Case Summary: Parmanand Katara v. Union of India (1989)

The present article provides the case summary of Parmanand Katara v. Union of India (1989) with a suitable conclusion at the end.

The 201st report of the Law Commission of India states that as per the doctors, at least 50% of the fatalities can possibly be averted if the road accident victims are managed to get admitted to a hospital within the first one hour of the accident. The first hour is the crucial time where the right medical facilities at the right time reduce the chance of any fatalities or worse situations. Thus, it is important that the road accident victims are provided with basic first aid at least to enable them to survive till they reach the nearest hospital.

The other question that needs close determination is what could be possibly done in the situation when the hospital and its doctors don’t attend to the patient or refuse to do the treatment. It was with the landmark judgment of Parmanand Katara v. Union of India [1] in 1989 by the Supreme Court which held that it is obligatory for a doctor or a hospital, both public and private, to provide immediate emergency medical aid to a victim of a road accident.

Introduction

Article 21 of the Constitution of India states that “no person shall be deprived of his/her life or personal liberty except according to the procedure established by law”[2]. The provision envisages various rights allied to or coming under the right to life and personal liberty. One such right is the right to health which forms an indispensable part of the fundamental right to life as mentioned under article 21. The obligation of fulfilling this right of citizens passes over to our medical practitioners, particularly the cases which involve accidents and emergency conditions.

The obligation on the medical practitioners and doctors is cast so because of the fact that the life of the road accident victim rests in the skill of the doctors attending him/her and the treatment provided to them on time. Nonetheless, victims of road accidents are usually denied or refused treatment and are redirected to be admitted to other hospitals due to mental apprehensions against medico-legal cases. A medico-legal case (MLC) involves “any case of an injury or ailment whereby affixing of liability by a law enforcement agency is necessary owing to the circumstances.[3]

It essentially means that besides providing medical treatment, an investigation by a law enforcement agency is also crucial to fix the responsibility regarding the present medical condition of the victim. The cases involve legal implications due to the nature and case for such injury and require additional paperwork and legal formalities to be completed beforehand by medical practitioners under the garb of formalities.

Resultantly, many road accident victims are denied medical treatment due to the fear of being pegged for providing evidence, being questioned or interrogated by the police or before a court, and getting cross-examined. Since such cases have both medical and legal implications it often happens that many hospitals and their doctors refuse to attend the patient and redirect accident cases to another hospital that is authorized to handle medico-legal cases.

Factual Background of the case

The Petitioner, Paramanand Katara is a human rights activist who filed a writ petition in the Supreme Court of India on the basis of a published newspaper report in the Hindustan Times in 1988, concerning the death of a scooter driver who was knocked down by a speeding car. The injured scooterist was then taken to the nearest hospital where the doctors refused to attend the patient and they directed for the patient to be taken to another hospital, the one authorized to entertain medico-legal cases but the hospital was located around 20km away.

Owing to the unnecessary delay in receiving the proper treatment on time, the patient succumbed to his injuries before he could even reach the directed hospital. Among other things, the petitioner Parmanand Katara under Article 32 of the Indian Constitution “prayed that the court issue directions to the Union of India that every injured citizen brought for medical treatment should be instantaneously given medical aid to preserve life”.

Subsequently, the Petitioner sought a procedural criminal law that is specifically adapted to avoid deaths caused by negligence in matters of a road accident and adequate compensation for the same. Therefore, the Ministry of Health and Family Welfare, the Indian Medical Council, and the Indian Medical Association were sued as respondents to the matter.

Issue and Fact of Law

Whether a person can be allowed treatment by the hospital authorities in accident cases, without having to follow several legal formalities before the victim is rendered medical aid.

Contentions of the Parties

Contrary to the usual practice in petitions with two opposing parties, in the present case, the contention of the respondents was on the same line as of the petitioner, however, with more input towards covering the legal aspects and measures incorporated by them.

It was contended that the hindrance in this process is said to be caused by statutory requirements to fulfil all the required legal formalities in the presence of a police officer before administering treatment to the victim. One of the respondents, the Indian Medical Council raised two relevant clauses of the Code of Medical Ethics, 1970 that imposed duty and obligation upon the doctors and medical practitioners to render their professional services. The two relevant clauses contented by the Respondents are as discussed below:

• Clause 10 of the 1970 code stated that a physician was not bound to treat every sick person. However, in emergency situations like victims of road accidents, it would be an obligation on a practitioner to be ready to respond and render his/her service in the time of need.
• On the other hand, clause 13 of the code provided that the freedom of practitioners to choose whom to serve would be available to them, except for the case of emergencies. It also further states that a medical practitioner should not withdraw himself from treating or attending someone and barred willful commission of negligence.

The afore-mentioned clauses represent the duty imposed on doctors and practitioners to serve and treat those injured to their best without rescuing themselves from performing their professional duty. A detailed reading of Clause 13 further connotes that it strictly barred willful negligence by the practitioners in order to establish the same degree of care and skill while dealing with emergency cases which clearly indicated that even the Medical Council itself has professional expectations from the practitioners.

Contrary to the Code of 1970, other legislations including the CrPC, The Indian Penal Code, or the Motor Vehicles Act didn’t restrict from providing medical treatment before completing formalities. Human life is indubitably more valuable than prioritizing to get done with formalities first and to ensure the same, required amendments would have to be effectuated soon to be able to provide immediate medical care and relief to the injured ones.

The respondents in the present case also suggested an amendment to the Indian Evidence Act where the court will consider a practitioner’s diary as evidence for accident cases to avoid the hassles of presenting before the court physically.

Despite showing that the mentioned legislation didn’t bar medical practitioners from rendering emergency aid, the ground reality of cases had cast innumerable doubts and fears into their minds who seek to steer clear from litigation.

Decision Held

Based on the writ petition filed by the Petitioner before the court, the Supreme Court has made the following observations:

1. Article 21 of the Indian Constitution casts the primary obligation on the state to preserve life.
2. There can be no second opinion on the fact that the preservation of human life is of paramount importance. Once human life is lost, it can’t be restored as resurrection is beyond the capacity of a man. Every doctor, whether at a government hospital or otherwise, has the professional obligation to extend his or her services with due expertise for protecting life.
3. It is also to note that there’s no legal impediment as such for a medical professional when he or she is called upon or requested to attend to an injured person from an accident that is in need of immediate medical assistance. There is no doubt that the effort to save the injured person should be the top priority not only of the medical professionals but even of the police and any other citizen who happened to be connected with the accident matter or who happens to notice such an incident or a situation.
4. For lawyers and judges and all others, those who are concerned should keep in mind that a man in all medical professions should not be unnecessarily harassed for purposes of interrogation or for any other formalities. Further, the person should be dragged for or during interrogations at the police station. Such instances must be avoided as far as possible.

Conclusion

The Division Bench of the Hon’ble Supreme Court upheld that the right to life is of paramount importance and that the right would override the legal and medical formalities in case of emergency aid. The Code of Medical Ethics, 1970 which was primarily dealing with the professional duties and obligations of doctors and medical practitioners was later revised into the Indian Medical Council (Professional Conduct, Etiquette, and Ethics) Regulations in 2002, entailing similar clauses concerning obligations of practitioners.

Additionally, the purview of the right to health as implied under Article 12 has been expanding ever since with many landmark judgments which have proved to be debunking the confusion surrounding provision for emergency medical aid. It is the duty of the public as well as the doctors and law enforcement agencies to help the individuals in need of immediate medical assistance, especially when we talk about road accident victims. To conclude, no law shall come in the way to hinder a person’s fundamental right to receive medical assistance as per Article 21 of the constitution and no medical practitioner is to be subject to harassment in the name of formalities.

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[1] (1989) 4 SCC 286.

[2] INDIA CONST. art. 21.

[3] Medicolegal Issues: Guidelines To Medical Officers, National Health Systems Resource Centre, Available Here

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