Mr. X v. Hospital Z

AIR 1999 SC 495; JT 1998 (7) SC 626; 1998 (6) SCALE 230
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Mr. X, the Appellant, was about to get married when it was found that he was living with HIV. “The marriage was called off on the ground of blood test conducted at the respondent’s hospital in which the appellant was found to be HIV(+).” As members of the Appellant’s family and community came to know of his HIV status, he was ostracized from the community. He eventually had to leave the state and relocate to another city.

The Appellant consequently approached the National Consumer Dispute Redressal Commission (NCDRC) to claim damages against the Respondent. The Appellant contended that the Respondent had illegally disclosed his medical information and breached their duty to keep information about patients confidential. NCDRC, however, dismissed the petition stating that the remedy for such a dispute would be in civil court.

The Appellant then filed the appeal in the Supreme Court arguing that the “duty of care” applicable to those in the medical profession included the “duty to maintain confidentiality.” It was further argued that since the duty was breached the Respondent were liable to pay damages.

To address the issue regarding the duty to maintain confidentiality, the Court placed reliance on the Code of Medical Ethics (the Code) formulated by the Indian Medical Council. It held that the medical profession did have a duty to “not disclose the secrets of a patient that have been learnt in the exercise of…profession.” The Court, however, held that the doctor’s duty to maintain confidentiality did not confer an absolute right on the patient. It held that in public interest and in cases where the duty to maintain confidentiality could result in a health risk to another, this duty would not be binding on the doctor. The Court, therefore, held that since the marriage posed a health risk to the woman the doctor was not bound by the duty to maintain confidentiality.

As to whether divulging his medical record violated the Appellant’s right to privacy, the Court held that though the right to privacy was part of the right to life under Article 21 of the Constitution, it was not an absolute right. The Court held that to prevent crime and to protect public health and morals the right to privacy and the correlating duty to maintain confidentiality would be suspended. It therefore held that disclosing the HIV status of the Appellant to the intended wife did not violate his right to privacy.

Though the issue of a “right to marry” was not raised by the parties, the Court nevertheless held that such a right was not absolute. It held that in cases of right to marry, the right to marry and the correlated duty to disclose facts that could affect the marriage or the spouse lay in the same person. The Court, further, placed reliance on various marriage laws to state that infection with venereal disease was a ground for divorce and therefore each partner had the moral and legal duty to inform the intended spouse of any such disease that they might be infected with. The Court also placed reliance on the Indian Penal Code, 1860 to hold that if a person knowingly acted in a way that he knew was likely to spread the disease, such a person would be guilty of an offence.

Regarding the relation between the rights of the Appellant and the rights of his intended spouse, the Court held that her right to life in such a case would include her right to be informed of the Appellant’s HIV status. The Court also held that in any case when fundamental rights of two people conflicted with each other, the right which would promote public health and morality should be advanced. The Court therefore held that though people living with HIV are entitled to “all respects as human beings”, sex with them or its possibility had to be avoided to prevent other people from being infected.

“The argument of the learned counsel for the appellant, therefore, that the respondents were under a duty to maintain confidentiality… cannot be accepted as the proposed marriage carried with it the health risk to an identifiable person who had to be protected from being infected with the communicable disease from which the appellant suffered. The right to confidentiality, if any, vested in the appellant was not enforceable in the present situation.” Para. 18.

“[A] person may have a right to marry but this right is not without a duty. If that person is suffering from any communicable venereal disease or is impotent so that marriage would be a complete failure or that his wife would seek divorce from him on that ground, that person is under a moral, as also legal duty, to inform the woman with whom the marriage is proposed that he was not physically healthy and that he was suffering from a disease which was likely to be communicated to her. In this situation, the right to marry and duty to inform about his ailment are vested in the same person.” Para. 37.

“[T]he Right of Privacy is an essential component of right to life envisaged by Article 21. The right, however, is not absolute and may be lawfully restricted for the prevention of crime, disorder or protection of health or morals or protection of rights and freedom of others.” Para. 27.

“Since ‘Right to Life’ includes right to lead a healthy life so as to enjoy all faculties of the human body in their prime condition, the respondents, by their disclosure that the appellant was HIV(+), cannot be said to have, in any way, either violated the rule of confidentiality or the right of privacy. Moreover, where there is a clash of two Fundamental Rights, as in the instant case, namely, the appellant's right to privacy as part of right to life and…right to lead a healthy life which is…Fundamental Right under Article 21, the right which would advance the public morality or public interest, would alone be enforced through the process of Court…” Para. 9.