'Doctors cannot work under threat of violence', says Supreme Court

A doctor cannot be expected to exercise sound and independent judgment while working under the fear of physical violence, intimidation or coercion, the Supreme Court has said, underlining that the safety of medical professionals is not merely a matter of their personal protection but essential to the larger public interest.

A Bench of Justices Vikram Nath and Sandeep Mehta made the observations in its detailed order cancelling the bail of Shiv Sena corporator Ramesh Sukrya Mhatre and three of his associates, who are accused of assaulting and verbally abusing doctors at the Shastri Nagar Municipal Hospital in Dombivli, Maharashtra.

Safety linked to patient care

The court said doctors are entrusted with responsibilities that directly affect the life and well-being of patients, requiring them to remain composed and capable of exercising independent professional judgment.

An environment in which medical professionals can discharge those responsibilities without fear is therefore not simply a matter of convenience, it said. Violence or the threat of violence could compromise the conditions necessary for doctors to make critical medical decisions.

“A doctor cannot reasonably be expected to exercise sound and independent judgment while labouring under the apprehension of physical violence, intimidation or coercion,” the court said.

It added that the safety and dignity of medical professionals were not matters of “personal privilege” but safeguards serving the larger public interest by ensuring medical care is provided with the concentration, composure and judgment the profession requires.

Grievances must follow law

At the same time, the Supreme Court made it clear that doctors are not beyond scrutiny or accountability.

Patients and their families remain entitled to question treatment, complain about alleged negligence or delays, seek an investigation into an adverse medical outcome and pursue remedies available under law.

What cannot be permitted, the Bench said, is the replacement of these lawful mechanisms with intimidation, coercion or violence.

A grievance, however genuine, cannot provide a licence to resort to violence against healthcare professionals, the court said. Allowing such conduct would not merely endanger individual doctors but undermine the environment in which medical professionals make decisions affecting patients' lives and health.

Bail cancelled in assault case

The observations came as the Supreme Court set aside a Bombay High Court order granting bail to Mhatre and three other accused — Ramesh Laxman Pawar, Pramod alias Prakash Uddhav Nikam and Akshay Sharad Karande.

The four are accused of assaulting and verbally abusing three doctors, including a woman doctor, who were on duty in the labour ward of Shastri Nagar Municipal Hospital on July 6.

The Supreme Court directed the four accused to surrender before the trial court by October 5.

The Bombay High Court had granted bail to Mhatre on August 7 while directing that the trial be fast-tracked and completed within a stipulated period.

Court flags impact on doctors

The Supreme Court said the High Court, while granting bail, had failed to adequately consider the wider impact of the alleged conduct on the medical fraternity.

Material before the court indicated that the incident had generated such fear and apprehension among the doctors concerned that they were compelled to tender their resignations.

The Bench said this circumstance could not be treated merely as incidental to the allegations against the accused. It was directly relevant to assessing the possibility of intimidation and the ability of doctors to discharge their professional responsibilities without fear.

The impact of the alleged conduct on the functioning of the healthcare institution and the confidence of medical professionals therefore deserved consideration while deciding bail, the court said.

Witness protection ordered

Since the prosecution case depends substantially on the testimony of doctors and hospital staff, the Supreme Court directed the trial court to ensure adequate protection for all material witnesses throughout the proceedings.

The protection is to be provided in accordance with the Maharashtra Witness Protection and Security Act, 2017.

The trial court was asked to remain alert to any apprehension of threats, intimidation or coercion. Where necessary, it can direct the district administration or superintendent of police to provide appropriate protection so that witnesses can testify freely and without external pressure.

The Supreme Court, however, clarified that the accused could renew their applications for bail before an appropriate forum if there was a material change in circumstances.

Role of elected representatives

The Bench also made significant observations about the responsibilities of elected representatives, saying public office carries an obligation to strengthen institutions through which grievances are addressed.

An elected representative cannot assume the functions of the police, administrator or court, it said. The use of personal influence to secure compliance through intimidation or fear could have consequences extending beyond the immediate victim and weaken public confidence in the rule of law.

The court examined Mhatre's criminal antecedents and noted that 18 cases were stated to have previously been registered against him, including cases involving serious offences. His counsel has maintained that the earlier cases were politically motivated and that he had been acquitted in them.

The Bench held that such antecedents were a material consideration in deciding bail and could not be brushed aside without proper examination.

Hospital stay during custody questioned

The court also raised concerns over Mhatre's stay in the prison ward of the district civil hospital in Thane during his police custody from July 10 to July 13 and subsequently during judicial custody.

It noted that he had thereby substantially avoided confinement in prison and sought discharge from the hospital immediately after a release memo was issued following the July 15 bail order.

The court said the circumstances raised serious concerns about whether the influence associated with his position had been used to circumvent the effective operation of the custodial process.

The Bench also directed the Maharashtra government to examine whether applicable preventive-detention laws could be invoked against Mhatre and his associates in the circumstances of the case.

For the court, the larger principle went beyond the allegations against the individual accused: dissatisfaction with treatment must be addressed through legal and institutional mechanisms, while doctors must be able to treat patients and make difficult clinical decisions without the threat of violence hanging over them.