This article is authored by Afrin Sadia Nusrat, Associate, Mahbub & Company.
Since the pandemic, Bangladesh’s healthcare sector has gradually moved beyond the conventional model of in-person consultations, with video appointments, online prescriptions and app-based check-ups becoming increasingly familiar features of medical practice. What may initially have appeared to be a temporary response to restricted movement and limited hospital access has, over time, become part of the country’s broader healthcare delivery landscape. For patients outside major urban centres, this shift has made specialist advice more accessible and reduced the need to travel for every consultation. Its expansion, however, also brings into sharper focus an important regulatory question: whether Bangladesh’s existing legal framework is sufficiently equipped to address medical practice delivered through digital platforms.
At the center of this transformation are the Bangladesh Medical and Dental Council (BMDC) Telemedicine Guidelines, 2020, which were designed to provide a framework for online medical practice. These guidelines define telemedicine broadly, encompassing video, audio, text, and digital data exchange “within the territory of Bangladesh only” and emphasize that registered doctors should uphold the same professional and ethical norms as in traditional, in‑person care. They require explicit patient consent, patient and doctor identification, clinical judgment over appropriateness of teleconsultation and diligent record‑keeping of interactions.
Although the BMDC Guidelines provide an important point of reference for doctors and telemedicine platforms, they remain professional guidelines rather than legislation and therefore do not operate with the same force as an Act of Parliament. This distinction is significant because the more difficult questions arising from digital consultations, including liability, privacy, consumer protection and data security, must still be considered through general laws that were not drafted with digital healthcare in mind. As telemedicine becomes more embedded in routine medical practice, this gap is likely to become more apparent in disputes involving patients, practitioners and platform operators.
Negligence Without Tort Law
One of the central difficulties is that Bangladesh does not have a standalone tort statute governing medical negligence, which means that patients seeking relief must usually rely on existing legal routes that were not designed specifically for clinical negligence claims. At the criminal level, Section 304A of the Penal Code, 1860 criminalises death caused by rash or negligent acts and may, in principle, apply to care delivered either in person or through telemedicine. Its practical application, however, is limited because the provision is confined to cases involving death and may be difficult for claimants to invoke in light of the evidentiary and procedural hurdles associated with criminal proceedings.
At the civil level, a patient may seek to rely on the Consumer Rights Protection Act, 2009 by alleging a deficiency in service where payment was made for a consultation or for a platform-based service that fell below the expected standard. Even then, the Act may not comfortably cover every individual telemedicine consultation, particularly where the service was not provided through a commercial intermediary or where the relationship between the patient, doctor and platform is not clearly structured as a conventional consumer transaction. Its application would therefore depend on whether the telemedicine service can properly be characterised as a consumer service, leaving a measure of uncertainty in cases that do not fit neatly within that framework.
Patients may also attempt to seek relief through constitutional writs under Article 102 of the Constitution, which protects the right to life and personal liberty and may, in an appropriate case, support arguments relating to access to adequate healthcare. However, writ proceedings are not intended to serve as the primary route for compensation in individual negligence claims, particularly where the dispute turns on questions of clinical judgment, causation and loss. This means that a patient harmed by negligent telemedicine services may still have to navigate remedies that are indirect, uncertain and dependent on the facts of the particular case.
In the absence of codified tort principles, courts may have to approach telemedicine disputes through general negligence principles derived from common law. Bangladeshi jurisprudence has drawn on standards such as the Bolam test, which asks whether a doctor acted in accordance with a responsible body of medical opinion. When the consultation takes place remotely, however, that inquiry becomes more complex, as the court may have to consider whether a remote consultation was appropriate in the circumstances, whether a physical examination may have revealed warning signs, and whether poor video quality, connectivity or data transmission affected the doctor’s assessment. These questions illustrate why the ordinary language of medical negligence can become harder to apply when the clinical encounter itself is mediated through technology.
Prescription Rules and Practical Paradoxes
The guidelines also touch on prescribing medications. They state that a physician may prescribe medicines via teleconsultation “only when they are satisfied that s/he has gathered adequate and relevant information about the patient’s medical condition” and that prescribing without appropriate diagnosis “will amount to professional misconduct.”
The Guidelines also anticipate that BMDC may notify and revise a list of medicines that may be prescribed through teleconsultation, including commonly used medicines as well as medicines requiring more careful clinical judgment. Because the list is expected to be developed and amended administratively rather than set out in statute, uncertainty may arise in day-to-day practice over the scope of permissible remote prescribing. Doctors may therefore be cautious about prescribing chronic medications or more sensitive medicines through teleconsultation if the applicable restrictions are unclear, which could, in turn, limit the usefulness of telemedicine for patients who require routine follow-ups rather than one-off consultations.
While the Guidelines place appropriate emphasis on professional accountability, they do not set out a dedicated legal remedy for patients harmed by negligent advice, inadequate assessment or inappropriate prescriptions during a teleconsultation. In such cases, patients would still have to fall back on broader legal mechanisms that may not fully capture the clinical, technological and evidentiary features of remote care. The difficulty is therefore not that legal responsibility is absent, but that the framework for identifying and enforcing that responsibility remains less clear than the growing use of telemedicine would require.
AI, Platforms and Accountability
The state of ancillary technology further complicates the picture. The BMDC guidelines allow telemedicine tools including telephone, video, email, and even messaging platforms such as WhatsApp or generic chat apps. But the document also notes that only registered medical doctors may counsel or prescribe medicines and technology platforms themselves cannot exercise medical judgment or prescribe.
Artificial intelligence and machine-learning tools may assist doctors by supporting triage, flagging possible symptoms or organising patient information, but they cannot replace medical judgment in giving advice or issuing prescriptions. Bangladesh does not yet have a dedicated statutory regime governing liability for AI-assisted clinical decisions, which means that any harm arising from such tools would likely have to be assessed through general negligence principles. If an AI-supported diagnostic suggestion contributes to a misdiagnosis, responsibility may depend on the conduct of the doctor, the role of the platform, the design or use of the tool, and the information available during the consultation. Although this approach may be workable in individual disputes, it does not provide patients, practitioners or technology providers with a clear standard before harm occurs.
In practice, how do telemedicine disputes unfold?
In practice, a patient alleging misdiagnosis during a teleconsultation may first consider whether the matter can be framed as a deficiency in service under the Consumer Rights Protection Act, 2009. Where the harm results in death, the patient’s family may also consider whether criminal negligence proceedings under the Penal Code are available. In a narrower category of cases involving broader questions of access to healthcare or public law duties, constitutional arguments may be raised through writ proceedings before the High Court Division. Each of these routes may offer a possible avenue for relief, but none is specifically designed for the factual setting of digital medical care, where questions of diagnosis, consent, technology and platform responsibility may overlap.
Taken together, these routes do not provide the clarity or predictability that a codified tort framework could offer. In the absence of such a framework, courts and claimants must rely on statutes developed for other purposes, including consumer protection and criminal negligence, to address disputes arising from digital healthcare. This makes the legal pathway more fragmented than it should be for a service that is no longer peripheral to healthcare delivery, but is increasingly becoming part of how patients seek and receive medical advice.
A Legal Framework Still Under Construction
Bangladesh’s telemedicine guidelines provide an important ethical and clinical foundation, particularly by recognising that remote care must still be delivered by registered doctors applying professional standards. Their limitation, however, lies in the fact that they remain guidelines and do not, by themselves, create a comprehensive system of enforceable legal rights or liabilities. The Consumer Rights Protection Act and the Penal Code may provide partial routes for redress in appropriate cases, but neither was framed with the realities of digital healthcare in mind. The present legal architecture therefore remains dependent on instruments that address only parts of the problem, rather than the full set of relationships created by remote medical practice.
Doctors are expected to apply the same professional standards online as they do in person, yet the law does not clearly define how those standards should operate when the consultation is conducted remotely and the doctor must depend on what can be seen, heard or transmitted through a digital platform. Patients are required to provide explicit consent, but that consent may not resolve the more difficult question of compensation where negligent telecare causes harm. Platforms are expected to list only BMDC-registered doctors, but comprehensive statutory rules on data handling, interoperability and platform liability remain underdeveloped. These unresolved questions are likely to become more significant as digital health services expand beyond emergency or convenience-based use and begin to form part of ordinary healthcare delivery.
As Bangladesh continues to expand telemedicine as part of its broader digital health agenda, the need for a clearer legal framework will become increasingly difficult to avoid. Such a framework should protect patients without discouraging responsible innovation, while also giving doctors and platforms a more certain understanding of the standards expected of them before disputes arise. Legal certainty in this area would therefore serve not only those seeking remedies after harm has occurred, but also those trying to provide remote healthcare in a manner that is ethical, accountable and sustainable.
Until that framework develops, telemedicine will continue to occupy an important but legally unsettled space in Bangladesh’s healthcare system, offering meaningful improvements in access to medical advice while also raising questions that the existing legal framework is not yet fully prepared to answer.
