Indian Journal of Medical Ethics

COMMENTARY


Rethinking medical liability in India: Supreme Court’s call for judicial review and ongoing uncertainty

Ranjit Immanuel James, Omprakash V Nandimath, Balaji Jayasankar, Alexander Thomas

Published online first on July 29, 2025. DOI:10.20529/IJME.2025.058

Abstract

The landmark 1995 judgment by the Supreme Court of India included doctors within the purview of the Consumer Protection Act (CPA) 1986, hinting that other professions, including legal services, could also fall under its ambit. However, in 2024, the apex court ruled in ‘Bar of Indian Lawyers Through its President vs DK Gandhi PS National Institute of Communicable Diseases and Anr.’, that lawyers are not liable for professional deficiencies under the CPA, emphasising the lack of universal standards for assessing dereliction of duty in legal services. Although this landmark verdict let advocates off the hook, it calls into question the Court’s 30-year-old decision. This ruling has reignited the debate on whether doctors should be equated with other service providers under the CPA 2019, particularly in light of the rise in defensive medicine practices, which increase healthcare costs and erode doctor–patient trust. In this commentary, we will discuss the analysis and observations of the apex court in the DK Gandhi case, contributing to the ongoing discourse on medical liability under the CPA in India.

Keywords: advocates, Consumer Protection Act, doctors, India, medical negligence, Supreme Court


Background

A few decades ago, doctors were considered demigods, and the medical profession was considered noble. However, recent trends in litigation suggest otherwise [1, 2, 3, 4]. To add insult to injury, over the years, legislation and judicial decisions have evolved more in favour of patients. Additionally, India could face severe consequences due to the malpractice crisis. Hence, it is crucial to look back and analyse the path we have taken and suggest accessible and sustainable healthcare plans for the future, securing patients’ rights and avoiding the harassment of doctors through the misuse of medical negligence litigation. In this commentary, we discuss the analysis of the Supreme Court in Bar of Indian Lawyers Through its President vs DK Gandhi PS National Institute of Communicable Diseases and Anr., 2024 — which excludes advocates from the ambit of the Consumer Protection Act (CPA) [5] — and assess the applicability of its reasoning to the medical profession, contributing to the ongoing discourse about medical liability under the CPA in India.

The perpetual debate: The first phase (pre-1995)

Prior to the enactment of the Special Act, the CPA 1986 [6], all civil suits concerning medical negligence were addressed by civil courts. However, after consumer dispute redressal forums were established under the CPA, many cases were also filed in consumer tribunals. This led to confusion among stakeholders about whether a patient can seek consumer redressal forums, considering healthcare a service within the scope of the CPA and file a complaint against healthcare professionals. This was complicated by the conflicting opinions of various high courts. While some of them opined that medical services could be included within the ambit of the CPA, others dissented from this viewpoint [7]. This initiated a nationwide debate about whether healthcare should also be excluded from the scope of the CPA.

Second phase (1995–May 2024)

The Indian Medical Association approached the Supreme Court to resolve the conflicting views and speculation. In 1995, the landmark case of Indian Medical Association vs VP Shantha, adjudicated by a three-judge bench of the Indian Supreme Court, established a pivotal precedent by confirming that doctors and hospitals are included under the CPA [8]. This ruling marked a dramatic shift in the interpretation of the Act, suggesting that its applicability could extend to other professions, including the legal profession. In evaluating whether medical professionals fall under the CPA, the apex court considered several key points. Firstly, although medical practitioners are subject to the disciplinary oversight of the Medical Council of India and/or state medical councils, this regulatory framework does not exempt their services from the ambit of the Act. Secondly, the services provided by medical practitioners to patients should not be categorised as services rendered under a “contract of personal service”. This distinction affirms that patient care is a service akin to other consumer transactions. Finally, the framework of the consumer disputes redressal forums, and the availability of appeal provisions, ensure that redressal mechanisms are well-equipped to handle the complexities associated with complaints of deficiencies in the medical services provided by doctors [7]. Surprisingly, in this ruling, there appears to be no deliberation about whether medical and legal professionals should be compared with other occupations, such as plumbers, carpenters, bankers, etc. Consequently, in the 2009 ruling in Bar of Indian Lawyers vs DK Gandhi, the National Consumer Dispute Redressal Commission (NCDRC) determined that legal professionals also fall under the ambit of the CPA, referencing the findings of the apex court in VP Shantha’s case [5].

Third phase (since May 2024)

The Bar Council subsequently appealed this decision in the Supreme Court. During the hearing, the Supreme Court’s division bench, comprising two judges, examined a moot question: Are lawyers providing legal services to clients covered by the CPA? Ultimately, the apex court overturned the NCDRC’s ruling, determining that lawyers cannot be held liable under the CPA for alleged deficiencies in their professional services while representing their clients [5].

This case posed three critical questions before the court: One, does the CPA cover professionals? Two, is the legal profession sui generis (unique)? Finally, can the services provided by advocates be classified as a “contract of personal service”? In its analysis, the Supreme Court scrutinised the legislative intent behind the CPA and observed that the primary aim of the CPA 2019 [9], and its predecessor, enacted in 1986, is to protect consumers from unethical and unfair trade practices rather than to regulate professional services. The appellants contended that, unlike the medical profession, which has established scientific standards for determining standards of care, the legal profession lacks a universal standard or objective metric for assessing alleged negligence. They argued that the complexities inherent in the legal profession, due to the intricate framework and functioning of the legal system, the lack of precise answers, and the subjective nature of outcomes, present significant challenges. Consequently, the court concluded that the legal profession is indeed sui generis, given its regulated nature and integral role within the judiciary, distinguishing it from other professions, including medicine [5].

The court also deliberated on whether the services provided by advocates constitute a “contract of personal service” based on a legal precedent, suggesting that while a higher degree of client control implies a contract of service, greater independence indicates otherwise (contract for service). This ultimately led the court to affirm that legal services do not fall within the scope of the CPA [5,10]. One of the judges (Justice Pankaj Mithal) compared Indian consumer protection laws with those of other jurisdictions and advocated for the exclusion of legal services from the CPA. Meanwhile, Justice Bela M Trivedi, the other judge, emphasised the distinction between professionals and businesspeople or traders, asserting that clients and patients should not be classified as consumers and recommended that a larger bench should review the three-decade-old verdict [5].

The debate continues

This apex court’s judgment has reignited the ongoing debate among doctors about the applicability of consumer protection laws to physicians. Despite the existence of standard treatment guidelines for various conditions, the complex and unpredictable nature of medical science presents challenges unique to each patient’s case. Even with the highest standards of care, desired outcomes are not always guaranteed, as they often depend on factors beyond a physician’s control, including patient-specific circumstances. Under the CPA, there has been a marked increase in litigation against doctors for alleged medical negligence in India, which may result in a malpractice crisis. However, this overwhelming burden on doctors has necessitated the widespread adoption of defensive medicine, which can negatively impact patient care and overall public health [11, 12].

Why should the medical profession be included under the CPA?

Many believe that due to the commercialisation of medical services, healthcare should fall within the jurisdiction of the CPA. This would provide an avenue for affected patients or their families to seek redressal in the form of compensation, acknowledging their status as consumers within the healthcare sector. Additionally, according to the legal mandate under Section 38(7) of the CPA 2019, redressal commissions are required to dispose of every admitted complaint within 90 days from the date of receipt of notice by the opposite party, if it does not require the analysis or testing of commodities [9]. For the aggrieved party, — patients and/or their families — this is certainly a cheaper and relatively quicker option than traditional civil courts.

The medical profession: “sui generis”?

It is an undisputed fact that medical science is not an exact science; cures cannot be guaranteed due to the complexities and variables involved. If we were to compare the argument put forth in the DK Gandhi case, particularly the Supreme Court’s observation regarding the autonomy of clients, medical professionals also rely on the patient’s consent for their treatment, thus giving patients control over their decisions — except in emergencies, where doctors might act to save lives without consent. This understanding of the patient’s autonomy may be enough to deem medical services a “contract of personal service” and place them outside the scope of the CPA.

Furthermore, the appellants in the DK Gandhi case argued that the Advocates Act of 1961, as a special Act, should take precedence over the CPA. They contended that applying the CPA to advocates would lead to a flood of unnecessary litigations and conflicting decisions on issues previously settled by the Supreme Court [5]. It is pertinent to note that a special Act — the National Medical Commission Act of 2019 (previously the Indian Medical Council Act, 1956) — already regulates the medical profession. Although doctors are governed by the regulatory frameworks established by the National Medical Commission (formerly by the Medical Council of India), which ensure accountability through state medical councils that effectively address patient grievances, consumer dispute redressal forums and the special provision in the newly enacted criminal law vis-à-vis Bharatiya Nyaya Sanhita, under Section 106(1), provide additional grievance resolution avenues to patients [13, 14, 15]. Doctors in India are already under immense pressure due to the litigious environment, prompting the widespread practice of defensive medicine, which could be detrimental to society in the long run.

Consumer protection laws of other jurisdictions

It is important to note that consumer protection laws concerning healthcare in various countries present differing views across the globe. A few jurisdictions, such as the European Union (EU), Taiwan, Maryland (USA), Québec (Canada), and Malaysia, explicitly exclude healthcare from their respective consumer protection laws due to its technical complexity, its critical role as a service of general interest, and the substantial public funding allocated to mitigate defensive medical practices; this necessitates specialised regulations. Additionally, professionals who are governed by a professional code are subject to distinct oversight, further distinguishing healthcare from typical consumer transactions [16, 17, 18, 19, 20, 21, 22]. However, civil law countries in the EU, like the Netherlands, Finland, Denmark, and Norway, have robust medical injury compensation systems outside of traditional litigation. The Healthcare Quality, Complaints and Disputes Act of 2015, which came into force in 2016 in the Netherlands, was established to ensure quick resolutions within six weeks via complaint procedures; appeals to dispute committees should be adjudicated within six months [23, 24]. Finland’s Patient Insurance Act, 2019, which replaced the Patient Injury Act, 1987, offers compensation within three months through the Patient Insurance Centre [23,25]. Denmark’s Patient Compensation Programme, under the Danish Patient Insurance Scheme, 1991, requires proof that the injury was caused by the healthcare system and usually resolves claims within nine months [23, 26]. The Norwegian System of Patient Injury Compensation, a public agency, emphasises efficiency and accessibility and handles claims free of charge, with decisions appealable to the Patient Injury Compensation Board [23, 27]. Although in common-law countries like Ireland and the UK, medical professionals are considered traders under consumer protection laws, their clinical negligence cases are addressed by tort laws [28, 29].

Conclusion

The never-ending discussion on doctors’ liability in alleged negligence cases requires thorough deliberation. While a judicial review potentially offers a pathway for progress, its outcomes remain uncertain. Whether the recommendation made by one judge requires the chief justice of India to convene a constitutional bench or is to be construed as an observation is a matter of technical inquiry. Given that the world is divided on this matter, and considering the evolving perspectives following the recent verdict of the apex court in the DK Gandhi case, we believe it is high time to reevaluate India’s stance on including healthcare under the CPA. If the Supreme Court were to revisit its 30-year-old verdict, there is hope that the re-evaluation of medical liability will lead to a robust healthcare framework that upholds patients’ rights, fosters trust, and alleviates the anxieties faced by medical professionals.


Authors: Ranjit Immanuel James (corresponding author — ranjit_immanuel@yahoo.co.in), Associate Professor, Department of Forensic Medicine & Toxicology, Christian Medical College Vellore, Tamil Nadu, INDIA; Omprakash V Nandimath (ovn101@hotmail.com), Professor of Law, National Law School of India University, Bengaluru, Karnataka, INDIA; Balaji Jayasankar (jayasankar.bala@gmail.com), Speciality Registrar General Surgery, West Suffolk Hospital, Bury St Edmunds, England, UNITED KINGDOM; Alexander Thomas (alexthomas.ahpi@gmail.com), Founder and Patron, Association of Healthcare Providers India, Bengaluru, Karnataka, INDIA.

Conflict of Interest: None declared                                                                                                                                                                                         Funding: None

To cite: James RI, Nandimath OV, Jayasankar B, Thomas A. Rethinking medical liability in India: Supreme Court’s call for judicial review and ongoing uncertainty. Indian J Med Ethics. Published online first on July 29, 2025. DOI: 10.20529/IJME.2025.058

Submission received: October 22, 2024

Submission accepted: May 2, 2025

Manuscript Editor: Veena Johari

Peer Reviewers: Amarendra Pattnaik and an anonymous reviewer

Copyediting: This manuscript was copyedited by The Clean Copy.

Copyright and license

©Indian Journal of Medical Ethics 2025: Open Access and Distributed under the Creative Commons license (CC BY-NC-ND 4.0), which permits only noncommercial and non-modified sharing in any medium, provided the original author(s) and source are credited.


References

  1. Akther S. Medical litigation needs to be looked holistically. ET Healthworld. 2019 Nov 3[cited 2025 Mar 29]. Available from: https://health.economictimes.indiatimes.com/news/industry/medical-litigation-needs-to-be-looked-holistically-ravindra-mangal/71881614
  2. Khattri S. Stats on medical negligence cases in India in comparison to other countries. New Delhi: Dr. Sunil Khattri & Associates; 2023 May 29 [cited 2025 Mar 29]. Available from: https://www.delhimedicalnegligence.com/post/stats-on-medical-negligence-cases-in-india-in-comparison-to-other-countries
  3. James RI, Khandekar I. Doctors, FIRs, and arrest in alleged medical negligence cases in India: Demystifying the legal tenability. J Assoc Physicians India. 2024;72(3):87–92. https://www.japi.org/article/japi-72-3-87
  4. Ravi K, Devnath GP, James RI. Medical negligence in India: Urgent call for comprehensive data, tort reforms, and cultural transformation to revitalize healthcare system. Med J DY Patil Vidyapeeth. 2024;17(2):259–61. https://doi.org/10.4103/mjdrdypu.mjdrdypu_601_23
  5. Supreme Court of India. Bar of Indian Lawyers Through its President vs DK Gandhi PS National Institute of Communicable Diseases and Anr. 2024 INSC 410. Available from: https://indiankanoon.org/doc/101402736/
  6. Government of India. The Consumer Protection Act 1986. Act No. 68 of 1986, 1986 Dec 24. [Cited 2025 Mar 29]. Available from: https://www.indiacode.nic.in/bitstream/123456789/6922/1/consumer_protection_act_1986.pdf
  7. 7. Goel R, Amarnath M, James RI, Amarnath A. Legal mechanisms and procedures in alleged medical negligence: A review of Indian laws and judgments. Natl Med J India. 2024;37(1):39–45. https://doi.org/10.25259/NMJI_955_2021
  8. Supreme Court of India. Indian Medical Association vs VP Shanta and Ors. 1995 INSC 720. Available from: https://indiankanoon.org/doc/723973/
  9. Ministry of Law and Justice, Govt of India. The Consumer Protection Act 2019. Act No. 35 of 2019 [Cited 2025 Mar 19]. Available from: https://consumeraffairs.nic.in/sites/default/files/CP%20Act%202019.pdf
  10. Supreme Court of India. Dharangadhra Chemical Works Ltd. vs State of Saurashtra and Ors. 1956 INSC 71. Available from: https://indiankanoon.org/doc/1996477/
  11. Chaudhary A, Barwal VK. Defensive medicine in the context of the Indian health system. Indian Pediatr. 2022;59(11):882–884. https://doi.org/10.1007/s13312-022-2649-4
  12. Dudeja S, Dhirar N. Defensive medicine: Sword of Damocles. Natl Med J India. 2018;31(6):364–365. https://doi.org/10.4103/0970-258X.262898
  13. Ministry of Law and Justice, Govt of India. The National Medical Commission Act 2019. Act No. 30 of 2019. Available from: https://www.nmc.org.in/nmc-act/
  14. Medical Council of India. Indian Medical Council (professional conduct, etiquette and ethics) regulations. New Delhi: MCI;2002[Cited 2024 Aug 29]. Available from: https://www.nmc.org.in/wp-content/uploads/2017/10/Ethics-Regulations-2002.pdf
  15. Ministry of Home Affairs, Govt of India. The Bharatiya Nyaya Sanhita 2023, Act No. 45 of 2023[Cited 2024 Aug 29], sec. 106 (1) (India). Available from: https://www.mha.gov.in/sites/default/files/250883_english_01042024.pdf
  16. European Union. Directive 2011/83/E.U. of The European Parliament and of the Council on Consumer Rights, amending Council Directive 93/13/EEC and Directive 1999/44/E.C. of the European Parliament and of the Council and repealing Council Directive 85/577/EEC and Directive 97/7/EC of the European Parliament and of the Council. 2011 Oct 25 [cited 2024 Aug 29]. Available from: https://eur-lex.europa.eu/eli/dir/2011/83/oj
  17. Ya-Ling Wu. Comment: The applicability of the Consumer Protection Law in medical malpractice disputes in Taiwan. Washington International Law Journal. 2007;16(3):805. Available from: https://digitalcommons.law.uw.edu/wilj/vol16/iss3/10
  18. Taiwan Supreme Court. Chin-Ying Yao Su vs Miao-Li Hospital, Department of Health. 2005 Jun 23[cited 2024 Aug 29]. 94 Docket No. TAI-SHANG 1156
  19. Taiwan Supreme Court. Sheng-Chan Chien vs Fang-Ping Chen 2006 Sep 28. 95 Docket No. TAI-SHANG 2178.
  20. Maryland Consumer Protection Act, Maryland 1975 [cited 2024 Aug 29]. Available from: https://govt.westlaw.com/mdc/Document/N490242509CDA11DB9BCF9DAC28345A2A?viewType=FullText&originationContext=documenttoc&transitionType=CategoryPageItem&contextData=(sc.Default)
  21. Legis Quebec. Consumer Protection Act 1978 (Québec) [cited 2024 Aug 29]. Available from: https://www.legisquebec.gouv.qc.ca/en/pdf/cs/P-40.1%20.pdf
  22. Government of Malaysia. Consumer Protection Act 1999 (Malaysia) [cited 2024 Aug 29]. Available from: https://www.aseanconsumer.org/file/post_image/CONSUMER%20PROTECTION%20ACT%201999%20AMENDMENT%202019%20.pdf
  23. xKuldeep H, Chopra N. Learning from the European Union: India should not exclude medical professionals from Consumer Protection Act. NLR Blog by NLIU Law Review. 2024 June 30[cited 2025 Apr 2]. Available from: https://nliulawreview.nliu.ac.in/blog/learning-from-the-european-union-india-should-not-exclude-medical-professionals-from-consumer-protection-act/
  24. Ministry of Health, Welfare and Sport, Netherlands. Healthcare Quality, Complaints and Disputes Act (Official Gazette 2015, 407) 2015 Oct 7[cited 2025 June 27]. Available from: https://zoek.officielebekendmakingen.nl/stb-2015-407.html
  25. Ministry of Social Affairs and Health, Finland. Patient Insurance Act 2019. SDK 948/2019 [cited 2025 June 27]. Available from: https://finlex.fi/fi/lainsaadanto/2019/948
  26. Danish Act on the Right to Complain and Receive Compensation within the Health Service 2017 (Denmark) [cited 2025 June 27]. Available from: https://eng.patienterstatningen.dk/Media/638463453122880452/Summary-of-the-Danish-Act-on-the-Right-to-Complain-and-Receive-Compensation.pdf
  27. Norwegian Ministry of Health and Care Services. Norwegian System of Patient Injury Compensation [cited 2025 June 27]. Available from: https://www.regjeringen.no/en/dep/hod/organisation-and-management-of-the-ministry-of-health-and-care-services/etater-og-virksomheter-under-helse–og-omsorgsdepartementet/Subordinate-institutions/the-norwegian-system-of-patient-injury/id279763/
  28. Government of Ireland. Consumer Rights Act 2022 [cited 2025 Mar 29]. Available from: https://www.irishstatutebook.ie/eli/2022/act/37/enacted/en/html
  29. Consumer Rights Act 2015 (United Kingdom) [cited 2025 Mar 29]. Available from: https://www.legislation.gov.uk/ukpga/2015/15/contents