The bench of Chief Justice DY Chandrachud, also comprising Justices JB Pardiwala and Manoj Misra, stated that fostering an inclusive environment for disabled individuals pursuing medical studies is “a vital component of quality healthcare.”
Published Nov 08, 2024 | 10:01 AM ⚊ Updated Nov 08, 2024 | 10:01 AM
In a landmark judgement, the Supreme Court has called for inclusivity and transparency in the medical college admission process of persons with disabilities (PwD) and asked the Union government to issue fresh guidelines for admitting PwD candidates.
“The committee formulating the guidelines must include experts with disability or persons who have worked on disability justice. The guidelines shall comply with the judgements of this court and contemporary advancements in disability justice,” the Supreme Court said in its judgement on Tuesday, 5 November.
The bench of Chief Justice DY Chandrachud, also comprising Justices JB Pardiwala and Manoj Misra, stated that fostering an inclusive environment for disabled individuals pursuing medical studies was “a vital component of quality healthcare.”
The judgement was issued in a case concerning a candidate with muscular dystrophy seeking to participate in the NEET-UG 2024 counselling process.
“When we create avenues for inclusion, we work towards improving systems and institutions. In the context of healthcare, the inclusion of persons with disabilities is a vital component of quality healthcare,” the judgement said.
It added that the guidelines and recommendations that express concern about “lowering the standard of medical practice” on account of persons with disabilities missed the fact that those standards may be inadequate to begin with.
“The quality of a system is informed by its ability to empathise with and relate to the recipients. A system without an adequate number of practitioners who have lived experiences will not be able to fully imagine the obstacles and grievances faced by a diverse population. Diversity of workforce is crucial for a diverse society, so that everyone may have a stake in the system and the system can effectively discharge its duties toward everyone,” the judgement said.
The apex court directed the National Medical Commission (NMC) to issue fresh guidelines for the admission of PwD candidates to medical courses.
The guidelines, the court emphasised, must adhere to the principles of fairness, transparency, and consistency. Importantly, the court insisted that the committee formulating these guidelines must include experts, who were either disabled or have worked extensively in disability justice.
“The guidelines shall comply with the judgements of this court and contemporary advancements in disability justice,” the court observed. This was a call for the legal and medical communities to recognise that reasonable accommodation was not only a legal requirement but a moral imperative that fostered equal access to opportunities.
The court’s judgement came with a detailed set of directives to ensure a more inclusive process for medical education.
Disability Assessment Boards (DABs) must focus on assessing the functional competence of candidates with disabilities, rather than merely quantifying their disabilities. This functional competency approach has been recognised globally as the most effective method for evaluating a candidate’s ability to perform in a medical course.
The conduct of DABs must be transparent, fair, and consistent with the principles of the rule of law. Boards must also ensure that candidates are not subjected to physical or attitudinal barriers during the assessment process, which could make them uncomfortable.
The court stressed that reasonable accommodation was a fundamental right for PwDs. Without such accommodations, candidates would face discrimination, violating their constitutional right to equality and justice.
It further emphasised that the inclusion of disabled individuals in medical education would directly contribute to enhancing the quality of healthcare, aligning with constitutional guarantees under Articles 21, 14, 19, and 15.
The court ordered that NEET applicants must be provided with detailed information about the accessibility norms of various medical colleges. This information would include the provisions for reasonable accommodations available at the institutions, enabling PwD candidates to make informed decisions about where they could apply.
Medical colleges must establish Enabling Units to act as points of contact for students with disabilities seeking clinical accommodations. These units would ensure that students receive the necessary support throughout their education and training.
Dr Satendra Singh, Professor at the University College of Medical Sciences, Delhi, and a prominent disability researcher and activist, stated that the Supreme Court recently addressed the persistent issue of “over-medicalisation” by the Disability Assessment Boards (DABs) at AIIMS Nagpur and Delhi.
“The apex court compared the functional competence assessment I conducted for the appellant with previous, regressive approaches. It criticised the NMC for using the outdated term ‘brought below 80%’ and its antiquated perspective, which suggests that persons with disabilities should ‘introspect and assess’ their ability to meet the standards and outcomes set by the NMC,” he said.
“The assumption that accommodations would lower competence standards is unfounded. In fact, the court noted that the real problem might lie in the standards themselves, which may need to be updated to be truly inclusive,” Dr Singh further stated.
He said that the Supreme Court incorporated his six key suggestions in the order and passed directions to improve inclusivity in medical education.
The Chief Justice of 🇮🇳 recently delivered a landmark Supreme Court judgment, paving the way for more inclusive #MedEd.
The apex court granted relief to a candidate with over 80% #disability, referencing voices like Waharu Sonavane, Judith Heumann, Martin Luther King Jr., 1/ pic.twitter.com/ekXf2R6fF4
— Satendra Singh, MD (@drsitu) November 7, 2024
The Supreme Court’s judgement also referenced its previous order in the case of Omkar Gond, which had directed the formation of a new committee to ensure compliance with constitutional and statutory rights for PwD candidates.
It directed the NMC to create a new set of guidelines based on the functional competency approach and human rights model, as well as consult with experts on disability rights.
The court further noted that the Disability Assessment Board of AIIMS, Nagpur, had failed to apply the applicable statutory and regulatory standards in its assessment process.
As a result, the Nagpur bench of the Bombay High Court had set aside the Board’s report. The Supreme Court ordered AIIMS, Nagpur, to create a supernumerary seat for the candidates involved, ensuring they are not denied access to medical education based on outdated practices.
(Edited by Majnu Babu).
