1. Medical professional — Disclosure of HIV(+) status to proposed spouse — Claim for damages for breach of medical confidentiality and violation of right to privacy. (Para 2 , 3 , 4 , 5 )
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1998 Supreme(SC) 1011
SUPREME COURT OF INDIA
B.N.Kirpal : S.Saghir Ahmad
Tokugha Yepthomi
Versus
Apollo Hospital Enterprises Limited
Case No. : 4641 of 1998
Date of Decision : 9/21/98
Advocates Appeared: Arora Meenakshi
The right to medical confidentiality and privacy under Article 21 is not absolute and is overridden by the right to life and health of others, specifically when disclosing a communicable disease to a prospective spouse to prevent infection.
Headnote:(A) Indian Medical Council Act - Sections 20-A and 33(m) - Constitution of India - Article 21 - Indian Penal Code - Sections 269 and 270 - Hindu Marriage Act, 1955 - Section 13(1)(v) - Dissolution of Muslim Marriages Act, 1939 - Section 2 - Parsi Marriage and Divorce Act, 1936 - Section 32 - Special Marriage Act - Section 27 - Duty of medical confidentiality - Right to privacy - Disclosure of HIV positive status to prospective spouse - The duty to maintain confidentiality is not absolute and is subject to exceptions where public interest or the health of others is at risk (Paras 14, 15, 16). The right to privacy, as an essential component of the right to life under Article 21, is not absolute and may be lawfully restricted for the protection of health or the rights and freedoms of others (Paras 22, 24, 25).
(B) Right to Marry - The right to marry is not absolute and is subject to the duty to inform a prospective partner about a communicable venereal disease. Where such a disease exists, the right to marry is treated as a "suspended right" until the person is cured (Para 33).
(C) Criminal Liability - Knowingly marrying and transmitting a disease dangerous to life may constitute an offence under Sections 269 and 270 of the Indian Penal Code, thereby imposing a duty on medical practitioners to disclose such information to prevent the commission of a crime (Paras 34-37).
Facts of the case:
A medical professional, while donating blood at a hospital, was found to be HIV positive. The hospital disclosed this status to the professional's prospective spouse, resulting in the cancellation of the marriage and subsequent social ostracization of the professional. The professional sought damages for breach of medical confidentiality and violation of the right to privacy.
Findings of Court:
The disclosure of the HIV positive status was not violative of the rule of confidentiality or the right to privacy because it saved the prospective spouse from infection. The right to life of the prospective spouse to lead a healthy life overrides the patient's right to privacy in this specific context.
Issues: Whether the disclosure of a patient's HIV positive status to a prospective spouse constitutes a breach of medical confidentiality or a violation of the right to privacy under Article 21 of the Constitution.
Ratio Decidendi: The court ruled that the duty of confidentiality and the right to privacy are not absolute and must yield to the protection of public health and the right to life of others. In the context of marriage, a person with a communicable venereal disease has a "suspended right" to marry and a legal/moral duty to disclose the condition. Disclosure to prevent the infection of a spouse is justified as it protects the spouse's fundamental right to life and prevents the medical practitioner from becoming a participant in a potential criminal act under the Indian Penal Code.
Result: Appeal dismissed.
Legal Category Hierarchy
- tort
- constitutional law
- family law
- crime and sentencing
Table of Contents
2. Breach of medical duty of confidentiality and infringement of the right to privacy under Article 21 — Liability for damages. (Para 6 , 11 , 17 )
3. Right to privacy and medical confidentiality are not absolute — Overridden by public interest and the right to health of an identifiable third party. (Para 7 , 8 , 9 , 10 , 12 , 13 , 14 , 15 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 34 , 35 , 36 , 37 , 39 )
4. Right to privacy and medical confidentiality yield to the right to life and health of others when a communicable disease poses an immediate risk. (Para 16 , 25 , 33 , 38 )
5. Appeal dismissed. (Para 40 )
6. Is the duty of a physician to maintain patient confidentiality absolute?
No. While physicians are ethically and professionally bound to maintain secrecy, exceptions exist where disclosure is required by court order or when public interest overrides confidentiality, specifically to prevent immediate or future health risks to others. (Para 14 , 15 , 16 )
7. How is the conflict between a patient's right to privacy and a third party's right to health resolved?
The right to privacy under Article 21 is not absolute. Where a clash occurs between a patient's privacy and another's right to a healthy life, the right that advances public interest and morality—the right to health—prevails. (Para 22 , 24 , 38 )
8. Does a person suffering from a communicable venereal disease have an absolute right to marry?
No. Such a person has a moral and legal duty to inform the proposed spouse. Until cured, the right to marry is considered a suspended right and cannot be enforced through a court. (Para 33 )
9. What are the legal consequences of knowingly spreading a life-threatening disease through marriage?
Under Sections 269 and 270 of the Indian Penal Code, any person who negligently or malignantly does an act likely to spread the infection of a disease dangerous to life is liable for punishment. (Para 34 , 35 , 36 )
JUDGMENT
S. Saghir Ahmad, J.
(1) INFRINGEMENT of Suspended Right to marry cannot be legally compensated by damages either in Torts or common law, is our answer to the problem raised in this appeal which is based on the peculiar facts of its own.
(2) THE appellant after obtaining the Degree of MBBS in 1987 from Jawaharlal Institute of Post Graduate Medical Education and Research, Chandigarh, completed his internship and junior residence at the same college. In June, 1990 he joined the Nagaland State Medical and Health Service as Assistant Surgeon Grade-1. Thereafter, the appellant joined the MD Pharmacology Course though he continued in the Nagaland State Service on the condition that he would resume his duties after completing the MD Course. In September, 1991 the appellant joined the further Course of Diploma in Opthamalogy which he completed in April, 1993. In August, 1993 he resumed his duties in the Nagaland State Health Service as Assistant Surgeon Grade-I.
(3) ONE Itokhu Yepthomi who was ailing from a disease which was provisionally diagnosed as Aortic Anuerism was advised to go to the Apollo Hospital at Madras and the appellant was directed by the government of Nagaland to accompany the said patient to Madras for treatment. For the treatment of the above disease, ltokhu Yepthomi was posted for surgery on 31/05/1995 which, however, was cancelled due to shortage of blood. On 1/06/1995 the appellant and one Yehozhe who was the driver of ltokhu Yepthomi were asked to donate blood for the latteR.Their blood samples were taken and the result showed that the appellants blood group was A (+ve). On the next date, namely, on 2/06/1995, ltokhu Yepthomi was operated for Aortic Anuerism and remained in the Hospital till 10th June, 1995 when he was discharged.
(4) IN August, 1995 the appellant proposed marriage to one Ms. Akali which was accepted and the marriage was proposed to be held on 12/12/1995. But the marriage was called off on the ground of blood test conducted at the respondents hospital in which the appellant was found to be HIV(+). The appellant went again to the respondents hospital at Madras where several tests were conducted and he was found to be HIV(+). Since the marriage had been settled but was subsequently called off, several people including members of the appellants family and persons belonging to his community became aware of the appellants HIV(+) status. This resulted in severe criticism of the appellant and he was ostracized by the community. The appellant left Kohima (Nagaland) around 26/11/1995 and started working and residing at Madras.
(5) THE appellant then approached the National Consumer Disputes Redressal Commission for damages against the respondents, on the ground that the information which was required to be kept secret under Medical ethics was disclosed illegally and, therefore, the respondents were liable to pay damages. The Commission dismissed the Petition as also the application for interim relief summarily by order dated 3/07/1998 on the ground that the appellant may seek his remedy in the Civil court.
(6) LEARNED counsel for the appellant has vehemently contended that the principle of "duty of care", as applicable to persons in medical profession, includes the duty to maintain confidentiality and since this duty was violated by the respondents, they are liable in damages to the appellant.
(7) DUTY to maintain confidentiality has its origin in the Hippocratic Oath, which is an ethical code attributed to the ancient Greek physician Hippocrates, adopted as a guide to conduct by the medical profession throughout the ages and still used in the graduation ceremonies of many medical schools and colleges. Hippocrates lived and practised as a Physician between third and first century BC. He has been referred to by Plato as a famous Asclepiad who had philosophical approach to medicine. His manuscripts, the Hippocratic Collection [Corpus Hi
