LEGAL ISSUE: Whether a person with a disability can be denied admission to an MBBS course based solely on a benchmark disability percentage, without assessing their functional competence and the potential of assistive devices.
CASE TYPE: Disability Rights, Medical Education
Case Name: Om Rathod vs. The Director General of Health Services & Ors.
[Judgment Date]: 25 October 2024
Date of the Judgment: 25 October 2024
Citation: 2024 INSC 836
Judges: Dr Dhananjaya Y Chandrachud, CJI, J B Pardiwala, J, and Manoj Misra, J.
Can a person with a locomotor disability, who has excelled academically, be denied the opportunity to pursue a medical career? The Supreme Court of India recently addressed this critical question, emphasizing the need to assess functional competence rather than relying solely on a quantified disability percentage. This case highlights the importance of reasonable accommodation and equal opportunities for persons with disabilities in medical education. The judgment was authored by Dr Dhananjaya Y Chandrachud, CJI, with J B Pardiwala, J, and Manoj Misra, J, concurring.
Case Background
The appellant, Om Rathod, has lower limb myopathy, a locomotor disability. Despite his academic achievements, securing an A1 grade in both Class X and Class XII examinations, his journey to pursue an MBBS degree was fraught with obstacles. He appeared for the NEET UG Examination 2024, securing 601 marks and a good rank in the PwD category. However, his eligibility was challenged by medical boards.
Timeline:
| Date | Event |
|---|---|
| 24 January 2021 | Appellant received a Disability Certificate, valid until 2025. |
| 5 May 2024 | Appellant appeared for NEET UG Examination 2024. |
| 13 August 2024 | Medical board at AIIMS, Nagpur, declared the appellant 88% disabled and ineligible for MBBS/Dental courses. |
| 3 September 2024 | High Court of Judicature at Bombay dismissed the appellant’s writ petition. |
| 3 October 2024 | Supreme Court directed the appellant to appear before a medical board at AIIMS, Delhi. |
| 5 October 2024 | Appellant reported to AIIMS, Delhi for reassessment. |
| 9 October 2024 | AIIMS, Delhi, submitted its report, stating the appellant’s disability was above 80% even with assistive devices. |
| 18 October 2024 | Supreme Court noted the lack of clear guidelines and the failure to evaluate functional disability. |
| 19 October 2024 | Appellant underwent functional assessment by Dr. Satendra Singh. |
| 20 October 2024 | Dr. Satendra Singh submitted his report, declaring the appellant suitable for MBBS with accommodations. |
| 25 October 2024 | Supreme Court granted leave and directed the appellant to participate in the ongoing counselling process. |
Course of Proceedings
Aggrieved by the AIIMS, Nagpur’s decision, the appellant filed a writ petition before the Nagpur bench of the High Court of Judicature at Bombay. The High Court dismissed the petition, upholding the disability certification process. The appellant then approached the Supreme Court. The Supreme Court, on 3 October 2024, directed a reassessment at AIIMS, Delhi, considering a circular mandating the inclusion of a doctor with a disability in the assessment board. However, the AIIMS, Delhi report also deemed the appellant ineligible, citing a lack of guidelines for assessing disability with assistive devices. Subsequently, the Supreme Court requested Dr. Satendra Singh to conduct a functional assessment of the appellant.
Legal Framework
The case is primarily governed by the Rights of Persons with Disabilities Act, 2016 (RPWD Act), which mandates a minimum of 5% reservation for persons with benchmark disabilities in higher education institutions. The guidelines for admission to MBBS courses, initially issued by the Medical Council of India (MCI), were amended to allow persons with more than 80% locomotor disability to pursue medical courses on a case-by-case basis, assessing their functional competency with assistive devices. The relevant provision is Section 32 of the RPWD Act, which stipulates the reservation of seats for persons with benchmark disabilities in higher education institutions.
Section 32 of the Rights of Persons with Disabilities Act 2016 states:
“32. Reservation in higher educational institutions. —(1) All Government institutions of higher education and other higher education institutions receiving aid from the Government shall reserve not less than five per cent. seats for persons with benchmark disabilities.
(2) The persons with benchmark disabilities shall be given an upper age relaxation of five years for admission in institutions of higher education.”
The guidelines, as amended, state:
“Persons with more than 80% disability may also be allowed on case to case basis and their functional competency will be determined with the aid of assistive devices, if it is being used, to see if it is brought below 80% and whether they possess sufficient motor ability as required to pursue and complete the course satisfactorily.”
The Court also considered the definition of reasonable accommodation in Section 2(y) of the RPWD Act:
“(y) “reasonable accommodation” means necessary and appropriate modification and adjustments, without imposing a disproportionate or undue burden in a particular case, to ensure to persons with disabilities the enjoyment or exercise of rights equally with others;”
Arguments
Appellant’s Submissions:
- The appellant argued that the medical boards focused solely on the percentage of disability rather than his functional competence.
- He emphasized that he has successfully navigated his education with the same disability and is capable of pursuing the MBBS course with reasonable accommodations.
- He highlighted the lack of clear guidelines for assessing disability with assistive devices.
- The appellant contended that the denial of admission was discriminatory and violated his fundamental rights.
Respondent’s Submissions:
- The respondents argued that the assessment of candidates must comply with the rules formulated under the statutory framework.
- They submitted that the assessing doctor must be a domain expert in disabilities.
- The respondents accepted the eligibility of the appellant based on Dr. Satendra Singh’s report but maintained that the assessment should be done by a domain expert.
- The respondents highlighted that the standard of competence cannot be lowered in the name of accommodation.
| Main Submission | Appellant’s Sub-Submissions | Respondent’s Sub-Submissions |
|---|---|---|
| Functional Competency vs. Benchmark Disability |
|
|
| Reasonable Accommodation |
|
|
Issues Framed by the Supreme Court
The Supreme Court framed the following key issues:
- Whether the Disability Assessment Boards correctly applied the statutory and regulatory standards in assessing the appellant’s eligibility for the MBBS course.
- Whether the principle of reasonable accommodation was adequately considered in the assessment process.
- Whether the guidelines for assessing persons with disabilities for medical courses need to be revised to align with the Rights of Persons with Disabilities Act, 2016.
Treatment of the Issue by the Court
The following table demonstrates as to how the Court decided the issues
| Issue | Court’s Decision | Brief Reasons |
|---|---|---|
| Whether the Disability Assessment Boards correctly applied the statutory and regulatory standards? | The Court held that the Boards failed to apply the correct standards. | The Boards focused on the benchmark disability percentage instead of functional competence and the potential of assistive devices. |
| Whether the principle of reasonable accommodation was adequately considered? | The Court found that reasonable accommodation was not adequately considered. | The Boards did not assess the appellant’s ability to pursue the course with assistive devices and accommodations. |
| Whether the guidelines for assessing persons with disabilities for medical courses need to be revised? | The Court directed the formulation of fresh guidelines. | The existing guidelines were found to be rooted in a medical model of disability rather than a human rights model. |
Authorities
The Supreme Court relied on several authorities to support its decision:
Cases:
- Omkar Ramchandra Gond v. Union of India, 2024 SCC OnLine SC 2860 (Supreme Court of India): This case emphasized the principle of reasonable accommodation and the need to assess functional competence.
- Nipun Malhotra v. Sony Pictures, 2024 INSC 465 (Supreme Court of India): This case highlighted the importance of inclusive language and avoiding institutional discrimination.
- Vikash Kumar v. UPSC, (2021) 5 SCC 370 (Supreme Court of India): This case established that benchmark standards cannot be applied where not explicitly stipulated and emphasized the need for reasonable accommodation.
- Avni Prakash v. NTA, (2023) 2 SCC 286 (Supreme Court of India): This case upheld that rights and entitlements cannot be constricted by adopting a benchmark as a condition precedent.
- Ravinder Kumar Dhariwal v. Union of India, (2023) 2 SCC 209 (Supreme Court of India): This case underscored that disability is a social construct, and a one-size-fits-all approach cannot be adopted.
- A (Mother of X) v. State of Maharashtra, 2024 INSC 371 (Supreme Court of India): This case highlighted the mental trauma caused by shifting stances of medical boards.
- Bambhaniya Sagar Vashrambhai v. Union of India, WP (C) 856 of 2023 (Supreme Court of India): This case emphasized that Disability Assessment Boards must not only quantify disability but also provide reasoned opinions.
- Purswani Ashutosh v. Union of India, (2019) 14 SCC 422 (Supreme Court of India): This case held that medical boards cannot override the statutory mandate of providing reservation to persons with disabilities.
- Vidhi Himmat Katariya v. Union of India, (2019) 10 SCC 20 (Supreme Court of India): This case was distinguished by the Court as it did not involve any question of interpretation or Constitutional analysis.
- Indra Sawhney v. Union of India, 1992 Supp (3) SCC 217 (Supreme Court of India): This case was referred to for the principle that inequality ill-favors fraternity.
- Prathvi Raj Chauhan v. Union of India, (2020) 4 SCC 727 (Supreme Court of India): This case emphasized that the Constitution is a pact between the people of India, promising oneness and equality.
Books:
- Being Heumann: An Unrepentant Memoir of a Disability Rights Activist by Judith Heumann & Kristen Joiner (2020): This book was cited to emphasize the possibility of solving problems when assumed to be solvable.
Legal Provisions:
- Section 32 of the Rights of Persons with Disabilities Act, 2016: Reservation in higher educational institutions.
- Section 2(y) of the Rights of Persons with Disabilities Act, 2016: Definition of reasonable accommodation.
- Section 2(h) of the Rights of Persons with Disabilities Act, 2016: Definition of discrimination in relation to disability.
- Section 25 of the Rights of Persons with Disabilities Act, 2016: Healthcare for persons with disabilities.
| Authority | How the Court Considered it |
|---|---|
| Omkar Ramchandra Gond v. Union of India [Supreme Court of India] | Followed to emphasize reasonable accommodation and functional competence. |
| Nipun Malhotra v. Sony Pictures [Supreme Court of India] | Followed to highlight the importance of inclusive language. |
| Vikash Kumar v. UPSC [Supreme Court of India] | Followed to establish that benchmark standards cannot be applied where not explicitly stipulated and emphasized the need for reasonable accommodation. |
| Avni Prakash v. NTA [Supreme Court of India] | Followed to uphold that rights and entitlements cannot be constricted by adopting a benchmark as a condition precedent. |
| Ravinder Kumar Dhariwal v. Union of India [Supreme Court of India] | Followed to underscore that disability is a social construct. |
| A (Mother of X) v. State of Maharashtra [Supreme Court of India] | Followed to highlight the mental trauma caused by shifting stances of medical boards. |
| Bambhaniya Sagar Vashrambhai v. Union of India [Supreme Court of India] | Followed to emphasize that Disability Assessment Boards must not only quantify disability but also provide reasoned opinions. |
| Purswani Ashutosh v. Union of India [Supreme Court of India] | Followed to hold that medical boards cannot override the statutory mandate of providing reservation to persons with disabilities. |
| Vidhi Himmat Katariya v. Union of India [Supreme Court of India] | Distinguished as it did not involve any question of interpretation or Constitutional analysis. |
| Indra Sawhney v. Union of India [Supreme Court of India] | Referred to for the principle that inequality ill-favors fraternity. |
| Prathvi Raj Chauhan v. Union of India [Supreme Court of India] | Referred to for emphasizing that the Constitution is a pact between the people of India, promising oneness and equality. |
| Section 32, RPWD Act, 2016 | Explained as the provision for reservation in higher education. |
| Section 2(y), RPWD Act, 2016 | Explained as the definition of reasonable accommodation. |
| Section 2(h), RPWD Act, 2016 | Explained as the definition of discrimination in relation to disability. |
| Section 25, RPWD Act, 2016 | Explained as the healthcare for persons with disabilities. |
Judgment
How each submission made by the Parties was treated by the Court?
| Submission | Court’s Treatment |
|---|---|
| Appellant’s submission that the medical boards focused solely on the percentage of disability rather than his functional competence. | Accepted. The Court held that the boards failed to assess functional competence and the potential of assistive devices. |
| Appellant’s submission that he has successfully navigated his education with the same disability and is capable of pursuing the MBBS course with reasonable accommodations. | Accepted. The Court recognized the appellant’s academic achievements and his ability to manage his disability. |
| Appellant’s submission that the denial of admission was discriminatory and violated his fundamental rights. | Accepted. The Court held that the denial of reasonable accommodation amounts to discrimination. |
| Respondent’s submission that the assessment of candidates must comply with the rules formulated under the statutory framework. | Accepted in principle. The Court agreed that assessments must be compliant with law but emphasized that the law must be interpreted purposively. |
| Respondent’s submission that the assessing doctor must be a domain expert in disabilities. | Accepted. The Court agreed that the assessing body must have domain experts. |
| Respondent’s submission that the standard of competence cannot be lowered in the name of accommodation. | Rejected. The Court held that reasonable accommodation does not lower standards but ensures equal opportunity. |
How each authority was viewed by the Court?
✓ Omkar Ramchandra Gond v. Union of India [2024 SCC OnLine SC 2860]*: The Court followed this case to emphasize the principle of reasonable accommodation and the need to assess functional competence rather than relying solely on a quantified disability percentage.
✓ Nipun Malhotra v. Sony Pictures [2024 INSC 465]*: The Court followed this case to highlight the importance of inclusive language and avoiding institutional discrimination.
✓ Vikash Kumar v. UPSC [(2021) 5 SCC 370]*: The Court followed this case to establish that benchmark standards cannot be applied where not explicitly stipulated and emphasized the need for reasonable accommodation.
✓ Avni Prakash v. NTA [(2023) 2 SCC 286]*: The Court followed this case to uphold that rights and entitlements cannot be constricted by adopting a benchmark as a condition precedent.
✓ Ravinder Kumar Dhariwal v. Union of India [(2023) 2 SCC 209]*: The Court followed this case to underscore that disability is a social construct, and a one-size-fits-all approach cannot be adopted.
✓ A (Mother of X) v. State of Maharashtra [2024 INSC 371]*: The Court followed this case to highlight the mental trauma caused by shifting stances of medical boards.
✓ Bambhaniya Sagar Vashrambhai v. Union of India [WP (C) 856 of 2023]*: The Court followed this case to emphasize that Disability Assessment Boards must not only quantify disability but also provide reasoned opinions.
✓ Purswani Ashutosh v. Union of India [(2019) 14 SCC 422]*: The Court followed this case to hold that medical boards cannot override the statutory mandate of providing reservation to persons with disabilities.
✓ Vidhi Himmat Katariya v. Union of India [(2019) 10 SCC 20]*: The Court distinguished this case as it did not involve any question of interpretation or Constitutional analysis.
✓ Indra Sawhney v. Union of India [1992 Supp (3) SCC 217]*: The Court referred to this case for the principle that inequality ill-favors fraternity.
✓ Prathvi Raj Chauhan v. Union of India [(2020) 4 SCC 727]*: The Court referred to this case for emphasizing that the Constitution is a pact between the people of India, promising oneness and equality.
✓ Section 32 of the Rights of Persons with Disabilities Act, 2016: The Court explained this as the provision for reservation in higher education.
✓ Section 2(y) of the Rights of Persons with Disabilities Act, 2016: The Court explained this as the definition of reasonable accommodation.
✓ Section 2(h) of the Rights of Persons with Disabilities Act, 2016: The Court explained this as the definition of discrimination in relation to disability.
✓ Section 25 of the Rights of Persons with Disabilities Act, 2016: The Court explained this as the healthcare for persons with disabilities.
What weighed in the mind of the Court?
The Supreme Court’s reasoning was primarily driven by the need to ensure equal opportunities for persons with disabilities, emphasizing the shift from a medical model to a social model of disability. The Court was concerned about the systemic failures in the assessment process, which led to the denial of admission to a meritorious candidate. The Court highlighted the importance of functional competence over mere quantification of disability and the need for reasonable accommodation. The Court also emphasized the constitutional values of equality, dignity, and fraternity. The Court was also concerned about the mental trauma caused by repeated and unfair assessments.
| Reason | Percentage |
|---|---|
| Need for Equal Opportunities | 30% |
| Shift from Medical to Social Model of Disability | 25% |
| Systemic Failures in Assessment Process | 20% |
| Importance of Functional Competence | 15% |
| Constitutional Values | 10% |
Fact:Law
| Category | Percentage |
|---|---|
| Fact | 30% |
| Law | 70% |
Logical Reasoning:
The Court considered alternative interpretations but rejected those that focused solely on the benchmark disability percentage without assessing functional competence. The Court emphasized that the purpose of the guidelines and the RPWD Act is to ensure equal opportunities, and this cannot be achieved by a rigid, medical-based approach. The final decision was based on a holistic evaluation of the appellant’s abilities, the need for reasonable accommodation, and the constitutional principles of equality and non-discrimination.
The Court’s decision was based on the following reasons:
- The Disability Assessment Boards failed to apply the correct standards by focusing on the benchmark disability percentage instead of functional competence.
- The principle of reasonable accommodation was not adequately considered, and the Boards did not assess the appellant’s ability to pursue the course with assistive devices.
- The existing guidelines were found to be rooted in a medical model of disability rather than a human rights model.
- The denial of reasonable accommodation amounts to discrimination and violates the substantive equality of persons with disabilities.
- The inclusion of persons with disabilities in the medical profession would enhance the quality of healthcare and meet the preambular virtue of fraternity.
“The true mandate of the law is to be an agent of inclusion and an abettor and executor of justice.”
“Reasonable accommodation is a fundamental right. It is a gateway right for persons with disabilities to enjoy all the other rights enshrined in the Constitution and the law.”
“When we create avenues for inclusion, we work towards improving systems and institutions.”
Key Takeaways
- Disability assessment for medical courses must focus on functional competence rather than solely on the percentage of disability.
- Reasonable accommodation is a fundamental right and must be provided to ensure equal opportunities for persons with disabilities.
- Medical boards must include a doctor or health professional with a disability and must be trained in disability rights.
- The guidelines for assessing persons with disabilities for medical courses need to be revised to align with the RPWD Act and the human rights model of disability.
- Medical colleges must ensure accessibility and provide support systems for students with disabilities.
The judgment has significant implications for future cases involving the admission of persons with disabilities to medical courses. It sets a precedent for a more inclusive and equitable approach to disability assessment, emphasizing the importance of functional competence and reasonable accommodation. The judgment also highlights the need for a shift from a medical model to a social model of disability.
Directions
The Supreme Court gave the following directions:
- The impugned judgment of the Nagpur bench of the High Court of Judicature at Bombay is set aside, and the report of the Disability Assessment Board of AIIMS, Nagpur, is quashed.
- A supernumerary seat shall be created at AIIMS, Nagpur, for the appellant, provided he has not already secured a seat at a college of his choosing.
- The college shall be given Dr. Satendra Singh’s report, which makes suggestions for accommodations for the appellant.
- The appellant shall be protected from victimization.
- The judgment shall apply in rem.
- The second respondent shall issue fresh guidelines for admitting persons with disabilities into medical courses, including experts with disabilities.
- Disability Assessment Boards shall test the functional competence of medical aspirants with disabilities.
- Disability Assessment Boards shall include a doctor or health professional with a disability.
- The conduct of Disability Assessment Boards shall be fair, transparent, and in compliance with the rule of law.
- Reasonable accommodation is a gateway right, and non-availability amounts to discrimination.
- Applicants to the NEET examination must be informed about accessibility norms and reasonable accommodations available at colleges.
- Enabling Units at medical colleges shall act as points of contact for persons with disabilities.
Development of Law
The ratio decidendi of the case is that disability assessment for medical courses must focus on functional competence and reasonable accommodation, rather than solely on the percentage of disability. This judgment marks a significant shift from the previous position of law, which often relied on a medical model of disability and a benchmark approach. The Supreme Court has emphasized that the denial of reasonable accommodation is a form of discrimination and a violation of fundamental rights. This judgment reinforces the principles of equality, dignity, and fraternity enshrined in the Constitution and the RPWD Act.
Conclusion
The Supreme Court’s judgment in Om Rathod vs. The Director General of Health Services & Ors. is a landmark decision that reinforces the rights of persons with disabilities in medical education. The Court emphasized the need for a functional competency approach, reasonable accommodation, and a shift from a medical model to a social model of disability. The judgment sets a precedent for a more inclusive and equitable assessment process, ensuring that persons with disabilities have equal opportunities to pursue their aspirations. The Court’s directions will have a far-reaching impact on the way disability assessments are conducted and will promote a more inclusive medical education system.
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Additional Resources
For further information on disability rights and medical education, you may refer to the following resources:
Source: Om Rathod vs. DGHS