{"id":6443,"date":"2025-07-17T11:38:54","date_gmt":"2025-07-17T11:38:54","guid":{"rendered":"https:\/\/www.legalserviceindia.com\/Legal-Articles\/?p=6443"},"modified":"2025-07-17T11:44:07","modified_gmt":"2025-07-17T11:44:07","slug":"medical-liability-india-reform-gross-negligence-bns-106","status":"publish","type":"post","link":"https:\/\/www.legalserviceindia.com\/Legal-Articles\/medical-liability-india-reform-gross-negligence-bns-106\/","title":{"rendered":"Inadvertent Mischief Caused By V P Shantha And BNS 106(1) Need To Be Addressed"},"content":{"rendered":"\n<blockquote class=\"wp-block-quote is-layout-flow wp-block-quote-is-layout-flow\">\n<p>\u201cCourts have played a salutary and corrective role in innumerable instances. They are highly respected by our people for that. At the same time, the dividing line between judicial activism and judicial overreach is a thin one.\u201d<br><strong>\u2014 Prime Minister Dr. Manmohan Singh<\/strong><\/p>\n<\/blockquote>\n\n\n\n<blockquote class=\"wp-block-quote is-layout-flow wp-block-quote-is-layout-flow\">\n<p>&#8220;Judicial activism is not the same as judicial overreach. The former is a peacemaker; the latter is a trespasser.&#8221;<br><strong>\u2014 Former CJI Ranjan Gogoi<\/strong><\/p>\n<\/blockquote>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Medical_Liability_in_India_Key_Concerns\"><\/span>Medical Liability in India: Key Concerns<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p>The medical fraternity in India is greatly agitated by two major issues:<\/p><div id=\"ez-toc-container\" class=\"ez-toc-v2_0_82_2 counter-hierarchy ez-toc-counter ez-toc-grey ez-toc-container-direction\">\n<div class=\"ez-toc-title-container\">\n<p class=\"ez-toc-title\" style=\"cursor:inherit\">Table of Contents<\/p>\n<span class=\"ez-toc-title-toggle\"><a href=\"#\" class=\"ez-toc-pull-right ez-toc-btn ez-toc-btn-xs ez-toc-btn-default ez-toc-toggle\" aria-label=\"Toggle Table of Content\"><span class=\"ez-toc-js-icon-con\"><span class=\"\"><span class=\"eztoc-hide\" style=\"display:none;\">Toggle<\/span><span class=\"ez-toc-icon-toggle-span\"><svg style=\"fill: #0c0c0c;color:#0c0c0c\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"list-377408\" width=\"20px\" height=\"20px\" viewBox=\"0 0 24 24\" fill=\"none\"><path d=\"M6 6H4v2h2V6zm14 0H8v2h12V6zM4 11h2v2H4v-2zm16 0H8v2h12v-2zM4 16h2v2H4v-2zm16 0H8v2h12v-2z\" fill=\"currentColor\"><\/path><\/svg><svg style=\"fill: #0c0c0c;color:#0c0c0c\" class=\"arrow-unsorted-368013\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"10px\" height=\"10px\" viewBox=\"0 0 24 24\" version=\"1.2\" baseProfile=\"tiny\"><path d=\"M18.2 9.3l-6.2-6.3-6.2 6.3c-.2.2-.3.4-.3.7s.1.5.3.7c.2.2.4.3.7.3h11c.3 0 .5-.1.7-.3.2-.2.3-.5.3-.7s-.1-.5-.3-.7zM5.8 14.7l6.2 6.3 6.2-6.3c.2-.2.3-.5.3-.7s-.1-.5-.3-.7c-.2-.2-.4-.3-.7-.3h-11c-.3 0-.5.1-.7.3-.2.2-.3.5-.3.7s.1.5.3.7z\"\/><\/svg><\/span><\/span><\/span><\/a><\/span><\/div>\n<nav><ul class='ez-toc-list ez-toc-list-level-1 ' ><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-1\" href=\"https:\/\/www.legalserviceindia.com\/Legal-Articles\/medical-liability-india-reform-gross-negligence-bns-106\/#Medical_Liability_in_India_Key_Concerns\" >Medical Liability in India: Key Concerns<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"https:\/\/www.legalserviceindia.com\/Legal-Articles\/medical-liability-india-reform-gross-negligence-bns-106\/#Comparing_New_Legal_Changes_with_Previous_Regulations\" >Comparing New Legal Changes with Previous Regulations<\/a><ul class='ez-toc-list-level-4' ><li class='ez-toc-heading-level-4'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"https:\/\/www.legalserviceindia.com\/Legal-Articles\/medical-liability-india-reform-gross-negligence-bns-106\/#Key_Distinctions\" >Key Distinctions<\/a><\/li><\/ul><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"https:\/\/www.legalserviceindia.com\/Legal-Articles\/medical-liability-india-reform-gross-negligence-bns-106\/#Proposed_Reforms_to_Improve_Conditions_for_Medical_Professionals\" >Proposed Reforms to Improve Conditions for Medical Professionals<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-5\" href=\"https:\/\/www.legalserviceindia.com\/Legal-Articles\/medical-liability-india-reform-gross-negligence-bns-106\/#No-Fault_Compensation_Scheme_An_Overview\" >No-Fault Compensation Scheme: An Overview<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-6\" href=\"https:\/\/www.legalserviceindia.com\/Legal-Articles\/medical-liability-india-reform-gross-negligence-bns-106\/#Key_Features\" >Key Features<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-7\" href=\"https:\/\/www.legalserviceindia.com\/Legal-Articles\/medical-liability-india-reform-gross-negligence-bns-106\/#How_These_Reforms_Improve_Patient_Rights_Safety\" >How These Reforms Improve Patient Rights &amp; Safety<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-8\" href=\"https:\/\/www.legalserviceindia.com\/Legal-Articles\/medical-liability-india-reform-gross-negligence-bns-106\/#Comparison_Table_Fault-Based_vs_No-Fault\" >Comparison Table: Fault-Based vs. No-Fault<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-9\" href=\"https:\/\/www.legalserviceindia.com\/Legal-Articles\/medical-liability-india-reform-gross-negligence-bns-106\/#Steps_to_Implement_Effectively\" >Steps to Implement Effectively<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-10\" href=\"https:\/\/www.legalserviceindia.com\/Legal-Articles\/medical-liability-india-reform-gross-negligence-bns-106\/#Additional_Considerations\" >Additional Considerations<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-11\" href=\"https:\/\/www.legalserviceindia.com\/Legal-Articles\/medical-liability-india-reform-gross-negligence-bns-106\/#Initial_Issue\" >Initial Issue<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-12\" href=\"https:\/\/www.legalserviceindia.com\/Legal-Articles\/medical-liability-india-reform-gross-negligence-bns-106\/#Reforming_Criminal_Liability_for_Medical_Procedures_Parliamentary_Pathways\" >Reforming Criminal Liability for Medical Procedures: Parliamentary Pathways<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-13\" href=\"https:\/\/www.legalserviceindia.com\/Legal-Articles\/medical-liability-india-reform-gross-negligence-bns-106\/#Problem_Statement_Blanket_Criminalization\" >Problem Statement: Blanket Criminalization<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-14\" href=\"https:\/\/www.legalserviceindia.com\/Legal-Articles\/medical-liability-india-reform-gross-negligence-bns-106\/#Core_Legislative_Amendments\" >Core Legislative Amendments<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-15\" href=\"https:\/\/www.legalserviceindia.com\/Legal-Articles\/medical-liability-india-reform-gross-negligence-bns-106\/#Drafting_the_Amendment_Bill_Key_Provisions\" >Drafting the Amendment Bill: Key Provisions<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-16\" href=\"https:\/\/www.legalserviceindia.com\/Legal-Articles\/medical-liability-india-reform-gross-negligence-bns-106\/#Steps_to_Enact_Reform\" >Steps to Enact Reform<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-17\" href=\"https:\/\/www.legalserviceindia.com\/Legal-Articles\/medical-liability-india-reform-gross-negligence-bns-106\/#Additional_Considerations-2\" >Additional Considerations<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-18\" href=\"https:\/\/www.legalserviceindia.com\/Legal-Articles\/medical-liability-india-reform-gross-negligence-bns-106\/#Gross_Negligence_Legal_Definition\" >Gross Negligence: Legal Definition<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-19\" href=\"https:\/\/www.legalserviceindia.com\/Legal-Articles\/medical-liability-india-reform-gross-negligence-bns-106\/#International_Approaches_to_Criminal_Liability_in_Medical_Practice\" >International Approaches to Criminal Liability in Medical Practice<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-20\" href=\"https:\/\/www.legalserviceindia.com\/Legal-Articles\/medical-liability-india-reform-gross-negligence-bns-106\/#Potential_Impacts_of_Liability_Reforms_on_Patient_Care\" >Potential Impacts of Liability Reforms on Patient Care<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-21\" href=\"https:\/\/www.legalserviceindia.com\/Legal-Articles\/medical-liability-india-reform-gross-negligence-bns-106\/#AI_Understanding_Gross_Medical_Negligence\" >AI: Understanding Gross Medical Negligence<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-22\" href=\"https:\/\/www.legalserviceindia.com\/Legal-Articles\/medical-liability-india-reform-gross-negligence-bns-106\/#Legal_Framework_under_BNS_Sec_1061\" >Legal Framework under BNS Sec 106(1)<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-23\" href=\"https:\/\/www.legalserviceindia.com\/Legal-Articles\/medical-liability-india-reform-gross-negligence-bns-106\/#Why_%E2%80%9CGross%E2%80%9D_Is_about_the_Act_Not_Just_the_Outcome\" >Why \u201cGross\u201d Is about the Act, Not Just the Outcome<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-24\" href=\"https:\/\/www.legalserviceindia.com\/Legal-Articles\/medical-liability-india-reform-gross-negligence-bns-106\/#Key_Criteria_for_Gross_Medical_Negligence\" >Key Criteria for Gross Medical Negligence<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-25\" href=\"https:\/\/www.legalserviceindia.com\/Legal-Articles\/medical-liability-india-reform-gross-negligence-bns-106\/#Applying_This_Definition_in_Practice\" >Applying This Definition in Practice<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-26\" href=\"https:\/\/www.legalserviceindia.com\/Legal-Articles\/medical-liability-india-reform-gross-negligence-bns-106\/#Beyond_the_Statute_Comparative_Perspectives\" >Beyond the Statute: Comparative Perspectives<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-27\" href=\"https:\/\/www.legalserviceindia.com\/Legal-Articles\/medical-liability-india-reform-gross-negligence-bns-106\/#What_aspects_of_gross_negligence_interest_you_most\" >What aspects of gross negligence interest you most?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-28\" href=\"https:\/\/www.legalserviceindia.com\/Legal-Articles\/medical-liability-india-reform-gross-negligence-bns-106\/#What_strategies_can_healthcare_professionals_use_to_prevent_gross_negligence\" >What strategies can healthcare professionals use to prevent gross negligence?<\/a><\/li><\/ul><\/li><\/ul><\/nav><\/div>\n\n\n\n\n<ol class=\"wp-block-list\">\n<li>The inadvertent inclusion of healthcare under the <strong>Consumer Protection Act, 1986<\/strong> by the <em>IMA vs. V.P. Shantha (1995)<\/em> judgment.<\/li>\n\n\n\n<li>The <strong>criminalization of registered medical professionals<\/strong> under the <strong>Bharatiya Nyaya Sanhita (BNS), 2023<\/strong> when a procedure results in the patient\u2019s death\u2014despite earlier assurances of decriminalization.<\/li>\n<\/ol>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Comparing_New_Legal_Changes_with_Previous_Regulations\"><\/span>Comparing New Legal Changes with Previous Regulations<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<ol class=\"wp-block-list\">\n<li>Inclusion of Healthcare under the Consumer Protection Act <strong>Pre-1995:<\/strong> Medical services were not covered under the CPA 1986. Patients relied on:<ul><li>Civil courts (tort claims) for compensation<\/li><li>Criminal prosecutions under IPC in rare cases<\/li><li>Disciplinary action by Medical Councils (no power to award damages)<\/li><\/ul><strong>Post-1995 (IMA vs. V.P. Shantha):<\/strong> Supreme Court declared paid medical services as &#8220;service&#8221; under CPA 1986. This allowed consumer forums to:\n<ul class=\"wp-block-list\">\n<li>Hear deficiency-in-service complaints<\/li>\n\n\n\n<li>Award compensation without civil-court delays<\/li>\n\n\n\n<li>Use district, state, and national commissions<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li>Criminal Liability for Death by Negligence Regulation Scope Penalty Medical Exception Section 304A IPC (1860) Death by rash or negligent act not amounting to culpable homicide Up to 2 years\u2019 imprisonment, or fine, or both No statutory carve-out; courts require proof of gross negligence BNS Section 106 (2023) 1. Death by general negligence<br>2. Hit-and-run fatalities 1. Up to 5 years + fine<br>2. Up to 10 years + fine Doctors: Capped at 2 years + fine when a procedure causes death \u00a0<\/li>\n<\/ol>\n\n\n\n<h4 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Key_Distinctions\"><\/span>Key Distinctions<span class=\"ez-toc-section-end\"><\/span><\/h4>\n\n\n\n<ol class=\"wp-block-list\">\n<li><strong>Punishment Ceiling:<\/strong>\n<ul class=\"wp-block-list\">\n<li>IPC 304A: Max 2 years for all<\/li>\n\n\n\n<li>BNS 106(1): Max 5 years (general), but 2 years for doctors<\/li>\n\n\n\n<li>BNS 106(2): 10 years for fleeing drivers<br>\u00a0<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>Explicit Medical Clause:<\/strong><br>IPC applied uniform standards; BNS offers capped punishment but continues criminalization, despite decriminalization promises.<br>\u00a0<\/li>\n\n\n\n<li><strong>Disciplinary vs. Criminal Regimes:<\/strong>\n<ul class=\"wp-block-list\">\n<li><strong>Before BNS:<\/strong> Handled via Medical Councils, tort law, and rarely IPC 304A<\/li>\n\n\n\n<li><strong>After BNS:<\/strong> Adds expanded criminal liability while retaining existing forums<br>\u00a0<\/li>\n<\/ul>\n<\/li>\n<\/ol>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Proposed_Reforms_to_Improve_Conditions_for_Medical_Professionals\"><\/span>Proposed Reforms to Improve Conditions for Medical Professionals<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<ol class=\"wp-block-list\">\n<li>Legislative Amendments\n<ul class=\"wp-block-list\">\n<li>Exclude routine healthcare from CPA or insert gross-negligence threshold<\/li>\n\n\n\n<li>Remove procedural death liability for doctors under BNS 106<\/li>\n\n\n\n<li>Define \u201cgross negligence\u201d using Jacob Mathew case standards<br>\u00a0<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li>Institutional Mechanisms\n<ul class=\"wp-block-list\">\n<li>Set up Health Tribunals with medical and legal experts<\/li>\n\n\n\n<li>Use pre-litigation Expert Review Panels for causation and negligence<\/li>\n\n\n\n<li>Launch a no-fault compensation scheme<br>\u00a0<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li>Professional Safeguards\n<ul class=\"wp-block-list\">\n<li>Provide safe-harbor for adherence to clinical protocols<\/li>\n\n\n\n<li>Subsidize professional indemnity insurance<\/li>\n\n\n\n<li>Ensure Good Samaritan legal protection<br>\u00a0<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li>Procedural Safeguards\n<ul class=\"wp-block-list\">\n<li>Mandatory mediation before consumer court admission<\/li>\n\n\n\n<li>Time-bound case resolution<\/li>\n\n\n\n<li>Compensation caps via standard tariff schedules<br>\u00a0<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li>Capacity Building and Awareness\n<ul class=\"wp-block-list\">\n<li>Expand CME on risk, consent, and medico-legal literacy<\/li>\n\n\n\n<li>Run awareness campaigns on treatment expectations<\/li>\n\n\n\n<li>Launch legal helplines for medical professionals<\/li>\n<\/ul>\n<\/li>\n<\/ol>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"No-Fault_Compensation_Scheme_An_Overview\"><\/span>No-Fault Compensation Scheme: An Overview<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Key_Features\"><\/span>Key Features<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Causation-based eligibility<\/li>\n\n\n\n<li>Administrative process (not courts)<\/li>\n\n\n\n<li>Fixed compensation schedules<\/li>\n\n\n\n<li>Fast payout timelines<\/li>\n\n\n\n<li>Possible additional support services (rehab, counselling)<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"How_These_Reforms_Improve_Patient_Rights_Safety\"><\/span>How These Reforms Improve Patient Rights &amp; Safety<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Faster Compensation:<\/strong> Less stress and legal costs<\/li>\n\n\n\n<li><strong>Encourages Disclosure:<\/strong> Less blame, more transparency<\/li>\n\n\n\n<li><strong>Data-Driven Safety:<\/strong> Uses claims data to enhance system-level care<\/li>\n\n\n\n<li><strong>Equal Access:<\/strong> Ensures equitable redress regardless of background.<br>\u00a0<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Comparison_Table_Fault-Based_vs_No-Fault\"><\/span>Comparison Table: Fault-Based vs. No-Fault<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><thead><tr><th>Aspect<\/th><th>Fault-Based System<\/th><th>No-Fault System<\/th><\/tr><\/thead><tbody><tr><td>Burden of Proof<\/td><td>Patient must prove provider fault<\/td><td>Only need to show treatment\u2013injury link<\/td><\/tr><tr><td>Speed of Resolution<\/td><td>Years of litigation<\/td><td>Months via administration<\/td><\/tr><tr><td>Legal Costs<\/td><td>High<\/td><td>Low<\/td><\/tr><tr><td>Error Reporting<\/td><td>Discouraged due to legal risk<\/td><td>Encouraged by non-punitive system<\/td><\/tr><tr><td>Coverage<\/td><td>Only in negligence<\/td><td>All avoidable harm<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Steps_to_Implement_Effectively\"><\/span>Steps to Implement Effectively<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<ol class=\"wp-block-list\">\n<li>Draft enabling legislation with clear criteria<\/li>\n\n\n\n<li>Create an administrative authority or trust<\/li>\n\n\n\n<li>Fund via levies, insurance premiums, or health budgets<\/li>\n\n\n\n<li>Develop standardized tariff-based compensation<\/li>\n\n\n\n<li>Link data to patient-safety reform systems<\/li>\n\n\n\n<li>Conduct stakeholder education campaigns<\/li>\n\n\n\n<li>Monitor metrics and review periodically<\/li>\n\n\n\n<li>Provide appeals\/review boards for disputed claims<\/li>\n<\/ol>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Additional_Considerations\"><\/span>Additional Considerations<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Ensure clinical regulation aligns with no-fault findings<\/li>\n\n\n\n<li>Preserve confidentiality while sharing safety data<\/li>\n\n\n\n<li>Customize model to Indian context, e.g., New Zealand\u2019s ACC<\/li>\n\n\n\n<li>Allow phased transition from tort to no-fault model.<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Initial_Issue\"><\/span>Initial Issue<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p>Q. This takes care of the inadvertent mischief caused by the V P Shantha judgment. No fault compensation will be available to the patients even after health care is declared out of CPA. However, the mischief caused by blanket inclusion of \u2018medical procedure by a registered medical practitioner\u2019 to criminalizing medical profession, has to be addressed. This can be done by parliament only.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Reforming_Criminal_Liability_for_Medical_Procedures_Parliamentary_Pathways\"><\/span>Reforming Criminal Liability for Medical Procedures: Parliamentary Pathways<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Problem_Statement_Blanket_Criminalization\"><\/span>Problem Statement: Blanket Criminalization<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p>Patients and doctors face uncertainty because \u201cmedical procedure by a registered medical practitioner\u201d is swept into general criminal provisions without nuance.<\/p>\n\n\n\n<p>This blanket inclusion exposes routine clinical decisions\u2014even when taken in good faith, with consent and adherence to standards\u2014to criminal prosecution.<\/p>\n\n\n\n<p>A targeted legislative fix from Parliament is the only way to clarify boundaries, safeguard professional discretion, and protect patient rights.<br>&nbsp;<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Core_Legislative_Amendments\"><\/span>Core Legislative Amendments<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Amend the relevant clause in the Bharatiya Nyaya Sanhita (or IPC), carving out a \u201cclinical acts in good faith\u201d exception.<\/li>\n\n\n\n<li>Introduce \u201cgross negligence\u201d as the threshold for criminal liability, replacing the current \u201cany negligence\u201d standard.<\/li>\n\n\n\n<li>Require prior sanction or a prima facie review by a medical board before any criminal proceeding can be launched.<\/li>\n\n\n\n<li>Explicitly recognise informed consent and adherence to established clinical protocols as a defense to criminal charges.<br>\u00a0<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Drafting_the_Amendment_Bill_Key_Provisions\"><\/span>Drafting the Amendment Bill: Key Provisions<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><thead><tr><th>Current Text Issue<\/th><th>Proposed Amendment<\/th><\/tr><\/thead><tbody><tr><td>All medical acts by registered practitioners can attract criminal liability.<\/td><td>Exclude clinical acts done in good faith, with consent, from criminal provisions.<\/td><\/tr><tr><td>Negligence standard undefined\u2014any error risks prosecution.<\/td><td>Define \u201ccriminal negligence\u201d as conduct showing gross disregard for patient safety.<\/td><\/tr><tr><td>No pre-prosecution medical review.<\/td><td>Mandate a medical-expert committee review before filing.<\/td><\/tr><tr><td>Absence of explicit consent defense.<\/td><td>Insert a clause validating documented informed consent.<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Steps_to_Enact_Reform\"><\/span><br>Steps to Enact Reform<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<ol class=\"wp-block-list\">\n<li><strong>Drafting and Stakeholder Consultation<\/strong>\n<ul class=\"wp-block-list\">\n<li>Ministry of Health leads bill-drafting with inputs from medical councils, patient groups, legal experts.<\/li>\n\n\n\n<li>Circulate a white paper outlining proposed exceptions and thresholds.<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>Parliamentary Committee Review<\/strong>\n<ul class=\"wp-block-list\">\n<li>Refer the draft to a Joint Committee on Law and Health for detailed clause-by-clause scrutiny.<\/li>\n\n\n\n<li>Invite testimony from clinicians, jurists, and patient-rights advocates.<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>Debate and Passage in Parliament<\/strong>\n<ul class=\"wp-block-list\">\n<li>Introduce the bill in Lok Sabha and Rajya Sabha, ensuring explanatory statements highlight patient-safety and doctor-protection.<\/li>\n\n\n\n<li>Amend based on committee feedback; secure majority support.<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>Presidential Assent and Notification<\/strong>\n<ul class=\"wp-block-list\">\n<li>Obtain Presidential assent; publish in the Gazette of India.<\/li>\n\n\n\n<li>Set an effective date, allowing a transition period for medical boards to form review committees.<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>Rule-Making and Capacity Building<\/strong>\n<ul class=\"wp-block-list\">\n<li>Frame rules detailing the composition and powers of the pre-prosecution medical review board.<\/li>\n\n\n\n<li>Train law-enforcement officers and prosecutors on the new threshold and procedures.<\/li>\n<\/ul>\n<\/li>\n<\/ol>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Additional_Considerations-2\"><\/span>Additional Considerations<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Align criminal-law reforms with professional disciplinary mechanisms under the National Medical Commission.<\/li>\n\n\n\n<li>Monitor impact via periodic parliamentary reviews: track number of prosecutions, case outcomes, and stakeholder feedback.<\/li>\n\n\n\n<li>Draw lessons from the UK\u2019s gross-negligence manslaughter threshold and New Zealand\u2019s ACC \u201cgood-faith\u201d carve-outs.<\/li>\n\n\n\n<li>Communicate changes widely\u2014through medical associations, patient-rights NGOs, and law-enforcement training\u2014to ensure clarity and compliance.<\/li>\n<\/ul>\n\n\n\n<blockquote class=\"wp-block-quote is-layout-flow wp-block-quote-is-layout-flow\">\n<p>This parliamentary roadmap will recalibrate the balance between accountability and professional autonomy, ensuring that only truly culpable conduct faces criminal sanction while preserving trust in the medical profession.<\/p>\n<\/blockquote>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Gross_Negligence_Legal_Definition\"><\/span>Gross Negligence: Legal Definition<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Gross negligence occupies a higher threshold than ordinary negligence, reflecting an extreme departure from the standard of care expected of a reasonable person.<\/li>\n\n\n\n<li>Defined as the \u201clack of slight diligence or care\u201d or a \u201cconscious, voluntary act or omission in reckless disregard of a legal duty and of the consequences to another party\u201d.<\/li>\n\n\n\n<li>It goes beyond mere carelessness, involving a willful or wanton disregard for the safety or rights of others.<\/li>\n\n\n\n<li>In medical contexts, gross negligence might include operating on the wrong patient, amputating the wrong limb, or ignoring critical allergy alerts.<br>\u00a0<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"International_Approaches_to_Criminal_Liability_in_Medical_Practice\"><\/span>International Approaches to Criminal Liability in Medical Practice<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><thead><tr><th>Country\/Region<\/th><th>Primary Route<\/th><th>Criminal Liability<\/th><th>Key Features<\/th><\/tr><\/thead><tbody><tr><td>Europe (e.g., France, Germany)<\/td><td>Civil\/judicial<\/td><td>Rare<\/td><td>Handled by judges; payouts more likely but smaller, as negligence alone need not trigger criminal fault<\/td><\/tr><tr><td>Russia<\/td><td>Criminal courts<\/td><td>Frequent<\/td><td>1,800 criminal cases filed in 2017; prosecutions led by state investigators rather than medical panels<\/td><\/tr><tr><td>Italy<\/td><td>Criminal predominant<\/td><td>High<\/td><td>Most malpractice suits filed criminally; evidence gathering by state; high defensive medicine due to liability concerns<\/td><\/tr><tr><td>United Kingdom<\/td><td>Civil tort &amp; gross-negligence manslaughter<\/td><td>Exceptional<\/td><td>Requires proof of duty, breach, causation of death, and an obvious risk of death to a reasonable person<\/td><\/tr><tr><td>United States<\/td><td>Predominantly civil<\/td><td>Limited<\/td><td>Criminal charges only in extreme recklessness or intentional harm; most disputes resolved via malpractice insurers<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Potential_Impacts_of_Liability_Reforms_on_Patient_Care\"><\/span><br>Potential Impacts of Liability Reforms on Patient Care<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Reduction in defensive medicine:<\/strong> Clearer \u201cgross negligence\u201d standards and immunity for good-faith emergency acts help doctors focus on optimal care rather than fearing prosecution.<\/li>\n\n\n\n<li><strong>Preservation of emergency services:<\/strong> Protections for life-saving interventions encourage timely decisions, reducing hesitation in critical situations.<\/li>\n\n\n\n<li><strong>Strengthened patient-safety culture:<\/strong> Distinguishing systemic errors from culpable conduct channels adverse-event data into quality-improvement initiatives rather than individual blame.<\/li>\n\n\n\n<li><strong>Equitable access to compensation:<\/strong> A high negligence threshold may delay or limit recourse for patients harmed by substandard\u2014but not grossly negligent\u2014care.<\/li>\n\n\n\n<li><strong>Enhanced trust and transparency:<\/strong> Clear legal benchmarks foster open disclosure of medical errors, building stronger patient\u2013provider relationships.<\/li>\n\n\n\n<li><strong>Risk of unintended barriers:<\/strong> If the gross-negligence standard is set too narrowly, some patients might perceive hurdles in claiming redress for genuine harms.<\/li>\n<\/ul>\n\n\n\n<p><strong>Q.<\/strong> The difficulty is in defining gross in terms of intent or application and not quantum of damage. Gross negligence (act) as per your definition may not result in any harm while a non-gross act may result in death. As per the provisions of BNS, grossness is either causing grievous hurt or death. BNS Sec 106(1) is for causing death which may be by a simple procedure like just inserting a needle in the chest or attempt to remove wax from ear. Medical act is a procedure performed by a licensed medical practitioner with the consent of the patient. By itself it cannot be gross, it may be risky. To my mind, gross medical negligence is when the act is either done by an incompetent person not licensed to treat, or the procedure is not recognized and approved, and is palpably not medical.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"AI_Understanding_Gross_Medical_Negligence\"><\/span>AI: Understanding Gross Medical Negligence<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Legal_Framework_under_BNS_Sec_1061\"><\/span>Legal Framework under BNS Sec 106(1)<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li>BNS Sec 106(1) treats \u201cgrossness\u201d as conduct causing grievous hurt or death.<\/li>\n\n\n\n<li>Mere harm isn\u2019t enough; the statute targets acts so egregious they result in serious injury or fatality.<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Why_%E2%80%9CGross%E2%80%9D_Is_about_the_Act_Not_Just_the_Outcome\"><\/span>Why \u201cGross\u201d Is about the Act, Not Just the Outcome<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li>A licensed doctor\u2019s procedure\u2014even if risky\u2014follows an accepted standard and informed consent.<\/li>\n\n\n\n<li>If no grievous harm occurs, the act may be negligent but not \u201cgross\u201d under the intent-based lens.<\/li>\n\n\n\n<li>Conversely, a minor mishap by a quack can be \u201cgross\u201d if the practitioner had no right to perform it.<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Key_Criteria_for_Gross_Medical_Negligence\"><\/span>Key Criteria for Gross Medical Negligence<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<ol class=\"wp-block-list\">\n<li><strong>Practitioner Competence<\/strong>\n<ul class=\"wp-block-list\">\n<li>Performed by someone lacking the required license or credentials.<\/li>\n\n\n\n<li>No reasonable expectation that they could foresee or prevent the risk.<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>Recognition and Approval<\/strong>\n<ul class=\"wp-block-list\">\n<li>Procedure falls outside sanctioned medical practice (no textbooks, no peer-review).<\/li>\n\n\n\n<li>Lacks institutional or regulatory backing (medical boards, hospital protocols).<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>Palpable Departure from Standard of Care<\/strong>\n<ul class=\"wp-block-list\">\n<li>So far removed from accepted norms that any competent peer would instantly deem it unacceptable.<\/li>\n\n\n\n<li>Not a mere error in technique but a fundamental breach (e.g., injecting household bleach).<\/li>\n<\/ul>\n<\/li>\n<\/ol>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Applying_This_Definition_in_Practice\"><\/span>Applying This Definition in Practice<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Evidence-Gathering<\/strong>\n<ul class=\"wp-block-list\">\n<li>Verify practitioner\u2019s licensing, training records, hospital affiliations.<\/li>\n\n\n\n<li>Collect expert opinions on whether the intervention has any basis in medical literature.<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>Causation vs. Grossness<\/strong>\n<ul class=\"wp-block-list\">\n<li>You must link the act to the injury (causation) and show the act was so extreme it violated fundamental professional duties (grossness).<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Beyond_the_Statute_Comparative_Perspectives\"><\/span>Beyond the Statute: Comparative Perspectives<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li>In several common-law jurisdictions, gross negligence is judged against a \u201crecklessness\u201d standard\u2014did the actor consciously disregard a substantial risk?<\/li>\n\n\n\n<li>India\u2019s approach aligns: intent need not be malicious, but indifference or extreme departure suffices.<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"What_aspects_of_gross_negligence_interest_you_most\"><\/span>What aspects of gross negligence interest you most?<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p>Its proof in court, comparative rules in other countries, or strategies to prevent such acts in healthcare settings?<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"What_strategies_can_healthcare_professionals_use_to_prevent_gross_negligence\"><\/span>What strategies can healthcare professionals use to prevent gross negligence?<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p><strong>Written By: Dr Shri Gopal Kabra<\/strong><br>MBBS, LLB, MSc, MS(Anatomy), MS(Surgery)<br>Email. kabrasg@hotmail.com Mobile: 8003516198<\/p>\n","protected":false},"excerpt":{"rendered":"<p>\u201cCourts have played a salutary and corrective role in innumerable instances. They are highly respected by our people for that. At the same time, the dividing line between judicial activism and judicial overreach is a thin one.\u201d\u2014 Prime Minister Dr. Manmohan Singh &#8220;Judicial activism is not the same as judicial overreach. The former is a<\/p>\n","protected":false},"author":60,"featured_media":4988,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_bbp_topic_count":0,"_bbp_reply_count":0,"_bbp_total_topic_count":0,"_bbp_total_reply_count":0,"_bbp_voice_count":0,"_bbp_anonymous_reply_count":0,"_bbp_topic_count_hidden":0,"_bbp_reply_count_hidden":0,"_bbp_forum_subforum_count":0,"two_page_speed":[],"_jetpack_memberships_contains_paid_content":false,"_joinchat":[],"footnotes":""},"categories":[87],"tags":[24],"class_list":{"0":"post-6443","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-medico-legal","8":"tag-just-in"},"jetpack_featured_media_url":"https:\/\/www.legalserviceindia.com\/Legal-Articles\/wp-content\/uploads\/2025\/06\/Dr.-S.G.Kabra_-1.jpg","jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/www.legalserviceindia.com\/Legal-Articles\/wp-json\/wp\/v2\/posts\/6443","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.legalserviceindia.com\/Legal-Articles\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.legalserviceindia.com\/Legal-Articles\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.legalserviceindia.com\/Legal-Articles\/wp-json\/wp\/v2\/users\/60"}],"replies":[{"embeddable":true,"href":"https:\/\/www.legalserviceindia.com\/Legal-Articles\/wp-json\/wp\/v2\/comments?post=6443"}],"version-history":[{"count":0,"href":"https:\/\/www.legalserviceindia.com\/Legal-Articles\/wp-json\/wp\/v2\/posts\/6443\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.legalserviceindia.com\/Legal-Articles\/wp-json\/wp\/v2\/media\/4988"}],"wp:attachment":[{"href":"https:\/\/www.legalserviceindia.com\/Legal-Articles\/wp-json\/wp\/v2\/media?parent=6443"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.legalserviceindia.com\/Legal-Articles\/wp-json\/wp\/v2\/categories?post=6443"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.legalserviceindia.com\/Legal-Articles\/wp-json\/wp\/v2\/tags?post=6443"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}