Madras HC Rules: No Picking and Choosing in Treating Patients

Madras HC: Denying treatment to poor patients, despite agreeing to the terms under the bond, goes against medical ethics
Emphasizing that economically disadvantaged individuals must receive the same level of care as those who can afford paid treatment. (Representational image: Wikimedia Commons)
Emphasizing that economically disadvantaged individuals must receive the same level of care as those who can afford paid treatment. (Representational image: Wikimedia Commons)

The Madras High Court recently ruled that doctors cannot adopt a selective approach when treating patients, emphasizing that economically disadvantaged individuals must receive the same level of care as those who can afford paid treatment. This decision came as the Court dealt with two writ petitions against the Director of Public Health and Preventive Medicine's order appointing certain doctors as Assistant Surgeons (Specialists) based on a bond agreement under Rule 19(1) of the Tamil Government Servants (Conditions of Services) Act, 2016.

Justice S.M. Subramaniam, presiding over a single bench, highlighted that the core objective of the medical profession is to serve humanity. He stressed that doctors, particularly those working in government hospitals, must provide the same specialized care to poor patients as they would to those paying for treatment. Denying treatment to poor patients, despite agreeing to the terms under the bond, goes against medical ethics, he added. This bond requires doctors to serve in government hospitals for a specified period, ensuring they offer their specialized services to the needy.

The petitioners, who were represented by Advocate M. Vijaya Ragavan, contended that they had already served during the COVID-19 pandemic, which should count towards their two-year service obligation under the bond. They argued that the bond conditions were unfair and should be nullified. However, Government Advocate K. Tippu Sulthan defended the bond, emphasizing that the terms were agreed upon by the doctors when they accepted their postgraduate medical course seats, which were subsidized by the government.

Justice S.M. Subramaniam, presiding over a single bench, highlighted that the core objective of the medical profession is to serve humanity. 
 (Representational image: Pixabay)
Justice S.M. Subramaniam, presiding over a single bench, highlighted that the core objective of the medical profession is to serve humanity. (Representational image: Pixabay)

The Court noted that the doctors had willingly signed the bond, agreeing to serve in government hospitals to repay the government's investment in their education. This condition aimed to provide free, specialized medical care to the underprivileged across Tamil Nadu. Justice Subramaniam underlined that saving lives is paramount and that government hospitals urgently need specialized doctors to ensure that even the poorest receive high-quality medical care.

The Court further stated that health care is a fundamental right under Article 21 of the Constitution, and financial constraints should not prevent anyone from receiving specialized treatment. The bond scheme addresses this issue by ensuring that economically weaker sections get the medical attention they deserve.

Regarding the petitioners' claim that their COVID-19 service should count towards the bond period, the Court dismissed it as unjustifiable. Justice Subramaniam pointed out that the pandemic was a crisis period requiring everyone's contribution, and using it to bypass the bond obligations was unacceptable. The bond's purpose is to ensure continued specialized care for the poor, not just during emergencies but as a consistent policy.

(Input from various sources)

(Rehash/ Susmita Bhandary/MSM)

Emphasizing that economically disadvantaged individuals must receive the same level of care as those who can afford paid treatment. (Representational image: Wikimedia Commons)
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