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Doctors owe a constitutional duty to treat the havenots: Supreme Court


Doctors owe a constitutional duty to treat the havenots: Supreme Court

Every prescription starts from Rx, not from the amount of bill- Supreme Court

New Delhi: Directing all the hospitals in Delhi built on subsidized land to scrupulously observe the conditions imposed by the government circular including that to provide free treatment to 10% indoor patients and 25% outdoor patients of poor strata of the society, the bench of Justice Arun Mishra and Justice Uday Umesh Lalit recently made detailed observations about the free treatment of the poor in the country and the role of medical practitioners in the same

The court indeed took a sharp notice of the growing commercialization in the healthcare and the ills which are creeping in the medical profession

It is unfortunate that most of the hospitals are being run on a commercial basis and various ills have sunk in the noble medical profession. Right from wrong reporting, uncalled for investigation inclusive of invasive one, even as to heart and other parts of the body, which are wholly unnecessary, are performed, it is time for soulsearching for such big hospitals in and around Delhi, Gurgaon etc  and other places. They must ponder what they are doing. Is it not a criminal act? Simply by the fact that action is not taken does not absolve the responsibility. Time has come to fix accountability and to set right the evils which have rotten the system.

The medical profession had never been intended to be an exploitative device to earn money at the cost of patients who require godly approach and helping hand of doctors. Every prescription starts from Rx, not from the amount of bill. Being big commercial international hospitals in and around Delhi, they are not above the ethical standards which they have to maintain at all costs even by extending financial help to the have-nots.

in our considered opinion, members of the medical profession owe a constitutional duty to treat the havenots. They cannot refuse to treat a person who is in dire need of treatment by a particular medicine or by a particular expert merely on the ground that he is not in a position to afford the fee payable for such an opinion/treatment. The moment it is permitted, the medical profession would become purely a commercial activity, it is not supposed to be so due to its nobleness

The bench, which gave a massive 124-page judgment on the issue, indeed took a grim view of hospitals claiming to be charitable institutions.

The relief of the poor is one of the essential requirements of the charity. All hospitals are not charitable institutions as there may be hospitals which run commercially. The hospitals, which are operating under the guise of charity, are in fact being run on a commercial basis and it has become impossible for the poor to afford the lifesaving drugs at an affordable price . their right to life is in jeopardy. Merely by the expression hospital, it could not be successfully claimed by the respondenthospitals that they are charitable. They can be directed to fulfill their obligation and fulfill the purpose by undertaking charitable activities and give it the real meaning by giving free services as envisaged in the policy.

The bench analyzed in detail the history and the cases of Moolchand Hospital, St Stephens Hospital, Sita Ram Bhartia Institute of Science & Research and Foundation for Applied Research in Cancer in detail, slamming them for refusing the government directions on free treatment

It is regrettable that the land had been obtained by Moolchand Kharaiti Ram Trust which claims to be charitable and St. Stephens Hospital run by the Missionaries admittedly for charity, are questioning the very conditions for which they have come into being and it appears with the passage of time they have lost the very purpose of their establishment. In our opinion they should have welcomed the conditions imposed by the Government, considering their objectives and for the purpose, they have obtained the land. Two other hospitals, namely, Sita Ram Bhartia Institute of Science & Research and Foundation for Applied Research in Cancer also cannot wriggle out of their such obligations.

The action of the State cannot be said to be unauthorized, illegal or arbitrary in any manner whatsoever and is in furtherance of the very objectives for which the medical profession exists, it added

The court also made important observations in the light of growing commercialisation of healthcare, the court observed

It is very unfortunate that by and large the hospitals have now become centers of commercial  exploitation and instances have come to notice when a dead body is kept as security for clearance of bills of hospitals which is per se illegal and criminal act. In future, whenever such an act is reported to the police, it is supposed to register a case against management of Hospital and all concerned doctors involved in such inhumane act, which destroys the basic principles of human dignity and tantamount to a criminal breach of the trust reposed in the medical profession.

The hospitals nowadays have fivestar facilities. The entire concept has been changed to make commercial gains. They are becoming unaffordable. The charges are phenomenally high, and at times unrealistic to the service provided. The dark side of such hospitals can be illuminated only by sharing obligation towards economically weaker sections of the society. It would be almost inhuman to deny proper treatment to the poor owing to economic condition and when hospitals claim that they are doing charity at their own level, we find impugned order dated 2.2.2012 is simply an expression to the aforesaid activity which has been given a channelized form.

The bench categorically stated that the poor cannot be deprived of treatment, because of the economic disability

The poor cannot be deprived of the treatment by the best physician due to his economic disability in case he requires it. It is the obligation on the medical  professionals, hospitals, the State and all concerned to ensure that such person is  given treatment and not deprived of the same due to poverty. That is what is envisaged  in the Constitution also. On the making of a doctor, the State spends and invests a huge amount of public money and it is the corresponding obligation to serve the  needy and the treatment cannot be refused on the ground of financial inability of the patient to bear it. To such an extent, the right and moral obligation can be enforced and that precisely has been done by issuance of the impugned directions to provide free treatment in IPD and OPD to economically weaker sections of society. They have suffered so long and benefit has not percolated down to them of distributive justice and they are deprived of equal justice and proper treatment due to lack of financial means.

With these observations,  the apex court upheld the order of the Delhi government further asking the Delhi government to provide periodic reports on compliance with its order. The court added that hospitals that resist will lose their license.

Read Also: Private Hospitals on Subsidized land will treat poor for free, or face Shutdown: Supreme Court




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15 comment(s) on Doctors owe a constitutional duty to treat the havenots: Supreme Court

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  1. Dear JudgesThe hospitals run by corporates are at fault not the doctors individually. We see lot of free patients free in our consulting, including lawyers , press, police and judges!

  2. user
    Dr Suvimal Dutta July 12, 2018, 3:02 pm

    The court is under the impression that government spends a huge amount in making a doctor . This impression isn\’t correct in totality. Actually most of the the budget of medical colleges is spent on providing free treatment in the attached hospital .
    All taxes and government amenities paid by hospital at commercial rates .
    How often do the courts dispense justice free and outside of duty hours . In recent history only one case comes to mind, where a bail application was granted at 2am !

  3. U cannot stand in Courts without paying court fees. Is there any court which listens to havenots without charges. The SC judges come from lawyers , who charge astronomical fees. How many times they stand in court without taking fees? Please introspect. The real issue is tthat the govt hospitals are having very poor services, overburdened with work. If the govt spends more and manages hospitals in a better way, this type of questions will not arise. Moreover the students serve bond in ug pg and super speciality.
    SC cannot dictate that social service should be done by a certain class if people, this itself is non constitutional; the thing is voluntary! And what social service those people have given?

  4. compared to other profession doctors are doing charity most of the doctors do not charge there fees when he knows patient can not afford even the fees they charge is a charity they do not charge exorbitantly as other profession one senior physician can not earn in his life time what a senior lawyer in supreme court in a day we can not take adjournments we will have to decide on the spot when we make a wrong decision we are penalised heavily we will have to file insolvency one curios thing is the poor pay if they can not afford they go to government hospitals only upper middle class wants 5 star comfort at the same time do not want to pay

  5. user
    Dr. Prem Sagar Gupta July 12, 2018, 12:51 pm

    The only thing that is the basis for free treatment is subsidised rate of land. Why not the private hospitals shit to areas by purchasing cheap land ? Some hospitals are ready to pay the difference in land price and convert to Commercial ventures. One can understand cheaper rates for poor patients but not free treatment. Tragedy is those really poor and needy patients do not come for free treatment, only smart and semi-poor patients with BPL cards hold hospitals to ransom by claiming free treatment.
    Hospitals are required to pay commercial Property tax, Commercial rates for Electricity and water. Instead of doctor paying for the poor (as free treatment including medicines and procedures), let Govt. pay for him.
    May be doctor may give free consultation, hospital provides subsidised rates for bed but not free medicines and diagnostic.
    It may be a balancing act.