In Parmanand Katara v. Union of India[1], the Honourable Supreme Court of India (hereinafter, the Apex Court) considered a serious problem existing at present i.e. In a medico-legal case, such as an accident, doctors usually refuse to give immediate medical aid to victim till all legal formalities are completed. At times, the injured dies for want of medical aid pending the completion of legal formalities. The Apex court, however, has now very specifically clarified that preservation of life is most important.[2]

Once a person loses his or her life, status quo ante cannot be restored. It is a duty of any doctor to preserve life, irrespective of any criminal background of the patient. The Court observed:
A doctor at the Government hospital positioned to meet this State obligation is, therefore, duty bound to extend medical assistance for preserving life. Every doctor whether at a Government hospital or otherwise has the professional obligation to extend his services with due expertise for protecting life.

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 statutes or otherwise which would interfere with the discharge of this obligation cannot be sustained and must, therefore give way....[3]

The apex court has also observed that Article 21 of the Constitution of India casts an obligation on the State to preserve the life of a person. The patient, whether an innocent or a criminal liable to punishment under the laws of the society, it is the responsibility 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 be tantamount to be legal punishment. Every doctor whether at a government hospital or otherwise has the professional obligation to extend his services with due expertise for protecting life.[4]

The Court has held that Constitution envisages establishment of a welfare state, and in a welfare state, the primary duty of the government is to provide adequate medical facilities for the people. The government discharged this obligation by running hospitals and health centres to provide medical care to those who need them. Article 21 of the Constitution imposes an obligation on the State to safeguard the right to life of every individual. Preservation of human life is of paramount importance.[5]

The Court has insisted that government hospitals and the medical officers employed therein are duty bound to extend medical assistance for preserving human life. A government hospital�s failure to provide medical treatment to a needy person on time violates his right to life guaranteed by Article 21.[6] In the instant case the right of the petitioner under Article 21 was violated when he was denied treatment while being in a critical state and needed immediate medical attention.

Since his right under Article 21 was denied by government servants, the State is liable to pay him compensation for breach of the same. The Court awarded him twenty-five thousand rupees as compensation. Moreover, the Court issued several directions for avoidance of any such incident in future and to ensure immediate medical attention and treatment to persons in real need.

The Court laid stress on a very important and crucial point, viz., the State cannot plead lack of financial resources to carry out any of these directions meant to provide adequate medical services to people. The State cannot avoid its constitutional obligation to provide adequate and sufficient medical aid to the people on account of financial constraints.[7]

The Court also said that other States, though not parties to the instant case, should also take necessary steps to implement the directions given herein. The Court also expected that the government would render necessary assistance in the improvement of medical services in India.

However, in State of Punjab v. Ram Lubhaya Bagga[8], the Honourable Supreme Court has recognised that provisions of health facilities cannot be unlimited. It has to be to the extent that finances of the country permit as no country has unlimited resources to spend on any of its projects.[9] Moreover the right to get free as well as full medical aid or any facilities has been held to be not a fundamental right of an ex-serviceman. The policy decision in formulating contributory scheme for ex-servicemen and asking them to pay �one-time contribution�, does not violate the provisions under Article 21 nor is it inconsistent with Part IV of the Indian Constitution.[10]

In Common Cause v. Union of India[11], the Honourable Supreme Court highlighted the serious deficiencies and shortcomings in the matter of collection, storage and supply of blood through the various blood centres operating in the country, specially in the context of incidence of HIV infected cases. The Court directed the government to establish a National Council of Blood Transfusion as a registered society. The Court also directed the States to establish similar bodies. The Court suggested that the blood banks ought to be licensed under the Drugs Control Act.[12]

Conclusion
Government is duty bound to provide medical assistance to those in need. Doctors and medical practitioners, not only those working under the government but even those who have private practice, are under a duty to provide timely medical assistance to patients as and when required, denial of which amounts to violation of their fundamental right under Article 21.

End-Notes:

1. AIR 1989 SC 2039 (India).
2. Ibid.
3. Ibid.
4. Ibid.
5. Paschim Banga Khet Mazdoor Samity v. State of West Bengal, AIR 1996 SC 2426 (India).
6. M. P. JAIN, INDIAN CONSTITUTIONAL LAW 1232 (6th ed. 2010).
7. Khatri v. State of Bihar, (II), AIR 1981 SC 928 (India).
8. AIR 1998 SC 1703 (India).
9. Ibid.
10. Confederation of Ex-servicemen Association v. Union of India, AIR 2006 SC 2945 (India).
11. AIR 1996 SC 929 (India).
12. Ibid.