Supreme Court Clarifies Scope of Homeopathy in COVID-19 Treatment: Dr. AKB Sadbhavana Mission School of Homeo Pharmacy vs. Ministry of AYUSH (2020)

Introduction

Date of the Judgment: 15 December 2020

Citation: 2020 INSC 946

Judges: Ashok Bhushan, J., R. Subhash Reddy, J., M.R. Shah, J.

Can Homeopathic practitioners prescribe medicines for COVID-19, beyond merely boosting immunity? The Supreme Court of India addressed this question in an appeal against a Kerala High Court judgment that had restricted the scope of homeopathic treatment during the COVID-19 pandemic. The Supreme Court clarified the extent to which Homeopathic practitioners can administer treatment, emphasizing that they are not limited to prescribing only immunity boosters. The bench consisted of Justices Ashok Bhushan, R. Subhash Reddy, and M.R. Shah, with the judgment authored by Justice Ashok Bhushan.

Case Background

The case originated from a writ petition filed in the Kerala High Court by an advocate, who is an admirer of homeopathic medicine. The advocate sought the implementation of a notification issued by the Ministry of AYUSH, Government of India, dated 06.03.2020. This notification outlined the use of AYUSH systems, including homeopathy, in managing public health situations like the COVID-19 pandemic. The petitioner in the High Court argued that the State of Kerala had not adequately implemented the advisory, which could have helped control the spread of COVID-19 through immunity-boosting medicines. The High Court disposed of the writ petition with certain directions, which led to the present appeal by Dr. AKB Sadbhavana Mission School of Homeo Pharmacy, who was not a party to the original writ petition. The appellant was aggrieved by the directions in paragraph 14 of the High Court’s judgment, which they felt were overly restrictive and detrimental to the practice of homeopathy.

Timeline

Course of Proceedings

The Kerala High Court, in its judgment dated 21.08.2020, reviewed the advisory dated 06.03.2020 issued by the Ministry of AYUSH, along with the Government Orders of Kerala dated 08.04.2020 and 21.04.2020. The High Court noted that while the State Government had approved an action plan for Homeopathy, it was primarily for immunity boosting and not for treating COVID-19 patients or their contacts. The High Court directed that AYUSH practitioners could prescribe immunity boosters but should not advertise or prescribe medicines as a cure for COVID-19, except those specifically mentioned in the advisory. The High Court also stated that violations could lead to action under the Disaster Management Act, 2005. This direction was the reason for the appeal by Dr. AKB Sadbhavana Mission School of Homeo Pharmacy, who argued that the High Court’s directions were overly restrictive and went beyond the scope of the original writ petition.

Legal Framework

The primary legal framework for this case is based on the advisory issued by the Ministry of AYUSH, Government of India, dated 06.03.2020. This advisory outlines the role of AYUSH systems, including homeopathy, in managing COVID-19. The advisory permits the use of homeopathy for:

• Preventive and prophylactic measures, such as the use of Arsenicum album 30.
• Symptom management of COVID-19 like illnesses, using medicines like Arsenicum album, Bryonia alba, and Rhus toxicodendron.
• Add-on interventions to conventional care.

Additionally, the Homeopathy Central Council Act, 1973, and the Homeopathic Practitioners (Professional Conduct, Etiquette and Code of Ethics) Regulations, 1982, are relevant. Specifically, Regulation 6 of the 1982 Regulations prohibits advertising or soliciting patients by homeopathic practitioners.

The relevant extracts from the advisory dated 06.03.2020 are:

“i.Preventive and prophylactic:

Homoeopathy:
Arsenicum album 30, daily once in empty
stomach for three days. The dose should be
repeated after one month by following the
same schedule till Coronavirus infections
prevalent in the community.”


“ii. Symptom management of COVID-19 like
illnesses

Homoeopathy
Various medicines which found to be
effective in treating flu like illness are
Arsenicum album, Btyonia alba, Rhus toxico
dendron, Belladonna Gelsemium Eupatorium
perfoliatum. All these medicines should be
taken in consultation with qualified
physicians of respective AYUSH systems.”


“iii. Add on Interventions to the
conventional care

Homoeopathy
Medicine mentioned Symptom management of
COVlD-19 like illnesses under subhead
Homoeopathy can also be given as add on to
conventional care.”

Regulation 6 of the Homeopathic Practitioners (Professional Conduct, Etiquette and Code of Ethics) Regulations, 1982, states:

“6. (1) Advertising
Solicitation of patients directly or
indirectly by a practitioner of
Homoeopathy either personally or by
advertisement in the newspapers, by
placards or by the distribution of
circular cards or handbills is unethical.”

Arguments

Appellant’s Arguments:

• The appellant contended that the High Court’s direction to take action under the Disaster Management Act, 2005, against Homeopathic doctors prescribing drugs for COVID-19 was beyond the scope of the writ petition.
• The appellant argued that the Ministry of AYUSH advisory dated 06.03.2020 permitted the use of AYUSH systems for managing COVID-19 like illnesses, including preventive, prophylactic, and symptom management.
• The appellant submitted that the High Court erred in restricting Homeopathic practitioners to prescribing only immunity boosters, as the guidelines allowed for treatment of COVID-19 patients with the permission of local health authorities.
• The appellant highlighted that many state governments were prescribing Homeopathic medicines as immunity boosters, and the High Court’s directions were demoralizing for Homeopathic practitioners.

Respondent’s Arguments (Ministry of AYUSH):

• The Ministry of AYUSH submitted that it had decided to strengthen the COVID-19 medical response by using traditional healthcare systems, including AYUSH and Homeopathy.
• The Ministry referred to the advisory dated 06.03.2020 and subsequent guidelines, which permit Homeopathic practitioners to prescribe medicines for:
  • Preventive and prophylactic purposes.
  • Symptom management of COVID-19.
  • Add-on interventions to conventional care.
• The Ministry clarified that Homeopathic practitioners are allowed to prescribe medicines as an add-on to conventional treatment for COVID-19 patients and are not limited to prescribing only immunity boosters.
• The Ministry emphasized that the medicines should not be advertised as a cure but can be administered as a preventive measure, immunity booster, or add-on to conventional treatment.

The innovativeness of the argument by the appellant lies in highlighting the discrepancy between the High Court’s restrictive interpretation and the actual guidelines issued by the Ministry of AYUSH, which allowed for a broader scope of practice for Homeopathic practitioners.

Issues Framed by the Supreme Court

The Supreme Court considered the following issues:

1. Whether the directions issued by the High Court in paragraph 14 of its judgment were justified and within the scope of the writ petition.
2. Whether the High Court correctly interpreted the advisory dated 06.03.2020 issued by the Ministry of AYUSH regarding the role of Homeopathic practitioners in the context of COVID-19.

Treatment of the Issue by the Court

Authorities

The Supreme Court considered the following authorities:

• Advisory dated 06.03.2020 issued by the Ministry of AYUSH, Government of India. The Court relied on this advisory to determine the scope of permissible homeopathic practice during the COVID-19 pandemic.
• Government Order dated 21.04.2020 of the Government of Kerala, which approved the action plan outlining Homeopathy strategies for prevention and management of COVID-19 in Kerala.
• Homeopathy Central Council Act, 1973: The Court referred to this Act to highlight the regulatory framework for homeopathic practice in India.
• Homeopathic Practitioners (Professional Conduct, Etiquette and Code of Ethics) Regulations, 1982: The Court specifically cited Regulation 6, which prohibits advertising by homeopathic practitioners.
• Guidelines for Homeopathic practitioners for COVID-19 issued by the Ministry of AYUSH after 04.04.2020. These guidelines were considered to understand the therapeutic aid provided by homeopathy.

Judgment

What weighed in the mind of the Court?

The Supreme Court’s decision was primarily influenced by the need to correctly interpret and apply the Ministry of AYUSH’s advisory and guidelines. The Court emphasized that the High Court’s restrictive view of homeopathic practice was not in line with the government’s policy, which allows for a broader role for homeopathy in managing COVID-19. The Court also considered the need to ensure that Homeopathic practitioners are not unduly restricted in their practice, while also ensuring that they do not make false claims about curing the disease.

The Supreme Court’s reasoning was primarily focused on the legal interpretation of the AYUSH guidelines and the regulatory framework, which accounts for the higher percentage of legal considerations. The factual aspects of the case, such as the specific circumstances of the writ petition, played a lesser role in the Court’s decision.

Logical Reasoning:

The Supreme Court considered alternative interpretations, particularly the High Court’s restrictive view, but rejected it as it was not aligned with the Ministry of AYUSH’s guidelines. The Court emphasized that Homeopathic practitioners should be allowed to practice within the scope defined by the advisory and guidelines, which include preventive, symptomatic, and add-on treatments.

The decision was reached by clarifying that Homeopathic practitioners are not limited to prescribing only immunity boosters but can also provide treatment for symptom management and as an add-on to conventional care. The Court also emphasized that they should not advertise their medicines as a cure for COVID-19.

The Supreme Court’s decision was based on the following reasons:

• The High Court’s directions were overly restrictive and went beyond the scope of the writ petition.
• The High Court incorrectly interpreted the Ministry of AYUSH advisory, which allows for a broader role for homeopathy.
• Homeopathic practitioners are permitted to prescribe medicines not only as immunity boosters but also for symptom management and as add-on interventions.
• Homeopathic practitioners are prohibited from advertising their medicines as a cure for COVID-19.

The Court quoted the following from the judgment:

“When the Central as well as State Governments have approved prescription of certain mixtures and tablets, as immunity boosters, qualified medical practitioners in AYUSH can also prescribe the same, but only as immunity boosters.”

“The homeopathy does not cure the disease, but it cures the patients.”

“The guidelines, however, specifically provides that “the prescription has to be given only by institutionally qualified practitioners”.”

There were no minority opinions in this case. The judgment was unanimous.

The Court’s reasoning was based on a careful interpretation of the advisory and guidelines issued by the Ministry of AYUSH, along with the relevant regulations. The Court applied these to the facts of the case, clarifying the permissible scope of homeopathic practice during the COVID-19 pandemic.

The implications for future cases are that the Courts must interpret government advisories and guidelines in a manner that aligns with their intent and purpose, ensuring that they are not unduly restrictive. This case also clarifies the role of traditional medicine systems in public health emergencies.

No new doctrines or legal principles were introduced in this case. The Court clarified the existing guidelines and regulations, ensuring their proper application.

Key Takeaways

• Homeopathic practitioners are not limited to prescribing only immunity boosters but can also provide treatment for symptom management and as an add-on to conventional care for COVID-19 patients.
• Homeopathic practitioners must adhere to the guidelines issued by the Ministry of AYUSH and must not advertise their medicines as a cure for COVID-19.
• The judgment clarifies the role of traditional medicine systems in public health emergencies and ensures that practitioners are not unduly restricted in their practice.
• Courts must interpret government advisories and guidelines in a manner that aligns with their intent and purpose.

The future impact of this judgment is that it sets a precedent for the interpretation of government guidelines related to traditional medicine practices in public health emergencies. It also ensures that qualified practitioners are able to utilize their expertise within the framework of government regulations.

Directions

The Supreme Court modified the directions issued by the High Court in paragraph 14 of its judgment, clarifying that Homeopathic practitioners are not restricted to prescribing only immunity boosters but can also provide treatment for symptom management and as an add-on to conventional care, within the framework of the advisory and guidelines issued by the Ministry of AYUSH.

Development of Law

The ratio decidendi of this case is that Homeopathic practitioners have a broader role in managing COVID-19 than merely prescribing immunity boosters. The Supreme Court clarified the scope of practice as outlined in the Ministry of AYUSH advisory and guidelines, which allows for preventive, symptomatic, and add-on treatments. This judgment clarifies the previous position taken by the High Court, which had restricted the scope of homeopathic practice.

Conclusion

The Supreme Court’s judgment in Dr. AKB Sadbhavana Mission School of Homeo Pharmacy vs. The Secretary, Ministry of AYUSH & Ors. clarifies the permissible scope of homeopathic practice during the COVID-19 pandemic. The Court modified the Kerala High Court’s restrictive directions, emphasizing that Homeopathic practitioners can prescribe medicines for preventive, symptom management, and as add-on interventions, in addition to immunity boosting, as per the guidelines issued by the Ministry of AYUSH. This decision ensures that qualified practitioners can utilize their expertise within the framework of government regulations, while also prohibiting false claims about curing the disease.