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Synopsis

The Supreme Court recently held that the National Medical Council's 2019 guidelines, which stated, "both hands intact, with intact sensations, sufficient strength and range of motion are essential to be considered eligible for medical course," do not have any sanctity in law as they are antithetical to the Constitution and glorify ableism.

A bench of Justices B R Gavai and K V Vishwanathan said flexibility in addressing individual needs and requirements is an essential component of reasonable accommodation under the Rights of Persons with Disabilities Act, 2016.

"There cannot be a 'one size fits all' approach," the bench said.

The bench pointed out that two judgments delivered by the court in October 2024 had clearly mandated the revision of the guidelines.

"In our view, this prescription of 'both hands intact…' is completely antithetical to Article 41 of the Constitution; the principles enshrined in the United Nations Convention on the Rights of Persons with Disabilities and the salutary provisions of the RPwD Act. It also indicates a classification which is overbroad and glorifies ‘ableism’. It propagates that persons with typical abilities and with faculties similar to what the majority may have are somehow superior. This is precisely what the Directive Principles of State Policy, the United Nations Convention, and the RPwD Act abhor," the bench said.

In its judgment, the court gave detailed reasons for its December 12, 2024, order allowing a plea by Anmol and directing his admission to the MBBS course in Government Medical College, Sirohi, Rajasthan, against a seat reserved for Persons with Disabilities (PwD) (OBC).

The petitioner was aggrieved by the Punjab and Haryana High Court's order of September 23, 2024, which rejected his claim and upheld the denial of his admission to the MBBS course.

On November 25, 2024, the court directed the setting up of a medical board by AIIMS, New Delhi, to examine the petitioner's claim.

The five-member board stated that he was not suitable to pursue an undergraduate medical education program, which is a competency-based program of five and a half years, including one year of compulsory rotatory internship.

"The current NMC Guidelines perhaps need revision, and with respect to the current Guidelines, this Medical Board is not able to declare the candidate FIT to join MBBS course," the board stated.

Dr. Satendra Singh, however, submitted a separate report stating that the appellant could successfully navigate the MBBS course with clinical accommodations and assistive technologies.

"Accepting the report of five members and denying the admission of the appellant would be upholding the theory of ableism, which we are not prepared to do," the bench said, rejecting the board's report.

The court further said the prescription of "both hands intact…" has no sanctity in law as it does not admit of a functional assessment of the individual candidate, a factor fundamental to protecting the rights of persons with disabilities.

The court pointed out the need to revise the guidelines, as directed in the October 15, 2024, judgment in Omkar Ramchandra Gond and reiterated in the October 25, 2024, judgment in Om Rathod.

"We have also held that such an insistence in a statutory regulation is absolutely antithetical to the objectives of Article 41 and the principles set out in the United Nations Convention and the rights guaranteed under the RPwD Act. A prescription such as 'both hands intact…' reeks of ableism and has no place in a statutory regulation. In fact, it has the effect of denuding the rights guaranteed under the Constitution and the RPwD Act and makes a mockery of the principle of reasonable accommodation," the bench said.

The court opined that the correct approach is the one adopted by Dr. Satendra Singh—namely, not to bar a candidate at the threshold but to allow the candidate to complete the MBBS course and then decide whether to specialize in a nonsurgical or medical branch or continue as a General Duty Medical Officer.

"As rightly set out by Dr. Satendra Singh, it will be unfair to presume incompetence at the threshold without first providing an opportunity to the candidate and ensuring the availability of accommodations and assistive products," the bench said.

The bench noted that the National Medical Commission had earlier assured the court that it would constitute a new committee of domain experts to comply with the judgment and that fresh guidelines would be put in place.

"We direct this matter to be posted on March 3, 2025, to consider whether the National Medical Commission has formulated the revised guidelines in accordance with the judgments of this court, as directed in Omkar Ramchandra Gond and Om Rathod (supra) and further direct that the NMC shall file an affidavit explaining the current status before the said hearing date," the bench ordered.

Case Title: Anmol Vs Union of India & Ors