From Professional Deference to Patient-Centred Accountability: A Critical Analysis of Evolving Judicial Standards of Medical

Abstract

Indian medical-negligence law has developed primarily through judicial decisions rather than a unified legislative code. Its doctrinal centre has historically been professional deference: courts ask whether a practitioner acted in accordance with a responsible body of medical opinion and caution against judging clinical decisions with hindsight. At the same time, constitutional jurisprudence, consumer protection, informed-consent doctrine and hospital liability increasingly frame the patient as a rights-bearing participant rather than a passive recipient of professional judgment. This article critically examines that transition. Using doctrinal and policy analysis, it studies leading decisions from Indian Medical Association v. V. P. Shantha to Jacob Mathew, Samira Kohli, Kusum Sharma and V. Kishan Rao, alongside the Consumer Protection Act, 2019, the National Medical Commission Act, 2019, section 106(1) of the Bharatiya Nyaya Sanhita, 2023, and the unsettled professional-conduct framework. It argues that Indian law has not abandoned the Bolam principle; instead, it has fragmented it across treatment choice, diagnosis, disclosure, institutional responsibility, criminal culpability and proof. This fragmentation protects legitimate clinical discretion but produces inconsistent thresholds, uneven access to expert evidence, uncertain compensation and weak coordination between courts, consumer commissions and medical regulators. The article proposes a patient-centred reasonableness model that preserves deference for responsible clinical judgment while subjecting professional opinion to logical scrutiny, requiring material-risk disclosure, recognising systems negligence and calibrating remedies to culpability and harm. The shift needed is not from expertise to judicial substitution, but from unreviewable professional custom to transparent, evidence-based and rights-sensitive accountability.