Landmark Judgement by Justice Kannan -Terminally Ill can Claim Insurance

Milestone achieved towards the Patients Autonomy. Taking progressive step towards this direction, The Punjab and Haryana High Court in its landmark judgment authored by Justice K. Kannan has judicially acknowledged the Patients Autonomy and has held that when the family of the terminally ill patient refuses the treatment against the doctor’s advice, still they would be entitled for the insurance claim. Countering the claim of the Insurance Company who had taken a plea before the Hon’ble court that:

The counsel for the Insurance Company argued that he was already a TB patient with cirrhosis of liver and it cannot be surely predicated even without a post mortem that death was only account of head injury suffered in the accident. The doctor, who was examined in court, stated that chances of recovery could not be ruled out if the deceased had stayed on for treatment. The doctor was not however able to assess the “percentage of recovery possible” (sic), meaning thereby he was not able to assess the prospect of recovery. This, according to the counsel, would show that a patient who was indiscreet to deny himself the treatment and who could have been treated well could leave any cause of action for the representatives to plead that the death was only on account of accident.”

The Hon’ble Court not only discussed the law position of India but of first “right to die” case ever heard by the courts, i.e. the pronouncement of United States Supreme Court in the year 1990.

The patient autonomy in the manner of treatment is a facet of human right and it cannot be ever contended in court that the patient ought to have taken treatment that had a good prognosis for recovery. There have been instances where due to religious beliefs (for instance, Jehovah’s witnesses’ denial of blood transfusion), patients have declined to take treatment and courts have confronted these problems as well and come to decisions of hands off approach. That is precisely what has been also recorded in the discharge summary that the patient was getting discharged at his own risk and has assured that he will have no right of recourse against the doctor from the hospital. The undertaking will thus go far and no further. It will not exculpate a tort feasor or a person who is bound to indemnify to make possible a plea that the patient ought to have taken treatment. A right not to get treated is just as well a significant right to a patient as a right to be treated.”

The same position is prevalent as per the statues, wherein the Health Insurance facility is already available in the Netherlands in such circumstances. Interestingly the general practitioner is usually the main care provider for people who receive palliative care at home. In principle everyone living in the Netherlands has his own general practitioner, who can be consulted without the need for referral. There are altogether some 7800 practicing general practitioners in the Netherlands for a population of over 16 million. The care provided by the general practitioner is paid for through a patient’s compulsory health insurance fund insurance or private medical insurance. People with a relatively low income have health insurance fund insurance whereas people with a higher income have to take out private medical insurance.

Dr. Ashish Vashisht, a medical legal consultant in Chandigarh said that in entirety it can be safely concluded that the judgment will serve as a stepping stone towards the patient’s autonomy and their other legal & moral rights.

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