Volume of NEET litigation suggests need for reforms in medical education: CJI

The CJI, who has been heading a Supreme Court bench dealing with cases linked to NEET, said it is the bounden duty of the courts to intervene in matters whenever they witness injustice

The deluge of litigation related to the National Eligibility cum Entrance Test (NEET) is not only indicative of the aspiration of millions of students but also suggests the need to reform medical education, Chief Justice of India (CJI) Dhananjaya Y Chandrachud has said.

Chief Justice of India DY Chandrachud. (PTI)

Delivering the 19th Sir Ganga Ram Oration on “A prescription for justice: Quest for fairness and equity in healthcare”, the CJI, who has been heading a Supreme Court bench dealing with cases linked to NEET, on Sunday said it is the bounden duty of the courts to intervene in matters whenever they witness injustice.

“Often, courts cannot enter policy domain and it is the duty of the state to listen to the representations made by the students. However, whenever injustice is done, it becomes our bounden duty to intervene. The sheer volume of litigation of NEET cases is indicative of the hopes and aspirations of millions of students. It is proof that medicine is one of the most sought-after professions in India. Yet, the litigation is also symbolic of the need for reforms in medical education in India.”

As many as 1.61 million students registered for the NEET-UG, 2021. The number rose to 1.7 million for the year 2022.

In his address, the CJI highlighted the principles of justice must guide both the legal and medical professions, for both fields are concerned with fairness, equality, and the well-being of individuals and communities. He added in law, people should be treated fairly and not arbitrarily, and in healthcare, people should have equitable access to services and resources.

The CJI lamented that growing socio-economic inequalities in India disproportionately affect the health outcomes of marginalised groups. “People belonging to marginalised communities are perpetually faced with barriers in accessing health care. Social determinants of health, i.e. factors outside the healthcare system such as class, caste, gender, regional location often determine health status of an individual. Injustice in healthcare becomes evident when one looks at the people not merely by the means of a stethoscope but by understanding their social determinants to health.”

The CJI pointed out that low-quality housing sanitation, unclean water, and health- seeking behaviour determined by the social and economic capital of a family can lead to poor health. “Cases of tuberculosis afflict at a higher rate among the poor and undernourished. The risk of dying with TB while being treated is three times higher if undernourished. The inequality of outcome is a reflection of social fault lines.” He added neglect of social roots cripples the effectiveness of the healthcare system.

Rooting for healthcare justice, the CJI said that the principle involves an understanding that it is not just the individual, but social determinants, that impact a person’s health and absence of illness.

“Equality and fairness are prime factors that should permeate the healthcare system to facilitate justice. One way of understanding justice in healthcare is that there should be health equity. This means that each person has as fair, just and equal opportunity to be healthier.”

He said another component of healthcare justice includes the ethical principles that govern the interaction between medical professionals and patients with a view to give primacy to patient care and a patient’s bodily integrity and autonomy. “Ultimately the goal is to achieve fairness, promote dignity, and ensure people have similar capabilities to lead healthy lives and contribute to society.”

The CJI flagged concerns about the simmering anger of the public against injustice in healthcare, stating that the anger is aggravated when either a patient treats the doctor as an infallible service provider who mechanically provides services, or when a doctor looks at a patient merely as a medical issue which needs to be solved.

“This dehumanization of healthcare has often resulted in violent confrontations between the citizens and hospitals, with medical professionals being caught in the crossfire. This puts the lives of medical professionals at risk and creates a hostile environment for them to work in. The violence ends up hampering the delivery of medical services, which can have serious consequences for patients.”

The CJI said to fulfill the constitutional goal of the right to health, the state’s capacity to finance health care is an important consideration.

“It is imperative that the state policy is committed to improving people’s overall health and ensuring that quality health services are available to vulnerable sections. Health needs to be on the financial policy radar, to promote the productive potential of India’s population...the need of the hour is for the healthcare providers, community leaders, lawmakers, and policymakers to work together to identify possible initiatives and solutions that promote equitable access to healthcare.”