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Tuesday, August 30, 2005

Docs not liable for failed sterilisation operations: Supreme Court

Docs not liable for failed sterilisation operations: SC
http://www.tribuneindia.com/2005/20050830/nation.htm#3
S S Negi
Legal Correspondent

New Delhi, August 29
Holding that a doctor could not be held liable to pay damage for a failed sterilisation operation till any negligence on his part in performing the surgery is proved, the Supreme Court has directed the Union and State Governments to devise a welfare fund or insurance scheme to the persons in whose case operations had been unsuccessful.

“We are...clearly of the opinion that merely because a woman having undergone a sterilisation operation became pregnant and delivered a child, the operating surgeon or his employer cannot be held liable for compensation on account of unwanted pregnancy or unwanted child,” a Bench of Chief Justice R C Lahoti, Mr Justice C K Thakker and Mr Justice P K Balasubramanyan ruled.

The decision came on an appeal by the Punjab Government against awarding of Rs 50,000 compensation by courts below to a woman from Bathinda, who had conceived a child even after she under went a sterilisation operation in August 1984. A woman doctor of a local government hospital had performed the operation.

The woman had claimed a compensation of Rs 3 lakh from Punjab Government’s Health Department in a suit before a civil court for the failure of her operation. But the court directed the state to pay Rs 50,000 to her. The District Judge and the Punjab and Haryana High Court upheld the order of the civil court.

The Medical Officer of Civil Hospital, Bathinda, in his statement had told the civil judge that the “medical science recognises failure of sterilisation operations to the extent of 0.3 to 3 per cent.”

Taking note of it, the Supreme Court said the surgeon could be held liable in contract unless the plaintiff (affected woman) proved that she had been assured 100 per cent exclusion of pregnancy after the surgery and was only on the basis of such assurance that she was persuaded to undergo the operation.

To overcome this problem and without causing any harm to the family planning programme, The government should provide some solace to the person in whose case the operation was unsuccessful on account of “their illiteracy, ignorance or carelessness, the court said

The best course for the government would be to take steps to devise an insurance schemes to the women on whom the operations had been a failure as the rate of such failure was not alarmingly high but negligible considering the vastness of the family welfare programme being undertaken in the country, the court said.

Thursday, August 25, 2005

Supreme Court Appeal (Civil) 5128 of 2002 : Doctors not liable for failed Sterilisation

CASE NO.:
Appeal (civil) 5128 of 2002

PETITIONER:
State of Punjab

RESPONDENT:
Shiv Ram & Ors.

DATE OF JUDGMENT: 25/08/2005

BENCH:
CJI R.C. LAHOTI,C.K. THAKKER & P.K. BALASUBRAMANYAN

JUDGMENT:
J U D G M E N T

R.C. Lahoti, CJI

The plaintiffs-respondents, respectively husband and wife, filed a suit against the State of Punjab, the appellant before us and a lady surgeon who was in the State Government's employment at the relevant time, for recovery of damages to the tune of Rs.3,00,000/- on account of a female child having been born to them in spite of the wife-respondent No. 2 having undergone a tubectomy operation performed by the lady surgeon. According to the plaintiffs-respondents, they already had a son and two daughters from the wed-lock lasting over 17 years. In response to a publicity campaign carried out by the Family Welfare Department of the appellant-State, respondent No. 2 with the consent of respondent No.1, underwent a sterilization operation on 1.8.1984. A certificate in this regard bearing mark of identification No. 505, duly signed by the lady surgeon who performed the said surgery, was issued to her. She was given a cash award of Rs.150/- as an incentive for the operation. On 4.10.1991, respondent No. 2 gave birth to a female child. After serving a notice under Section 80 of the Code of Civil Procedure, a suit for recovery of damages was filed on 15.5.92 attributing the birth of the child to carelessness and negligence of the lady surgeon. The plaint alleged inter alia that the respondents considered abortion to be a sin and that is why after knowing of the conception they did not opt for abortion.

The State was impleaded as defendant No. 1 and the lady surgeon who performed the surgery was impleaded as defendant No.2.

The defendants filed a joint written statement. It was submitted that there was no negligence or carelessness in the performance of the surgery. It is stated in authoritative text books of medical science that pregnancy occurring after sterilization may be attributable to natural failure. It was also submitted that the plaintiffs having learnt of the unwanted pregnancy, should have sought medical opinion and opted for medical termination of pregnancy within 20 weeks which is
permissible and legal.

The parties went to trial. The plaintiff No.1, that is the husband, deposed on oath to substantiate the plaint averments. The wife, plaintiff No.2, did not appear in the witness box. On behalf of the defendants, one Dr. Sham Lal Thukral, Medical Officer, Civil Hospital, Bhatinda appeared to depose that medical science recognises failure of sterilization operations to the extent of 0.3% to 3% and the consequences of such failure can promptly be taken care of by the pregnant woman by undergoing abortion. The deponent produced five extracts (marked as Exhibits D2 to D6) from different textbooks of gynaecology in support of his statement. Original books were
produced for the perusal of the court and returned. The trial court and the first appellate court have not doubted the correctness of the expert medical opinion as expressed in the textbooks cited before the Court. However, the two courts have proceeded on the reasoning that on the birth of a child to a woman who was allured into undergoing sterilization operation by the State in pursuance of its Family Planning Schemes, the State was liable to compensate for the consequences of the
operation having failed. The suit was decreed for Rs.50,000/- with interest and costs. The decree for compensation passed by the trial court has been upheld by the first appellate court. The second appeal preferred by the State has been summarily
dismissed.

At the very outset, the learned Additional Advocate General appearing for the State of Punjab submitted that the appellant-State was not very serious about denying the payment of Rs.50,000/- to the plaintiffs-respondents as they are poor persons, but the State was certainly interested in having the legal issue resolved. He further submitted that the filing of such suits in the civil court or complaints before the Consumer Fora, are on an increase and decrees are being passed against the State without any basis in law and, therefore, the position of law needs to be clarified and settled.

Very recently, this Court has dealt with the issues of medical negligence and laid down principles on which the liability of a medical professional is determined generally and in the field of criminal law in particular. Reference may be had to Jacob Mathew v. State of Punjab & Anr. (2005) 6 SCC 1. The Court has approved the test as laid down in Bolam v. Friern Hospital Management Committee, [1957] 1 W.L.R. 582, popularly known as Bolam's Test, in its applicability to India. The relevant principles culled out from the case of Jacob Mathew (supra) read as under:

(1) Negligence is the breach of a duty caused by omission to
do something which a reasonable man guided by those
considerations which ordinarily regulate the conduct of
human affairs would do, or doing something which a
prudent and reasonable man would not do. The definition
of negligence as given in Law of Torts, Ratanlal & Dhirajlal
(edited by Justice G.P. Singh), referred to hereinabove,
holds good. Negligence becomes actionable on account of
injury resulting from the act or omission amounting to
negligence attributable to the person sued. The essential
components of negligence are three: 'duty', 'breach' and
'resulting damage'.


(2) A simple lack of care, an error of judgment or an accident,
is not proof of negligence on the part of a medical
professional. So long as a doctor follows a practice
acceptable to the medical profession of that day, he cannot
be held liable for negligence merely because a better
alternative course or method of treatment was also
available or simply because a more skilled doctor would
not have chosen to follow or resort to that practice or
procedure which the accused followed. When it comes to
the failure of taking precautions what has to be seen is
whether those precautions were taken which the ordinary
experience of men has found to be sufficient; a failure to
use special or extraordinary precautions which might have
prevented the particular happening cannot be the standard
for judging the alleged negligence.


(3) A professional may be held liable for negligence on one of
the two findings: either he was not possessed of the
requisite skill which he professed to have possessed, or, he
did not exercise, with reasonable competence in the given
case, the skill which he did possess. The standard to be
applied for judging, whether the person charged has been
negligent or not, would be that of an ordinary competent
person exercising ordinary skill in that profession. It is not
possible for every professional to possess the highest level
of expertise or skills in that branch which he practices. A
highly skilled professional may be possessed of better
qualities, but that cannot be made the basis or the
yardstick for judging the performance of the professional
proceeded against on indictment of negligence.


This Court has further held in Jacob Mathew's case
(supra):-
"Accident during the course of medical or
surgical treatment has a wider meaning.
Ordinarily, an accident means an unintended
and unforeseen injurious occurrence;
something that does not occur in the usual
course of events or that could not be
reasonably anticipated (See, Black's Law
Dictionary, 7th Edition). Care has to be taken
to see that the result of an accident which is
exculpatory may not persuade the human mind
to confuse it with the consequence of
negligence."


The plaintiffs have not alleged that the lady surgeon who
performed the sterilization operation was not competent to
perform the surgery and yet ventured into doing it. It is neither
the case of the plaintiffs, nor has any finding been arrived at by
any of the courts below that the lady surgeon was negligent in
performing the surgery. The present one is not a case where
the surgeon who performed the surgery has committed breach
of any duty cast on her as a surgeon. The surgery was
performed by a technique known and recognized by medical
science. It is a pure and simple case of sterilization operation
having failed though duly performed. The learned Additional
Advocate General has also very fairly not disputed the vicarious
liability of the State, if only its employee doctor is found to have
performed the surgery negligently and if the unwanted
pregnancy thereafter is attributable to such negligent act or
omission on the part of the employee doctor of the State.

The learned Advocate General has brought to our notice a
number of textbooks on gynaecology. We refer to some of them.

In Jeffcoate's Principles of Gynaecology, revised by
V.R. Tindall, MSc.,MD,FRCSE, FRCOG, Professor of Obstetrics
and Gynaecology, University of Manchester (Fifth Edition)
published by Butterworth Heinemann, the following technique of
female sterilization are stated:
"Female Sterilization
Techniques

1. Radiotherapy

A menopausal dose of external beam
irradiation to the ovaries is only attractive in so
far that they sterilize without involving the
woman in an operation. Their disadvantages
(as stated at pages 93 and 528) are such that
they are rarely used except in older women
who are seriously ill.

2. Removal of the ovaries

This sterilizes (provided an accessory ovary is
not overlooked) but is very rarely indicated as
it often results in severe climacteric symptoms.


3. Removal of the uterus

This is effective but involves an unnecessarily
major operation and destroys menstrual as
well as reproductive function. Its chief place is
in those cases where the need for sterilization
is associated with disease in the uterus or
cervix. But, to preclude further childbearing, it
is commonly carried out as part of another
operation. Examples are vaginal hysterectomy
as part of the cure of prolapse, and caesarean
hysterectomy. The latter is sometimes
advocated, in preference to caesarean section
and tubal ligation, on the grounds that it
prevents future uterine disease as well as
conception. Those women who have ethical
objections to tubal ligation may well prefer to
have a 'scarred uterus' removed. Except in
special circumstances, however, caesarean
hysterectomy is not justified as a sterilization
procedure.

As an elective sterilization procedure for
non-pregnant women, some gynaecologists
advocate hysterectomy (preferably vaginal) in
preference to tubal resection. This is because it
removes the possibility of the future
development of uterine disease such as
carcinoma of the cervix and eliminates the
chance of the woman suffering menstrual and
other upsets which sometimes follow less
radical procedures. Hysterectomy, however,
carries a much higher immediate morbidity
rate than does surgical tubal resection and can
be followed by other disturbances and regrets
at loss of menstrual function  an outward
sign of femininity."


4. Resection of fallopian tubes

Provided the pelvic organs are healthy,
one of the best methods is to remove 1-2 cm
of the middle of each tube and to bury the
ligated ends separately under the peritoneum.
Sometimes the cornua of the uterus are
excised, together with the adjacent portions of
the tubes. Excision of the whole of both tubes
is not so safe because it leaves the ovum free
to wander into a possible uterine fistula and
fimbriectomy should never be performed.
Retention of the abdominal ostia is an
advantage for it tends to ensure that ova
become trapped in the occluded tubes.

Of the more simple operations on the
fallopian tubes the best is the Pomeroy
procedure in which a loop of tube is excised
and the cut ends secured with a ligature. This
method has the advantage of avoiding
troublesome haemorrhage which can attend
the techniques described above, requires only
limited access, is speedy, and fails in not more
than 0.3 per cent of cases. The technique of
crushing and ligation of the tubes without
excising any part of them (Madlener operation)
is very unreliable, the failure rate being 3.0 per
cent; it is rarely practised now.


Whatever technique be used for dividing
the tubes, it is important to ligature their cut
ends with plain catgut. This is much more
likely to result in firm closure than is the use of
unabsorbable material, or even chromic gut.
Most failures are due to neglect of this
medicolegally very important point.


Resection of the tubes is usually carried
out abdominally and is particularly easy to
perform 2-4 days after delivery when the
uterus is an abdominal organ and the tubes
readily accessible. It can then, if necessary,
be carried out under local analgesia. Tubal
resection (preferably using the Pomeroy
technique) can also be performed vaginally
either during the course of another operation
or as the route of choice. As a method of
choice it is not new as is sometimes
suggested; it was regularly carried out in the
1920s."



Dealing with reliability of the sterilization procedures
performed and commonly employed by the gynaecologists, the
text book states (at p.621):-
Reliability
The only sterilization procedures in the female
which are both satisfactory and reliable are:
resection or destruction of a portion of both
fallopian tubes; and hysterectomy. No
method, however, is absolutely reliable and
pregnancy is reported after subtotal and total
hysterectomy , and even after hysterectomy
with bilateral salpingectomy. The explanation
of these extremely rare cases is a persisting
communication between the ovary or tube and
the vaginal vault.

Even when tubal occlusion operations are
competently performed and all technical
precautions are taken, intrauterine pregnancy
occurs subsequently in 0.3 per cent of cases.
This is because an ovum gains access to
spermatozoa through a recanalized inner
segment of the tube.

There is clinical impression that tubal
resection operations are more likely to fail
when they are carried out at the time of
caesarean section than at any other time. The
fact that they occasionally fail at any time has
led many gynaecologists to replace the term
'sterilization' by "tubal ligation" or "tubal
resection" in talking to the patient and in all
records. This has real merit from the
medicolegal standpoint."


[underlining by us]



In Shaw's Textbook of Gynaecology , after describing
several methods of female sterilization, the textbook states that
the most popular technique adopted in Mini-lapartomy
sterilization is Pomeroy method in which the fallopian tube is
identified on each side, brought out through the incision, and the
middle portion is formed into a loop which is tied at the base
with catgut and excised. The failure rate is only 0.4% and it is
mainly due to spontaneous recanalization. The operation is
simple, requires a short hospitalization, does not require any
sophisticated and expensive equipment like a laparoscope, and
can be performed in a primary health centre by a doctor trained
in this procedure. In Madlener method, a loop of the tube is
crushed and ligated with a non-absorbable suture. Failure rate
is of 7% and occurrence of an ectopic pregnancy are
unacceptable though it is a simple procedure to perform. There
are other methods, less popular on account of their indications,
which are also stated. Dealing with the topic of complications
and sequelae of sterilization, the textbook states:

"Failure rate of sterilization varies from 0.4%
in Pomeroy's technique, 0.3-0.6% by
laparoscopic method to 7% by Madlener
method. Pregnancy occurs either because of
faulty technique or due to spontaneous
recanalization."



In 'The Essentials of Contraceptive Technology',
written by four doctors and published by Center for
Communication Programs, The Johns Hopkins School of Public
Health in July, 1997, certain questions and answers are stated.
Questions 5 and 6 and their answers, which are relevant for our
purpose, read as under:

"5. Will female sterilization stop working
after a time? Does a woman who had a
sterilization procedure ever have to worry
about getting pregnant again?

Generally, no. Female sterilization should be
considered permanent. Failure rates are
probably higher than previously thought
however. A major new US study found that the
risk of pregnancy within 10 years after
sterilization is about 1.8 per 100 women 
about 1 in every 55 women. The risk of
sterilization failure is greater for younger
women because they are more fertile than
older women. Also, some methods of blocking
the tubes work better than others. Methods
that cut away part of each tube work better
than spring clips or bipolar electrocoagulation
(electric current). Effectiveness also depends
on the skill of the provider.

The same US study found that 1 of every 3
pregnancies after sterilization was ectopic. If a
woman who has had sterilization ever thinks
that she is pregnant or has an ectopic
pregnancy, she should seek help right away.

[underlining by us]



6. Pregnancy after female sterilization is
rare but why does it happen at all?

The most common reason is that the woman
was already pregnant at the time of
sterilization. Pregnancy also can occur if the
provider confused another structure in the
body with the fallopian tubes and blocked or
cut the wrong place. In other case pregnancy
results because clips on the tubes come open,
because the ends of the tubes grow back
together, or because abnormal openings
develop in the tube, allowing sperm and egg to
meet."



In newsletter "alert" September, 2000 issue, Prof.(Dr.)
Gopinath N. Shenoy writes:

"Female sterilization can be done by many
methods/techniques, which are accepted by
the medical professionals all over the world. It
is also an accepted fact that none of these
methods/techniques are cent percent 'failure
free'. This 'failure rate' may vary from method
to method. A doctor is justified in choosing
one method to the exclusion of the others and
he cannot be faulted for his choice if his choice
is based on reasonable application of mind and
is not 'palpably' wrong. A doctor has
discretionary powers to choose the
method/technique of sterilization he desires to
adopt."

[emphasis supplied]


In "The New England Journal of Medicine" , owned,
published and copyrighted by Massachusetts Medical Society, the
result of a research carried out by a team of doctors has been
published and widely circulated. 10,685 women enrolled and
eligible for long term follow up and willing to cooperate and
providing information were studied. The relevant part of the
result of the study reads as under:

"The median age of women at the time of
sterilization was 30 years (range, 18 to 44;
mean [+ SD],31+6). Most women were white
and had been pregnant at least twice (Table
1). In all, 143 women (1.3 percent) reported
pregnancies that were classified as true failure
of sterilization. For 66.4 percent of these
pregnancies, the classification was based on a
review of medical reports by the investigators.
The remainder were classified on the basis of
the woman's history alone."


In Medico-legal Aspects in Obstetrics and
Gynaecology, edited by three doctors, Chapter 18, deals with
Medico-legal Problems in Sterilization Operations. It is stated
therein that there are several methods of female sterilization of
which one that will suit the patient and the
surgeon/gynaecologist should be selected. In India, Pomeroy's
method is widely practised. Other methods include  Madlener's,
Irving's, Uchida's methods and so on. The text further states
that failure is one of the undesirous outcome of sterilization.
The overall incidence of failure in tubectomy is 0.4 per 100
women per year. The text describes the following events
wherefrom sterilization failure usually results:
i. Spontaneous recanalisation or fistula formation
is perhaps the most common cause of failure.
Though these are generally non-negligent
causes of failure, it is very difficult to convince
the patient if they are not informed beforehand
about the possibility.

ii. Undetected pregnancy at the time of
sterilization is an indefensible offence. To
avoid such incidence, tests to detect pregnancy
should be done before sterilization operation is
undertaken.

iii. Imperfect occlusion of the tube is a technical
loophole which may result in an unwanted
pregnancy. The chance is particularly high in
laparoscopic methods. If a gynaecologist fails
to place ring on any one of the tube due to
improper visualization, he or she must inform
the patient and her husband, and some other
contraceptive method should be advised.

iv. Occlusion of the wrong structure(s), e.g. round
ligament is a common, indefensible error which
may particularly happen if the surgeon is
inexperienced. This is more frequent in
laparoscopic methods where even confirmation
of the structure by biopsy is difficult, in case of
doubt.

It is thus clear that there are several alternative methods
of female sterilization operation which are recognized by medical
science of today. Some of them are more popular because of
being less complicated, requiring minimal body invasion and
least confinement in the hospital. However, none is foolproof
and no prevalent method of sterilization guarantees 100%
success. The causes for failure can well be attributable to the
natural functioning of the human body and not necessarily
attributable to any failure on the part of the surgeon.
Authoritative Text Books on Gynaecology and empirical
researches which have been carried out recognize the failure
rate of 0.3% to 7% depending on the technique chosen out of
the several recognized and accepted ones. The technique which
may be foolproof is removal of uterus itself but that is not
considered advisable. It may be resorted to only when such
procedure is considered necessary to be performed for purposes
other than merely family planning.

An English decision Eyre v. Measday (1986) 1 ALL ER 488
is very near to the case at hand. The facts of the case were that
in 1978, the plaintiff and her husband decided that they did not
wish to have any more children. The plaintiff consulted the
defendant gynaecologist with a view to undergoing a sterilization
operation. The defendant explained to the couple the nature of
the particular operation he intended to perform, emphasising
that it was irreversible. He stated that the operation 'must be
regarded as a permanent procedure' but he did not inform the
plaintiff that there was a small risk (less than 1%) of pregnancy
occurring following the operation. Consequently, both the
plaintiff and her husband believed that the result of the
operation would be to render her absolutely sterile and incapable
of bearing further children. In 1979 the plaintiff became
pregnant and gave birth to a child. The plaintiff brought an
action against the defendant for damages, inter alia, for breach
of contract, contending that his representation that the operation
was irreversible and his failure to warn her of the minute risk of
the procedure being unsuccessful, amounted to breach of a
contractual term, or express or implied collateral warranty, to
render her irreversibly sterile. The judge dismissed her claim
and the plaintiff appealed to the Court of Appeal.

The Court held 

"(1) The contract undertaken by the defendant
was to carry out a particular type of operation
rather than to render the plaintiff absolutely
sterile. Furthermore, the defendant's
representations to the plaintiff that the
operation was 'irreversible' did not amount to
an express guarantee that the operation was
bound to achieve its acknowledged object of
sterilizing the plaintiff. On the facts, it was
clear that the representations meant no more
than that the operative procedure in question
was incapable of being reversed.

(2) Where a doctor contracted to carry out a
particular operation on a patient and a
particular result was expected, the court would
imply into the contract between the doctor and
the patient a term that the operation would be
carried out with reasonable care and skill, but
would be slow to imply a term or unqualified
collateral warranty that the expected result
would actually be achieved, since it was
probable that no responsible medical man
would intend to give such a warranty. On the
facts, no intelligent lay bystander could have
reasonably inferred that the defendant was
intending to give the plaintiff a guarantee that
after the operation she would be absolutely
sterile and the fact that she believed that this
would be the result was irrelevant."


The appeal was dismissed. The Court of Appeal, upheld
the finding of the trial judge that the risk of pregnancy following
such a procedure to which the plaintiff was subjected is
described as very small. It is of the order of 2 to 6 in every
1000. There is no sterilization procedure which is entirely
without such a risk.

Slade L J, stated in his opinion that "in the absence of any
express warranty, the court should be slow to imply against a
medical man an unqualified warranty as to the results of an
intended operation, for the very simple reason that, objectively
speaking, it is most unlikely that a responsible medical man
would intend to give a warranty of this nature. Of course,
objectively speaking, it is likely that he would give a guarantee
that he would do what he had undertaken to do with reasonable
care and skill; but it is quite another matter to say that he has
committed himself to the extent suggested in the present case."

Purchas LJ, stated in his opinion that "it is true that as a
matter of deliberate election the defendant did not, in the course
of describing the operation which he was recommending,
disclose that there was a very small risk, one might almost say
an insignificant risk, that the plaintiff might become pregnant.
In withholding this information it must be borne in mind, first
that the defendant must have believed that the plaintiff would be
sterile, second that the chances were extremely remote that the
operation would be unsuccessful, third that in withholding this
information the defendant was following a practice acceptable to
current professional standards and was acting in the best
interest of the plaintiff, and fourth that no allegation of
negligence in failing to give this information to the plaintiff is
pursued any longer in this case. There are, therefore, in my
judgment, no grounds for asserting that the result would
necessarily be 100% successful."

In Thake v Morris , [1986] 1 All ER 497 (CA) the claim
for damages was founded on contract and not in torts. The
Court of Appeal firmly rejected the possibility of an enforceable
warranty. Neill L J said:

"a reasonable man would have expected the
defendant to exercise all the proper skill and care of
a surgeon in that speciality: he would not have
expected the defendant to give a guarantee of 100%
success."

Nourse L J said:

"of all sciences medicine is one of the least exact. In
my view, a doctor cannot be objectively regarded as
guaranteeing the success of any operation or
treatment unless he says as much in clear and
unequivocal terms."



We are, therefore, clearly of the opinion that merely
because a woman having undergone a sterilization operation
became pregnant and delivered a child, the operating surgeon or
his employer cannot be held liable for compensation on account
of unwanted pregnancy or unwanted child. The claim in tort can
be sustained only if there was negligence on the part of the
surgeon in performing the surgery. The proof of negligence shall
have to satisfy Bolam's test. So also, the surgeon cannot be
held liable in contract unless the plaintiff alleges and proves that
the surgeon had assured 100 % exclusion of pregnancy after the
surgery and was only on the basis of such assurance that the
plaintiff was persuaded to undergo surgery. As noted in various
decisions which we have referred to hereinabove, ordinarily a
surgeon does not offer such guarantee.


The cause of failure of sterilization operation may be
obtained from laparoscopic inspection of the uterine tubes, or by
x-ray examination, or by pathological examination of the
materials removed at a subsequent operation of re-sterilisation.
The discrepancy between operation notes and the result of x-ray
films in respect of the number of rings or clips or nylon sutures
used for occlusion of the tubes, will lead to logical inference of
negligence on the part of the gynaecologist in case of failure of
sterilisation operation. (See: Law of Medical Negligence and
Compensation by R.K. Bag, Second Edition, p.139)

Mrs. K. Sarada Devi, the learned counsel appearing for the
plaintiffs-respondents placed reliance on a 2-Judge Bench
decision of this Court in State of Haryana & Ors. v. Smt.
Santra, JT 2000 (5) SC 34, wherein this Court has upheld the
decree awarding damages for medical negligence on account of
the lady having given birth to an unwanted child on account of
failure of sterilization operation. The case is clearly
distinguishable and cannot be said to be laying down any law of
universal application. The finding of fact arrived at therein was
that the lady had offered herself for complete sterilization and
not for partial operation and, therefore, both her fallopian tubes
should have been operated upon. It was found as a matter of
fact that only the right fallopian tube was operated upon and the
left fallopian tube was left untouched. She was issued a
certificate that her operation was successful and she was
assured that she would not conceive a child in future. It was in
these circumstances, that a case of medical negligence was
found and a decree for compensation in tort was held justified.
The case thus proceeds on its own facts.

The methods of sterilization so far known to medical
science which are most popular and prevalent are not 100% safe
and secure. In spite of the operation having been successfully
performed and without any negligence on the part of the
surgeon, the sterilized woman can become pregnant due to
natural causes.
Once the woman misses the menstrual cycle, it
is expected of the couple to visit the doctor and seek medical
advice. A reference to the provisions of the Medical Termination
of Pregnancy Act, 1971 is apposite. Section 3 thereof permits
termination of pregnancy by a registered medical practitioner,
notwithstanding anything contained in the Indian Penal Code,
1860 in certain circumstances and within a period of 20 weeks
of the length of pregnancy. Explanation II appended to sub-
section (2) of Section 3 provides ____
"Explanation II. ____ Where any pregnancy
occurs as a result of failure of any device or
method used by any married woman or her
husband for the purpose of limiting the number of
children, the anguish caused by such unwanted
pregnancy may be presumed to constitute a grave
injury to the mental health of the pregnant
woman."



And that provides, under the law, a valid and legal ground
for termination of pregnancy. If the woman has suffered an
unwanted pregnancy, it can be terminated and this is legal and
permissible under the Medical Termination of Pregnancy Act,
1971.

The cause of action for claiming compensation in cases of
failed sterilization operation arises on account of negligence of
the surgeon and not on account of child birth. Failure due to
natural causes would not provide any ground for claim. It is for
the woman who has conceived the child to go or not to go for
medical termination of pregnancy. Having gathered the
knowledge of conception in spite of having undergone
sterilization operation, if the couple opts for bearing the child, it
ceases to be an unwanted child. Compensation for maintenance
and upbringing of such a child cannot be claimed.

For the foregoing reasons, we are of the opinion that the
judgments and the decrees passed by the High Court and courts
below cannot be sustained. The trial court has proceeded to
pass a decree of damages in favour of the plaintiffs-respondents
solely on the ground that in spite of the plaintiff-respondent No.2
having undergone a sterilization operation, she became
pregnant. No finding has been arrived at that will hold the
operating surgeon or its employer __ the State, liable for
damages either in contract or in tort. The error committed by
the trial court, though pointed out to the first appellate court and
the High Court, has been overlooked. The appeal has, therefore,
to be allowed and the judgment and decree under appeal have
to be set aside.

We have decided the question of law and held that the
decree awarding the damages was totally uncalled for and had
no foundation in law, and therefore, has to be set aside. The
present case is an occasion, which we would like to utilize for the
purpose of making certain observations on three related topics
noted hereunder.

(1) Jacob Mathew's case (2005) 6 SCC1 : a post script


In Jacob Mathew this Court dealt with the liability of a
medical practitioner in criminal law. Of course, the decision also
discussed in detail the law of medical negligence in general and
indicated the parameters of fixing liability. The distinction
between the concept of negligence in civil law and negligence in
criminal law was highlighted. The present case deals with the
law of negligence in tort. The basis of liability of a professional
in tort is negligence. Unless that negligence is established, the
primary liability cannot be fastened on the medical practitioner.
Unless the primary liability is established, vicarious liability on
the State cannot be imposed. Both in criminal jurisprudence and
in civil jurisprudence, doctors are liable for consequences of
negligence. In Jacob Mathew even while dealing with criminal
negligence, this Court has indicated the caution needed in
approaching a case of medical negligence having regard to the
complexity of the human body which is subjected to treatment
and the uncertainty involved in medical procedures. A doctor, in
essence, needs to be inventive and has to take snap decisions
especially in the course of performing surgery when some
unexpected problems crop up or complication sets in. If the
medical profession, as a whole, is hemmed in by threat of action,
criminal and civil, the consequence will be loss to the patients.
No doctor would take a risk, a justifiable risk in the
circumstances of a given case, and try to save his patient from a
complicated disease or in the face of an unexpected problem
that confronts him during the treatment or the surgery. It is in
this background that this Court has cautioned that the setting in
motion of the criminal law against the medical profession should
be done cautiously and on the basis of reasonably sure grounds.
In criminal prosecutions or claims in tort, the burden always
rests with the prosecution or the claimant. No doubt, in a given
case, a doctor may be obliged to explain his conduct depending
on the evidence adduced by the prosecution or by the claimant.
That position does not change merely because of the caution
advocated in Jacob Mathew in fixing liability for negligence, on
doctors.

(2) How the medical profession ought to respond

Medical profession is one of the oldest professions of the
world and is the most humanitarian one. There is no better
service than to serve the suffering, wounded and the sick.
Inherent in the concept of any profession is a code of conduct,
containing the basic ethics that underline the moral values that
govern professional practice and is aimed at upholding its
dignity. Medical Ethics underpins the values at the heart of the
practitioner-client relationship. In the recent times, professionals
are developing a tendency to forget that the self-regulation
which is at the heart of their profession is a privilege and not a
right and a profession obtains this privilege in return for an
implicit contract with society to provide good, competent and
accountable service to the public. It must always be kept in mind
that doctor's is a noble profession and the aim must be to serve
humanity, otherwise this dignified profession will lose its true
worth.

Medical profession has long subscribed to a body of ethical
statements developed primarily for the benefit of the patient.
The oldest expression of this basic principle comes from
Hippocrates, an early Greek Physician, born in 460 B.C. who
came to be known as the "Father of Medicine" and had devoted
his entire life to the advancement of medical science. He
formulated a code of conduct in the form of the Hippocratic
Oath, as he realized that knowledge and skill were not enough
for a physician without a code of standards and ideals. He coined
an oath of integrity for physicians, a code of standards and
ideals to which they must swear to adhere in the practice of their
profession. This continues till date to be the oath administered
to doctors when they join the profession:
"I swear by Apollo the physician, by Fsculapius, Hygeia,
and Panacea, and I take to witness all the gods, all the
goddesses, to keep according to my ability and my
judgement, the following Oath.

To consider dear to me as my parents him who taught me
this art; to live in common with him and if necessary to
share my goods with him; to look upon his children as my
own brothers, to teach them this art if they so desire
without fee or written promise; to impart to my sons and
the sons of the master who taught me and the disciples
who have enrolled themselves and have agreed to the
rules of the profession, but to these alone the precepts and
the instruction. I will prescribe regimens for the good of
my patients according to my ability and my judgement and
never do harm to anyone. To please no one will I prescribe
a deadly drug nor give advice which may cause his death.
Nor will I give a woman a pessary to procure abortion. But
I will preserve the purity of my life and my art. I will not
cut for stone, even for patients in whom the disease is
manifest; I will leave this operation to be performed by
practitioners, specialists in this art. In every house where I
come I will enter only for the good of my patients, keeping
myself far from all intentional ill-doing and all seduction
and especially from the pleasures of love with women or
with men, be they free or slaves. All that may come to my
knowledge in the exercise of my profession or in daily
commerce with men, which ought not to be spread abroad,
I will keep secret and will never reveal. If I keep this oath
faithfully, may I enjoy my life and practice my art,
respected by all men and in all times; but if I swerve from
it or violate it, may the reverse be my lot."


Many versions of Hippocratic Oath are prevalent. "Light
From Many Lamps" a book edited by Lilian Eichler Watson
contains a little different phraseology of that oath but certainly a
beautiful commentary on the significance of the Hippocratic
Oath. We would like to reproduce the oath and the commentary
hereunder: (pages 181-182);
"I do solemnly swear by that which I hold most
sacred:

That I will be loyal to the profession of
medicine and just and generous to its members;

That I will lead my life and practice my art in
uprightness and honor;

That into whatsoever house I shall enter, it
shall be for the good of the sick to the utmost of my
power, I holding myself aloof from wrong, from
corruption, and from the temptation of others to
vice;

That I will exercise my art solely for the cure of
my patients, and will give no drug, perform no
operation for a criminal purpose, even if solicited, far
less suggest it;

That whatsoever I shall see or hear of the lives
of men which is not fitting to be spoken, I will keep
inviolably secret.

These things I do promise, and in proportion as
I am faithful to this my oath may happiness and
good repute be ever mine __ the opposite if I shall be
forsworn."

[F.N.: The Hippocratic Collection, containing
the best of the ancient Greek medical writings, was
put together by Aristotle and has survived through
the centuries. The "Hippocratic Oath" is one of the
last and most inspiring passages in this Collection.
There are a number of versions of the famous Oath;
but the form given here is the one commonly used
today; and is an adaptation of a translation from the
original Greek.]

"The medical profession is and always has been one
of the most ethical of all professions; and this is due
at least in part to the centuries-old influence of the
Hippocratic Oath. This famous Oath has kept alive
the high standards and ideals set by Hippocrates,
and forms the basis of modern medical ethics.

Written more than twenty centuries ago, the
Hippocratic Oath has inspired generations of doctors
. . . and continues to do so even now. The Oath is
still administered by medical schools to graduating
classes; and thousands of physicians have framed
copies on their walls along with their diplomas.
Conscientious practitioners continue to live up to the
principles and ideals set down for their profession so
long ago by the "Father of Medicine."

Though it was written specifically for
physicians, the Hippocratic Oath sets an enduring
pattern of honor, integrity, and devotion to duty for
all people, in all professions." And certainly to
surgeons."





Many people argue that the original Hippocratic Oath is
inappropriate in a society that has seen drastic socio-economic,
political and moral changes, since the time of Hippocrates.
Certain parts of the original oath such as teaching the master's
sons the secrets of medicine without fees and the promise not to
bring a knife to another's body but to leave it to 'practitioners of
the craft' have been rendered obsolete as the modernisation of
education has led to the teaching of medical science in
institutions of higher learning, and specialisation in medicine has
led to physicians who specialise in a variety of fields including
surgery. Similarly, the legalisation on abortion and physician-
assisted suicide in certain parts of the world, has made it
awkward for some medical practitioners there to carry on in the
tradition of the original oath.
This has led to the modification of the oath to something
better suited for our times. One of the most widely used versions
is The Declaration of Geneva which was adopted by the
General Assembly of the World Medical Association at Geneva in
1948. Written with the medical crimes committed in Nazi
Germany in view, it is a 'declaration of physicians' dedication to
the humanitarian goals of medicine.' It is also perhaps the only
one to mention treating people equally, without regard as to
race, religion, social standing and political affiliations:
"I solemnly pledge myself to the service of humanity. I
will give to my teachers the respect and gratitude which
is their due. I will practice my profession with conscience
and dignity. The health of my patient will be my first
consideration. I will respect the secrets which are
confided in me. I will maintain by all means in my power
the honour and noble traditions of the medical profession.
My colleagues will be my brothers and sisters. I will not
permit consideration of religion, nationality, race or social
standing to intervene between my duty and my patient. I
will maintain the utmost respect for human life even
under threat. I will not use my medical knowledge
contrary to the laws of humanity. I make these promises
solemnly, freely and upon my honour."



In recent times the self regulatory standards in the
profession have shown a decline and this can be attributed to
the overwhelming impact of commercialization of the sector.
There are reports against doctors of exploitative medical
practices, misuse of diagnostic procedures, brokering deals for
sale of human organs, etc. It cannot be denied that black sheep
have entered the profession and that the profession has been
unable to isolate them effectively. The need for external
regulation to supplement professional self-regulation is
constantly growing. The high costs and investments involved in
the delivery of medical care have made it an entrepreneurial
activity wherein the professionals look to reaping maximum
returns on such investment. Medical practice has always had a
place of honour in society; currently the balance between service
and business is shifting disturbingly towards business and this
calls for improved and effective regulation, whether internal or
external. There is need for introspection by doctors  individually
and collectively. They must rise to the occasion and enforce
discipline and high standards in the profession by assuming an
active role.


(3) Need for devising a welfare fund or insurance scheme

Failure of many a sterilization operation, though
successfully performed, is attributable to causes other than
medical negligence as we have already discussed hereinabove.
And, yet the doctors are being faced with claim for damages.
Some of the claims have been decreed by the courts without
arriving at any finding providing a foundation in law for
upholding such a claim. The state is also being called upon to
honour such decrees on the principle of vicarious liability when
the surgeon has performed a surgery in discharge of his duty.
Mostly such surgeries are performed on a large scale and as a
part of family welfare programmes of the Government.
Obviously, such programmes are in public interest. Such like
decrees act as a disincentive and have deterrent effect on the
surgeons performing sterilization operations. The State, flooded
with such decrees is also inclined not to pursue family planning
camps on large scale though in public interest.


In Javed & Ors. v. State of Haryana & Ors. (2003) 8
SCC 369, popularly known as 'Two-Child Norm' case, this Court
had an occasion to deal with the problem of increasing
population, the danger which it poses for the progress of the
nation and equitable distribution of its resources and upheld the
validity of the Haryana legislation imposing a disqualification on
persons having more than two children from contesting for an
elective office. The fact cannot be lost sight of that while
educated persons in the society belonging to the middle-class
and the upper class do voluntarily opt for family planning and
are careful enough to take precautions or remedial steps to
guard against the consequences of failure of sterilization, the
illiterate and the ignorant and those belonging to the lower
economic strata of society face the real problem. To popularize
family planning programmes in such sections of society, the
State Government should provide some solace to them if they,
on account of their illiteracy, ignorance or carelessness, are
unable to avoid the consequences of a failed sterilization
operation. Towards this end, the State Governments should
think of devising and making provisions for a welfare fund or
taking up with the insurance companies, a proposal for devising
an appropriate insurance policy or an insurance scheme, which
would provide coverage for such claims where a child is born to
woman who has undergone a successful sterilization operation,
as in the present case.

Conclusion
The appeal is allowed. The judgment and decree passed by the trial court and upheld by the first appellate court and the High Court are set aside. The suit filed by the plaintiffs-respondents is dismissed. However, as we have already stated, in view of the concession given by the learned Additional Advocate General appearing for the appellant State, the amount of Rs.50,000/- if already paid to the plaintiff-respondent shall not be liable to be refunded by way of restitution. No order as to
costs.

Friday, August 12, 2005

Supreme Court Appeal (civil) 5041 of 2005

CASE NO.:
Appeal (civil) 5041 of 2005

PETITIONER:
P.A. Inamdar & Ors.

RESPONDENT:
State of Maharashtra & Ors.

DATE OF JUDGMENT: 12/08/2005

BENCH:
CJI R.C. LAHOTI Y.K. SABHARWAL D.M. DHARMADHIKARI ARUN KUMAR,G.P. MATHUR,TARUN CHATTERJEE & P.K. BALASUBRAMANYAN

JUDGMENT:
J U D G M E N T
JUDGMENT GIVEN BY
CJI R.C. LAHOTI,Y.K. SABHARWAL,D.M. DHARMADHIKARI,ARUN KUMAR,G.P. MATHUR,TARUN CHATTERJEE & P.K. BALASUBRAMANYAN

(Arising out of Special Leave Petition (C) No.9932 of 2004)
WITH
Civil Appeal No. 5042 of 2005 (@ SLP(C) No.9935/2004); Civil
Appeal No. 5043 of 2005 (@ SLP(C) No. 9936/2004); W.P. (C)
No. 276/2004; W.P. (C) No. 330/2004; W.P. (C) No. 357/2004;
I.A. NOS. 26, 27, 30, 31 AND 33 IN W.P. (C) No.350/1993; Civil
Appeal No. 5035 of 2005 (@ SLP(C) No.11244/2004; W.P.(C)
No. 302/204; W.P. (C) No. 347/2004; W.P. (C) No. 349/2004;
W.P. (C) No. 350/2004; W.P. (C) No. 387/2004; W.P. (C) No.
423/2004; W.P. (C) No. 480/2004; W.P. (C) No. 19/2005; W.P.
(C) No. 261/2004; W.P. (C) No. 265/2004; W.P. (C) No.
380/2004; W.P. (C) No. 358/2004; W.P. (C) No. 359/2004; W.P.
(C) No. 360/2004; W.P. (C) No.361/2004; W.P. (C) No.
362/2004; W.P. (C) No. 363/2004; C.A. No. 5257-5258/2004;
C.A. No. 5259/2004; C.A. No. 5260-5261/2004; C.A. No. 5262-
5263/2004; C.A. No. 5996/2004; C.A. No. 5992/2004; C.A. No.
5997-5998/2004; C.A. No. 7969-7971/2004; C.A. No.
7972/2004; C.A. No. 7973/2004; C.A. No. 7974/2004; C.A. No.
7975/2004; W.P. (C) No. 371/2004; W.P. (C) No.
368/2004; C.A. No. 7117-7119/2004; C.A. No. 7124-
7126/2004; CONMT.PET. (CIVIL) No. 561-563/2004 In C.A. No.
7117-7119/2004; CONMT. PET. (Civil) No. 564-566/2004 in
C.A. No. 7124-7126/2004; W.P. (C) No. 251/2004; Civil Appeal
No. 5036 of 2005 (@ SLP (C) No. 17464/2004); Civil Appeal No.
5037 of 2005 (@ SLP (C) No. 17549/2004); W.P. (C) No.
318/2004; Civil Appeal No. 5038 of 2005 (@ SLP(C) No.
17930/2004; Civil Appeal No. 5039 of 2005 (@ SLP (C) No.
17931/2004); Civil Appeal No. 5040 of 2005 (@ SLP (C) No.
17326/2003); W.P. (C) No. 386/2004; W.P. (C) No. 397/2004


R.C. Lahoti, CJI

Preliminary

Leave granted in all SLPs.

A Coram of 11 Judges, not a common feature in the
Supreme Court of India, sat to hear and decide T.M.A.Pai
Foundation v. State of Karnataka (2002) 8 SCC 481
(hereinafter 'Pai Foundation', for short). It was expected that
the authoritative pronouncement by a Bench of such strength on
the issues arising before it would draw a final curtain on those
controversies. The subsequent events tell a different story. A
learned academician observes that the 11-Judge Bench decision
in Pai Foundation is a partial response to some of the
challenges posed by the impact of Liberalisation, Privatisation
and Globalisation (LPG); but the question whether that is a
satisfactory response, is indeed debatable. It was further
pointed out that 'the decision raises more questions than it has
answered' (see : Annual Survey of Indian Law, 2002 at p.251,
254). The Survey goes on to observe "the principles laid down
by the majority in Pai Foundation are so broadly formulated
that they provide sufficient leeway to subsequent courts in
applying those principles while the lack of clarity in the judgment
allows judicial creativity " (ibid at p.256).

The prophecy has come true and while the ink on the
opinions in Pai Foundation was yet to dry, the High Courts
were flooded with writ petitions, calling for settlements of
several issues which were not yet resolved or which propped on
floor, post Pai Foundation. A number of Special Leave
Petitions against interim orders passed by High Courts and a few
writ petitions came to be filed directly in this Court. A
Constitution Bench sat to interpret the 11-Judge Bench decision
in Pai Foundation which it did vide its judgment dated
14.8.2003 (reported as - Islamic Academy of Education &
Anr. v. State of Karnataka & Ors., (2003) 6 SCC 697;
"Islamic Academy" for short). The 11 learned Judges
constituting the Bench in Pai Foundation delivered five
opinions. The majority opinion on behalf of 6 Judges was
delivered by B.N. Kirpal, CJ. Khare, J (as His Lordship then was)
delivered a separate but concurring opinion, supporting the
majority. Quadri, J, Ruma Pal, J and Variava, J (for himself and
Bhan, J) delivered three separate opinions partly dissenting from
the majority. Islamic Academy too handed over two opinions.
The majority opinion for 4 learned Judges has been delivered by
V.N. Khare, CJ. S.B. Sinha, J, has delivered a separate opinion.
The events following Islamic Academy judgment show
that some of the main questions have remained unsettled even
after the exercise undertaken by the Constitution Bench in
Islamic Academy in clarification of the 11-Judge Bench
decision in Pai Foundation. A few of those unsettled questions
as also some aspects of clarification are before us calling for
settlement by this Bench of 7 Judges which we hopefully propose
to do.

Pai Foundation and Islamic Academy have set out the
factual backdrop of the issues leading to the formulation of 11-
Judge and 5-Judge Benches respectively. For details thereof a
reference may be made to the reported decisions. A brief
summary of the past events, highlighting the issues as they have
travelled in search of resolution would be apposite.
II
BACKDROP

Education used to be charity or philanthropy in good old
times. Gradually it became an 'occupation'. Some of the
Judicial dicta go on to hold it as an 'industry'. Whether, to
receive education, is a fundamental right or not has been
debated for quite some time. But it is settled that establishing
and administering of an educational institution for imparting
knowledge to the students is an occupation, protected by Article
19(1)(g) and additionally by Article 26(a), if there is no element
of profit generation. As of now, imparting education has come
to be a means of livelihood for some professionals and a mission
in life for some altruists.

Education has since long been a matter of litigation. Law
reports are replete with rulings touching and centering around
education in its several aspects. Until Pai Foundation, there
were four oft quoted leading cases holding the field of education.
They were Unni Krishnan v. State of Andhra Pradesh (1993)
1 SCC 645, St. Stephen's College v. University of Delhi
(1992)1 SCC 558, Ahmedabad St. Xavier's College Society
v. State of Gujarat (1974)1 SCC 717 and In Re: Kerala
Education Bill, 1957, (1958) SCR 995. For convenience sake,
these cases will be referred to as Unni Krishnan, St.
Stephen's, St. Xavier's and Kerala Education Bill
respectively. All these cases amongst others came up for the
consideration of this Court in Pai Foundation.

Correctness of the decision in St. Stephen's was doubted
during the course of hearing of Writ Petition No. 350 of 1993
filed by Islamic Academy. As St. Stephen's is a
pronouncement of 5-Judge Bench, the matter was directed to
be placed before 7-Judge Bench.

An event of constitutional significance which had already
happened, was taken note of by the Constitution Bench.
"Education" was a State Subject in view of the following Entry 11
placed in List II ___ State List:-

"11. Education including universities,
subject to the provisions of entries 63,
64, 65 and 66 of List I and entry 25 of
List III."

By the Constitution (42nd Amendment) Act 1976, the
abovesaid Entry was directed to be deleted and instead Entry 25
in List III  Concurrent List, was directed to be suitably amended
so as to read as under:-

"25. Education, including technical
education, medical education and
universities, subject to the provisions of
entries 63, 64, 65 and 66 of List I;
vocational and technical training of
labour."


The 7-Judge Bench felt that the matter called for hearing
by a 11-Judge Bench. The 11-Judge Bench felt that it was not
bound by the ratio propounded in Kerala Education Bill and
St. Xavier's and was free to hear the case in wider perspective
so as to discern the true scope and interpretation of Article 30(1)
of the Constitution and make an authoritative pronouncement.

Eleven Questions and Five Heads of Issues in Pai
Foundation


In Pai Foundation, 11 questions were framed for being
answered. Detailed submissions were made centering around
the 11 questions. The Court dealt with the questions by
classifying the discussion under the following five heads:

1. Is there a fundamental right to set up educational
institutions and if so, under which provision?
2. Does Unni Krishnan require reconsideration?
3. In case of private institutions, can there be government
regulations and, if so, to what extent?
4. In order to determine the existence of a religious or
linguistic minority in relation to Article 30, what is to be
the unit __ the State or the country as a whole?
5. To what extent can the rights of aided private minority
institutions to administer be regulated?

Having dealt with each of the abovesaid heads, the Court
through the majority opinion expressed by B.N. Kirpal, CJ,
recorded answers to the 11 questions as they were framed and
posed for resolution. The questions and the answers as given by
the majority are set out hereunder:

"Q.1. What is the meaning and content of the expression
"minorities" in Article 30 of the Constitution of India?

A. Linguistic and religious minorities are covered by the
expression "minority" under Article 30 of the Constitution. Since
reorganization of the States in India has been on linguistic lines,
therefore, for the purpose of determining the minority, the unit
will be the State and not the whole of India. Thus, religious and
linguistic minorities, who have been put on a par in Article 30,
have to be considered Statewise.

Q.2. What is meant by the expression "religion" in Article
30(1)? Can the followers of a sect or denomination of a
particular religion claim protection under Article 30(1) on the
basis that they constitute a minority in the State, even though
the followers of that religion are in majority in that State?

A. This question need not be answered by this Bench; it will be
dealt with by a regular Bench.

Q.3 (a) What are the indicia for treating an educational
institution as a minority educational institution? Would an
institution be regarded as a minority educational institution
because it was established by a person(s) belonging to a
religious or linguistic minority or its being administered by a
person(s) belonging to a religious or linguistic minority?

A. This question need not be answered by this Bench; it will be
dealt with by a regular Bench.

Q.3(b) To what extent can professional education be treated as
a matter coming under minorities' rights under Article 30?

A. Article 30(1) gives religious and linguistic minorities the right
to establish and administer educational institutions of their
choice. The use of the words "of their choice" indicates that
even professional educational institutions would be covered by
Article 30.

Q.4. Whether the admission of students to minority educational
institution, whether aided or unaided, can be regulated by the
State Government or by the university to which the institution is
affiliated?

A. Admission of students to unaided minority educational
institutions viz. schools and undergraduate colleges where the
scope for merit-based selection is practically nil, cannot be
regulated by the State or university concerned, except for
providing the qualifications and minimum conditions of eligibility
in the interest of academic standards.
[emphasis by us]

The right to admit students being an essential facet of the
right to administer educational institutions of their choice, as
contemplated under Article 30 of the Constitution, the State
Government or the university may not be entitled to interfere
with that right, so long as the admission to the unaided
educational institutions is on a transparent basis and the merit is
adequately taken care of. The right to administer, not being
absolute, there could be regulatory measures for ensuring
educational standards and maintaining excellence thereof, and it
is more so in the matter of admissions to professional
institutions.
[emphasis by us]


A minority institution does not cease to be so, the moment
grant-in-aid is received by the institution. An aided minority
educational institution, therefore, would be entitled to have the
right of admission of students belonging to the minority group
and at the same time, would be required to admit a reasonable
extent of non-minority students, so that the rights under Article
30(1) are not substantially impaired and further the citizens'
rights under Article 29(2) are not infringed. What would be a
reasonable extent, would vary from the types of institution, the
courses of education for which admission is being sought and
other factors like educational needs. The State Government
concerned has to notify the percentage of the non-minority
students to be admitted in the light of the above observations.
Observance of inter se merit amongst the applicants belonging
to the minority group could be ensured. In the case of aided
professional institutions, it can also be stipulated that passing of
the common entrance test held by the State agency is necessary
to seek admission. As regards non-minority students who are
eligible to seek admission for the remaining seats, admission
should normally be on the basis of the common entrance test
held by the State agency followed by counselling wherever it
exists.

Q.5(a) Whether the minorities' rights to establish and
administer educational institutions of their choice will include the
procedure and method of admission and selection of students?



A. A minority institution may have its own procedure and
method of admission as well as selection of students, but such a
procedure must be fair and transparent, and the selection of
students in professional and higher education colleges should be
on the basis of merit. The procedure adopted or selection made
should not be tantamount to mal-administration. Even an
unaided minority institution ought not to ignore the merit of the
students for admission, while exercising its right to admit
students to the colleges aforesaid, as in that event, the
institution will fail to achieve excellence.

Q.5(b) Whether the minority institutions' right of admission of
students and to lay down procedure and method of admission, if
any, would be affected in any way by the receipt of State aid?


A. While giving aid to professional institutions, it would be
permissible for the authority giving aid to prescribe bye __ rules
or regulations, the conditions on the basis of which admission
will be granted to different aided colleges by virtue of merit,
coupled with the reservation policy of the State qua non-minority
students. The merit may be determined either through a
common entrance test conducted by the university or the
Government concerned followed by counselling, or on the basis
of an entrance test conducted by the individual institutions  the
method to be followed is for the university or the Government to
decide. The authority may also devise other means to ensure
that admission is granted to an aided professional institution on
the basis of merit. In the case of such institutions, it will be
permissible for the Government or the university to provide that
consideration should be shown to the weaker sections of the
society.

Q.5(c) Whether the statutory provisions which regulate the
facets of administration like control over educational agencies,
control over governing bodies, conditions of affiliation including
recognition/withdrawal thereof, and appointment of staff,
employees, teachers and principals including their service
conditions and regulation of fees, etc. would interfere with the
right of administration of minorities?

A. So far as the statutory provisions regulating the facets of
administration are concerned, in case of an unaided minority
educational institution, the regulatory measure of control should
be minimal and the conditions of recognition as well as the
conditions of affiliation to a university or board have to be
complied with, but in the matter of day-to-day management, like
the appointment of staff, teaching and non-teaching, and
administrative control over them, the management should have
the freedom and there should not be any external controlling
agency. However, a rational procedure for the selection of
teaching staff and for taking disciplinary action has to be evolved
by the management itself.

For redressing the grievances of employees of aided and
unaided institutions who are subjected to punishment or
termination from service, a mechanism will have to be evolved,
and in our opinion, appropriate tribunals could be constituted,
and till then, such tribunals could be presided over by a judicial
officer of the rank of District Judge.

The State or other controlling authorities, however, can
always prescribe the minimum qualification, experience and
other conditions bearing on the merit of an individual for being
appointed as a teacher or a principal of any educational
institution.

Regulations can be framed governing service conditions for
teaching and other staff for whom aid is provided by the State,
without interfering with the overall administrative control of the
management over the staff.

Fees to be charged by unaided institutions cannot be
regulated but no institution should charge capitation fee.

Q.6(a) Where can a minority institution be operationally
located? Where a religious or linguistic minority in State A
establishes an educational institution in the said State, can such
educational institution grant preferential admission/reservations
and other benefits to members of the religious/linguistic group
from other States where they are non-minorities?

A. This question need not be answered by this Bench; it will be
dealt with by a regular Bench.

Q. 6. (b) Whether it would be correct to say that only the
members of that minority residing in State A will be treated as
the members of the minority vis-`-vis such institution?

A. This question need not be answered by this Bench; it will be
dealt with by a regular Bench.

Q.7. Whether the member of a linguistic non-minority in one
State can establish a trust/society in another State and claim
minority status in that State?

A. This question need not be answered by this Bench; it will be
dealt with by a regular Bench.

Q.8. Whether the ratio laid down by this Court in St. Stephen's
case (St. Stephen's College v. University of Delhi, (1992) 1
SCC 558) is correct? If no, what order?

A. The basic ratio laid down by this Court in St. Stephen's
College case (supra) is correct, as indicated in this judgment.
However, rigid percentage cannot be stipulated. It has to be left
to authorities to prescribe a reasonable percentage having
regard to the type of institution, population and educational
needs of minorities.

Q. 9. Whether the decision of this Court in Unni Krishnan, J.P.
v. State of A.P., (1993) 1 SCC 645 (except where it holds that
primary education is a fundamental right) and the scheme
framed thereunder require reconsideration/modification and if
yes, what?

A. The scheme framed by this Court in Unni Krishnan case
(supra) and the direction to impose the same, except where it
holds that primary education is a fundamental right, is
unconstitutional. However, the principle that there should not be
capitation fee or profiteering is correct. Reasonable surplus to
meet cost of expansion and augmentation of facilities does not,
however, amount to profiteering.

Q. 10. Whether the non-minorities have the right to establish
and administer educational institution under Articles 21 and
29(1) read with Articles 14 and 15(1), in the same manner and
to the same extent as minority institutions?
and

Q. 11. What is the meaning of the expressions "education" and
"educational institutions" in various provisions of the
Constitution? Is the right to establish and administer
educational institutions guaranteed under the Constitution?

A. The expression "education" in the articles of the Constitution
means and includes education at all levels from the primary
school level up to the postgraduate level. It includes
professional education. The expression "educational institutions"
means institutions that impart education, where "education" is
as understood hereinabove.

The right to establish and administer educational
institutions is guaranteed under the Constitution to all citizens
under Articles 19(1)(g) and 26, and to minorities specifically
under Article 30.

All citizens have a right to establish and administer
educational institutions under Articles 19(1)(g) and 26, but this
right is subject to the provisions of Articles 19(6) and 26(a).
However, minority institutions will have a right to admit students
belonging to the minority group, in the manner as discussed in
this judgment."

The majority led by Kirpal, CJ, in Pai Foundation did say
that the expression "minorities" in Article 30 of the Constitution
of India, whether linguistic or religious, has to be determined by
treating the State and not the whole of India as unit. Questions
such as: (i) what is religion, (ii) what is the indicia for
determining if an educational institution is a minority institution,
(iii) whether a minority institution can operate extra-territorially
extending its activities into such states where the minority
establishing and administering the institution does not enjoy
minority status, (iv) the content and contour of minority by
reference to territories, were not answered in Pai Foundation
and were left to be determined by the regular Benches in
individual cases to be heard after the decision in Pai
Foundation. We also do not propose to involve ourselves by
dealing with these questions except to the extent it may become
necessary to do so for the purpose of answering the questions
posed before us.

Pai Foundation explained in Islamic Academy
Pai Foundation Judgment was delivered on 31.10.2002.
The Union of India, various State Governments and the
Educational Institutions, each understood the majority judgment
in its own way. The State Governments embarked upon
enacting laws and framing the regulations, governing the
educational institutions in consonance with their own
understanding of Pai Foundation. This led to litigation in
several Courts. Interim orders passed therein by High Courts
came to be challenged before this Court. At the hearing, again
the parties through their learned counsel tried to interpret the
majority decision in Pai Foundation in different ways as it
suited them. The parties agreed that there were certain
anomalies and doubts, calling for clarification. The persons
seeking such clarifications were unaided professional educational
institutions, both minority and non-minority. The Court
formulated four questions as arising for consideration in view of
the rival submissions made before the Court in Islamic
Academy:

"(1) whether the educational institutions are entitled to fix their
own fee structure;
(2) whether minority and non-minority educational institutions
stand on the same footing and have the same rights;
(3) whether private unaided professional colleges are entitled
to fill in their seats, to the extent of 100% , and if not, to
what extent; and
(4) whether private unaided professional colleges are entitled
to admit students by evolving their own method of
admission."

We could attempt at formulating the gist of the answers
given by the Constitution Bench of the Court as under:

(1) Each minority institution is entitled to have its own fee
structure subject to the condition that there can be no
profiteering and capitation fees cannot be charged. A provision
for reasonable surplus can be made to enable future expansion.
The relevant factors which would go into determining the
reasonability of a fee structure, in the opinion of majority, are:
(i) the infrastructure and facilities available, (ii) the investments
made, (iii) salaries paid to the teachers and staff, (iv) future
plans for expansion and betterment of the institution etc.

S.B. Sinha, J, defined what is 'capitation' and 'profiteering'
and also said that reasonable surplus should ordinarily vary from
6 per cent to 15 per cent for utilization in expansion of the
system and development of education.

(2) In the opinion of the majority, minority institutions stand on
a better footing than non-minority institutions. Minority
educational institutions have a guarantee or assurance to
establish and administer educational institutions of their choice.
State Legislation, primary or delegated, cannot favour non-
minority institution over minority institution. The difference
arises because of Article 30, the protection whereunder is
available to minority educational institutions only. The majority
opinion called it a "special right" given under Article 30.

In the opinion of S.B. Sinha, J, minority educational
institutions do not have a higher right in terms of Article 30(1);
the rights of minorities and non-minorities are equal. What is
conferred by Article 30(1) of the Constitution is "certain
additional protection" with the object of bringing the minorities
on the same platform as that of non-minorities, so that the
minorities are protected by establishing and administering
educational institutions for the benefit of their own community,
whether based on religion or language.

It is clear that as between minority and non-minority
educational institutions, the distinction made by Article 30(1) in
the fundamental rights conferred by Article 19(1)(g) has been
termed by the majority as "special right" while in the opinion of
S.B.Sinha, J, it is not a right but an "additional protection".
What difference it makes, we shall see a little later.

(3)&(4). Questions 3 and 4 have been taken up for
consideration together. A reading of the opinion recorded in
Islamic Academy shows that paras 58, 59 and 68 of Pai
Foundation were considered and sought to be explained. It
was not very clear as to what types of institutions were being
dealt with in the above referred to paragraphs by the majority in
Pai Foundation. Certainly, distinction was being sought to be
drawn between professional colleges and other educational
institutions (both minority and unaided). Reference is also found
to have been made to minority and non-minority institutions. At
some places, observations have been made regarding
institutions divided into groups only by reference to aid, that is
whether they are aided or unaided educational institutions
without regard to the fact whether they were minority or non-
minority institutions. It appears that there are a few
passages/sentences wherein it is not clear which type of
institutions the majority opinion in Pai Foundation was
referring to thereat. However, the majority opinion in Islamic
Academy has by explaining Pai Foundation held as under:

(1) In professional institutions, as they are unaided, there will
be full autonomy in their administration, but the principle
of merit cannot be sacrificed, as excellence in profession is
in national interest.


(2) Without interfering with the autonomy of unaided
institutions, the object of merit based admissions can be
secured by insisting on it as a condition to the grant of
recognition and subject to the recognition of merit, the
management can be given certain discretion in admitting
students.
(3) The management can have quota for admitting students at
its discretion but subject to satisfying the test of merit
based admissions, which can be achieved by allowing
management to pick up students of their own choice from
out of those who have passed the common entrance test
conducted by a centralized mechanism. Such common
entrance test can be conducted by the State or by an
association of similarly placed institutions in the State.


(4) The State can provide for reservation in favour of
financially or socially backward sections of the society.

(5) The prescription for percentage of seats, that is allotment
of different quotas such as management seats, State's
quota, appropriated by the State for allotment to reserved
categories etc., has to be done by the State in accordance
with the "local needs" and the interests/needs of that
minority community in the State, both deserving
paramount consideration. The exact concept of "local
needs" is not clarified. The plea that each minority unaided
educational institution can hold its own admission test was
expressly overruled. The principal consideration which
prevailed with the majority in Islamic Academy for
holding in favour of common entrance test was to avoid
great hardship and incurring of huge cost by the hapless
students in appearing for individual tests of various
colleges.

The majority opinion carved out an exception in favour of
those minority educational professional institutions which were
established and were having their own admission procedure for
at least 25 years from the requirement of joining any common
entrance test, and such institutions were permitted to have their
own admission procedure. The State Governments were
directed to appoint a permanent Committee to ensure that the
tests conducted by the association of colleges is fair and
transparent.

S.B. Sinha, J, in his separate opinion, agreed with the
majority that the merit and merit alone should be the basis of
selection for the candidates. He also agreed that one single
standard for all the institutions was necessary to achieve the
object of selection being made on merit by maintaining
uniformity of standard, which could not be left to any individual
institution in the matter of professional courses of study.
However, the merit criterion in the opinion of Sinha, J, was
required to be associated with the level of education. To quote
his words: "the merit criterion would have to be judged like a
pyramid. At the kindergarten, primary, secondary levels,
minorities may have 100% quota. At this level the merit may
not have much relevance at all but at the level of higher
education and in particular, professional education and
postgraduate-level education, merit indisputably should be a
relevant criterion. At the postgraduation level, where there may
be a few seats, the minority institutions may not have much say
in the matter. Services of doctors, engineers and other
professionals coming out from the institutions of professional
excellence must be made available to the entire country and not
to any particular class or group of people. All citizens including
the minorities have also a fundamental duty in this behalf."

Before we part with the task of summing up the answers
given to the four questions in Islamic Academy, we would like
to make a few observations of ours in this regard. First, the
majority opinion spread over 30 printed pages, and the minority
opinion spread over 60 printed pages, both though illuminating
and instructive, have nonetheless not summed up or pointedly
answered the questions. We have endeavoured to cull out and
summarize the answers, noted above, as best and as briefly as
we could from the two opinions. We would, therefore, hasten to
add that in order to fully appreciate the ratio of the two opinions,
they have to be read in detail and our attempt at finding out and
placing in a few chosen words the ratio decidendi of the two
separately recorded opinions, is subject to this limitation.
However, we shall make a reference to relevant passages from
the two opinions as and when it becomes necessary. A point of
significance which we would like to briefly note here itself, a
detailed discussion being relegated to a later part of this
judgment, is that the opinion of S.B. Sinha, J, has examined in
detail, the scope of protection conferred on minority institutions
by reference to their right to seek recognition or affiliation, an
aspect of wider significance which does not seem to have
received consideration with that emphasis either in Pai
Foundation or in the majority opinion in Islamic Academy.
We shall revert to this aspect a little later.
III
Issues herein

A Few Preliminary observations
Before we embark upon dealing with the issues posed
before us for resolution, we would like to make a few preliminary
observations as a preface to our judgment inasmuch as that
would outline the scope of the controversy with which we are
actually dealing here. At the very outset, we may state that our
task is not to pronounce our own independent opinion on the
several issues which arose for consideration in Pai Foundation.
Even if we are inclined to disagree with any of the findings
amounting to declaration of law by the majority in Pai
Foundation, we cannot; that being a pronouncement by 11-
Judge Bench, we are bound by it. We cannot express a dissent
or disagreement howsoever we may be inclined to do so on any
of the issues. The real task before us is to cull out the ratio
decidendi of Pai Foundation and to examine if the explanation
or clarification given in Islamic Academy runs counter to Pai
Foundation and if so, to what extent. If we find anything said
or held in Islamic Academy in conflict with Pai Foundation,
we shall say so as being a departure from the law laid down by
Pai Foundation and on the principle of binding efficacy of
precedents, over-rule to that extent the opinion of the
Constitution Bench in Islamic Academy.

It is pertinent to note, vide paras 2, 3 and 35 of Islamic
Academy, that most of the petitioners/applicants therein were
unaided professional educational institutions (both minority and
non-minority). The purpose of constituting the Constitution
Bench, as noted at the end of para 1, was "so that
doubts/anomalies, if any, could be clarified." Having answered
the questions, the Constitution Bench treated all interlocutory
applications as regards interim matters as disposed of (see para
23). All the main matters (writ petitions, transfer petitions and
special leave petitions) were directed to be placed before the
regular Benches for disposal on merits.

Islamic Academy in addition to giving clarifications on
Interlocutory Applications, directed setting up of two committees
in each State: one committee "to give effect to the judgment in
Pai Foundation" and to approve the fee structure or to propose
some other fee which can be charged by minority institutions
(vide para 7), and the other committee __ to oversee the tests
to be conducted by the association of institutions (vide para 19).

Since the direction made in Islamic Academy for
appointment of the Committees has been vehemently assailed
during the course of hearing before us, we would extract from
the judgment in Islamic Academy the following two passages
wherein, in the words of Khare, CJ, the purpose and the
constitution of the Committees, the powers conferred on and the
functions enjoined upon them are given:
"..we direct that in order to give effect to
the judgment in T.M.A. Pai case the
respective State Governments/concerned
authority shall set up, in each State, a
committee headed by a retired High Court
Judge who shall be nominated by the Chief
Justice of that State. The other member, who
shall be nominated by the Judge, should be a
Chartered Accountant of repute. A
representative of the Medical Council of India
(in short "MCI") or the All India Council for
Technical Education (in short "AICTE"),
depending on the type of institution, shall also
be a member. The Secretary of the State
Government in charge of Medical Education or
Technical Education, as the case may be,
shall be a member and Secretary of the
Committee. The Committee should be free to
nominate/co-opt another independent person
of repute, so that the total number of
members of the Committee shall not exceed
five. Each educational institute must place
before this Committee, well in advance of the
academic year, its proposed fee structure.
Along with the proposed fee structure all
relevant documents and books of accounts
must also be produced before the Committee
for their scrutiny. The Committee shall then
decide whether the fees proposed by that
institute are justified and are not profiteering
or charging capitation fee. The Committee will
be at liberty to approve the fee structure or to
propose some other fee which can be charged
by the institute. The fee fixed by the
Committee shall be binding for a period of
three years, at the end of which period the
institute would be at liberty to apply for
revision. Once fees are fixed by the
Committee, the institute cannot charge either
directly or indirectly any other amount over
and above the amount fixed as fees. If any
other amount is charged, under any other
head or guise e.g. donations, the same would
amount to charging of capitation fee. The
Governments/appropriate authorities should
consider framing appropriate regulations, if
not already framed, whereunder if it is found
that an institution is charging capitation fees
or profiteering that institution can be
appropriately penalised and also face the
prospect of losing its recognition/affiliation.
(para 7)

We now direct that the respective State
Governments do appoint a permanent
Committee which will ensure that the tests
conducted by the association of colleges is fair
and transparent. For each State a separate
Committee shall be formed. The Committee
would be headed by a retired Judge of the
High Court. The Judge is to be nominated by
the Chief Justice of that State. The other
member, to be nominated by the Judge,
would be a doctor or an engineer of eminence
(depending on whether the institution is
medical or engineering/technical). The
Secretary of the State in charge of Medical or
Technical Education, as the case may be, shall
also be a member and act as the Secretary of
the Committee. The Committee will be free to
nominate/co-opt an independent person of
repute in the field of education as well as one
of the Vice-Chancellors of the University in
that State so that the total number of persons
on the Committee do not exceed five. The
Committee shall have powers to oversee the
tests to be conducted by the association. This
would include the power to call for the
proposed question paper(s), to know the
names of the paper-setters and examiners
and to check the method adopted to ensure
papers are not leaked. The Committee shall
supervise and ensure that the test is
conducted in a fair and transparent manner.
The Committee shall have the powers to
permit an institution, which has been
established and which has been permitted to
adopt its own admission procedure for the
last, at least, 25 years, to adopt its own
admission procedure and if the Committee
feels that the needs of such an institute are
genuine, to admit, students of their
community, in excess of the quota allotted to
them by the State Government. Before
exempting any institute or varying in
percentage of quota fixed by the State, the
State Government must be heard before the
Committee. It is clarified that different
percentage of quota for students to be
admitted by the management in each minority
or non-minority unaided professional
college(s) shall be separately fixed on the
basis of their need by the respective State
Governments and in case of any dispute as
regards fixation of percentage of quota, it will
be open to the management to approach the
Committee. It is also clarified that no
institute, which has not been established and
which has not followed its own admission
procedure for the last, at least, 25 years, shall
be permitted to apply for or be granted
exemption from admitting students in the
manner set out hereinabove. (para 19)"



Sinha, J. has not specifically spoken of the Committees.
Nevertheless he made a reference to these Committees in his
opinion and thus impliedly recorded his concurrence with the
constitution of these Committees.
Vide para 20, the Constitution Bench has made it clear
that the setting up of two sets of Committees in the States has
been directed in exercise of the power conferred on this Court
by Article 142 of the Constitution and such Committees "shall
remain in force till appropriate legislation is enacted by
Parliament". Although the term 'permanent' has been used, but
it appears to us that these Committees are intended to be
transitory in nature.

Reference for constituting a Bench of a coram higher than
Constitution Bench


These matters have been directed to be placed for hearing
before a Bench of seven Judges under Orders of the Chief
Justice of India pursuant to Order dated July 15, 2004 in P.A.
Inamdar and Ors. v. State of Maharashtra and Ors., (2004)
8 SCC 139 and Order dated July 29, 2004 in Pushpagiri
Medical Society v. State of Kerala and Ors., (2004) 8 SCC
135. The aggrieved persons before us are again classifiable in
one class, that is, unaided minority and non-minority institutions
imparting professional education. The issues arising for decision
before us are only three:
(i) the fixation of 'quota' of
admissions/students in respect of unaided
professional institutions;


(ii) the holding of examinations for admissions
to such colleges, that is, who will hold the
entrance tests; and

(iii) the fee structure.

The questions spelled out by Orders of Reference
In the light of the two orders of reference, referred to
hereinabove, we propose to confine our discussion to the
questions set out hereunder which, according to us, arise for
decision:-

(1) To what extent the State can regulate the
admissions made by unaided (minority or non-
minority) educational institutions? Can the
State enforce its policy of reservation and/or
appropriate to itself any quota in admissions to
such institutions?


(2) Whether unaided (minority and non-minority)
educational institutions are free to devise their
own admission procedure or whether direction
made in Islamic Academy for compulsorily
holding entrance test by the State or
association of institutions and to choose
therefrom the students entitled to admission in
such institutions, can be sustained in light of
the law laid down in Pai Foundation?


(3) Whether Islamic Academy could have issued
guidelines in the matter of regulating the fee
payable by the students to the educational
institutions?


(4) Can the admission procedure and fee structure
be regulated or taken over by the Committees
ordered to be constituted by Islamic
Academy?

The issues posed before us are referable to headings 3
and 5 out of 'five headings' formulated by Kirpal, CJ in Pai
Foundation. So also speaking by reference to the 11 questions
framed in Pai Foundation, the questions and answers relevant
for us would be referable to question Nos. 3 (b), 4, 5 (a) (b) (c)
and (9).
IV
Submissions made
A number of learned counsel addressed the Court at the
time of hearing raising very many issues and canvassing
different view-points of law referable to those issues. We
propose to place on record, as briefly as we can, the principal
submissions made confined to the issues arising for decision
before us.


The arguments on behalf of the petitioners were led by
senior counsel Shri Harish Salve. Extensively reading various
relevant paragraphs and observations in different opinions in Pai
Foundation, learned counsel contends that the directions for
setting up permanent committees for regulating admissions and
fixing fee structure in unaided minority and non-minority
institutions issued in the case of Islamic Academy are contrary
to the ratio of judgment in Pai Foundation. According to
learned counsel, the directions clearly run counter to all earlier
Constitution Bench decisions of this Court in St. Stephen's,
St. Xavier's and Kerala Education Bill.

It is argued that in the judgment of the eleven judges in
Pai Foundation which deals with several diverse issues of
considerable complexity, every observation has to be understood
in its context. Paragraph 68 in Pai Foundation has wrongly
been read as the ratio of the judgement by the Bench of five
judges in the case of Islamic Academy. It is submitted that
paragraph 68 in the majority opinion in Pai Foundation has to
be read and understood in the context of the constitutional
interpretation placed on Articles 29 & 30 of the Constitution.
Reading thus, the directions for setting up permanent
committees, for fixing quota and fee structure seriously impinge
on the constitutional guarantee of autonomy to minority
institutions under Article 30 and to unaided non-minority
institutions under Article 19(1)(g). It is submitted that taking
over the right to regulate admission and fee structure of unaided
professional institutions is not a 'reasonable restriction' within
the meaning of Article 19(6) of the Constitution. Such restriction
is virtual negation of the constitutional protection of autonomy to
minorities in running educational institutions 'of their choice' as
provided in Article 30 of the Constitution.

Elaborating his legal propositions, learned senior counsel
Shri Salve argued that establishing and running an educational
institution is a guaranteed fundamental right of 'occupation'
under Article 19(1)(g) of the Constitution. Article 19(6) permits
State to make regulations and place reasonable restrictions in
public interest upon the rights enjoyed by citizens under Article
19(1)(g) of the Constitution. Any imposition of a system of
selection of students for admission would be unreasonable if it
deprives the private unaided institutions of the right of rational
selection which it has devised for itself. Subject to the minimum
qualifications that may be prescribed and to some system of
computing the equivalence between different kinds of
qualifications like a common entrance test, it can evolve a
system of selection involving both written and oral tests based
on principle of fairness. Reference is made to paragraph 40 of
the judgment in Pai Foundation.

It is submitted that the State can prescribe minimum
qualifications and may prescribe systems of computing
equivalence in ascertaining merit; however, the right of rational
selection, which would necessarily involve the right to decide
upon the method by which a particular institution computes such
equivalence, is protected by Article 19 and infringement of this
right constitutes an unreasonable encroachment upon the
constitutionally guaranteed autonomy of such institutions.

It is further argued that where States take over the right
of the institution to grant admission and/or to fix the fees, it
constitutes nationalization of educational institutions. Such
nationalization of education is an unreasonable restriction on the
right conferred under Article 19. Reliance is placed on paragraph
38 of the judgment in Pai Foundation.

Learned counsel further argues that schemes framed
relating to grant of admission and fixing of fees in Unni
Krishnan has been held to be unconstitutional by the 11-Judge
Bench in Pai Foundation. [Reference is made to paragraph 45
of the judgment in Pai Foundation] It is submitted that the
directions to set up committees for regulation of admission and
fee structure in Islamic Academy virtually do the same
exercise as was done in Unni Krishnan and disapproved in the
larger Bench decision in Pai Foundation. The submission in
substance made is that Unni Krishnan was disapproved in Pai
Foundation and has wrongly been re-introduced in Islamic
Academy.

It is argued that State necessity cannot be a ground to
curtail the right of a citizen conferred under Article 19(1)(g) of
the Constitution. The Constitution casts a duty upon the States
to provide educational facilities. The State is obliged to carry out
this duty from revenue raised by the State. The shortfall in the
efforts of the State is met by the private enterprise, that
however, does not entitle the State to nationalize, whether in the
whole or in part, such private enterprise. This, it is submitted, is
the true ratio of the Pai Foundation in so far as Article 19 of
the Constitution is concerned.

It is next argued that as held in St. Xavier's and re-
affirmed in Pai Foundation the right to establish and administer
educational institutions by minorities under Article 30 of the
Constitution is not an absolute right meaning thereby that it is
subject to such regulations that satisfy a dual test that is : the
test of 'reasonableness' and 'any regulation regulating the
educational character of the institutions so that it is conducive to
making the institution an effective vehicle of education for the
minority community and for the others who resort to it'. Any
regulation which impinges upon the minority character of the
institutions is constitutionally impermissible. It is submitted that
between the right of minorities to establish and administer the
educational institutions and the right of the State to regulate
educational activities for maintaining standard of education, a
balance has to be struck. The regulation in relation to
recognition/affiliation operates in the area of standard of
excellence and are unquestionable if they do not seriously curtail
or destroy the right of minorities to administer their educational
institutions. Only in maintaining standards of education, State
can insist by framing regulations that they be followed but in all
other areas the rights of minority must be protected. It is
conceded that mal-administration is not protected by Article 30
of the Constitution. Similarly, secular laws with secular object
that do not directly impinge upon the right of minority
institutions and operate generally upon all citizens do not
impinge upon Article 30 of the Constitution. This has been the
constitutional interpretation of Article 30 not because Article 30
admits no exception like Article 19(6) but because the right
conferred under Article 30 does not extend to these areas. The
laws that serve national interest do not impinge upon Article 30.

Learned counsel in elaborating his argument tried to make
a distinction between the rights of aided institutions and unaided
institutions. Article 29(2) places a limitation on the right of an
aided institution by providing that if State aid is obtained, 'no
citizen shall be denied admission on grounds only of religion,
race, caste, language or any of them'. It is submitted that as a
necessary corollary, no such limitation can be placed while
regulating admission in an unaided minority institution which
may prefer to admit students of minority community. So far as
unaided minority educational institutions are concerned, the
submission made is that government has no right or power,
much less duty, to decide as to which method of selection of
students is to be adopted by minority institutions. The role of the
government is confined to ensuring that there is no mal-
administration in the name of selection of students or in the
fixation of fees. No doubt, the State is under a duty to prevent
mal-administration, that is to control charging of capitation fees
for the seats regardless of merit and commercializing education
resulting in exploitation of students, but to prevent mal-
administration of the above nature or on the ground that there is
likelihood of such mal-administration, the State cannot take over
the administration of the institutions themselves into its own
hands. The likelihood of an abuse of a constitutional right cannot
ever furnish justification for a denial of that right. An
apprehension that a citizen may abuse his liberty does not
provide justification for imposing restraints on the liberty of
citizens. Similarly, the apprehension that the minorities may
abuse their educational rights under Article 30 of the
Constitution cannot constitute a valid basis for the State to take
over those rights.

Learned senior counsel Shri Ashok Desai appearing on
behalf of unaided Karnataka Private Medical Colleges (through its
Association) of both categories of minority and non-minority has
questioned the correctness of the directions in the case of
Islamic Academy for setting up permanent committees for
fixation of quota and determination of fees. According to him, as
held in Pai Foundation, in the name of controlling capitation,
there cannot be indirect nationalization and complete State
control of unaided professional institutes. In the case of Islamic
Academy, the ratio of Pai Foundation that autonomy of
unaided non-minority institutions is an important facet of their
right under Article 19(1)(g) and in case of minority under Article
19(1)(g) read with Article 30 of the Constitution has been
ignored.
On behalf of unaided private professional colleges, learned
counsel further submitted that there are many private
educational institutes which have been set up by people
belonging to a region or a community or a class in order to
promote their own groups. As long as these groups form an
unaided minority institution, they are entitled to have
transparent criteria to admit students belonging to their group.
For instance, scheduled castes and scheduled tribes have started
Ambedkar Medical College; Lingayaths have started KLE Medical
College in Belgaun and people belonging to Vokalliga community
have started Kempegowda Medical College. Similarly, Edava
community in Kerala has started its own colleges. Sugar
cooperatives in Maharashtra have started their own colleges.
Learned counsel also highlighted an instance of a college opened
in Tamil Nadu by State Transport Workers for the education of
their children on the engineering side. He submitted that if the
State is allowed to interfere in the admission procedure in these
private institutions set up with the object of providing
educational facilities to their own group, community or poorer
sections, the very purpose and object of setting up a private
medical college by a group or community for their own people
would be defeated.

According to learned counsel, the State control in unaided
private professional colleges can only be to the extent of
monitoring or overseeing its working so that they do not indulge
in profiteering by charging capitation fees and sacrifice merit.
According to the learned counsel, in the directions contained in
Islamic Academy, the main ratio of Pai Foundation that the
unaided institutions should have autonomy in the matter of
admission and fees structure has been totally forgotten. The
learned counsel raised very serious objections to the manner in
which the various permanent committees set up in several
States on the directions of Islamic Academy are conducting
themselves and forcing their decisions on private institutions.
The proposed fee structure is required to be placed before the
Committee in advance of the academic year by the institute. It is
the Committee which has to decide whether the fees proposed
by the institute are justified and do not amount to profiteering or
charging of capitation fees. The Committee has been given
liberty to approve the fee structure of the institute or to propose
a different fee structure. The fee fixed by the Committee is
binding for a period of three years and at the end of the said
period the institute would be at liberty to apply for revision.
Learned counsel gave in writing certain illustrations of decisions
of the Fee Committee in few unaided colleges in the State of
Karnataka and pointed out that without proper financial
expertise and without studying the relevant documents and
accounts, the Committee determined the fee structure by only
taking into account the affordability of the parents of the
students with no regard whatsoever to the viability of the
institute on the basis of finances so generated. It is argued as to
why private professional institutes should not be allowed to
modernize its facilities and provide better professional education
than government institutes. It is pointed out that in the case of
non-minority unaided M.S. Ramaiaya Medical College, Bangalore,
the Fee Committee initially fixed annual fee at Rs.2.55 lacs for
MBBS course as against the justification shown by the institute
for demanding Rs. 3.90 lacs. The decision of the Fee Committee
led to the filing of writ petition by the institute in the High Court
of Karnataka and agitation and demonstrations by the students'
union. The Committee under the pressure of the student
community reduced the annual fee to Rs.1.6 lacs which was re-
affirmed after the High Court directed that the management of
the unaided college should be heard before reducing the annual
fee.

Thus the learned counsel on behalf of the Karnataka
Private Medical College Association questioned the correctness of
the directions of the Bench in Islamic Academy. It is submitted
that as decided in Pai Foundation by a larger Bench, the
essence of private educational institutions is the autonomy that
the institution must have in its management and administration.
The 'right to establish and administer' particularly comprises the
right a) to admit students and b) to set up reasonable fee
structure. The autonomy of the institution, therefore, predicates
that all seats would be filled by the management and there can
be no reservations or quotas in favour of the State. In Pai
Foundation, the only observations made were that some
colleges may be required to admit a small percentage of
students belonging to weaker sections of the society by granting
them freeships or scholarships. It is conceded that autonomy of
a private educational institution to admit students of its choice
does not mean that there can be no insistence on transparency
in the admission procedure and on merit being the criterion for
admission. It is submitted that autonomy of a private
educational institution could mean that they can, according to
the objects and purposes of their institutions, give preference to
a particular class or group of students like SC/ST in Ambedkar
Medical College, students from backward area in Bijapur college
and transport employees' children in Madras State Corporation
Employees' College or the children of employees of Larson &
Turbo Company in a college established by that company. The
right to charge fees so as to run the college and to generate
sufficient funds for its betterment and growth cannot be
controlled by the State. That would seriously encroach upon the
autonomy of the private unaided institution. It is submitted, by
quoting Dr. S. Radhakrishnan, the then Chairman of the
University Education Commission, that interests of democracy lie
with the resistance of the trend towards governmental
domination of the educational process. In conclusion, learned
counsel representing Association of private unaided colleges in
Karnataka submits that the decision in Islamic Academy and
the directions made therein go far beyond the law laid down by
the larger Bench in Pai Foundation. The Bench in Islamic
Academy virtually reviewed the larger Bench decision in Pai
Foundation in guise of implementation of the said decision and
on the basis of later developments. In Islamic Academy, the
Bench accepted that there could be no rigid fee structure fixed
by the government for private institutions. An institute should
have the freedom to fix its own fee structure for day-to-day
running of the institute and to generate funds for its further
growth. Only capitation and diversion of profits and surplus of
the institute to any other business or enterprise was prohibited.
It is submitted that Islamic Academy contrary to the legal
position explained in Pai Foundation, could not set up in each
State permanent committees headed by retired High Court
Judges with the power to decide on the justification of the fee
proposed by the institute and propose any other fees. It could
also not make the fee fixed by the Committee binding for a
period of three years. Learned counsel submits that once the
college infrastructure and hospital facilities attached to the
medical college have been approved by the Medical Counsel of
India in accordance with its regulations, the total expenses of
college and hospital could be taken into account by the institute
to decide upon its own fee structure. Learned counsel, in
criticizing the directions in Islamic Academy, submitted that
although the scheme formulated in Unni Krishnan has been
expressly overruled in Pai Foundation on the ground that it
virtually nationalized education and resulted in surrendering total
process of selection to the State, the Bench in Islamic
Academy's case, in an attempt to take up preventive measures
to ensure merit and check profiteering in private unaided
professional institutions, cannot re-introduce quota system for
the management and the State and thus infringe upon the
autonomy of the institute. Such an attempt, learned counsel
contends, would be unconstitutional and violative of Article
19(1)(g) of the Constitution in the case of non-minority unaided
institutions and also violative of Article 30 in the case of minority
unaided professional institutions. Learned counsel argued that
constitutionally, as held in Pai Foundation, it is not permissible
for the State to impose a Government quota, its own reservation
policy, a lower scale of fees etc. on a private unaided non-
minority and unaided minority professional institutions, only by
taking into consideration the interests of students. In the State
of Karnataka for the academic year 2004-2005, by illustration, it
is shown that 75% of the intake capacity is the Government
quota in which are included 5% quota for sports, defence and
NCC; 50% quota for Scheduled Castes/Economically backward
classes/Scheduled Tribes/OBC, there is total 55% reservation
quota in 75% of the government quota. The remaining 25%
quota left for the management is also to be taken over by the
Government insisting on admitting students from the select list
prepared on the common entrance test conducted by the State.

Learned senior counsel Shri F. S. Nariman also supported
the submissions made by other counsel on behalf of the unaided
professional institutions and added that the observations of the
Bench in Islamic Academy clearly go far beyond anything said
by eleven judges in Pai Foundation. It is submitted that the
question of quota 50:50 for State and management as referred
to in St. Stephen's was in respect of aided minority educational
institutions and in Pai Foundation, the Bench never suggested
fixation of quota for State and management in case of unaided
professional institutions. Learned senior counsel particularly
pointed out that in Islamic Academy, the observations that
different percentage of quota for students to be admitted by the
management in each minority and non-minority unaided
professional institutions shall be separately fixed on the basis of
their need by the respective State Government, was a totally
new direction, nowhere to be found or supported by any of the
observations in any of the opinions of the 11-Jud