Law Must Adopt Patient Centric Approach :SC Awards 15L Compensation To The Husband Of Medical Negligence Victim [Read Judgment]

The Apex Court bench, also comprising of Justice Hemant Gupta, was considering an appeal against an order of National Consumer Disputes Redressal Commission that had set aside an order of the Madhya Pradesh State Consumer Disputes Redressal Commission holding Doctor and Director of a Hospital guilty of medical negligence.

Madhu Manglik, who was diagnosed with dengue fever, was admitted in a Hospital in Bhopal. After she died, her husband filed a complaint before the SCDRC seeking compensation in the amount of Rs. 48 lakhs on the ground that his spouse suffered an untimely death due to the medical negligence of the treating doctors at the hospital. SCDRC concluded that medical negligence was established and a compensation of Rs. 6 lakhs was awarded. NCDRC, on the appeal by the Doctor, reversed these findings.

In the judgment, Justice Chandrachud discussed the evolution of Medical negligence jurisprudence in India. He noted that the standard of care which is expected of a medical professional is the treatment which is expected of one with a reasonable degree of skill and knowledge. Medical negligence jurisprudence in India is characterized by a reliance on the 'Bolam test', the judge said. He says:

"The "Bolam test" has been the subject of academic debate and evaluation in India and other jurisdictions. Among scholars, the Bolam test has been criticized on the ground that it fails to make the distinction between the ordinary skilled doctor and the reasonably competent doctor. The former places emphasis on the standards adopted by the profession, while the latter denotes that negligence is concerned with departures from what ought to have been done in the circumstances and may be measured by reference to the hypothetical "reasonable doctor". The Court must determine what the reasonable doctor would have done and not the profession."

In this context, the judgment also discusses some decisions of English and Indian Courts and observed:

"Our law must take into account advances in medical science and ensure that a patient-centric approach is adopted. The standard of care as enunciated in the Bolam case must evolve in consonance with its subsequent interpretation by English and Indian Courts."

The court also added that standard adopted by the three-judge bench in Jacob Matthew includes the requirement that the course adopted by the medical professional be consistent with "general and approved practice". He added that, adopting a standard of care, Indian courts must be conscious of the fact that a large number of hospitals and medical units in our country, especially in rural areas, do not have access to latest technology and medical equipment. The judgment concludes the discussion on this with this observation:

"In the practice of medicine, there could be varying approaches to treatment. There can be a genuine difference of opinion. However, while adopting a course of treatment, the medical professional must ensure that it is not unreasonable. The threshold to prove unreasonableness is set with due regard to the risks associated with medical treatment and the conditions under which medical professionals function. This is to avoid a situation where doctors resort to 'defensive medicine' to avoid claims of negligence, often to the detriment of the patient. Hence, in a specific case where unreasonableness in professional conduct has been proven with regard to the circumstances of that case, a professional cannot escape liability for medical evidence merely by relying on a body of professional opinion."

In the present case, the bench noted that the treating doctors had failed to provide medical treatment in accordance with medical guidelines, and thus failed to satisfy the standard of reasonable care as laid down in the Bolam case and adopted by Indian Courts.

The bench, however, absolved the Director of the Hospital from liability. It said: "There is no basis for recording a finding of medical negligence against the Director of the hospital. The Director of the hospital was not the treating doctor or the referring doctor."

As regards compensation, the bench said that contribution made by a non-working spouse to the welfare of the family has an economic equivalent. It said:

"Thus, in computing compensation payable on the death of a home-maker spouse who is not employed, the Court must bear in mind that the contribution is significant and capable of being measured in monetary terms."

Allowing the appeal, the bench held that claimant will be entitled to receive an amount of Rs. 15 lakhs by way of compensation.

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