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Supreme Court of India

PRANAY KUMAR PODDERversusSTATE OF TRIPURA AND OTHERS

Citation
2017 INSC 264
Decided
23 March 2017

Holding

The Supreme Court held that the MCI may not categorically exclude candidates with colour‑vision deficiency without a detailed, expert‑driven assessment and therefore directed the MCI to constitute an expert committee to examine the issue.

Summary

The appellants, two candidates who scored the required marks for MBBS admission, were declared ineligible on the ground of partial colour‑vision deficiency (CVD). They challenged the decision of the Medical Council of India (MCI) and the State of Tripura before the High Court, which dismissed their writ petition, holding that the MCI's guidelines were binding. On appeal, the Supreme Court examined whether the MCI could bar candidates with CVD from medical courses based solely on a General Body resolution and considered the applicability of disability legislation. The Court noted international practice, medical literature, and the provisions of the Persons with Disabilities Act, 1995 and the Rights of Persons with Disabilities Act, 2016, emphasizing non‑discrimination and equality of opportunity. While not definitively deciding the eligibility question, the Court directed the MCI to constitute an expert committee comprising genetics, ophthalmology, psychiatry and medical education specialists to study CVD, suggest appropriate diagnostic tests, prosthetic aids, and recommend suitable areas of medical practice. The committee was to submit its report within three months, and the matter was listed for further hearing.

Issues considered

  • Whether the Medical Council of India can debar candidates suffering from colour‑vision deficiency from admission to MBBS courses based on a General Body resolution.
  • Whether the absence of a specific regulation under the Indian Medical Council Act renders the MCI's guidelines non‑binding.
  • Whether the provisions of the Persons with Disabilities (Equal Opportunities, Protection of Rights and Full Participation) Act, 1995 and the Rights of Persons with Disabilities Act, 2016 apply to candidates with colour‑vision deficiency.

Legislation cited

Subjects

Colour Vision DeficiencyMedical admission eligibilityDisability rightsMedical Council of IndiaExpert committeeEquality and non‑discriminationConstitutional lawPersons with Disabilities Act

Judgment

                       [2017] 2 S.C.R. 797



                 PRANAY KUMAR PODDER                               A
                               v.
              STATE OF TRIPURA AND OTHERS
                 (Civil Appeal No. 4393 of2017)
                       MARCH 23, 2017
                                                                    B
      [DIPAK MISRA AND A. M. KHANWILKAR, JJ.]
       Education/Educational institutions - Admission to medical
college - Students declared ineligible to take admission to MBBS
course on the score that they suffered partial colour blindness -
Question for consideration before this court is whether Medical
Council of India can debar the candidates suffering from CVD to
                                                                     c
undertake medical courses on the basis of decision taken by the
General Body - Thi.s Court directed MedicaL Council of India to
constitute Expert .Committee that shall include the representatives
of the Medical Council of India, experts from genetics,
ophthalmology, psychiatry and medical education - The Committee D
would review the situation and take note of prevalent conditions of
study and practice and suggest changes for adoption in the medical
course keeping in view the international practices - Expert
Committee shall also concentrate on diagnostic test for progress
and review of the disorder and the available prosthetics· aids to
                                                                     E
assist CVD medical practitioner - Thereafter. Committee shall submit
the report before this Court - Matter listed for farther hearing on
I 1'" July 2017 - Persons with Disabilities (Equal Opportunities,
Protection of Rights and Full Participation) Act, 1995 - Rights of
Persons with Disabilities Act, 2016.
                                                                     F
        Union of India v. Devendra Kumar Pand and Ors.
        (2009) 14 SCC 546 : (2009( 11 SCR 1; Union of India
        v. Sanjay Kumar (2004) 6 SCC 708 : [2004) 3 Suppl.
        SCR 463; Kuna/ Singh v. Union cif India (2003) 4 SCC
        524 : [2003) 1 SCR 1059; Justice Sunanda Bhandare
        Foundation v. Union of India and Anr. (2014) 14 SCC          G
        383 : (2014) 4 SCR 113 - distinguished.
      Dr. Kuna/ Kumar v. Union of India and Ors. 101 (2002)
      DLT 471; Rajasthan High Court in Parmesh Pachar v.
      Convener, Central RLW 2003 (4) Raj 2284 - referred
      to.                                                           H
                             797
798            SUPREME COURT REPORTS                           (2017] 2 S.C.R.


A                              Case Law Reference
      101 (2002) DLT 471                referred to               Para8
      RLW 2003 (4) Ra.i 2284            referred to               Para8
      [2009] 11 SCR 1                   distinguished             Para 27
B     [2004] 3 Suppl. SCR 463           distinguished             Para 27
      120031 1 SCR 1059                 distinguished             Para 27
      f2014J 4 SCR 113                  distinguished             Para 28
             CIVIL APPELLATE JURISDICTION: Civil Appeal No. 4393 of
c     2017
            From the Judgment and Order dated 26.08.2015 of the High Court
      ofTripura, Aga1tala in W. P. (C) No. 244 of 2015
                                       WITH

D            C. A. No. 4394 of2017.
            K. V. Vishwanathan (A.C.), Vikas Singh, Sr. Advs., Shoeb
      Alam, Mehul M. Gupta, Abhishek Kaushik, Dhananjay Bhaskar Ray,
      Ravi Raghunath, Siddhant Boxy, Mukunda Rao, K. V. Mohan,
      Chandra Prakash, Rituraj Biswas, Sujaya Bardhan, Gaurav Sharma,
E     Ms.Amandeep Kaur, Prateek Bhatia, Dhawal Mohan, Ms. Vara Gaur,
      Ms. Deepika Kalia, Shivam Singh, Gopal Singh, Ad vs. ·for the appearing
      parties.
             The Judgment of the Court was delivered by
             DIPAK MISRA, J. I. Leave granted.
F
             2. The appellants, after crossing two scores and one, nurtured the
      ambition, which is quite a usual feature to human nature unless the innate
      nature is distracted by Some kind of aberration, to prosecute medical
      education and for the said purpose they appeared in the examination and
      obtained the requisite marks to be selected. At that stage, the old saying
G     "the proposals conceived in mind are not always concretized" or the
      beginning does not achieve the end or for many a reason, as it appears,
      took the principal seat and the two students were declared to be ineligible
      to take admission to MBBS course at the stage of counselling held on
      23'd June, 2015 on the score that they suffered partial colour blindness.
      In such a situation, the appellants being determined and affirmatively
H
   PRANAY KUMAR PODDER v. STATE OF TRIPURA AND                                 799
             OTHERS [DIPAK MISRA, J.]

obstinate not to abandon their pursuit, approached the High Court of           A
Tripura at Agartala in W.P.(C) Nos.244 and 252 of 20i 5 seeking relief
that the declaration of ineligibility by the concerned Committee was
absolutely indefensible and legally impermissive. The submission of the
appellants was built on .the foundation that there were no regulations
framed by the Medical Council oflndia under the Indian Medical Council
                                                                                B
Act, 1956, debarring the likes from admission, for in the absence of a
regulation, neither any instruction nor resolution of the MCI could throttle
the right to appear.
       3. The stand and stance put forth by the appellants was resisted
by the State placing· reliance on the recommendations of the expert
Committee of the Medical Council oflndia. The said recommendations
                                                                                c
are as follows:- ·
       "The expert committee deliberated at length about the importance
       of normal colour vision to pursue various subjects in the curriculum
       of MBBS course. All the experts unanimously thought that the
       presence of normal colour vision was indispensable to acquire the D
       desired competency of a MBBS doctor. The presence of good
       colour vision is also ~ss~ntial to pursue post graduation in various
       disciplines of Medicine and Surgery. Moreover, as the normal
       colour vision is essential all the services mentioned under the
       category 'Technical' which included Indian Police Service, Indian E
       Forest Service, Railway Engineering Service, Indian Railway
       Traffic Service, Posts on Marine establishment, Telegraph
       Engineering Services etc., it is imperative that the doctor who
       conducts the medical exam of these individuals should also have.
       normal colour vision. The main recommendations of the
       Committee were as follows:-                                          F

       The testing of colour vision must be conducted in respect ofall
       the students for admission to MBBS course. The colour defective
       students should not be allowed to pursue the MBBS course as a
       normal colour vision is absolutely necessary for such a study."
                                                                                G
      4. Apart from that, reliance was also placed on the
recommendations dated I 21h October, 2004 ofthe General Body Meeting.
The said recommendations which are relevant are extracted hereunder:-
       " I. Admission of visually handicapped persons for MBBS:
       It is mandatory that the students who are selected to join MBBS          H
800            SUPREME COURT REPORTS                           [2017] 2 S.C.R.



A           course should undergo an eye examination by a qualified
            Ophthalmologist and must be certified to have best corrected visual
            activity of 619 in each eye. In case of one-eyed person, the best
            corrected visual activity should b.e 6/6. The candidate should be
            able to identify the three primary colours.
B           2. The time of onset blindness and continuation of their
            curriculum from thereon:
            Retention of normal vision is an absolute need for undergoing the
            training in medical curriculum unlike in other streams of education
            like Arts and Science. Medicine is a course where perfect vision
c           is the absolute need. The Committee recommends that a candidate
            who becomes visually challenged after having been admitied to
            the course and completed to a reasonable extent his clinical training
            may still be considered fit for assessment and final examination.
            However, if the candidate develops visual challenge before
            acquiring reasonable amount of knowledge and skill in clinical
D           and basic science he/she should be discharged from the course."
            5. The Division Bench of the High Court expressed the view that
      the guidelines issued by the Medical Council of India deserves to be
      given its due weightage by the Court and it should not interfere solely on
      the ground that the Regulations are silent with regard to the denial of
E     admission to an individual suffering from colour blindness. Being of this
      view, it dismissed the writ petition.
            6. When the matter was listed on the previous occasion, having
      regard to the nature of the issue that deserves to be delved into, v,e had
      appointed Mr. K.V. Viswanathan, learned senior counsel, as Amicus
F     Curiae to assist the Court.
            7. We have heard Mr. K.V. Mohan, learned counsel for the
      appellants, Mr. Vikas Singh, learned senior counsel along with Mr. Gaurav
      Sharma, learned counsel for the Medical Council oflndia and Mr. Sltivam
      Singh, learned counsel for the State ofTripura. Mr. Viswanathan, the
G     learned friend of the Court, has assisted the Court from many an angle.
             8. lt is submitted by Mr. Mohan, learned counsel appearing forthe
      appellants that the High Court has fallen into error by coming to hold
      that in the absence of prohibition in the Regulations, the opinion of the
      Committee would be binding. That apart, it is urged by him, final
H
      PRANAY KUMAR PODDER v. STATE OF TRJPURA AND                                801
                OTHERS [DIPAK MISRA, J.]

decision has not yet been taken with regard to the eligibility of candidates A
who suffer from Colour Vision Deficiency (CVD) by the General Body
for the purpose of prosecuting medical courses. Learned counsel would
submit that there is a distinction between visually handicapped person
and a person suffering from colour blindness or CVD, but the Medical
Council of India has treated both of them at par, as a consequence of
which the likes of the appellants have been compelled to face extreme . B
discrimination. To bolster his submission, he has commended us to a
decision of the Delhi High Court in Dr. Ku11a/ Kumar vs. U11ion of
India and Otlters 1 and a judgment of the Rajasthan High Court in
Parmesli Pac/tar vs. Co11ve11er, Central'.
       9. Mr. Vikas Singh, learned senior counsel appearing for the               c
Medical Council oflndia, controverting the submissions of Mr. Mohan,
contended that the Regulations by the Medical Council oflndia may not
be always specific and exhaustive and, therefore, in the absence of any
specific regulation, it can issue instructions/guidelines or frame or indicate
or provide guidance for the purpose of eligibility criteria as regards the        D
candidates who can take admission in the medical courses, for a statutory
Council, in all circumstances, may not be in a position to visualise all
ki11ds of situations. It is his further submission that the General Body
has specified that the candidates should be able to identify three primary
colours and the same would mean that a person who suffers from colour
blindness is within the excluded category. That apart, submits Mr, Singh,         E
the judgments rendered by the Delhi High Court and the High Court of
Rajasthan are prior to the date of resolution passed by the General Body
and, therefore, this Court should not lay"much emphasis on the judgments
of the said High Courts.
                    #
       10. Mr. Shivam Singh, learned counsel appearing for the State of           F
Tripura, echoec\ the submissions of Mr. Vikas Singh, learned senior counsel
for the Medical Council oflndia.
       11. Having noted the submissions of the learned counsel for the
contesting parties, the controversy could have become simpler as the
issue that emerges for consideration is whether the Medical Council of            G
India can debarthe candidates suffering from CVD to.undertake medical
courses on the basis of a decision taken by the General Body, but Mr.
Viswanathan, learned senior counsel appearing as the friend of the Court,
 1
     IOI (2002) DLT 471
 2
     RLW 2003 (4) Raj 2284                                                        H
802             SUPREME COURT REPORTS                              [2017] 2 S.C.R.


A     submits that this Court should travel beyond the narrow boundary of the
      binding effect of the decision or the resolution of the General Body of
      the Medical Council oflndia and perceive the controversy regard being
      had to the international framework, research, practice and prevalence.
      We are disposed to think that the submission advanced by Mr.
      Viswanathan in this regard is absolutely justified and, therefore, we are
B
      impelled to proceed to record the submissions advanced by him.
              12. It is canvassed by Mr. Viswanathan that colour blindness has
      to be understood as CVD and it happens when someone cannot distinguish
      between certain colours, usually between green and red and occasionally
      blue. Emphasizing on the said aspect, he has borrowed certain literature
c     and commented that the identification of a bush that has holly berries on
      it, the observation by a pi lot of the patterns of coloured lights at an airport
      and learning about a person's health by their complexion are all tasks in
      which a person with CVD may fail. Be it noted, the said concept finds
      place in the Article written by J. Anthony B. Spalding.
D
              13. Learned senior counsel, referring to various study material
      available, has referred to Shinobu lshihar, a Professor at Tokyo Imperial
      University who, in the year 1916, had developed a diagnostic method
      which is still the most common test for colour vision deficiency; and that
      test is called Ishihara test. We do not intend to elaborate on the methods
E     of the said test.

            14. Highlighting on the causes and prevalence, an article published
      under the heading "Colour Vision Deficiency" has been brought to our
      notice. We think it appropriate to reproduce the same:-

 F           "a. Color deficiency is usually a hereditary condition linked to the
             'X' Chromosome.
             b. Color vision deficiency can also be acquired-not only as a
             result of diseases or conditions of the retina, optic nerve, or more
             posterior visual pathways in the brain-but also as a result of
             exposure to toxins and certain drugs. Macular degeneration, optic
G
             neuritis, and strokes that affect certain areas of the occipital lobe,
             for example, can affect color perception. Head injuries, systemic
             diseases that damages nerves (e.g., multiple sclerosis), heavy metal
             poisoning, and certain medications (e.g., anti-malarials) also can
             affect color vision adversely.
H
    PRANAY KUMAR PODDER v. STATE OF TRIPURA AND                                         803
              OTHERS [DIPAK MISRA, J.]

       c. Unlike congenital color vision defects, acquired defects often                 A
       affect visual acuity, are asymmetric from eye to eye, and may
       change as the disease changes"'.
       d. Congenital CVD has a prevalence in the general population of
       8% for men and 0.4% for women'.
       e. Men are much more likely to be colorblind than women because                   B
       the genes responsible for the most common, inherited color
       blindness are on the X chromosome. Inherited color blindness
       can be present at birth, begin in childhood, or not appear until the
       adult years'.
       f. CVD prevalence varies from country to country and even race                    c
       to race. Vijayalakshmi et al, reported CVD in Hindu casts and
       religious groups of different parts oflndia. The prevalence reported
       was 2.1 % in 7542 males and 0.2% in 3519 females [9]. Jn Western
       Nepal, in a study on 964 school children ( 10-19 years age group),
       CVD was found in 18 boys with prevalence of3.8%, but none of                      D
       the girls was found affected [12]. In USA, prevalence ofCVD in
       junior medical students was 12.8% [1 O]. A study among medical
       students of Medical colleges, Kolkata, W.B. revealed prevalence
       of 4.8% in males. The prevalence of red-green colour anomaly
       among males was 27.3% and in females, 34.8%. There was
       significantly higher prevalence ofred green anomaly in females6 ."                E

      15. Learned senior counsel has reproduced certain passages
pertaining to ·diagnosis of colour blindness from the article "Colour
Blindness Causes, Risk Factors & Symptoms". They read as under:-
       "3. Diagnosis of Color Blindness
                                                                                         F
       a. Inherited color vision deficiency is usually diagnosed in early
       childhood using simple screening tests. The Hardy-Rand-Ritter
       (H-R-R_and Ishihara Color Plates are used to evaluate the type
       and degree of color deficiency. In these tests, the person is asked
3
  Colour Vision Deficiency- Publication Review by: Stanley J. Swierze\vski, Ill, M.D.    G
4
  Color Vision Deficiency in the medical profession - J Anthony B Splading
5
  Facts About Color Blindness - National Eye Institute of the National Institutes of
  Health, USA                                                                      .
6
  Prevalence of Colour vision Deficiency (CVD) In Medical Students in Kolkata, West
  Bengal Dipa Sabal, Kaushik Saha2 Volume 15. Issue 9 Ver. XII (September) 2016) PP
  0 l-03 "-"·"·.iosriournals.org
                                                                                         H
      804                 SUPREME COURT REPORTS                                  [2017) 2 S.C.R.



      A                to identify the colored shapes or numbers that lie within a jumble
':)                    of dots and vary in color and intensity. The physician detects and
                       categorizes the deficiency based on the person's responses.
                       b. The D-1 5 and the Fransworth-Munsell l 00-hue disk-matching
                       test evaluate the ability to identify gradations of color by placing
      B                discs in order'.
                       c. In a September 2015 Article in the Indian Journal of
                       Opthalmology', it is mentioned that Though many methods for
                       color vision testing are available, there is no consensus on the
                       ideal method, with different countries using different tests. In
      c                India, the Ishihara chaits are the most widely used, with additional
                       use of Edridge-Green lantern in civil services and Martin lantern
                       in armed forces.[l ,2) The Ishihara test is quick and easy and is
                       an excellent screening tool to detect those with red-green CVD.
                       However, it has a limited ability to classify CVD and determine
                       its severity. Organizations that require the correct recognition of
      D                colored signals (principally transport groups such as the Civil
                       Aviation Authority, Railways, Maritime, and Naval and Air force)
                       depend on a standard lantern test which imitates actual_ signal
                       systems simulating the workplace. Lanterns do not specifically
                       screen for color defects. It is surprising that even now, the general
      E                design oflanterns has·not changed very much since their creation
                       in 1891. With the exception of the Farnsworth lantern used in the
                       USA, there are scarce studies on the validation and reliability of
                       lanterns. The panel tests, including the Farnsworth Panel D-15
                       and Farnsworth-Munsell lOO-hue tests, are much more accurate
                       in classifying color deficiency. Farnsworth Panel D-15 Test is
      F                considerably quicker and more convenient test for routine clinical
                       use. Though not very sensitive, its speed and accuracy make it
                       useful. The relative insensitivity can also be an asset in judging
                       the practical significance of mild degrees ofcolor deficiency. For
                       example, individuals who fail the Ishihara plates but pass the D-
      G                15 panel will probably not have color discrimination problems under
                       most circumstances and in mostjobs.[l) Nagels anomaloscopes
                       is considered the gold standard for color vision testing in clinical

            7
                 Supra 3
            11   Tests for Colour Vision Deficiency: Is it time to revise the standards- Nidhi Pandey.
                 A.K. Chandrakar. M.L. Garg: Pt. J.N.M. Medical College, Raipur
      H
     PRANAY KUMAR PODDER v. STATE OF TRIPURA AND                                         805
               OTHERS [DIPAK MISRA, J.]

         research, however, it is an expensive instrument requiring an                    A
         experienced examiner's skills. Color vision is graded into higher
         and lower grade depending on the size of the aperture in the
         Edridge-Green lantern (I .3 mm vs. I 3 mm),[l] with the technical
         services category oflndian civil services, which includes police
         services requiring higher grade of color vision. The United States
                                                                                          B
         police service no longer implements a color vision standard though
         monochromats are barred.['!) Those who fail initial color vision
         screening by pseudoisochromatic plates should be further evaluated
         by anamaloscope or D-15 test to include anomalous trichromats
         who are the most numerous among the CVD persons. In an
         ongoing study, 500 candidates who appeared in the divisional                     c
         medical board were studied. Ishihara chart was used for initial
         screening of all candidates with further use of Edridge-Green
         lantern for candidates found to have CVD and selected for jobs
         requiring high grade of color vision. Sixty candidates (13%) were
         found to have CVD; 39 of those were selected for jobs requiring
                                                                                          D
         accurate cok>r perception. None of the candidates found to have
         CVD on testing by Ishihara chart could pass the lantern test.
         Only 21 candidates found to have CVD were previously aware
         of their deficiency...
         d. The Edridge Green-Lantern Test, 1891 is claimed to simulate
         railway signals and is used in testing engine drivers in Great Britain.          E
         It was used by the U.S. Navy for qualification of midshipmen and
         line officers prior to adoption of the Farnsworth Lantern Test in
         1953 9 •
         e. The Fransworth Lantern Test is the final qualifying test for the
         U.S. Navy, the U.S. Coast Guard Academy, and the U.S. Merchant                   F
         Marine Academy. It also may be used by the U.S. Army for
         qualification of pilots and by the U.S. FAA Aviation Medical
         Examiners. In addition, it is used by some U.S. railroad systems
         and other organizations. 10 "
      16. It is worth noting that Mr. J. Anthony B. Sp lading, in his article,            G
has found that medical professionals and practitioners suffering from

9
    Color Vision Tests~ National Research Council (US) Committee on Vision~ Procedures
   for Testing Color Vision; Report of Working Group 41. Washington (DC) : National
   Academies Press (US); 1981
10
   Supra 9                                                                                H
806                 SUPREME COURT REPORTS                               [2017] 2 S.C.R~


A      CVD have difficulty in detecting' 1:-
                • "Body color changes (pallor, cyanosis,         jaundice)
                • Skin rashes and erythema -
                • Stage I pressure ulcers -
B
                • Blood or bile in urine, faces, sputum, vomit -
                • Malaena - Mouth and throat conditions -
                • Test strips for blood and urine -
C               • Color coded charts, slides, and prints -
                • Color coded medications -
                • Color sensitive monitors"
               17. Learned senior counsel would submit that the Ophthalmologist
       -Association of Australia has issued a publication in 2009 1' which covers
0
      . the following aspects:-
                 "i. No medical course excludes students with abnormal colour
                 vision, with the possible exception of a medical college in Taiwan
                 that is known to have had a policy in 1995 of excluding students if
                 they failed the D-15 test.
E
                 ii. There have been colour vision requirements for meaical courses
                 in Japan but efforts to relax these began in the late 1980s and it
                 seems they have been successful.
                 Iii. The prevalence of abnormal colour vision among medical
F                practitioners is probably the same as it is in the general population.
                 While medical practitioners with abnormal colour vision have
                 reported that they sometimes made errors due to their colour vision
                 deficiency, it is not known how often they occur and how serious
                 they are.

G                iv. The errors that do occur need to be viewed in the context of
                 the fact that medical error is not uncommon and has a variety of
       11
            The Truth About Color Vision in Healthcare - Dr. Terrace L. Waggoner Sr.. O.D,
          Terrace L. Waggoner Jr.
       12 J Anthony B Spalding, Barry L. Cole, Fraz A Mir: Advice for medical students and

            practitioners with colour vision deficiency: a website resource -Clin Exp Optom
H           2010;-93: I: 3941
   PRANAY KUMAR PODDER v. STATE OF TRIPURA AND                                   807
             OTHERS [DIPAK MISRA, J.]

      causes. The right approach to error minimization is to recognise            A
      errors when they occur, identify their cause and find ways to
      avoid their recurrence. This approach should apply to errors that
      may arise because of abnormal colour vision.
      v. Medical practitioners with abnormal colour vision can minimise
      errors by their choice of specialty, by placing reliance on sources         B
      of information that do not depend on colour and making sure they
      have good observation conditions, especially good lighting.
      vi. It was suggested that all medical students who have abnormal
      colour vision should be aware of their deficiency before entering
      a medical course, that they should know its severity and have an
      appreciation of the kind of problems it may cause in their chosen
                                                                                  c
       career."
       18. Relying on the aforesaid literature, it is submitted by the learned
senior counsel that considering that an MBBS student is also authorized
to perform surgeries and the complete diagnosis and prognosis of a
disease.or disorder may sometimes depend upon colour detection, there             D
is requirement for restriction in the field of practice of an individual with
CVD in this country. He has mentioned certain areas where difficulties
may arise. The said areas, according to him, are:-
       "Pathology
       Surgery and Surgical Branches (Ophthalmology, ENT, Gynae,                  E
       Orthopaedics Etc.)
       Skin
       General Medicine etc."
     19. According to the learned senior counsel, there are certain areas         F
where an individual with CVD can effectively practice and they are:-
       "Psychiatry
       Social and Preventive Medicine
       Anatomy                                                                    G
       Physiology
       Pharmacology etc.
       Anaesthetics"
       20. At this juncture, we may refer to the decision of the Delhi            H
808            SUPREME COURT REPORTS                             [2017] 2 S.C.R.


A     High Court in Dr. Kuna/ Kanwr (supra). The learned Single Judge of
      the High Court of Delhi made the following observations:-
            " At the outset, I may notice that there is not hindrance or restriction
            on the petitioner, who is a duly qualified and registered medical
            petitioner to carry out his practice as a general physician. He is
B           authorized to prescribe drugs and treat patients, without acquiring
            any further post graduate qualification. The petitioner has been
            found to be meritorious student. He is found to be eligible for a
            course in M.D. (Pathology), based on his ranking in the
            examination. Based on the report as received from L.L.R.M.
            College, regarding the colour blindness, he had been declined
c           admission to M.D. (Pathology). There appears to be some
            justification for denying admission to the petitioner in Pathology.
            This is because in Pathology the concerned pathologist has to
            examine various colour slides under a microscope. The inability
            to distinguish colours could be a handicap in minute examination
D           of various bacteria and examination of different slides. However,
            this should not prevent the petitioner from pursuing other courses
            or disciplines, where colour blindness may not be a handicap."
            In the said case, the High Court issued a writ of mandamus to
      grant admission to the petitioner therein in the post-graduate course of
E     Psychiatry.
             21. The Division Bench of the High Court of Rajasthan, in the
      case of Parmesli Pachar (supra), referred to eertain literature in the
      field and, eventually, opined thus:-
            "Thus, it is clear that in British, American, Australian and Canadian
F           medical schools, a student suffering from colour blindness is not
            barred from being admitted. In the opinion of Professor Roger
            Robinson, Retired Professor of Paediatrics at Guy's Hospital
            Medical School, London, as expressed in his letter dated 28.6.2002
            (referred to above), denial of admission to a candidate by a medical
            school on the basis ofred-green colour blindness is unacceptable
G
            and discriminatory.
            It is interesting to note that the Medical Council of India has
            recognised medical degrees of various foreign universities even
           ·though they are admitting students with colour vision deficiency
            or colour blindness. The.Second Schedule to the Indian Medical
H
        . PRANAY KUMAR PODDER v. STATE OF TRIPURA AND                                 809
                    OTHERS [DIPAK MISRA, J.]

            Council Act, 1956, reveals that Bachelor of Medicine and Bachelor         A
            of Surgery from University of Bristol, University of Leeds,
            University. of Liverpool, Univer~!ty·_ of London, University of
            Oxford, University of Sheffield, University of Wales, University
            of Edir,iburgh, University of Glasgow, University of Dundee,
            University of New South Wales, University of Melbourne,
                                                                                      B
            Dalhousie University etc., are recognised.
             It is queer logic that while a colour blind student can seek admission
             in the aforesaid foreign universities, he cannot seek admission in
             the home University. In case he qualifies in Bachelor of Medicine
             or Bachelor of Surgery in spite ofhis colour vision deficiency, his
           . qualification will be recognised in India just because he has the
                                                                                       c
             stamp ofa foreign university. The deficiency which is considered
             to be a handicap for the purposes of grant of admission in a home
             university, no longer remains a debarring factor. This hypocritical
             policy has no logic and relevancy.                                ·
            . 22. As advised, at present, we do not intend to either lean in favour
                                                                                      ·o
      of the view of the Delhi High Court or generally accept the perceptior,i
      of the view cifthe High Court ofRajasthan:. .                               .
              23. In the course of deliberation, it is submitted by Mr. Viswanathan

I     -that complete ban on the admission of individuals suffering from CVD
       to the MBBS course would violate confernient of equal opportunities
       and fair treatment. To buttress the said submission, he has drawn immense
                                                                                       E

I
!      inspiration from certain articles from the Convention on the Rights of
    , Persons with Disabilities and Optional Protocol to which India is a
     ,signatory. Article I of the said Convention deals with 'purpose'. It is as
       follows:- ·                                                                ·    F
             ."The purpose of the present Convention is to promote, protect
              and ensure the full and equal enjoyment of all human rights and
              fundamental freedoms by all persons with disabilities, and to
         ·-- promote respect for their inherent dignity.
                 Persons with disabilities include those who have long-term            G
             physical, mental, intellectual or sensory impairments which in
             interaction with various barriers may hinder their full and effective
             participation in society on an.equal basis with others."
            24.Article 3 stipulates 'general principles'. We think it appropriate
      to extract the same:-                          ~                                 H -
810            SUPREME COURT REPORTS                           [20 I 7] 2 S.C.R.
                                             ..
A           "The principles of the present Convention shal I be:
            a. Respect for inherent dignity, individual autonomy including the
            freedom io make one's own choices, and independen~e of persons;
            b. Non-discrimination;
            c. Full and effective participation and inclusion in society;
B
            d. Respect for difference and acceptance of person~ with
            disabiliiies as part of human diversity and humanity;
            e. Equality ofopportunity;
             f. Accessibility;
c            g. Equality between men and women;
            h. Respect for the evolving capacities of children with disabilities
             and respect for the right of children with disabilities to preserve
             their identities."
            25. Article 4 provides for 'general obligations' and Article 9 of the
D     Convention lays the postulate of accessibility. Learned senior counsel
      would emphasize on the concept of accessibility, especially, clause (g)
      of Article 9. That apart, he has drawn our attention to Article 51(c) of
      the Constitution oflndia which is as follows:-
            '.'5 I. Promotion of international peace and security.- The State
             shall endeavour to -             ·                 ·      ·
E
            (c) foster respecffor international law and treaty obligations in
            the dealings oforganised peoples with one another,"
           26. On the basis of the aforesaid, it is urged by the learned senior
    counsel that with the progress of science, expansion of many vistas of
F   knowledge,  inclusive culture having regard to inclusive society and respect
    for differently-abled persons, it is obligatory on the part of the Medical
    Council of India to take a progressive m"easure so that an individual
  - suffering from CVD may not feel like an alien to the concept of equality
    which is the fonjuris of our Constitution.
.G          27, In Unio11 oflt1c/ia vs. Deve1u/ra Kumar Pa11d a11d Otllersu,
      a two-Judge Bench has, after referring to two authorities in U11io11 of
      l11dia vs. Sa11jay Kumar' and Ku11fll Si11gll vs. U11io11 of l11dia1·',

      "(2009) 14 sec 546
      "(200~) 6 sec 10s
      "(2003) 4 sec s24
H
I
I

I,,
              810


              A
                              SUPREME COURT REPORTS
                                                            ..
                                                                              [20 I 7] 2 S.C.R.          r                    :· l
                                                                                                                               ••r.:
                                                                                                                          PRANAYKUMAR PODDER v. STATE OF TRIPURAAND
                                                                                                                                   OTHERS [DIPAK MISRA, J.]
                                                                                                                                                                                                     811

                           "The principles of the present Convention shall be:
I                                                                                                                     expressed doubt whether a person lacking colour perception can claim           A
                          a. Respect for inherent dignity, individual autonomy including the                          to be a person entitled to any benefit under the Act.·
                          freedom io make one's own choices, and independen~e of persons;
                          b. Non-discrimination;                                                                            28. In this regard, a passage from Justice Su11mula Blumdare
                                                                                                                      Fou11datio11 vs. U11io11 ofJ11dia a11d A11otlter" is apt quoting. It reads
              B            c. Full and effective participation and inclusion in society;                              as under:-.                          ·
                          d. Respect for difference and acceptance of person~ with                                           "9. Be that as it may, the beneficial provisions of the 1995 Act         B
                          disabilities as part of human diversity and humanity;
                                                                                                                             cannot be allowed to remain only on paper for years and thereby
                          e. Equality of opportunity;
                                                                                                                             defeating the very purpose of such law and legislative policy. The
                          f. Accessibility;                                                                                  Union, States, Union Territories and all those upon whom obligation
          c              g. Equality between men and women;                                                                  has been cast under the 1995 Act have to effectively implement
                         h. Respect for the evolving capacities of children with disabilities                                it. As a matter of fact, the role of the governments in the matter      c
                         and respect for the right of children with disabilities to preserve                              . -suc.h as this has to be proactive. In the matters of providing relief
                         their identities."                                                                           :      to those who are differently abled, the approach and attitude of
                                                                                                                             the executive must be liberal and relief oriented and not obstructive
                         25. Article 4 provides for 'general obligations' and Article 9 of the                               or lethargic. A little concern for this class who are differently
          D        Convention lays the postulate of accessibility. Learned senior counsel                                    abled can do wonders in their life and help them stand on their
                  would emphasize on the concept of accessibility, especially, clause (g)                                    own and not remain on mercy of others. A welfare State, that             D
                  of Article 9. That apart, he has drawn our attention to Article 51(c) of                                   India is, must accord its best and special attention to a section of
                  the Constitution ofindia which is as follows:-                                                             our society which comprises of differently abled citizens. This is
                        '.'51. Promotion of international peace and security.- The State                                     true equality and effective conferment of equal opportunity.':
          E             shall endeavour to -            · ·             ·      ·
                                                                                                                            29. We are absolutely conscious that the said authorities have
                                                                                                                    been rendered                                                                E
                        (c) foster respect for international law and treaty obligations in                   ~               .     . . in the context of the Persons with Disabilities (Equal
                                                                                                                                                              -

                        the dealings oforganised peoples with one another,"                                         Opportunities, Protection ofRights and Full Participation Act), I995 (for
                                                                                                                    short, 'the 1995 Act') and the said Act has been repealed in 20I 6 and a
                26. On the basis of the aforesaid, it is urged by the learned senior
          counsel that with the progress of science, expansion of many vistas of                                    new Act, i.e~. the Rights .of Persons with Disabilities Act, 2016 (49 of .
      F knowledge, inclusive culture having regard to inclusive society and respect                                 2016) has come into force. The present case, needless to say, does not .
                                                                                                                  . deal with any kind ofre.servation as laid down in the said Act. However, F
         for differently-abled persons, it is obligatory on the part of the Medical
                                                                                                                    it is urged by Mr. Viswanathan, learned Amicus Curiae, that once colour
         Council of India to take a progressive m"easure so that an individual
       - suffering from CVD may not feel like an alien to the concept of equality                  ·!
                                                                                                  _,,,
                                                                                                                    blindness is not considered as a disability under the 1995 Act and also
         which is the (011 juris of our Constitution.                                                               not a disability. under the 20 I 6 Act, the nature and severity of colour
                                                                                                                    blindness and the disciplines they can practise has to be given a re:.'look.
      G               27, In Unio11of111(/ia vs. Deve1U/ra Kumar Pa1U/ and Otllersu,
               a two-Judge Bench has, after referring to two authorities in Unio11 of                                       30. Though we are not deciding the controversy at present, for            G
                                                                                                                      we are inclined to issue certain directions to have a complete picture
               I11dia vs. Sanjay Kumar" and Ku1U1/ Si11gll vs. U11io11 of ltulia 1·',
                                                                                                                      and projection, yet we are disposed to observe that a human being is a
               "(2009) 14 sec 546                                                                   I                 magnificent creation of the Creator and that magnificence should be
               "(2004) 6 sec 708                                                                                      exposed in a humane, magnanimous and ·all-inclusive manner so that all
      H        "<200J) 4 sec 524                                                                    I
                                                                                                                      "(2014) 14 SCC.383 .                                                            H


                                                                                                                 ~.
812              SUPREME COURT.REPORTS•                      -- [2017] 2 S.C.R.


A
                           ..
      tend to feel that they have their deserved space. Total exclusion_ for
      admission to medical courses without any stipulation in which they really
      can practise,"and re1,1der assistance would tantamount to regressive
      thinking. When we conceive of global phenomenon and universal -
      brotherhood, efforts are to be made to be within the said parameters.
      The march of science, apart from our constitutional warrant and values,
D
      commands inclusion and not exclusion. That is the way a believer in
      human rights should think.
             31. In view of the aforesaid submissions, we direct as follows:-
             (!) The Medical Counci I oflndia shall constitute a Committee of
c     experts that shall .include the representatives of the Medical Council of
      India, experts from genetics, ophthalmology, psychiatry and medical
      education, who shall be from outside the members of the MediCal Council
      of India.. At this juncture, we must apprecia~ly state that Mr. Vikas
      Singh, learned senior counsel, has submitted that the Court may say that
      the persons as experts who are to be taken from outside, shall be from_
D     the All India Institute of Medical Sciences (AIIMS), and the Post.Graduate
      Institute of Medical Education and Research,,Chandigarh:_. ·
            (II) The Medical Council of India may also in~ite Mr. K.V.
      Viswanathan along with Mr." M: Shoeb Alam to as'siSt them to take a
      view. De it noted, Mr. Vikas Singh has gladly accepted the suggestion.·
E
            (Ill) The expert Committee shall review" the situation and take
      note of the prevalent conditions of the study and practice arid suggest•
      changes for adoption in the medical course keeping in view the
      international practices. ·

F
             (IV) The expert Committee shall also concentrate on diagnostic
      test for progress and review of the disorder and what are the available
      prosthetics aids to assist CVD medical practitioners and what areas of
      practice could they undertake without difficulty with these aids.
           (V) The Committee shall meet within a period of three weeks and ·
      submit a report to this Court within three months hence.
G
             32. Let the matter be listed for further hearing on 11"' July, 2017.
                                           .            ~           ' '-.... .



      Dcvika Gujral                                            . ,,. Directions issued.

H


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