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Judgment Summary — P.S. Asopa, J.

Factual and Procedural Background

The petitioner is an undertrial who has been in judicial custody since 7.6.2003 after arrest in the course of investigation in FIR No. 146/2003, P.S. Vidhyadhar Nagar, Jaipur. He faces multiple criminal cases and allegations under Sections 401, 411, 413 IPC and Sections 5/25(1) and 14/25(2) of the Antiquities and Art Treasures Act. Over time he was examined by jail doctors and doctors of S.M.S. Hospital and diagnosed with ailments including inguinal hernia, hiatus hernia, inflammation of the gallbladder, enlarged prostate and dental problems.

The petitioner earlier filed a writ (SBCWP No. 6894/2003) and this Court directed respondents to obtain assistance of a specialist (or a team of specialists) from a Government hospital (department of Gastroenterology) to visit the petitioner in jail; that writ petition was disposed of on 19.11.2003.

The petitioner later moved an application on 30.11.2006 under Sections 167 and 309 CrPC seeking compliance with the High Court order. The trial Court declined to direct special medical treatment and observed it had no power under those provisions; it suggested the petitioner could approach the High Court. Subsequent examinations (recorded on various dates) continued to identify ailments; jail authorities referred the petitioner to S.M.S. Hospital for treatment, but the petitioner refused surgery there and sought treatment by doctors of his own choice at his own cost via the present writ petition (a mandamus).

Legal Issues Presented

  1. Whether an undertrial prisoner is entitled to be examined and treated by a doctor of his own choice at his own expense while in judicial custody.
  2. How Article 21 of the Constitution applies to undertrial prisoners in the context of specialized medical treatment and what reasonable restrictions (if any) can lawfully be imposed on that right.
  3. Whether the State/jail authorities' offer to permit treatment by a doctor of the petitioner’s choice after court hours and after completion of prosecution witnesses is acceptable in law.

Arguments of the Parties

Petitioner's Arguments

  • The petitioner has a fundamental right under Article 21 of the Constitution to receive treatment by the doctor of his choice at his own expense and not allowing this violates Article 21.
  • The guidelines/documents filed by respondents relating to medical treatment in S.M.S. Hospital are not relevant to justify denial of treatment by a doctor of the petitioner’s choice.
  • Reliance was placed on Supreme Court judgments (Nilabati Behera; D.K. Basu; Bibhuti Nath Jha) to support that Article 21 protections extend to persons in custody.

Respondents' Arguments

  • The respondents did not dispute the petitioner’s illnesses or that medical examinations were carried out and reports were provided to him.
  • The petitioner refused consent for the RIH operation in S.M.S. Hospital. Without his consent an operation cannot be performed.
  • The petitioner's medical needs are being attended to; jail authorities take assistance of specialists; he is being provided medical aid and facilities at S.M.S. Hospital, which is a reputed government referral hospital.
  • The accused’s attendance is necessary during trial proceedings; the State offered that after court hours and after completion of prosecution witnesses the petitioner could obtain treatment of his choice at his own cost.
  • Counsel referred to Rajasthan Prisoners (Attendance in Courts) Rules, 1956 and certain circulars dated 29.6.94 and 9.5.95 concerning admission and treatment, though the Rules of 1956 relate to court attendance rather than medical treatment per se.

Table of Precedents Cited

Precedent Rule or Principle Cited For Application by the Court
Nilabati Behera (SMT) @ Lalita Behera v. State of Orissa, (1993) 2 SCC 746 Holdings that convicts, prisoners and undertrials are not deprived of Article 21 rights except according to procedure established by law; State obligation to ensure no infringement of right to life while in custody (para 31 quoted). The Court relied on para 31 to reiterate that Article 21 applies to persons in custody but subject to reasonable restrictions; this supports the proposition that undertrials retain Article 21 yet cannot be treated identically to free citizens in exercising that right.
D.K. Basu v. State of W.B., (1997) 1 SCC 416 Observations on custodial protection from torture/abuse, the importance of safeguarding affirmed rights, and that a citizen does not shed Article 21 rights upon arrest (paras 9 and 22 quoted). The Court cited D.K. Basu to emphasise that Article 21 rights remain for those in custody but are subject to reasonable restrictions and procedures; used to reject a simplistic acceptance of the State's concession to allow treatment solely after court hours at the accused’s cost.
Bibhuti Nath Jha v. State of Bihar, (2005) 12 SCC 286 A Medical Board recommendation that an accused-appellant be given treatment in a reputed mental hospital (the court noted the medical recommendation and its consequences in the case context). The Court noted this decision in the context of cases where medical boards recommend specialized treatment; the opinion observes the medical board's recommendation in that case and uses it as an illustrative precedent concerning medically recommended treatment for accused persons.

Court's Reasoning and Analysis

The Court proceeded by first accepting the undisputed factual premise that the petitioner requires medical treatment and that government doctors (including specialists from S.M.S. Hospital) had diagnosed specific diseases. It recorded that the petitioner had refused surgery at S.M.S. Hospital and that treatment for his ailments was not otherwise available in S.M.S.

The Court analyzed the legal claims through the lens of Supreme Court authority holding that Article 21 rights apply to convicts and undertrials but are subject to reasonable restrictions and procedures. Nilabati Behera and D.K. Basu were invoked to establish the foundational principle that a person in custody does not lose Article 21 protections but that these protections can lawfully be regulated given the restricted liberty of those in custody.

Applying that principle, the Court emphasized the distinction between a free citizen and an undertrial: undertrials cannot be treated identically with respect to Article 21 because their liberty is curtailed by confinement. The Court therefore rejected the State's conceded arrangement to allow the petitioner to obtain private treatment by his chosen doctor after court hours and after completion of prosecution witnesses, holding that such a concession was inconsistent with the permissible restrictions on undertrial prisoners' exercise of Article 21 rights as laid down by the Supreme Court.

The opinion further considered institutional and practical facts: jail doctors conduct the first examination and then specialist government doctors (such as those of S.M.S. Hospital) are engaged; S.M.S. Hospital is described in the record as a longstanding, reputed referral hospital with nationally and internationally recognised doctors. Given the availability of appropriate treatment at S.M.S. and its status as the principal government referral hospital in Rajasthan, the Court saw no compelling reason why the petitioner should refuse treatment there.

Balancing the petitioner’s claim to a doctor of his choice against the permissible restrictions on undertrials, the Court concluded that the petitioner should be permitted to receive the diagnosed treatment while remaining in judicial custody at S.M.S. Hospital rather than being allowed out for treatment by private doctors of his choice at his own expense.

Holding and Implications

Holding: The writ petition is partly allowed. The petitioner is permitted to be treated in judicial custody at S.M.S. Hospital, Jaipur for the diseases diagnosed by specialist doctors.

The Court further directed the State Government to frame suitable guidelines for medical treatment of undertrial/convict prisoners within a period of three months and ordered that a copy of the order be sent to the Secretary, Home Department, Government of Rajasthan, Jaipur for compliance.

Implications: The direct effect is that the petitioner will receive the diagnosed medical treatment while in judicial custody at S.M.S. Hospital and the State must formulate guidelines for prisoner medical treatment within three months. The opinion applies existing Supreme Court principles regarding Article 21 and undertrials but does not purport to lay down a new, broader precedent beyond applying those principles to the facts; no additional or novel rule was announced beyond the directives above.

    V.N Ghiya v. State Of Rajasthan

    The Judgment of the Court was delivered by

    P.S Asopa, J.:— By this writ petition, the petitioner who is in judicial custody and against whom many trials are going on in many criminal cases, has sought a writ, order or direction in the nature of mandamus directing the respondents to allow the petitioner to obtain specialist treatment of his various diseases as may be medically advised at the hospital and by the doctors of his choice at his own cost.

    2. Briefly stated the relevant facts of the case are that the petitioner was arrested in the course of investigation in FIR No. 146/2003 P.S Vidhyadhar Nagar, Jaipur and has been in custody since 7.6.2003 The allegations against the petitioner relate to the commission of offences under Section 401, 411, 413 IPC and Section 5/25(1) and Section 14/25(2) of the Antiquities and Art Treasurers Act. Apart from the aforesaid case, there are many criminal cases pending against the petitioner before various Courts in the State of Rajasthan. From time to time the petitioner has been examined by the Jail Doctors or the Doctors of the SMS Hospital and he was found to be suffering from various diseases like inguinal hernia, hiatus hernia, inflammation of Gall bladder & enlarged prostrate and dental etc. When the proper treatment was not given, the petitioner filed the writ petition being SBCWP No. 6894/2003 and this Court directed the respondents to take assistance of a specialist from a Government hospital in the department of Gastroentrology or if necessary a team of specialists who can visit the petitioner in Jail and assess about his ailment and his health condition with the above directions the writ petition was disposed of on 19.11.2003

    3. Thereafter the petitioner moved an application on 30.11.2006 before the trial Court under Secs. 167 and 309 Cr. P.C Praying therein that the order of the High Court may be complied with. The trial Court observed that under the aforesaid provisions of law, it has no power to make available special medical treatment to the under trial prisoners. As regards the noncompliance of the order of the High Court, the trial Court observed that petitioner is free to move an application before High Court.

    4. Subsequently, on 16.6.07, on examination, it was found that the petitioner is suffering from enlarged prostate, then again the petitioner was examined on 6.12.2007 and it was found that he also was suffering from inflammation of the gallbladder and hernia. The petitioner was also advised to go for dental checkup. On 24.2.2007, the Additional Sessions Judge (Fast Track) No. 1, Jaipur recorded that he had no right to determine as to the place of the treatment of an under trial prisoner and it is for the jail authorities to decide the matter. It is further stated in the writ petition that the jail authorities were grossly negligent in providing treatment to the petitioner and referred him to the SMS Hospital but the petitioner did not agree for the surgery of Hernia in S.M.S Hospital, Jaipur.

    5. The counsel for the petitioner submits that he has a fundamental right under Article 21 of the Constitution of India to be treated by the doctor of his own choice at his own expenses. Not allowing the petitioner to get himself treated by the doctor of his own choice at his own expenses is violative of Art. 21 of the Constitution of India. The counsel for the petitioner further submits that the guidelines/documents filed by the respondents relating to the medical treatment in SMS Hospital, Jaipur are not relevant.

    6. The counsel for the petitioner in support of above mentioned submissions has placed reliance on the judgments of Supreme Court rendered in Nilabati Behera (SMT) @ Lalita Behera v. State of Orissa and reported in (1993) 2 SCC 746, D.K Basu v. State of W.B reported in (1997) 1 SCC 416 : (1997 (1) RLW (SC) 95) and Bibhuti Nath Jha v. State Of Bihar. reported in (2005) 12 SCC 286.

    7. The above cited case of Nilabati Behera (supra) (1993) 2 SCC 746, relates to death in police custody and the claim of compensation. However in para 31, the Supreme Court has held that even the convicts, prisoners or undertrials cannot be denied the fundamental right of Art. 21 of the Constitution of India except according to the procedure established by law. The Supreme Court further observed that his liberty is in the very nature of things circumscribed by the very fact of his confinement and therefore his interest in the limited liberty left to him is rather precious. Para No. 31 of the said judgment is as follows:

    “31. It is axiomatic that convicts, prisoners or undertrials are not denuded of their fundamental rights under Article 21 and it is only such restrictions, as are permitted by law, which can be imposed on the enjoyment of the fundamental right by such persons. It is an obligation of the State to ensure that there is no infringement of the indefeasible rights of a citizen to life, except in accordance with law, while the citizen is in its custody. The precious right guaranteed by Article 21 of the Constitution of India cannot be denied to convicts, undertrials or other prisoners in custody, except according to procedure established by law. There is a great responsibility on the police or prison authorities to ensure that the citizen in its custody is not deprived of his right to life. His liberty is in the very nature of things circumscribed by the very fact of his confinement and therefore his interest in the limited liberty left to him is rather precious.”

    8. The Judgment rendered in D.K Basu v. State of W.B (1997) 1 SCC 416 (supra) is also in case of death in police custody where the Supreme Court has laid down various guidelines before making arrest and compensation in case of custody violence/death. In para No. 9 of the judgment, the Supreme Court has observed that the protection of an individual from torture and abuse by the police and other law-enforcing officers is a matter of deep concern in a free society. In case of violation of fundamental rights guaranteed under Articles 21 and 22 of the Constitution of India, monetary compensation should be awarded. Para No. 9 of the said judgment is as follows:

    “9. The importance of affirmed rights of every human being need no emphasis and, therefore, to deter breaches thereof becomes a sacred duty of the Court, as the custodian and protector of the fundamental and the basic human rights of the citizens. Custodial violence, including torture and death in the lock-ups, strikes a blow at the rule of law, which demands that the powers of the executive should not only be derived from law but also that the same should be limited by law. Custodial violence is a matter of concern. It is aggravated by the fact that it is committed by persons who are supposed to be the protectors of the citizens. It is committed under the shield of uniform and authority in the four walls of a police station or lockup, the victim being totally helpless. The protection of an individual from torture and abuse by the police and other lawenforcing officers is a matter of deep concern in a free society. These petitions raise important issues concerning police powers, including whether monetary compensation should be awarded for established infringement of the Fundamental Rights guaranteed by Articles 21 and 22 of the Constitution of India. The issues are fundamental.”

    9. The counsel has further placed reliance on last part of para 22 of the said judgment where the Court has observed that does a citizen shed off his fundamental right to life, the moment a policeman arrests him? Can the right to life of a citizen be put in abeyance on his arrest? These questions touch the spinal cord of human rights’ jurisprudence. The answer, indeed, has to be an emphatic “No”. The precious right guaranteed by Article 21 of the Constitution of India cannot be denied to convicts, undertrials, detenus and other prisoners in custody, except according to the procedure established by law by placing such reasonable restrictions as are permitted by law. Last part of para No. 22 is as follows:

    “No civilized nation can permit that to happen. Does a citizen shed off his fundamental right to life, the moment a policeman arrests him? Can the right to life of a citizen be put in abeyance on his arrest? These questions touch the spinal cord of human rights’ jurisprudence. The answer, indeed, has to be an emphatic “No”. The precious right guaranteed by Article 21 of the Constitution of India cannot be denied to convicts, under-trials, detenus and other prisoners in custody, except according to the procedure established by law by placing such reasonable restrictions as are permitted by law.”

    10. In the case of Bibhuti Nath Jha v. State Of Bihar. (2005) 12 SCC 286 (supra), cited by the counsel for the petitioner, the Medical Board recommended that accused-appellant be given treatment in reputed mental hospital in Ranchi, therefore, bail application was not pressed.

    11. The counsel for the respondent in the reply has not disputed the fact of illness of the petitioner and submitted that the medical investigation was carried out and the report was given to the petitioner. The accused has not consented for RIH Operation in SMS Hospital, Jaipur and without consent operation is not possible. Even after his refusal, he is getting best medical aids and facilities. The Jail authorities are also taking assistance of specialists for the treatment of the petitioner. It is further submitted that day to day hearing is going on in the trial as per High Court direction where presence of accused is necessary. The counsel for the respondents further submitted that after Court hours and after completion of the prosecution witnesses the petitioner is free to take medical assistance as per his own choice and at his own cost.

    12. On raising the quarry that “Is there any specific provision in the jail manual for treatment?, the counsel for the respondent has referred to only the Rajasthan Prisoners (Attendance in Courts) Rules, 1956 (hereinafter referred to be as “the Rules of 1956”), when again pointedly asked, whether there was any other specific rule for medical treatment or any guidelines available?, the counsel for the respondent has placed the circulars. The Rules of 1956 cited above, relates to the attendance in Courts and not for medical treatment. However, the counsel for the respondent has placed reliance on some of the circulars dated 29.6.94, and 9.5.95 for adequate treatment and admission of the accused in the hospital.

    13. In view of above, there is no dispute that the petitioner requires treatment for which he was examined by the Government Doctors and the exact disease was detected and the petitioner refused to be treated by the Government Doctors in SMS Hospital, Jaipur. It is also not disputed that treatment of disease with which the petitioner is suffering is not available in SMS Hospital, Jaipur.

    14. The dispute is whether the petitioner is entitled to be examined by the doctor of his own choice at his own expenses. The respondents were and are prepared to allow the petitioner to be treated in SMS Hospital, Jaipur in the judicial custody but the accused has refused for operation of Hernia and filed the present writ petition for treatment from the doctor of his own choice at his own expenses.

    15. In the aforesaid judgments of Supreme Court cited by the counsel for the petitioner, it is clear that reasonable restrictions are permitted in the case of undertrial prisoners and convicts on exercise of their fundamental right of life guaranteed under Article 21 of the Constitution of India. Hence, they cannot be treated at par with the citizens who are outside the jail. The basic difference is of freedom available to undertrial prisoners/convict and the citizen who is outside the jail in exercise of the said fundamental right guaranteed under Article 21 of the Constitution of India. The citizens are entitled for protection of fundamental right guaranteed under Article 21 of the Constitution of India subject to the reasonable restriction by State by taking resort to regulate the same, therefore, the contention/concession made by the counsel for State to allow the petitioner for treatment after Court hours at his own expenses is not accepted, being contrary to the aforesaid restriction in exercise of fundamental right under Article 21 of the Constitution of India by an undertrial prisoners as held by Supreme Court in aforesaid judgments. Nevertheless the right to life under Article 21 of the Constitution of India is subject to the above restriction available to the petitioner even if there is no provision in the jail manual.

    16. From the practice prevailing for medical examination of the prisoners/convicts, the convict/prisoners are to be first examined by the jail doctor and they further act as per the advise of the jail doctor. The petitioner was examined by the jail doctor and further services of specialized Government Doctors of SMS Hospital were taken. The SMS hospital is attached with Medical College since last more than 50 years and the doctors of SMS have earned name and the Awards at National as well as International level as would be evident from the documents submitted by counsel for the respondents. Thus the SMS Hospital is the reputed and biggest Referral Hospital in Rajasthan. The concession made by the counsel for the State that treatment of petitioner by the doctor of his own choice at his own cost after Court hours and after completion of the prosecution witness is not justified on account of availability of proper treatment, therefore, there appears to be no reason for not taking treatment which is available in SMS Hospital.

    17. In view of above, the writ petition is partly allowed and the petitioner is permitted to be treated in judicial custody at SMS Hospital, Jaipur for the disease which has been diagonized by the specialist doctors.

    18. The State Government is directed to frame the suitable guidelines for medical treatment of the undertrial/convict prisoners within a period of three months.

    19. A copy of this order be sent to the Secretary, Home Department, Govt. of Raj., Jaipur for compliance.

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    V.N Ghiya v. State Of Rajasthan
    (Mar 18, 2008)