No less than 5.2 million people die each year owing to medical negligence in India. Thus far, such apathy towards the lives of patients was treated as culpable homicide not amounting to murder. But the Bharatiya Nyaya (Second) Sanhita, 2023 has decriminalised medical negligence — the Indian Medical Association had made a special request to the Union home minister in this regard. Registered medical practitioners will now face imprisonment for up to two years and a fine if medical negligence can be established. An additional clause has been introduced if the person at fault flees or fails to report the incident, for which the BNS has set aside imprisonment of up to 10 years. It is encouraging that the IMA’s request to grant complete immunity to doctors has not been granted — some checks are necessary when a life has been snuffed out. But the establishment of medical negligence remains a challenging prospect. This is especially so in the case of medicine, which is a highly specialised and unpredictable field. It must also be remembered that this vagueness, a legacy of the Indian Penal Code, can be weaponised: Kafeel Khan, a doctor from Uttar Pradesh, had to fight a long battle to exonerate himself of charges of medical negligence levelled by the State.

Doctors, on principle, should be held accountable for their ineptitude. But this coin, so to speak, has two sides. A sizeable segment of doctors bears the brunt of violence from patients’ families and others on charges —imagined or real — of negligence. Although there is no Central legislation on this yet, 19 states in India have passed laws to protect healthcare workers and establishments from such unruly mob behaviour. The first such law was promulgated in 2007. Yet, not one single conviction has taken place since then. Violence against health workers adversely affects the quality of care they can deliver. Moreover, punitive measures against medical negligence may not be enough to eradicate the malaise. Doctors in India are severely overburdened; this is bound to leave room for human errors. Further, the healthcare infrastructure in the country is beleaguered — India has a shortage of at least 2.4 million hospital beds — and, as such, doctors cannot be held responsible for the deaths that take place owing to the lack of facilities. The punitive response to medical negligence on the part of doctors should be thought through carefully. The rights of doctors matter as do the lives of patients.