INTRODUCTION

The nightmare of people from most advanced countries dying on the streets due to non-availability of beds in hospitals is turning into
reality during this pandemic.The situation in India is grave. Developed countries worldwide became helpless at the peak of the
pandemic as the number of patients exceeded the public health care infrastructure. However, in India, the helplessness in providing
adequate medical care is imposed on the citizens due to non-cooperation from private hospitals. During the pandemic, the private
Hospitals, on the one hand, refused to treat non- COVID 19 patients by mandating a COVID 19 negative certificate and on the other
hand did not open up their infrastructure for the COVID-19 patients by citing health concerns of its negative patients. This
non-cooperation of private hospitals was precipitated by inaction of the government in enforcing their writ on these hospitals. These
dire circumstances compel everyone to ponder upon a pertinent question related to emergency medical care in India. However, Indians
most often wake to the reality of their rights trampled upon without any redress by institutions created under the Constitution.

EMERGENCY MEDICAL CARE IN INDIA

India is the second highest populated country in the world. If we compare the growth of the Indian population with the most populated
country in the world.
● The massive population growth has created scarcity in essentials required by a citizen to live with dignity and respect as
mandated under Article 21 of the Constitution of India. -However, Emergency Medical Aid facility also being a requirement
under the right to life cannot be denied, and a citizen deprived of other necessities should be at least guaranteed that.
● The significance of emergency medical aid cannot be dismissed in a densely populated country like India, where everyone is
living a stressful life and competing amongst the basic necessities of life.
● The Supreme Court of India has held that the right to life guaranteed under Article 21 includes within its ambit the right to health
and medical care. The right to life consists of the right to live a healthy life to enjoy all facilities of the human body.
● In India, there is no specific law laid down by the government to provide emergency medical care and is often interpreted as a
right guaranteed under Article 21 of Constitution of India by the Supreme Court of India and respective High Courts.

INITIATIVES BY THE SUPREME COURT OF INDIA

The first time when medico-legal case ever discussed by the Supreme Court of India was in the case of
Parmandand Katara vs. Union of India & Ors.
-In this case, a public-spirited person has filed a Public Interest Litigation under Article 32 of the Constitution of India, 1950.
-The said petition was filed in response to a news report of a scooterist who was knocked down by a car and died due to lack of
medical treatment.
-Following the accident, the scooterist was taken to the nearest hospital but was turned away and sent to another hospital 20 km away,
which was authorised to handle medico-legal cases.
-The scooterist died while he was being transported to the other hospital[7]. In this case, the Supreme Court of India for the very first
time has held that Article 21 of the Constitution of India includes the right to emergency medical care and articulated the importance
of the golden hour..
-The Hon'ble Apex court has held that it is the Right of the Citizen and also the obligation of the State to preserve life and doctors at
government hospitals are therefore required to provide medical assistance to preserve life[8]. This judgement was the first initiative
taken by the Supreme Court of India to protect the rights of the citizens of this country as per Article 21.

Consumer Education And Research Centre Vs Union Of India

The Supreme Court held that timely medical aid is an integral part of the right to life as per Article 21. “Social justice which is a
device to ensure life to be meaningful and liveable with human dignity requires the State to provide to workmen facilities and
opportunities to reach a minimum standard of health, economic security and civilised living. The health and strength of the worker,
the Court said, was an integral facet of the right to life. Denial thereof denudes the workmen the finer facets of life violating Article 21

Paschim Banga Khet Mazdoor Samiti vs State of West Bengal

-Thereafter a serious issue was put before the Supreme Court of India where the victim, an agricultural labour, who fell from a train
and was denied emergency medical aid in 5 public hospitals and ultimately was admitted in a private hospital where he had to pay an
exorbitant amount.
-The victim then approached the Supreme Court claiming damages as he was denied medical aid by the public hospitals, which
amounts to a breach of Article 21 of the Constitution of India. The issue before the Supreme Court was in the context of availability of
facilities in Government hospitals for treatment of persons sustaining severe injuries. During the pendency of this writ petition before
the Supreme Court, the State Government, by appointing an Enquiry Committee decided to investigate the matter meticulously.
-The said Committee filed its report majorly pointing that the government hospitals are not sufficiently equipped to deal with serious
cases and further made certain recommendations to stop the recurrence of such incidents. In this case, the Hon'ble Supreme Court has
held that preservation of human life is utmost important because if timely medical care is not provided to the victim it may cause his
death or leave him permanently paralysed, in such cases obtaining status-quo ante is impossible.Thus, when such unfortunate
incidents occur, it is beyond the capacity of the human being to repair. The Supreme Court has held that denial of emergency medical
care is in violation of Article 21 of the Constitution of India. Hence it is the fundamental right of the citizens to be provided with
emergency medical care without any condition.
The Supreme Court further held that there is no doubt that financial resources are needed for providing these facilities. Nonetheless, it
cannot be ignored that it is the constitutional obligation of the State to provide adequate medical services to the people. Whatever is
necessary for this purpose has to be done.
In the background of this, the Supreme Court also recommended to the State that they should form a Central Bed Bureau to ensure
availability of a bed in an emergency. This facility should be maintained at State level hospitals, where a centralised communication
system will be formed. This system will ensure that patients can be referred immediately to the hospital equipped with bed related to
the treatment. If this is done most of the deaths which occur in India can be avoided since many of the victims die because of
non-availability of beds or denial of emergency medical care.

Indian Medical Association vs V. P. Shanta

The Supreme Court of India finally decided this issue and held that the patients who avail medical care are included under the
definition of the “Consumer” and healthcare is defined as “Service” as per the Consumer Protection Act. Though incorporating
healthcare services under the scope of the Consumer Protection Act does not serve the purpose because there are times when the
patient has no guardian to look after and requires emergency medical care. This results in a denial of emergency medical care.

EMERGENCY MEDICAL CARE

Conditions which call for emergency medical care are generally:
● Accidents
○ Road accidents: These are common. Hundreds of road accidents occur throughout the year, specifically in big cities and
towns where vehicular traffic is heavy The accident may involve a single person being run over or a number of persons
crushed by collision between vehicles or a bus falling into a gorge or a river. Sometimes, even a train may crush a bus
or truck on a railway crossing injuring and killing many. Under these conditions, the injured persons and the dead
bodies are to be rushed to the nearest hospitals for emergency medical care, Critically wounded persons may need
surgical operations and observation and treatment in ICCU or ICU where available Where facilities are not available,
the critically injured patients should be transferred by ambulance to fully equipped hospitals or nursing homes.
○ Rail accidents: Passenger trains are derailed by signal or mechanical failure or by human errors injuring or killing many
people. All of those injured or killed need emergency medical care.
○ Collapses: A rail or road bridge may collapse causing a bus or some compartments of a train to fall and injure or kill
many. The collapse of the bridge may also injure or kill people walking over or under the bridge. Similarly, an old
house or a building under construction may collapse and injure or kill the residents or the workers. All these injured
people need emergency medical care.
○ Natural calamities: earthquake, flood, typhoon, lightning etc. These may destroy many structures and also injure and
kill many human beings.In some cases of natural calamity, the loss of life is very heavy and injured persons are also
many in number. The injured may have to be air-lifted to nearby hospitals. Medical camps with emergency facilities are
set up. Doctors are flown from various parts of the country and treatment is provided. This kind of calamity which
injures or kills thousands of people is deemed to be a national emergency.
● Delivery: In some cases of pregnant women, emergency medical care becomes necessary. Such a patient is taken to a hospital
and sent to the labour room for delivery. It is laudable that many clubs and voluntary organisations are operating ambulance
services which can be availed in times of emergency. These organisations also supply oxygen cylinders to meet emergencies. All
hospitals have their own ambulances. To burn or bury dead bodies is also an emergency. Those who cannot afford to carry the
dead body, 'Satkar Samitis' are helping them. All district hospitals and medical college hospitals have emergency departments to
attend to patients requiring emergency medical care.
● Bites: Every year hundreds of people die being bitten by poisonous snakes. Snake-bitten patients should be transferred to the
nearest health centre or hospital for treatment. Any delay may turn fatal.
● Cardiac or Coronary attacks: Persons attacked with heart troubles or strokes need immediate medical care. Ambulance or not, in
the event of serious attacks, such patients should be rushed to the nearest hospital or nursing home for emergency medical care.
To receive medical treatment is his right.

Application Of Emergency Medical Care In Covid-19 Pandemic:

In India, a National Lockdown under Disaster Management Act, 2005 was announced on 24th March 2020 and was extended from
time to time till partial opening on 8th June 2020. The citizens were directed to stay at home by the government by ensuring them
every possible help for maintaining their health and wellbeing.The non-availability of emergency medical aid forced them to think
about themselves facing a similar situation resulting in mass migration.Instead of saving the lives of patients suffering from medical
emergencies other than COVID-19, hospitals turned them down due to which the golden hour is lost.The authorities failed to act upon
such negligence by the hospitals in time. Even the Supreme Court, which has passed so many directions in cases related to emergency
medical care, did not take timely decisions to redress such issues and rejected petitions filed on the subject on the grounds of
non-interference in public policy.