officials noticed that this particular student neither reported her arrival nor contacted the health department officials. The health officials contacted the family over the phone and later visited their house. They were, however, unresponsive.
According to the health department officials, the student belongs to a Christian sect, which does not believe in science and medicine, and instead puts faith in prayers.
In such instances of refusal to follow directives or obstruction of procedures, the person can be arrested under the Disaster Management Act, 2005, Thrissur District Collector S Shanavas told TNM.
According to the Disaster Management Act, 2005, if a person obstructs an official from discharging his functions under the Act and refuses to follow any direction, given by Central or state government, he shall be, on conviction, punishable with imprisonment for a term that may extend to one year or with fine, or both. If such obstruction or refusal results in loss of lives or imminent danger, they shall be punishable with imprisonment for a term of upto two years.
The Collector also said that depending on the situation, the person can be detained or arrested under other legal provisions, too.
For example, an individual can be detained under the Public Health Act. “If any action of the individual can cause imminent danger to public health, district collectors can arrest and keep the person (suspected cases) in detention for the purpose of isolation and observation,” said Dr AV Jayakrishnan, former president of Indian Medical Association (Kerala).
“However, if the person requires treatment or administration of medicines yet refuses to take treatment, the officials can get a court order and follow the procedure,” added Dr Jayakrishnan.
Can person refuse to take tests?
According to medico-legal expert Dr N Srinivasan Raghavan, only if the treatment or investigation pertains to an individual and not the larger society, can the patient refuse.
“But, coronavirus is not individual-centric. If a person gets infected by coronavirus, there is a possibility of large contamination of society and the locality the patient lives in,” Dr Raghavan said.
“Under such circumstances, the patient cannot act as a representative of society and refuse treatment. The state government has every responsibility to protect the community and send the samples for testing,” he said.
In circumstances where a person refuses to submit their samples for testing, the government must explain the implication of the patient’s decision and the possible impact that it may have on society. Usually, patients agree when informed of the consequences.
For instance, after a three-hour-long discussion, the medical student in Kerala agreed and was later brought to the isolation ward of Thrissur Medical College on Friday. She is under observation, health department sources said.
Dr Raghavan added that in some cases, as a last resort, the government has the right to make the patient comply and conduct an investigation, if it is in the interest of society.
While the law does not specifically mention anything regarding the refusal of treatment or tests on grounds of religious beliefs, there are certain provisions under the Indian Penal Code that penalise people who commit an act that may spread an infection and endanger life. In such cases, the prosecution must prove a mala fide or a criminal intention or knowledge of wrongdoing.
(With inputs from Sandeep Vellaram)