Pt. Parmanand Katara v. Union Of India & ORS.

on 28 August, 1989

Petitioner: PT. Parmanand Katara

v.

Respondent: Union Of India & ORS.

Date of judgement 28/08/1989

Citation: 1989 AIR 2039, 1989 SCR (3) 997

INDEX

Sr.no. Topic Page no.

1. Introduction 2
2. Holding or ratio decidendi 3
3. Facts 3-4
4. Arguments 4
5. Law applied 5.
6. Held 5-6
7. Conclusion 6
8. Case as president 7
9. Recommendation 8

1
Introduction:

“Preservation of/saving life” and “duty of care” are established as absolute, non-negotiable and
supreme constitutional obligations of the medical profession and the State. Conversely, refusing
adequate and emergency care in institutions such as police stations, prisons, railways, and public
and private medical establishments is considered a violation of the fundamental right to life.

A writ petition was filed in the Supreme Court by a public-spirited person in response to a news
report of a scooterist who was knocked down by a car and died due to lack of medical treatment.
Following the accident, the scooterist was taken to the nearest hospital, but was turned away and
sent to another hospital 20kms away which was authorized to handle medico-legal cases. The
scooterist died while he was being transported to the other hospital. The petitioner sought the
issuance of a specific direction to the Union of India by the Supreme Court which read as: “every
citizen brought for treatment should instantaneously be given medical aid to preserve life and
thereafter the procedural criminal law should be allowed to operate in order to avoid negligent
death and in the event of breach of such direction, apart from any action that may be taken for
negligence, appropriate compensation should be admissible.” Along with the Union of India, the
Medical Council of India and the Indian Medical Association were impleaded as respondents.

The Union of India, through its Ministry of Health and Family Welfare, referred to the decisions
of a committee chaired by Director General of Health Services, highlighting that such decisions
mandated all doctors to immediately treat patients without waiting for completion of police
formalities. But, despite government attention to this issue, no discernable improvement could be
detected; hospitals and doctors were still refusing patients due to medico-legal issues. The Union
of India further stated that nothing in the Indian Penal Code 1860, Criminal Procedure Code
1973, Motor Vehicles Act 1988 or any other legislation prevented doctors from assisting those

2
injuredinaccidents.
The Medical Council of India referred to its Code of Medical Ethics, which states that medical
professionals need to attend injured persons immediately without waiting for a police report or
completion of other police formalities. It further submitted that it is in the public interest for
health care providers to be able to provide immediate care without waiting for legal formalities
and for doctors to be indemnified under the law in cases where they proceed to provide
immediate care within the scope of their professional duties.

The Indian Medical Association submitted an affidavit recognizing that certain police rules and
the Criminal Procedure Code necessitate certain legal formalities occur before a victim receives
medical aid in order to preserve evidence, and that such requirements can sometimes result in the
death of serious injured individuals1

Holding OR Ratio Decidendi:

This case is a landmark case where duties and responsibilities of a doctor has been discussed at
length especially as to how every doctor whether at a Government hospital or otherwise being
in the medical profession should uphold the professional dedication and responsibility to extend
his service for protecting human life. The case holds that the doctor does not infringe any law of
land by proceeding to take up any medico legal case and treat the injured victim on his
appearance before him either by himself or being carried by others. And also the courts will not
summon a medical professional attending to such a medico legal case
to provide evidence unless the same is important to the case and even if he is summoned, the
men in the profession should not be harassed, made to wait and waste time unnecessarily. 2

Facts:

1
PT. Parmanadh Katara v. Union OF India, https://uniteforreprorights.org/resources/pt-parmanand-katara-v-union-
india (last accessed on 18/02/2019) .
2
Case study on emergency medical aid, available at: https://www.scribd.com/document/140666556/LM-1-
PROJECT-docx( last accessed on 25-02-2019).

3
The petitioner, who claims himself to be a human right activist, filed this writ petition in public
interest on the basis of a newspaper report concerning the death of a scooterist who was knocked
down by a speeding car. The report further states that the injured person was taken to the nearest
hospital but the doctors there refused to attend on him; that they told that he be taken to another
hospital, located some 20 kilometers away, which was authorized to handle medico-legal cases;
and that the victim succumbed to his injuries before he could be taken to the other hospital. The
petitioner has prayed the directions be issued to the Union of India that every injured citizen
brought for treatment should instantaneously be given medical aid to preserve life and thereafter
the procedural criminal law should be allowed to operate in order to avoid negligent death, and
in the event of breach of such direction, apart from any action that may be taken for negligence,
appropriate compensation should be admissible.3

Arguments:

It was contended by the Union of India that the prevailing police rules and Criminal Procedure
Code necessitated the fulfillment of several legal formalities before a victim
could be rendered medical aid. The rationale behind this complicated procedure was to keep all
evidence intact. And in case the formalities were not observed, the doctors were harassed by the
police and were therefore unwilling to accept medico-legal cases. There were three issues before
the Supreme Court:
Firstly,
Whether there are any legal impediments that hindered timely treatment in medico-legal cases;
Secondly,
What is the nature of the duty of the Government, the Government hospital and the police in
medico-legal case;
and,
Whether private hospitals could refuse to treat medico-legal cases?
The petitioner, Parmanand Katara, prayed the directions be issued to the Union of India that that
every injured citizen brought for treatment should be instantly treated by the doctor, that is he
should be given immediate medical aid in order to bring the patient out of risk zone at the earliest
with a view to preserving life and thereafter the procedural criminal law should be allowed to

3
Emergency medical aid, available at: https://indiankanoon.org/doc/498126(last visited on 26-02-2019).

4
operate in order to avoid negligent death and in situation of breach of such directions, apart from
any action that may be taken for negligence, appropriate compensation should also be
admissible4

Act Or Law Applied:

Constitution of India, 1950: Article 21-- Obligation on the State to preserve life--Every doctor
has professional obligation to extend services to protect life--All Government hospitals/Medical
institutions to provide immediate medical aid in all cases.
Indian Medical Council Act, 1860: Section 33--Indian Medical Council/Code of Medical
Ethics--Clauses 10 and 13—Obligation to sick--Patient not to be neglected—Court emphasized
necessity to provide immediate medical aid.
Practice and Procedure: Medical professional--Law courts will not summon unless evidence is
necessary--Should not be made to wait and waste time unnecessarily.5

Held:

(1)Article 21 of the Constitution casts the obligation on the State to preserve life.

(2) There can be no second opinion that preservation of human life is of paramount importance.
That is so on account of the fact that once life is lost, the status quo ante cannot be restored as
resurrection is beyond the capacity of man.

(3)The patient whether he be an innocent person or a criminal liable to punishment under the
laws of the society, it is the obligation of those who are in charge of the health of the community
to preserve life so that the innocent may be protected and the guilty may be punished. Social
laws do not contemplate death by negligence to tantamount to legal punishment.
(4) Every doctor whether at a Government hospital or otherwise has the professional obligation
to extend his services with due expertise for protecting life.

4
PT. Parmanad katara v. union of India, available at: https://www.scribd.com/document/140666556/LM-1-
PROJECT-docx( last accessed on 26-02-2019)
5
Emergency medical aid, available at: https://indiankanoon.org/doc/498126(last visited on 26-02-2019).

5
(5) No law or State action can intervene to avoid/delay the discharge of the paramount
obligation cast upon members of the medical profession. The obligation being total, absolute and
paramount, laws of procedure whether in statute or otherwise which would interfere with the
discharge of this obligation cannot be sustained and must, therefore, give way.
(6) The Court gave directions for giving adequate publicity to the decision in this case by the
national media, the Doordarshan and the all India Radio, as well as through the High Courts and
the Sessions Judges.6

Conclusion :

The Code of Medical Ethics framed by the Medical Council was approved on 23rd October,
1970. This only reveals an unfortunate state of affairs where the decisions are taken at the
highest level good intentioned and for public good but unfortunately do not reach the
common man and it only remains a text good to read and attractive to quote.

It is clear that there is no legal impediment for a medical professional when he is called upon or
requested to attend to an injured person needing his medical assistance immediately. There is
also no doubt that the effort to save the person should be the top priority not only of the medical
professional but even of the police or any other citizen who happens to be connected with the
matter or who happens to notice such an incident or a situation.
The members of the legal profession, our law courts and everyone concerned will also keep in
mind that a man in the medical profession should not be unnecessarily harassed for purposes of
interrogation or for any other formality and should not be dragged during investigations at the
police station and it should be avoided as far as possible.
Law courts will not summon a medical professional to give evidence unless the evidence is
necessary and even if he is summoned, attempt should be made to see that the men in this
profession are not made to wait and waste time unnecessarily.

6
Supra5

6
Case has also severs as president:

The three cases considered illustrate two types of emergencies – accidents: a motor vehicle
accident, a fall from a train, and a medical emergency, such as a cardiac problem. In all three, the
patient was refused admission on the ground that there were no beds available. In one case, the
victim (Hakim Sheikh) was an agricultural laborer who was a member of the Paschim Banga
Khet Mazdoor Samiti, a labour union. He fell from a moving train on his way to work, and was
denied admission in five public hospitals. In the first case, the victim died and in the other two,
the victims were finally admitted to private hospitals and had to pay exorbitant amounts for their
treatment.7

The ethical dimensions of the jurisprudence in this area are founded on and integral to the
principle of the “right to life and dignity”, enshrined in Article 21 of the Constitution. Building
on this principle, the SCI judgments have established that the ethical duty to “save or preserve
life” is the unequivocal jurisprudential principle. The courts have reiterated that it is binding both
on the State as well as the medical profession. In the Parmanand Katara judgment, access to
emergency care was declared a fundamental right. Critics described it as a symbolic and “paper
right” , as no pathway was suggested to realize this right.1 Nonetheless, it served as a launching
pad for the further evolution of healthcare jurisprudence. In a particular litigation the Bombay
HC applied the principle of “saving life” to public services, specifically in the case of the
railways. It issued a series of directives for the establishment of an emergency response and care
system. The most important outcomes of this litigation were that the responsibility of the
railways was extended to providing treatment to patients in railway hospitals, and that the
railways were directed to save the lives of all accident victims within the railway premises
(inclusive of those travelling without tickets).

In Pravat Kumar Mukerjee v. Ruby General Hospital the supreme court has taken the subject suo
moto in the view of PT. Paramand Katara .

7
Emergency medical care in India, available at: https://ijme.in/articles/the-jurisprudence-of-emergency-medical-
care-in-india-an-ethics-perspective (last visited 27-02-2019).

7
Recommendations/ Suggestions:

1. Several policy measures including a comprehensive law to institutionalize ethical

principle for streamlining ethics in the public and private healthcare system.
2. The Indian health care system needs simple, managerial reform that can no longer be
denied to the people. For example, how a first-point-of-contact institution, whether
private or public, a small clinic or a large hospital, responds when a person is brought in
clinical distress is critical. Equally crucial is monitoring the quality and robustness of that
response. Who’s watching, is the question and who is accountable for the failures in
health service delivery? That, undoubtedly, is the elephant in the room.
3. The once who helped the victim should be dealt with little softness by the police so the
everyone in the society would be promoted, not be afraid of helping road accident
victims.