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Doctors welcome top court’s order on medical negligence

By, New Delhi
Oct 29, 2024 08:08 AM IST

The landmark judgment, which medical professionals say could help curtail spurious negligence complaints, stressed that complications—even unforeseen ones—do not automatically indicate professional misconduct.

Medical professionals across India welcomed a Supreme Court ruling last week that shields doctors from negligence claims based solely on unexpected treatment outcomes, emphasising that liability must be proven through clear evidence of departure from standard medical practices.

The landmark judgment, which medical professionals say could help curtail spurious negligence complaints, stressed that complications—even unforeseen ones—do not automatically indicate professional misconduct. (HT PHOTO)
The landmark judgment, which medical professionals say could help curtail spurious negligence complaints, stressed that complications—even unforeseen ones—do not automatically indicate professional misconduct. (HT PHOTO)

The landmark judgment, which medical professionals say could help curtail spurious negligence complaints, stressed that complications—even unforeseen ones—do not automatically indicate professional misconduct.

“This has been a long-pending demand to ensure doctors don’t face cases that don’t qualify as medical negligence,” said Dr MC Misra, senior surgeon and former director of All India Institute of Medical Sciences, Delhi. “Some amount of risk always remains following not just complex but even simple procedures, particularly in surgery. If the outcome isn’t as expected, it cannot be termed as medical negligence.”

The court rejected the principle of “res ipsa loquitur”—meaning “the thing speaks for itself”—in medical cases, with Justices PS Narasimha and Pankaj Mithal ruling that poor outcomes alone cannot establish negligence.

Dr Misra, added, “It is a fair assessment of the SC. People must also understand error of judgment is not negligence. What is important in such cases is to see whether adequate management of complication was done in a timely manner or not. What we could do is to have a system in place like they have in New Zealand which they call ‘no fault compensation’. In case there is an error by the medical team and there is an untoward treatment outcome, the family could be compensated for it.”

Dr K Srinath Reddy, founder of the Public Health Foundation of India, said the ruling “clearly separates intentional malpractice and incorrect or incompetent care from unintended adverse consequences of correctly administered care as per widely accepted professional norms.”

“Results may not match patient’s expectations due to a variety of factors unrelated to the doctor’s professional competence or diligent attention to patient safety. Each case of an adverse outcome must be judged on the basis of a complete assessment of all contributory factors without a prejudicial assumption of medical negligence,” he added.

The bench emphasised that medical procedures carry inherent risks, and unpredictable outcomes should not automatically lead to malpractice conclusions.

Office-bearers of state medical councils, who investigate cases of medical negligence along with the police, also admit there is a thin line between medical negligence and error of judgment.

Delhi Medical Council’s Dr Girish Tyagi noted that whilst patients often view complications as negligence, “Out of 100 cases we examine, at least 85 to 90 do not fall under medical negligence but are cases where the treatment outcome was not as expected.”

“This is an exemplary judgment; however we should keep in mind doctors should be judged based on knowledge and skills imparted to them as not every doctor is a specialist. Also, it is high time to implement NEXT exam to have quality Indian Medical Graduates,” said Dr SK Sarin, former chairman, board of governors, Medical Council of India.

Dr Kunal Saha, President, People for Better Treatment, said, “Although there can be no argument that holding a doctor guilty for medical negligence should be based on “clear evidence” against the accused doctor, as observed by the Apex Court but court’s rather credulous comment that a doctor is not negligent solely because the treatment didn’t produce expected result does a great disservice to the countless genuine victims of gross medical negligence across India. Over the past two decades that our organization has been dealing with numerous medical victims and representing many of them in courts pro bono, I’ve not come across a single where the victim’s family has opted to seek justice only because the patient did not respond to the treatment as expected. If people in India were suing doctors for every unsuccessful treatment then every death of a patient would have resulted in a lawsuit against doctors. Unfortunately, almost the exact opposite is reality in India today.”

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