Medical liability: Time to clarify accountability

In 1996, the landmark Indian Medical Association (IMA) vs V P Shantha case, which was decided by a divisional bench of the Supreme Court comprising three judges, set a pivotal precedent by affirming that doctors are encompassed within the purview of the Consumer Protection Act (CPA). This ruling also signalled a significant shift in the understanding of the Act, implying that other professionals, such as those in the legal profession, could also potentially be impacted and brought under the ambit of the CPA. The National Consumer Commission held that legal professionals do come under the CPA, based on the findings of IMA vs V P Shantha.

However, the recent judgement of the Supreme Court (Justices Bela Trivedi and Pankaj Mithal) in BCI & Others vs D K Gandhi emphasised that lawyers would not be held liable under the Consumer Protection Act, 2019 (CPA) for any alleged deficiencies in providing their professional services while representing clients. It was argued that, unlike the medical profession, where scientific standards exist to decide the standard of care, there is no universal standard of care or objective test that exists or can be prescribed as the threshold in the case of the legal profession to adjudicate upon the question of abdication of duty of care.

This case once again renews the ongoing debate within the medical community: should medical doctors be equated with other service providers, such as carpenters, bankers, plumbers, and so on, under consumer protection laws? While standard treatment guidelines are in place, the intricate nature of medicine, known for its lack of exact science, poses unique challenges in each patient’s case. Even with the application of the best standards of care, desired outcomes may not always be achieved. Medical professionals are trained to provide optimal care ethically, with outcomes largely dependent on the patient’s condition.

The Supreme Court focused on legislative intent and whether the legislature ever intended to include professionals within the purview of the CPA. In answering this question, the court observed that “professionals could not be called businessmen or traders, nor could clients or patients be called consumers.” It is also required to bear in mind that the terms ‘business’ or ‘trade’ having a commercial aspect involved cannot be used interchangeably with the term ‘profession’ which normally would involve some branch of learning or science. The very purpose and object of the CPA, 1986, as re-enacted in 2019, was to provide protection to consumers from unfair trade practices and unethical business practices only. There is nothing on record to suggest that the legislature ever intended to include professions or professionals within the purview of the Act.

The court went further and examined whether the legal profession is distinct from other professions, even when considered in light of the V P Shantha case logic, and concluded that the legal profession cannot be compared with any other profession, and particularly not with the medical profession. In this context, one of the judges categorically observed that the V P Shantha case be re-examined by the constitutional bench for its correctness. The second judge, Justice Pankaj Mithal, compares the Indian consumer protection law with many comparable laws from other jurisdictions. From that comparative analysis, he states that “in India, the services of professionals, more particularly those of lawyers, have to be excluded from consumer protection law.” The submission to the Chief Justice of India for revisiting the P Shantha judgement merely made as an orbiter by one of the judges deciding the case raises the technical point of whether the CJI is obliged to constitute the constitutional bench in this regard or whether it is only an observation.

The ongoing debate regarding the accountability of medical professionals under consumer protection laws highlights important considerations, especially amidst the increasing practice of defensive medicine, which leads to higher costs. The essential trust between doctors and patients is gradually diminishing. At this juncture, it may be appropriate to re-evaluate the current framework to strike a balance between safeguarding consumer rights and fostering a medical environment that prioritises patient welfare and trust.

(Omprakash is Professor of law, National Law School of India University, Bengaluru, and Thomas is Founder and Patron, Association of
Healthcare Providers India)