Oct 29, 2024 07:06 PM IST
The judgment offers a pathway for change, but real progress will depend on whether it is followed by action. The path forward will require vigilance to ensure that the medical community does not revert to reflexive exclusion but commits to a more nuanced, inclusive approach to medical education
Since the declaration of the revised National Eligibility cum Entrance Test -Under Graduate (NEET-UG) result on July 26, courts across the country have witnessed a spurt of litigation by persons with disabilities. The stories of these persons typically have a common script. They appeared for the NEET-UG examinations based on their disability certificate in the persons with disabilities (PwD) category. They cleared the exam and got allotted a college. Thereafter, they were made to undergo a medical assessment by the National Medical Council (NMC), in line with its information bulletin for the NEET-UG examination. This assessment found them ineligible. The finding of disqualification often lacks any reason and is merely based on the person’s disability being above a particular percentage.
Such persons then come to court. Even if the high court sends the person for a revaluation, persons with the same disability are found either eligible or ineligible, based on the subjective perception of the able-bodied doctors conducting the assessment.
This subjectivity raises the question: What should a just disability assessment entail for it to correctly assess the competence of students with disabilities in line with their rights to access education and employment in fields traditionally seen as off-limits to them? A three-judge bench of the Supreme Court in Vidhi Himmat Katariya v. Gujarat (2019) proffered that the court should defer to adverse conclusions arrived by assessment boards. Such an approach does not contemplate the possibility that the opinion of doctors, despite their best intent, is often conditioned by structural biases. Such bodies tend to look at a disability purely as a medical ailment and not as a barrier that can be overcome through statutorily mandated reasonable accommodations. These assessment boards also ignore that persons with disability have a personal stake and interest in improving access to equitable health care. Thus, the assessment of their competence cannot disregard their unique competence to make medical services more accessible.
Against this backdrop, the recent Supreme Court judgment in Omkar Ramachandra Gond v. Union of India is a welcome development. The judgment does four important things. First, it holds that the mere existence of a benchmark disability is not sufficient to disqualify a PwD from pursuing medicine. This is significant as the current NMC regulations straightaway disqualify persons with benchmark disabilities of visual, hearing and speech impairment, for instance.
Second, it emphasises that the medical board assessing the disability must return a finding as to whether the person will or will not be able to pursue medicines, with clear reasoning for the same.
Third, it highlights the importance of reasonable accommodation and inclusive education. It is not enough for the board to state that the person has a disability that in the ordinary course cannot be accommodated. The board must explore what reasonable accommodations, short of undue hardship, can be made. Therefore, candidates cannot be simply rejected on the basis that they are square pegs that cannot fit in a round hole.
And, lastly, it directs the establishment of appellate authorities. Given that there is at present no appellate mechanism before which the findings of the board can be challenged, it is open to courts to order a revaluation of the candidate when the assessment is not in line with the above stated parameters. In other words, the infirmities in the disability assessment process would not enjoy the immunity accorded to “expert opinion”.
The ruling has already begun to show its impact. The Supreme Court, drawing on the Gond judgment’s reference to Satendra Singh, himself a doctor with a disability, appointed him as a domain expert to assess the functional ability of a candidate with muscular dystrophy to pursue medicine. As the Gond judgment is implemented in future cases, it will be important to monitor how courts deploy its principles and whether medical institutions, such as the NMC, genuinely embrace the spirit of inclusion.
The judgment offers a pathway for change, but real progress will depend on whether it is followed by action. The path forward will require vigilance to ensure that the medical community does not revert to reflexive exclusion but commits to a more nuanced, inclusive approach to medical education. As we move toward a more accessible society, this judgment serves as an important milestone in the fight for equal opportunities in all fields, including but not limited to medicine.
Rahul Bajaj is the co-founder of Mission Accessibility, a senior associate fellow (Disability Rights) at the Vidhi Centre for Legal Policy, adjunct faculty, BMU School of Law, and an advocate. Prannv Dhawan is an advocate. The authors have been involved in some of the cases discussed in this article though not in the Gond case. The views expressed are personal
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