{"file_name": "2024_10_2187_2226_EN.pdf", "text": "[2024] 10 S.C.R. 2187 : 2024 INSC 836\n\nOm Rathod \nv. \nThe Director General of Health Services & Ors.\n\n(Civil Appeal No. 12110 of 2024)\n\n25 October 2024\n\n[Dr Dhananjaya Y Chandrachud,* CJI, \nJ.B. Pardiwala and Manoj Misra, JJ.]\n\nIssue for Consideration\n\nAppellant had lower limb myopathy, a locomotor disability. He secured \nan all India PwD rank of 84 and a State PwD rank of 4 in NEET UG \nExamination 2024. However, was held ineligible to pursue MBBS \ncourse by the designated Medical Board at AIIMS, Nagpur holding \nthat the appellant was 88% disabled which was higher than the \nmaximum permissible disability fixed by the regulation governing \nadmission in the PWD category for MBBS course. By way of the \nimpugned judgment, High Court held that the certification of the \ndegree of disability was in accordance with prescribed procedures.\n\nHeadnotes†\n\nEducation/Educational Courses – MBBS course – NEET UG \nExamination 2024 – Rights of Persons with Disabilities Act, \n2016 – As per the Guidelines for admission of students with \n‘Specified Disabilities’ under the 2016 Act w.r.t admission \nin MBBS Course, persons having over 80% locomotor \ndisabilities may be admitted to a medical course on a case \nto case basis after assessing their functional competence \nto navigate academic and practical requirements – Vide \nNEET Disability Certificate dtd. 13.08.24, Medical board at \nAIIMS, Nagpur assessed the appellant’s disability to be 88% \nand therefore, held the appellant ineligible to pursue MBBS \ncourse – Writ petition filed by appellant, dismissed by High \nCourt – Challenged – Supreme Court directed re-assessment \nof the appellant by Medical Board at AIIMS, Delhi which \nconcurred with the AIIMS Nagpur Medical Board – However, \nthe Board noted lack of clear guidelines to assess disability \nwith assistive devices in terms of the guidelines – Direction \nfor re-assessment of the appellant for a functional competency \ntest – Appellant was assessed to be eligible for pursuing the \n\n*Author\n\n\f2188 \n\n[2024] 10 S.C.R.\n\nMBBS course with assistive devices – Permitted to participate \nin the ongoing counselling – Appellant sought seat at the \ncollege allocated in the initial rounds of counselling or at any \ncollege in his home State-Maharashtra:\n\nHeld: Appellant was subjected to protracted and mentally exhausting \nassessments that failed to apply the correct standards, leading to \na declaration of ineligibility – Report dtd. 13.08.24 of the Disability \nAssessment Board of AIIMS, Nagpur quashed as it did not apply \nthe statutory and regulatory standards applicable to the assessment \nof a person with disability– Impugned judgment of High Court set \naside – A supernumerary seat be created at the AIIMS, Nagpur and \nallocated to the appellant if he has not already secured a seat at a \ncollege of his choosing – College be given the report dtd.20.10.24 \nwhich makes suggestions as to the accommodations which may be \nextended to the appellant – Judgement to apply in rem. [Paras 32, 59]\n\nDirections by Supreme Court – Admission to persons with \ndisabilities into medical courses – Formulation of guidelines – \nInclusion of persons with disability in the medical profession – \nConstitution of India – Preamble; Articles 21, 19, 14, 15 – \nPreambular virtue of fraternity; Right to life, dignity, freedom, \nequality and non-discrimination:\n\nHeld: National Medical Council to issue fresh guidelines for admitting \npersons with disabilities into medical courses – The committee \nformulating the guidelines must include experts with disability or \npersons who have worked on disability justice – The guidelines \nshall comply with the judgments of this Court and contemporary \nadvancements in disability justice – The Disability Assessment \nBoards shall eschew from a benchmark model to test the functional \ncompetence of medical aspirants with disability  – The second \nrespondent shall issue appropriate guidelines in this regard – The \nDisability Assessment Boards shall include a doctor or health \nprofessional with disability as per the directions of the first respondent \ndated 24 March 2022 – Conduct of the Disability Assessment \nBoards shall be fair, transparent and in compliance with principles \nof the rule of law – Attention must be paid to ensure that candidates \nappearing before the Board do not feel uncomfortable on account \nof physical or attitudinal barriers – Reasonable accommodation is \na gateway right to avail all other fundamental, human and legal \nrights for persons with disabilities – Non-availability of reasonable \naccommodation amounts to discrimination and violates substantive \nequality of persons with disabilities – The inclusion of persons with \ndisability in the medical profession would enhance the quality of \n\nDigital Supreme Court Reports\f[2024] 10 S.C.R. \n\n2189\n\nhealthcare and meet the preambular virtue of fraternity and the \nguarantees in Articles 21, 19, 14 and 15 of the Constitution – \nApplicants to the NEET examination must be informed about the \ncompliance of accessibility norms and provisions of reasonable \naccommodation available at colleges – The respondents shall issue \nappropriate directions to create a database with relevant information \non accessibility and reasonable accommodation – Enabling Units \nat medical colleges shall act as points of contact for persons with \ndisability desirous of accessing clinical accommodations. [Para 60]\n\nRights of Persons with Disabilities Act, 2016 – Shift from \ncharity based to a rights based approach – Scheme of the \nAct – Discussed – Appendix \"H-1\" of the Guidelines regarding \nadmission of students with ‘Specified Disabilities’ under the \nRights of Persons with Disabilities Act, 2016 with respect to \nadmission in MBBS Course – Purposive interpretation of – \nFair assessment of competence – Principle of reasonable \naccommodation – Functional competency test – Purpose \nstated – Constitution of India – Articles 21, 19, 14, 15 – Right \nto life, dignity, freedom, equality and non-discrimination.\n\nDisability Assessment Boards – Role; approach – Stated.\n\nCase Law Cited\n\nOmkar Ramchandra Gond v. Union of India, 2024 SCC OnLine \nSC 2860; Nipun Malhotra v. Sony Pictures [2024] 7 SCR 246  : \n2024 INSC 465; Ravinder Kumar Dhariwal v. Union of India [2021] \n13 SCR 823 : (2023) 2 SCC 209; Vikash Kumar v. UPSC [2021] \n12 SCR 311 : (2021) 5 SCC 370; Avni Prakash v. NTA [2021] \n11 SCR 891  : (2023) 2 SCC 286; A (Mother of X) v. State of \nMaharashtra [2024] 5 SCR 470 : 2024 INSC 371; Bambhaniya \nSagar Vashrambhai v. Union of India WP (C) 856 of 2023; Purswani \nAshutosh v. Union of India (2019) 14 SCC 422; Omkar Gond  v. \nUnion of India (2024) SCC OnLine SC 2401; Vidhi Himmat \nKatariya  v. Union of India [2019] 12 SCR 821  : (2019) 10 SCC \n20; Indra Sawhney v. Union of India [1992] Supp. 2 SCR 454 : \n(1992) Supp. 3 SCC 217; Prathvi Raj Chauhan v. Union of India \n[2020] 2 SCR 727 : (2020) 4 SCC 727 – referred to.\n\nBooks and Periodicals Cited\n\nJudith Heumann & Kristen Joiner (2020). Being Heumann: An \nUnrepentant Memoir of a Disability Rights Activist. Beacon Press : \nBoston, Massachusetts; Singh S, Medical Council of India’s new \n\nOm Rathod v. The Director General of Health Services & Ors.\f2190 \n\n[2024] 10 S.C.R.\n\nguidelines on admission of persons with specified disabilities: Unfair, \ndiscriminatory and unlawful. Indian J Med Ethics. 2019 Jan-Mar; \n4(1) NS: 29-34. DOI: 10.20529/IJME.2018.064; UN. Committee \non the Rights of Persons with Disabilities (22nd sess). CRPD/C/\nIND/CO/1. Concluding observations on the initial report of India : \nCommittee on the Rights of Persons with Disabilities. Geneva : \nUN, 29 Oct. 2019 – referred to.\n\nRights of Persons with Disabilities Act, 2016. \n\nList of Acts\n\nList of Keywords\n\nMBBS course; NEET UG Examination 2024; Medical aspirant; \nDisability; Locomotor disability; Muscular Dystrophy; PwD category; \nPersons with Disability; National Medical Council; Medical Board \nat AIIMS; AIIMS, Nagpur; AIIMS, Delhi; Disability assessments; \nMaximum permissible disability; Guidelines for admission of \nstudents with ‘Specified Disabilities’; Functional competence to \nnavigate academic and practical requirements; NEET Disability \nCertificate; Assistive devices; Ongoing counselling; Disability \nAssessment Board; Doctor or health professional with disability; \nFunctional competency test; Functional disability; Quantified \ndisability; Functional assessment; Disability law in India; Shift \nfrom charity based to a rights based approach; Reasonable \naccommodation; Fundamental rights; Preamble; Justice, liberty \nand equality, fraternity; Disability rights; Convention on Rights of \nPersons with Disability; Eradication of discrimination; Transparency, \nfairness and consistency; Supernumerary seat; Inaccessibility; \nNon-inclusion.\n\nCase Arising From\n\nCIVIL APPELLATE JURISDICTION: Civil Appeal No. 12110 of 2024\n\nFrom the Judgment and Order dated 03.09.2024 of the High Court \nof Judicature at Bombay at Nagpur in WPC No. 4918 of 2024\n\nAppearances for Parties\n\nShadan Farasat, Sr. Adv., Talha Abdul Rahman, M Shaz Khan, \nTaha Bin Tasneem, Sudhanshu Tewari, Rafid Akhter, Faizan Ahmad, \nPrannv Dhawan, Advs. for the Appellant.\n\nDigital Supreme Court Reports\f[2024] 10 S.C.R. \n\n2191\n\nMs. Archana Pathak Dave, A.S.G., Gaurav Sharma, Sr. Adv., \nShashank Bajpai, Ms. Sushma Verma, Karunesh Kumar Shukla, \nGopi Chand, Amrish Kumar, Prateek Bhatia, Dhawal Mohan, \nParanjay Tripathi, Rajesh Raj, Ms. Ankita Dogra, Advs. for the \nRespondents.\n\nJudgment / Order of the Supreme Court\n\nJudgment\n\nDr Dhananjaya Y Chandrachud, CJI\n\nTable of Contents*\n\nA. Background........................................................................\n\nB. Pillar to post: scaling the ramparts of courts and \nhospitals..............................................................................\n\n3\n\n5\n\nC. The maze to inclusion: RPWD Act and guidelines............... 15\n\nD. Principle of fair assessment of competence: reasonable \naccommodation and the functional competence \nmodel................................................................................... 19\n\nE. Building bridges for the nation: principle to practice......... 31\n\nF. Conclusions........................................................................ 42\n\nThe Stage\n\nWe didn’t go up to the stage \nno one asked us, actually \nonly by pointing fingers \nthey showed us our place \nand we sat there; \n‘great’, they exclaimed. \nAnd they went up on the stage \nstarted narrating us our own sorrows \nbut, ‘our sorrows remained ours \nnever became theirs…’\n\n* Ed. Note: Pagination as per the original Judgment.\n\n– Waharu Sonavane1\n\nOm Rathod v. The Director General of Health Services & Ors.\f2192 \n\n[2024] 10 S.C.R.\n\n1. \n\nA. Background\n\nLegal principles and their application often stand at opposite banks \nof the river. The distance between them is manifest before us. The \nappellant has undergone a crash course in navigating the Indian \nlegal system - from statutory prescriptions, regulatory stipulations, \nHigh Court adjudication, regulatory and court ordered disability \nassessments to the race to justice before this Court. Four assessments \nlater - the appellant’s fate now hangs in the balance and this \nCourt is asked to interfere to ensure that the balance does not tilt \nunfavourably and fall into disarray. Vital foundational questions have \nbeen thrown open for debate before this Court. What is expected of \nan Indian medical graduate? Can a person with disability aspire to \nmeet these expectations? Or is their only option to resign their fate \nto a society that places a premium on disabled bodies - every step \nof the way? Academic and practical rigour of the medical profession \nnotwithstanding, should the journey of an Indian to navigate their \nway into the medical profession be this arduous? Is our collective \nobsession with disability too strong to focus on a person’s ability? \nIs our nation ready to benefit from the talent and experiences of \npersons with disabilities? Or should we continue to sacrifice them \nat the altar of technicalities?\n\n2. We answer these questions by rooting them in the web of \nConstitutional law principles, statute, regulatory framework and \nguidelines which are germane for this case. The bone of contention \nbefore us turns on the manner in which the Disability Assessment \nBoards must function while certifying the eligibility of a candidate \nfor the MBBS course. The appellant has lower limb myopathy  - \na locomotor disability. The appellant has been an academic \nsuccess. He secured an A1 grade in his matriculate (Class X) and \nintermediary (Class XII) examination held by the Central Board \nof Secondary Education. He aspires, now, to enter the medical \nprofession. With this resolve, the appellant appeared for the NEET \nUG Examination 2024 on 5 May 2024 under the unreserved/\nEWS-PwD category and secured 601 marks (out of a total marks \nof 720). This placed the appellant at an all India PwD rank of 84 \nand a State PwD rank of 4. Despite having a Disability Certificate \n\n1 \n\nPoem translated from its original version in Marathi – written in the context of the tribal movement being \nco-opted by persons who claim to speak on their behalf while simultaneously othering them.\n\nDigital Supreme Court Reports\f[2024] 10 S.C.R. \n\n2193\n\ndated 24 January 2021 which was to be valid until 2025  – the \nappellant submitted himself to the mandatory assessment to get \nhis eligibility certified by a designated medical board at AIIMS, \nNagpur. Appendix “H-1” of the Guidelines regarding admission of \nstudents with ‘Specified Disabilities’ under the Rights of Persons \nwith Disabilities Act, 2016 with respect to admission in MBBS Course \nprescribes that persons having over eighty percent disability may \nbe admitted to a medical course on a case by case basis after \nassessing their functional competence to navigate academic and \npractical requirements.\n\n3. The medical board at AIIMS, Nagpur comprised of an Associate \nProfessor in Physical Medicine and Rehabilitation; an Assistant \nProfessor of Orthopaedics; and a Professor who was the Chairman \nof the Disability Board at AIIMS, Nagpur. The Board, by a NEET \nDisability Certificate dated 13 August 2024, opined that the appellant \nis 88% disabled and is therefore ineligible to pursue an MBBS/\nDental course. \n\nB. Pillar to post: scaling the ramparts of courts and hospitals\n\n4. Aggrieved by this, the appellant filed a writ petition under Article 226 \nof the Constitution before the Nagpur bench of the High Court of \nJudicature at Bombay, challenging the NEET Disability Certificate \nissued by AIIMS, Nagpur. The High Court by the impugned judgment \ndated 3 September 2024 dismissed the writ petition and held that \nthe certification of the degree of disability was in accordance with \nprescribed procedures. The appellant challenged the impugned \njudgment by a petition for special leave before this Court under \nArticle 136 of the Constitution.\n\n5. On 3 October 2024, this Court directed the appellant to appear \nbefore a medical board at AIIMS, Delhi to reassess him keeping in \nmind the circular issued by the first respondent on 24 March 2022. \nThe circular inter alia made mandatory directions to include a doctor \nor health professional with disability in every Disability Assessment \nBoard. The appellant accordingly reported to AIIMS, Delhi at 11 AM \non 5 October 2024. The five member board submitted its report \ndated 9 October 2024 inter alia finding that there were no changes \nin most disability components despite assistive devices. The report \nalso stated that there are no clear guidelines available to assess \nthe disability with assistive devices. The report states as follows:\n\nOm Rathod v. The Director General of Health Services & Ors.\f2194 \n\n[2024] 10 S.C.R.\n\n“The candidate was re-assessed with the assistive device \n(single hand crutch & motorised scooty). There was minimal \nto no change in most of the components for disability \nevaluation as per the GOI gazette (March 2024) with these \nassistive devices. The possibility of wheelchair usage was \nalso explored which might be required for better efficiency \nin ambulation component in near future. However, there \nare no clear guidelines available to assess the disability \nwith assistive devices as per the Govt. of India gazette \nguideline. Further it is to be noted that safety, efficiency \nand agility of movements are needed to independently use \nthe devices and many times some manual support is also \nrequired which may not be available to the candidate at \nall times and may affect the safety of the candidate and \nthe patients during the skills based training provided in the \nvarious setups in the labs and hospitals during the MBBS \ncourse training. The Board after careful evaluations of \nall possibilities concurs with the opinion of the previous \nmedical board held at AIIMS Nagpur dated 13.08.2024 \nthat the disability is above 80% even with consideration of \nassistive devices and also both upper limbs have significant \ninvolvement and hence the candidate is ineligible to pursue \nMBBS course.”\n\n6. The appellant in his affidavit countering the AIIMS, Delhi report has \nelucidated his experience. He submits that he was made to wait for \nlong hours on each date when he was asked to appear. He was not \ngiven clear directions or information about the steps to follow in his \nassessment. The first stage of the examination was conducted by \nan able bodied doctor from the PMR department who was unduly \nfocused on the medical condition of the appellant. He underwent a \nlarge number of tests including climbing stairs and power assessment. \nWhen the appellant informed the Board that he used (i) a wheelchair, \n(ii) crutches, and (iii) an electric scooter for mobility, he was asked \nwhy he did not bring his wheelchair. To this, the appellant stated that \nbringing a wheelchair was not logistically possible given that he had \ntravelled from his place of residence at Washim in Maharashtra to \nDelhi by air, on short notice. \n\n7. The Board did not ask him any questions which would allow the \nappellant to counter the basis for the Board’s findings. He was \n\nDigital Supreme Court Reports\f[2024] 10 S.C.R. \n\n2195\n\nonly asked (i) if he would be able to undertake his professional \nduties and (ii) if he could conduct his daily activities. He responded \npositively to both and stated that he had already completed his \nsecondary education with the same disability and had managed \nto navigate adequately thus far. Eventually, the AIIMS, Delhi \nreport dated 9 October 2024 fell into the error of being a mere \nbenchmark evaluation report. The report adjudged the disability of \nthe appellant to be 80% - down from 88% which was reported by \nAIIMS, Nagpur on 13 August 2024. While the AIIMS, Nagpur report \ndid not evaluate the appellant with assistive devices to assess his \nfunctional ability, the AIIMS Delhi report did use these devices but \nultimately opined that there were no government guidelines on the \nuse of such devices. \n\n8. By an order dated 18 October 2024, this Court noted the statement \nof AIIMS, Delhi on the lack of clear guidelines and observed that the \nAIIMS report failed to evaluate the (i) extent of functional disability \nof the appellant; and (ii) the extent to which the use of assistive \ndevices would have the potential to bring the functional disability \nwithin the permissible limits in terms of the government notification. \n\n9. Relying on the judgment of this Court in Omkar Ramchandra Gond v. \nUnion of India,2 we requested Dr Satendra Singh of Infinity Ability to \nassist the Court on whether notwithstanding the quantified disability, \nthe appellant can pursue the MBBS degree course. In arriving at \nhis evaluation, Dr Satendra Singh was requested to examine the \nappellant and to have due regard to such assistive devises and \ntheir potential to assist the appellant to fulfil the requirements of the \ndegree course in medicine.\n\n10. The appellant made himself available at the University College of \nMedical Sciences and Guru Teg Bahadur Hospital, University of Delhi \nat 10 AM on 19 October 2024. He was made to undergo functional \nassessment and was asked to demonstrate his competence at the \nMedical Simulation Centre at the Physiology and Pathology central \nlab. Dr Satendra Singh gauged the accommodations necessary for \nthe appellant by interacting with him to understand his limitations \nand barriers. Accordingly, the following premises were established \nin assessing the appellant:\n\n2 \n\n2024 SCC OnLine SC 2860.\n\nOm Rathod v. The Director General of Health Services & Ors.\f2196 \n\n[2024] 10 S.C.R.\n\n“Disability: Limb Girdle Muscular Dystrophy (mobility-\nrelated physical disability)\n\nPotential Functional limitations: Inability to stand for long \nhours; difficulty in standing suddenly from sitting position\n\nPotential Barriers to learning: Lack of accessible spaces\n\nWhat is being assessed: Cognitive, psychomotor and \naffective skills and ability to arrive at a diagnosis using \npatient history and examination in line with NMC’s five \nroles of an Indian Medical Graduate in CBME\n\nAppropriate and reasonable accommodation: Given \nthe tight space of clinical environments, smaller/compact \nscooters are a good choice which Om is already using. This \nwill allow him to continue with the pace and demands of \na busy ward/OPD/OT independently and is much superior \nthan a manual wheelchair which is often dependent on \nhuman assistance.”\n\n11. Dr Satendra Singh submitted his report on 20 October 2024. \nThis Court duly furnished the report to the second respondent, \nNational Medical Council, on 21 October 2024 to enable them to \nformulate their response. The report by Dr Satendra Singh outlined \nthe functional disability of the appellant to be an inability to stand \nindependently which may prove limiting in clinical rotations in \nsurgical settings. The report suggested solutions to enable the \nappellant in such cases. The report further suggested clinical \naccommodations for the appellant to reduce the barriers he may \nencounter. The report determined the accommodations necessary \nfor the appellant to be reasonable and in compliance with existing \nnorms. The report formulated four questions and answered them \nas follows:\n\n\"a) Would the proposed accommodation result in a failure \nto meet the NMC CBME’s inherent requirements? \nNot in my opinion\n\nb) Would the accommodation legitimately jeopardize \n\npatient safety? Not in my opinion\n\nc) Would the proposed accommodation result in the \nimproper waiver of a core requirement of the CBME? \nNot in my opinion\n\nDigital Supreme Court Reports\f[2024] 10 S.C.R. \n\n2197\n\nd) Would the proposed accommodation pose an undue \nhardship on the medical college (budgets wise)? Not \nin my opinion”\n\n12. \n\nIn stark contrast to the approach of the two AIIMS reports, when Dr \nSatendra Singh assessed the appellant on the request of this Court, \nhe carried out a functional assessment. The process to determine \nthe clinical accommodation for the appellant involved having a \nfrank conversation with him about the barriers he faces - physical, \neducational and attitudinal. The approach adopted was not whether \nthe appellant would succeed in a medical college but was rather \nto ensure that the appellant has equal opportunity and can start at \nthe same level playing field as his classmates. After determining \nthe accommodations needed by the appellant through an interview \nprocess, some questions were posed to him. These questions were \nas follows:\n\n\"i. How does muscular dystrophy impact you in daily life?\n\nii. How have you mitigated this impact in an educational \n\nsetting (Class X,XII)?\n\niii. What, if anything, exacerbates or worsens your \n\ndisability?\n\niv. Do you anticipate needing to receive treatment such \nthat you may need to “step out” of the curriculum \nat some point to attend to disability-related needs?\n\nv. Have you ever seen a clinical setting, or do you \nanticipate additional barriers during the clinical \nportion of your MBBS? (prompted with example \ncompetencies)\n\nvi. Have you reviewed the MBBS curriculum? If not, we \ncan do this together to identify any potential barriers.\n\nvii. Have you ever used assistive technology to mitigate \n\nthe impact of your disability?\n\nviii. Are you aware of adaptive equipment used to navigate \n\nthe clinical environment.\n\nix. What are your biggest concerns about entering the \n\nMBBS program?\n\nOm Rathod v. The Director General of Health Services & Ors.\f2198 \n\n[2024] 10 S.C.R.\n\nx. What is your understanding of reasonable \naccommodation which you repeatedly mentioned in \nyour affidavit.” \n\n13. Based on the preliminary conversation, the report noted that the \nappellant is concerned about the differential treatment which was \nmeted out to him by previous Disability Assessment Boards despite \nhim having successfully navigated with the disability for his entire \nlife. The appellant was surprised that he was being doubted and his \naccomplishments questioned without being afforded an opportunity \nwith simulation labs and reasonable accommodations. \n\n14. The appellant was then made to undergo a functional assessment \nwhich included being given various instruments which he would be \nrequired to use in his course and profession. The nature of the tasks \ngiven to the appellant shows that they were done in progression, with \nbasic instruments being given first, followed by the use of assistive \ndevices to examine his abilities and then being tested in other, more \ncomplex tasks. The report states as follows:\n\n“1.4 Functional assessment: Om was first shown how to \nrecord blood pressure using a mercury sphygmomanometer, \nhow to elicit reflexes, and how to use a tuning fork to check \nfor deafness. He was then asked to demonstrate these \nskills, which he successfully did, showing his eagerness \nto learn after just one demonstration. Next, he was given \na foldable crutch to test whether it could assist him in \nstanding from a seated position, but I observed that he \nhas developed his own coping mechanisms to navigate \nphysical barriers. This is often an innovative strategy used \nby people with disabilities in environments that are not \nfully accessible.\n\nHe was then taken to the laboratory and asked to \nreach examination tables of three different heights. He \nwas able to access two of them, demonstrating that an \nadjustable examination table would be a suitable clinical \naccommodation for him.\n\nAfterward, he was taken to our Medical Simulation Centre, \nwhere he was shown how to perform Cardiopulmonary \nResuscitation (CPR) in a simulated real-life scenario \n\nDigital Supreme Court Reports\f[2024] 10 S.C.R. \n\n2199\n\nof a person lying on the floor after a heart attack. After \nthe demonstration, Om sat down on the floor to perform \nCPR. Considering it was his first experience in such \na lab (his previous two assessments did not involve \nsimulation), and to make the situation less intimidating, \nhe was first guided on a baby mannequin, which he \nsuccessfully managed. He also succeeded in giving an \nintravenous and intramuscular deltoid injection, as well \nas inserting a cannula after a demonstration. Please find \nsome pictures below.\n\nFor Om, who uses a mobility scooter, the functional \nlimitation lies in his inability to stand independently. This \nmay pose a challenge during clinical rotations in surgical \nsettings, where he would need to be at standing height to \nobserve procedures. Potential solutions could include using \na standing or hydraulic wheelchair, providing remote visual \naccess to the surgery via a monitor, or arranging for all \nparties to sit during minor surgeries. These accommodations \ncan help mitigate barriers without imposing undue burden \nThe disability access appointee or Coordinator of the \nEnabling Unit or Equal Opportunity Cell (as mandated \nby the UGC) at Om’s future medical college should \ninteract with him to propose these accommodations on \nan individual basis before the preclinical, paraclinical, and \nclinical rotations begin.”\n\n15. The report thereafter gave detailed (but not exhaustive) suggestions \nfor clinical accommodations for the appellant during his course - for \neach of the years of his education and the mandatory internship. The \nreport finally outlined the overall assessment of the appellant and \ndeclared him to be suitable, with appropriate clinical accommodations, \nto pursue MBBS. The section of the report on overall assessment \nreads as follows:\n\n“4. Overall assessment\n\n4.1 Throughout the assessment, Om’s diagnosed muscular \ndystrophy has not interfered with his learning or self-care. \nHe quickly adapted to new situations and found interesting \nand unique ways to complete tasks in unfamiliar settings. \nFor example, while initially unfamiliar with the full extent of \n\nOm Rathod v. The Director General of Health Services & Ors.\f2200 \n\n[2024] 10 S.C.R.\n\nthe physical skills required in the MBBS program during the \nsimulation lab experience, Om expressed confidence that \nthese barriers could be easily mitigated using his existing \ncompensatory skills and creative approaches to procedures.\n\nAs an 18-year-old who flew on an airplane for the first \ntime while traveling for reassessment in Delhi, Om showed \nremarkable zeal and passion for becoming a doctor and \nis suitable with appropriate clinical accommodations \nto pursue MBBS.\n\nOm should be given opportunities to demonstrate how he \ncan successfully navigate clinical environments. Students \nwith disabilities should be “Welcomed and Valued,” as \ndemonstrated by the General Medical Council UK’s \nguidelines on reasonable accommodation (GMC, UK). The \nNMC should consider implementing similar regulations \nto guide faculty and minimize attitudinal barriers rooted \nin the medical model of disability. In the post-RPDA \n(Rights of Persons with Disabilities Act) era, with the \nadvent of technology, we must welcome and recognize \nthe competence of students with disabilities.\n\n4.2 Progressive Disability – Is It a Concern?\n\nSuch concerns fall into the realm of ableism. It is “a system \nof assigning value to people’s bodies and minds based \non societally constructed ideas of normalcy, productivity, \ndesirability, intelligence, excellence, and fitness. These \nconstructed ideas are deeply rooted in eugenics, anti-\nBlackness, misogyny, colonialism, imperialism, and \ncapitalism. This systemic oppression that leads to people \nand society determining people’s value based on their \nculture, age, language, appearance, religion, birth or living \nplace, “health/wellness”, and/or their ability to satisfactorily \nre/produce, “excel” and “behave.” You do not have to be \ndisabled to experience ableism” (Lewis, 2022). \n\nIn Iyer Seetharaman Venugopalan vs. Union of \nIndia, the Bombay High Court initially denied an MD in \nPsychiatry to a blind doctor who had retinitis pigmentosa \nand progressively lost his vision. However, thanks to the \nintervention of the Supreme Court under Hon’ble CJI, \n\nDigital Supreme Court Reports\f[2024] 10 S.C.R. \n\n2201\n\nhe was allowed to pursue Psychiatry and is now in his \nfinal year, doing successfully. Similarly, Dr. Sharad Philip, \nwho also experienced progressive vision loss, successfully \ncompleted his MD in Psychiatry from NIMHANS Bangalore \nand is now a faculty member at AIIMS Guwahati.\n\nOm can similarly choose to either remain a general \nMBBS doctor or pursue a specialty that is less physically \ndemanding. Only he is best placed to take this decision \nafter completing MBBS. We should not restrict a bright \nstudent on the basis of assumptions and ableist \nbeliefs.”\n\n16. Accordingly, the appellant was assessed to be eligible for pursuing \nthe MBBS course with assistive devices. The second respondent \nhas fairly accepted the eligibility of the appellant and has only joined \nissue with the fact that the assessment of candidate by a doctor \nmust comply with the rules formulated under the statutory framework. \nThese rules require the assessing doctor to be a domain expert in \ndisabilities. In the present case this Court requested Dr Satendra \nSingh to assess the appellant which shall not be a precedent. To \nthat extent the submission of the second respondent is accepted. \nWe may note that this Court was constrained to order a functional \ncompetency test due to the failure of the previous two Boards to \napply the legally permissible standard. The appellant shall not be \nmade to undergo any further assessments as part of his admission \nto the MBBS course. On 25 October 2024 this Court granted leave \nand directed that the appellant be permitted to participate in the \nongoing counselling process arising out of NEET UG 2024. \n\n17. Unfortunately, this run hardly obviates further labour. The appellant \nfinds himself re-entering the NEET counselling process after a lapse of \nvaluable time. He was allocated a seat at the Dr Shankarrao Chavan \nGovernment Medical College, Nanded in the first and second rounds \nof All India Level counselling. Now, stray vacancies for the category \nof persons with disabilities at the All India Level are available in only \nnine colleges, none of which are in the home State of the appellant – \nMaharashtra. The appellant submits that none of the nine colleges \nare compliant with accessibility norms and adequate support systems \nnecessary for him to enjoy a level playing field. The appellant now \nprays that this Court create a seat for him at the college which he \nwas allocated in the initial rounds of counselling or for that matter at \n\nOm Rathod v. The Director General of Health Services & Ors.\f2202 \n\n[2024] 10 S.C.R.\n\nany college in Maharashtra. The run of the appellant from Washim \nto Nagpur and Delhi accompanied by several assessments now \nstands the chance of being fruitless. The appellant prays that this \nCourt exercises its power to do complete justice under Article 142 of \nthe Constitution. Additionally, the appellant prays that this Court may \nissue directives on the manner in which the grievances of exclusion \nof disabled candidates is to be considered inter alia by courts. \n\nC. The maze to inclusion: RPWD Act and guidelines\n\n18. Section 323 of the Rights of Persons with Disabilities Act 20164 \nstipulates that all Government and Government aided institutions of \nhigher learning shall reserve not less than five percent of seats for \npersons with benchmark disability. The enactment of the RPWD Act \nin 2016 marked a paradigm shift in disability law in India from charity \nbased to a rights based approach. Accordingly, the erstwhile Medical \nCouncil of India5 formulated guidelines on admission of persons \nwith specific disability in MBBS courses. The Government of India \napproved the proposal of the committee on 28 January 2019 and \nissued a notification in the gazette on 5 February 2019. \n\n19. The report stipulated the guidelines in Appendix “H” which laid down \nsix categories of locomotor disabilities including muscular dystrophy. \nAll persons with a locomotor disability above eighty percent were \nrendered ineligible for medical courses. Appendix “H” was substituted \nby Appendix “H-1” on 13 May 2019. The amendment allowed \npersons with more than eighty percent locomotor disabilities to \npursue medical courses on a case to case basis. The new appendix \nstates as follows:\n\n“Persons with more than 80% disability may also be allowed \non case to case basis and their functional competency \nwill be determined with the aid of assistive devices, \nif it is being used, to see if it is brought below 80% and \n\n3 \n\n4 \n\n5 \n\n“32. Reservation in higher educational institutions.—(1) All Government institutions of higher\neducation and other higher education institutions receiving aid from the Government shall reserve not \nless than five per cent. seats for persons with benchmark disabilities.\n(2) The persons with benchmark disabilities shall be given an upper age relaxation of five years for\nadmission in institutions of higher education.”\n\n“RPWD Act”\n\n“MCI”\n\nDigital Supreme Court Reports\f[2024] 10 S.C.R. \n\n2203\n\nwhether they possess sufficient motor ability as required \nto pursue and complete the course satisfactorily.”\n\n(emphasis supplied)\n\n20. The amended guidelines brought about a welcome change by \neschewing from a purely benchmark model to a functional ability \nmodel. For candidates with more than eighty percent locomotor \ndisability, the guidelines allow their functional competency to be \ndetermined using assistive devices to see if it can be brought below \n80%. The second respondent has submitted that a new committee \nwill be constituted to recommend new guidelines for admission of \npersons with disabilities into medical courses. \n\n21. The report of the MCI (the erstwhile version of the second respondent) \nwhich was the basis of the existing guidelines evidently found itself \nworking in the remnants of the pre-RPWD Act legal regime. Besides \nmaking archaic observations requiring persons with disabilities to \n‘introspect and assess themselves whether they are likely to meet \nMCI standards and outcomes’ the guidelines also noted the definition \nof reasonable accommodation in Section 2(y)6 of the RPWD Act. The \nreference was only to further state that the standard of competence \ncannot be lowered in the name of accommodation. The observations, \nmade without specific context on the standard or the accommodation \nin question, states as follows:\n\n“MCI is aware of this provision and respects it. However, \nMCI cannot agree to enforce reasonable accommodation \nthat would alter or lower the standard of competence – \nwhich exists to protect patients – that is required. Such \nan accommodation, if granted would be ‘unreasonable’, \nand not reasonable. Moreover, in some cases, even with \nreasonable accommodation, it may not be possible for \nevery disabled medical student to successfully and safely \nundertake all stages of medical education and training ”\n\n22. From promoting self-rejection of disabled medical aspirants to \nassuming that their accommodations would lower the standard of \n\n6 \n\n“(y) “reasonable accommodation” means necessary and appropriate modification and adjustments,\nwithout imposing a disproportionate or undue burden in a particular case, to ensure to persons with\ndisabilities the enjoyment or exercise of rights equally with others;”\n\nOm Rathod v. The Director General of Health Services & Ors.\f2204 \n\n[2024] 10 S.C.R.\n\ncompetence and would regardless be fruitless – the guidelines have \ncharted their way into disrepute. Vitally, the resistance to alter the \nstandard in a framework that has historically effaced a marginalised \ngroup – namely disabled persons other than in the capacity of a \npatient – is antithetical to any rights based approach to disability law. \nMany other issues of critical importance arise from these guidelines \nwhich are not germane to evaluate the case before us but may be \nopen for an appropriate proceeding.7 The current guidelines allow \npersons with more than eight percent locomotor disability to be \nadmitted to MBBS course on a case by case basis after a functional \ncompetency to see whether their disability can be ‘brought below \n80%.’ Before proceeding to analyse this guideline, it is essential that \nwe clarify the phrase ‘brought below 80%’. \n\n23. The intention of the guideline in using the term ‘brought below 80%’ \nis ostensibly to mean that the functional assessment shall evaluate \nif the person with disability can perform the tasks which they are \nexpected to perform as a student and a practitioner. The assumption \nin using the phrase ‘below 80%’ defeats the purpose of the guideline \nwhich is to allow candidates into the MBBS course on a case by case \nbasis. Bodies are not biological parts put together – each to serve a \npre-determined role. They are alive – with thoughts, feelings, dreams \nand aspirations. All bodies – abled and disabled – are guaranteed \ndignity under the Constitution. A person with disability has to navigate \nthe rigours of a society which was modelled on the premise of their \nabsence. The disability of a person is a reflection on the inaccessibility \nof the society and not a comment upon the individual. A person does \nnot overcome disability but learns to navigate life with it. Disability \nis not a thing to be overcome or brought down, but an attribute to \nbe acknowledged and accommodated. The use of the term ‘brought \nbelow 80%,’ as well intentioned as it may be, fails at this foundational \npremise. One cannot assume that all persons with more than 80% \nlocomotor disability are incompetent to pursue medicine when their \nfunctional abilities have not been assessed. The medical model of \ndisability apparent in the phrase must give way to a social model of \ndisability which takes into account the variety of experiences and \n\n7 \n\nSee Singh S, Medical Council of India’s new guidelines on admission of persons with specified \ndisabilities: Unfair, discriminatory and unlawful. Indian J Med Ethics. 2019 Jan-Mar; 4(1) NS: 29-34. DOI: \n10.20529/IJME.2018.064.\n\nDigital Supreme Court Reports\f[2024] 10 S.C.R. \n\n2205\n\n24. \n\noutcomes which persons with disabilities have when they interact \nwith different kinds of societies and accommodations.\n\nIn Nipun Malhotra v. Sony Pictures,8 this Court opined that words \ncultivate institutional discrimination and that the language of our \ndiscourse ought to be inclusive rather than alienating. When it comes \nto rights – language matters. Words may not always adequately reflect \nthe intention of the drafter. Some words may be used unwittingly, \nwithout knowledge of their harmful consequences. Nevertheless, \nthese words influence the thinking of others who hear them. Words \nare the tools one deploys to formulate thoughts. An expansive \nvocabulary allows people to think and articulate their thoughts better. \nWhen we use appropriate and sensitive language, we aspire for the \nquality of our thought to be broadened and evolve towards being \nemancipatory and inclusive. \n\nD. Principle of fair assessment of competence: reasonable \naccommodation and the functional competence model\n\n25. The guidelines (Appendix “H-1”) stipulate that the functional \ncompetence of an aspirant with a locomotor disability above eighty \npercent may be assessed with the help of assistive devices. A \npurposive interpretation of this guideline requires us to interpret it \nin light of the legislative intent of the governing statute, namely, the \nRPWD Act. The RPWD Act is a watershed legislation for disability \nrights in India. It honours India’s commitment at the international \nlevel under the Convention on Rights of Persons with Disability. The \npreamble to the RPWD Act states that:\n\n“…AND WHEREAS the aforesaid Convention lays down \nthe following principles for the empowerment of persons \nwith disabilities,– \n\n(a) \n\nrespect for inherent dignity, individual autonomy \nincluding the freedom to make one’s own choices, \nand independence of persons;\n\n(b) non-discrimination;\n\n(c) \n\nfull and effective participation and inclusion in society;\n\n8 \n\n[2024] 7 SCR 246 : 2024 INSC 465, para 74.\n\nOm Rathod v. The Director General of Health Services & Ors.\f2206 \n\n[2024] 10 S.C.R.\n\n(d) \n\nrespect for difference and acceptance of persons with \ndisabilities as part of human diversity and humanity;\n\n(e) equality of opportunity;\n\n(f) accessibility;\n\n(g) equality between men and women;\n\n(h) \n\nrespect for the evolving capacities of children with \ndisabilities and respect for the right of children with \ndisabilities to preserve their identities;...”\n\n26. The Act harmonises the Constitutional promise of full citizenship \nwith action - by creating a framework in which persons with \ndisabilities may translate their rights into remedies. To establish \na bed of rights, Section 2 of the Act defines and acknowledges \nbarriers,9 discrimination,10 inclusive education11 and reasonable \naccommodation.12 Section 3 of the Act affords the right to equality \nand non-discrimination for persons with disabilities. The requirement \nof assessing the functional competence of a medical aspirant with \nover eighty percent locomotor disability recognises that assessment \nmust be done on a case to case basis. The method of assessment \nby designated Disability Assessment Boards must therefore reflect \nthe approach and intent of the legal framework within which the \nBoards operate. An assessment for functional competency entails an \nanalysis of the skill set which a person with disability must learn in \norder to compete and pursue the medical course. This is a marked \ndifference from requiring a specific manner which a candidate must \nuse to achieve the outcome. For example, a functional competency \nmodel would require a candidate to effectively communicate with \n\n9 \n\n10 \n\n11 \n\n12 \n\n“(c) “barrier” means any factor including communicational, cultural, economic, environmental, institutional, \npolitical, social, attitudinal or structural factors which hampers the full and effective participation of \npersons with disabilities in society;”\n\n“(h) “discrimination” in relation to disability, means any distinction, exclusion, restriction on the basis of \ndisability which is the purpose or effect of impairing or nullifying the recognition, enjoyment or exercise \non an equal basis with others of all human rights and fundamental freedoms in the political, economic, \nsocial, cultural, civil or any other field and includes all forms of discrimination and denial of reasonable \naccommodation;”\n\n“(m) “inclusive education” means a system of education wherein students with and without disability \nlearn together and the system of teaching and learning is suitably adapted to meet the learning needs of \ndifferent types of students with disabilities;”\n\n“(y) “reasonable accommodation” means necessary and appropriate modification and adjustments, \nwithout imposing a disproportionate or undue burden in a particular case, to ensure to persons with \ndisabilities the enjoyment or exercise of rights equally with others;”\n\nDigital Supreme Court Reports\f[2024] 10 S.C.R. \n\n2207\n\npatients but would not require them to have speech or intact hands. \nBy focusing on the end points, the approach avoids any ableism to \nseep into the assessment and avoids reifying that there is one and \nonly one manner to achieve desired outcomes. \n\n27. A failure to create a conducive environment is a failure to provide \nreasonable accommodation.13 Section 2(h) of the RPWD Act defines \ndiscrimination in the context of disability as “any distinction, exclusion, \nrestriction on the basis of disability which has the purpose or effect \nof impairing or nullifying the recognition, enjoyment or exercise on \nan equal basis with others of all human rights and fundamental \nfreedoms in the political, economic, social, cultural, civil or any other \nfield and includes all forms of discrimination and denial of reasonable \naccommodation.” The denial of reasonable accommodation is \nexpressly recognised as discrimination under the RPWD Act. For \nthe proper realisation of reasonable accommodation, a person with \ndisability must be identified using correct parameters and thereafter \nthe accommodations necessary have to be determined on a case \nby case basis. \n\n28. Justice KV Viswanathan speaking for this Court in Omkar Gond (supra) \nhas applied a purposive interpretation to the guidelines (Appendix “H-1”) \nin the context of a medical aspirant with dialectic incapacity. This Court \nheld that the principle of reasonable accommodation in Section 2(y) \nof the RPWD Act read with Article 41 of the Constitution necessarily \nmeans that (i) a person cannot be disqualified merely on the basis of \na benchmark quantification. Such a criteria would be unconstitutional \nfor being overbroad; (ii) the Disability Assessment Board must not act \nas monotonous automations looking at the quantified disability and \ndisqualifying candidates. The Board must examine if the candidate \ncan pursue the course with their disability; and (iii) in doing so, the \nBoard is not merely obliged to provide assistive devices and other \nsubstances which will help the candidate. The true role of the Board \nis to assess the competence of a candidate.\n\n29. The principle of reasonable accommodation is not only statutorily \nprescribed but also rooted in the fundamental rights guaranteed to \npersons with disabilities under Part III of the Constitution. Reasonable \naccommodation is a fundamental right. It is a gateway right for \n\n13 Ravinder Kumar Dhariwal v. Union of India (2023) 2 SCC 209\n\nOm Rathod v. The Director General of Health Services & Ors.\f2208 \n\n[2024] 10 S.C.R.\n\npersons with disabilities to enjoy all the other rights enshrined in the \nConstitution and the law. Without the gateway right of reasonable \naccommodation, a person with disability is forced to navigate in a world \nwhich excludes them by design. It strikes a fatal blow to their ability \nto make life choices and pursue opportunities. From mundane tasks \nof daily life to actions undertaken to realise personal and professional \naspirations - all are throttled when reasonable accommodations are \ndenied. Reasonable accommodation is a facet of substantive equality \nand its failure constitutes discrimination. In Vikash Kumar v. UPSC,14 \nthis Court adjudicated on whether a person with a writer’s cramp is \nentitled to a scribe for writing the examination. Allowing the use of \na scribe, this Court held that the benchmark standard can only be \napplied where expressly stipulated. Section 2(s) of the RPWD Act \ndefines a person with disability as a person with long term physical, \nmental, intellectual or sensory impairment which, in interaction with \nbarriers, hinders their full and effective participation in society equally \nwith others. Therefore, a person - to be considered as a person with \ndisability - does not have to qualify any benchmark. The principle \nthat the rights and entitlements cannot be constricted by adopting a \nbenchmark as a condition precedent was also upheld by this Court \nin Avni Prakash v. NTA.15\n\n30. Section 3 of the RPWD Act affords persons with disabilities a right \nto equality and non-discrimination. In Vikash Kumar (supra) this \nCourt held that Section 3 casts an affirmative obligation on the \nGovernment and private entities to take steps to ensure reasonable \naccommodation and utilize the capacity of persons with disabilities by \nproviding an appropriate environment. There is a positive obligation \nto realise the inclusive premise in the concept of reasonable \naccommodation. This includes the duty to create an environment \nconducive for the development of persons with disabilities. This \nCourt has held that:\n\n“... The accommodation which the law mandates is \n‘reasonable’ because it has to be tailored to the \nrequirements of each condition of disability. The \nexpectations which every disabled person has are unique \n\n14 \n\n15 \n\n[2021] 12 SCR 311 : (2021) 5 SCC 370\n\n[2021] 11 SCR 891 : (2023) 2 SCC 286\n\nDigital Supreme Court Reports\f[2024] 10 S.C.R. \n\n2209\n\nto the nature of the disability and the character of the \nimpediments which are encountered as its consequence.\n\n...\n\n48. Failure to meet the individual needs of every \ndisabled person will breach the norm of reasonable \naccommodation. Flexibility in answering individual needs \nand requirements is essential to reasonable accommodation. \nThe principle of reasonable accommodation must also \naccount for the fact that disability based discrimination is \nintersectional in nature. The intersectional features arise \nin particular contexts due to the presence of multiple \ndisabilities and multiple consequences arising from \ndisability. Disability therefore cannot be truly understood \nby regarding it as unidimensional.”\n\n(emphasis supplied)\n\n31. \n\nIn Ravinder Kumar Dhariwal v. Union of India,16 while dealing with \na case of a CRPF officer with a mental health condition, this Court \nhad the opportunity to opine that disability is a social construct. Its \nmanifestation is contingent on the manner in which it interacts with \ninter alia social, economic and historical factors. A one-size-fits-all \napproach cannot be adopted in assessing disability. Disability is not a \nuniversal but an individualistic conception based on the impairments \nthat a person has along with the barriers they face. Since the \nbarriers that every person faces are personal to their interpersonal \nand structural surroundings - a general observation of permissible \nbehaviour cannot be made. \n\n32. Central to the principles of reasonable accommodation and the \nindividualized experience of disability is the right to access legal \nprotections without undue mental hardship. If persons with disabilities \nmust repeatedly turn to the courts to correct the missteps of \nauthorities, then the rights recognized by this Court and the RPWD \nAct risk becoming hollow assurances. For every person who has the \nawareness or ability to move this Court there are numerous others \n\n16 \n\n[2021] 13 SCR 823 : (2023) 2 SCC 209\n\nOm Rathod v. The Director General of Health Services & Ors.\f2210 \n\n[2024] 10 S.C.R.\n\nwho suffer in silence. In the present case, the appellant was subjected \nto protracted and mentally exhausting assessments that failed to \napply the correct standards, leading to a declaration of ineligibility. \nHis first journey by air was not for leisure or education but to undergo \na medical assessment in Delhi by an order of this Court. In this \nprocess, valuable time was lost, and the appellant faced intrusive \nand irrelevant questioning. Persons with disabilities often confront \nsystemic failures that engender a deep sense of disappointment - \na disappointment that reflects the frequency and predictability with \nwhich the system fails them. Those with disabilities who aspire to \nsucceed must not only plan meticulously but also brace themselves \nfor the barriers they will inevitably face due to their disabilities.\n\n33. For many persons with disabilities, the stress of medical visits - \nthe frequent trips to hospitals, the constant readiness to attend \nappointments, the long waits, the uncertainty of a doctor’s availability, \nand the anxiety over the results - forms part of their lived reality. At \nthe very least, they deserve a process and an outcome that is fair \nand reasoned. The mental toll which processes before a medical \nboard has on people is recognised by this Court. In A (Mother \nof X) v. State of Maharashtra,17 this Court had the opportunity to \nopine on the shifting stances of medical boards which are often \nobserved in cases relating to medical termination of pregnancy. This \nCourt held that the lack of application of proper standards, simpliciter \nrecantation of statutory provision and changes in opinions cause \nundue mental trauma to the pregnant person. In the backdrop of \nthe fear of prosecution which many registered medical practitioners \n(RMP) have, this Court emphasised on the role of medical experts \nto ensure that the fundamental rights of persons before them is not \ncompromised. The Court held as follows:\n\n“...The opinion of the RMP is decisive in matters of \ntermination of pregnancy under the MTP Act. The purpose \nof the opinion of the RMP borrows from the legislative intent \nof the MTP Act which is to protect the health of a pregnant \nperson and facilitate safe, hygienic, and legal abortion. The \nright to abortion is a concomitant right of dignity, autonomy \n\n17 \n\n2024 INSC 371 : [2024] 5 SCR 470\n\nDigital Supreme Court Reports\f[2024] 10 S.C.R. \n\n2211\n\nand reproductive choice. This right is guaranteed under \nArticle 21 of the Constitution. The decision to terminate \npregnancy is deeply personal for any person. The choice \nexercised by a pregnant person is not merely about their \nreproductive freedom but also about their agency as \nrecognised by this court in X v. State (NCT of Delhi). It \nis therefore imperative that the fundamental right of \na pregnant person is not compromised for reasons \nother than to protect the physical and mental health \nof the pregnant person. \n\n...\n\n23. The opinion of the RMP or the medical board, as the \ncase may be, is indispensable under the scheme of the \nMTP Act. This inadvertently gives the power to the \nRMP or the medical board to stand in the way of a \npregnant person exercising their choice to terminate \nthe pregnancy. When there is fear or apprehension in the \nmind of the RMP or the medical board it directly jeopardises \nthe fundamental freedoms of pregnant persons guaranteed \nunder the Constitution....”\n\n(emphasis supplied)\n\n34. Therefore, this Court has in the past opined on the pattern of conduct \nin medical boards and sought to align it with legal and Constitutional \nguarantees so as not to render the fundamental rights of persons \nbefore these boards nugatory. In Bambhaniya Sagar Vashrambhai v. \nUnion of India,18 this Court has held that Disability Assessment \nBoards must not adopt the approach of a recluse by confining \nthemselves to only quantifying the disability of a candidate. In that \ncase, the medical board had reported an unreasoned opinion that \nthe candidate was ineligible to continue his MBBS course on account \nof being more than 80% disabled. Like in A (Mother of X) (supra), \nthe Court in Bambhaniya (supra) also emphasised the need for \nelaborate reasons by the medical board while reporting their opinions. \n\n18 WP (C) 856 of 2023.\n\nOm Rathod v. The Director General of Health Services & Ors.\f2212 \n\n[2024] 10 S.C.R.\n\n35. \n\nIn Purswani Ashutosh v. Union of India,19 this Court was deciding \nif a medical aspirant who had appeared for the NEET UG Exam \n2018 was eligible for the reservation earmarked for persons with \ndisabilities. Despite having low vision impairment - the Medical \nBoard had opined that the petitioner in that case was ineligible for \nreservation. While rejecting the opinion of the committee, this Court \nheld that a medical board cannot be allowed to override the statutory \nmandate of providing reservation to persons with disabilities. No \ncommittee has primacy over the law. We must emphasize that the \nopinions of medical boards and committees are not only required \nto adhere to legal standards but must also embody core principles \nof the rule of law within their processes. This Court, following a \nconsistent line of precedent, has underscored the need for reasoned \nand transparent decisions by such boards, given the profound impact \nthese opinions have on the life trajectory of individuals before them. \n\n36. At its core, the rule of law demands predictable rules, equitable \napplication, unbiased adjudication and fair, transparent treatment of \nindividuals. In cases of assessment, this entails informing individuals \nabout the procedures, standards, tools, and all pertinent aspects \nof the assessment in advance. Such transparency is essential to \navoid any arbitrary uncertainty arising from obscure or inconsistent \nprocedures. The procedures must be inherently fair and bear a rational \nand cogent nexus with the purpose which is sought to be achieved. \nA committee’s role goes beyond mere quantification of disability; \ndisability is a factual condition. The key question for a Disability \nAssessment Board is whether an individual with a disability, aided by \nmodern scientific tools and devices, can enter the MBBS program. \nPut differently, the board must assess whether it is infeasible for the \ncandidate to pursue a medical career with their disability.\n\n37. Appendix “H-1” stipulates that assessments, particularly for individuals \nwith locomotor disabilities exceeding 80%, should focus on evaluating \nfunctional competence. This functional competency test serves two \ncritical purposes. First, it emphasizes the abilities of the person with \na disability, assessing their capability rather than their limitations. \nSecond, it mandates an evaluation rooted in practical relevance, \naligning the candidate’s abilities with the functional requirements of \n\n19 \n\n(2019) 14 SCC 422\n\nDigital Supreme Court Reports\f[2024] 10 S.C.R. \n\n2213\n\nthe MBBS curriculum. Mere quantification of disability is insufficient \nand fails to address the necessary criteria, a position this Court has \nconsistently upheld as unsatisfactory in such cases.20\n\n38. At this point, it is imperative to deal with the holding of this Court in \nVidhi Himmat Katariya v. Union of India.21 In that case, persons \nwith disabilities who had appeared for the NEET UG Exam 2019 \nhad moved this Court against their disqualification by the Medical \nBoard. Appendix “H” had been issued midway through the process \nfor admitting candidates from the NEET UG 2019. The primary \ncontention of the petitioners was that since the new guidelines were \nissued in the middle of the admission process, they must not apply \nto the ongoing process. The petitioners prayed to be tested against \nthe rules as they existed at the time of the application process for \nthe examination, namely, the MCI guidelines of 2017. On this count, \nthe Court ruled against the petitioners. The demurrer argument of the \npetitioners was that they have not been tested on relevant parameters. \nThis Court while rejecting the argument noted that the petitioners \nwere disqualified for not meeting the eligibility criteria of having “both \nhands intact, with intact sensation, sufficient strength and range of \nmotion.” Accordingly, the Court refused to sit in appeal over the expert \nbody’s opinion. The judgment of the Court in Vidhi Himmat Katariya \n(supra) was specific to the facts of that case and did not involve any \nquestion of interpretation or Constitutional analysis. The Court was \nnot examining any criteria and did not scrutinise the guidelines to \ninspect their validity. The Court did not have the benefit of looking \nat the firm roots which reasonable accommodation has grown within \nthe fold of the Constitution. Further, the judgments of this Court in \nVikash Kumar (supra), Avni Prakash (supra), Ravinder Dhariwal \n(supra) and Omkar Gond (supra) were not available to the Court while \ndealing with the case of Vidhi Himmat Katariya (supra). Therefore, \nthe opinion in Vidhi Himmat Katariya (supra) is inapplicable. \n\n39. Courts are not expert bodies in matters of medicine. The competent \nauthority to adjudge the eligibility of a person to pursue a medical \ncourse is the Disability Assessment Board. However, courts have the \njurisdiction to ensure that the manner in which the Board proceeds and \n\n20 Omkar Gond v. Union of India (2024) SCC OnLine SC 2401; Vikash Kumar v. UPSC (2021) 5 SCC 370; \n\nBambhaniya Sagar Vasharambhai v. Union of India, WP (C) 856 of 2023\n\n21 \n\n[2019] 12 SCR 821 : (2019) 10 SCC 20\n\nOm Rathod v. The Director General of Health Services & Ors.\f2214 \n\n[2024] 10 S.C.R.\n\nfunctions is in compliance with established principles of law. Ultimately, \nthe Court will have to rely on the opinion of the Board to adjudicate the \nlegal remedies of a person with disability. The interference of Courts \nis not to supplant its opinion for that of the experts but to ensure that \na holistic evaluation of competence is conducted and that no person’s \ncareer is set at naught with the stroke of a pen.\n\n40. The Courts cannot be stupefied into inaction by the lack of adequate \nframework or expertise when questions of fundamental rights emerge. \nNo person forfeits their claim to education or other pursuits of life \non account of their disability. The flurry of cases concerning medical \naspirants with disability which has come before this Court shows that \nthe overarching issue is a sense of over medicalization of disabled \nbodies by the Assessment Boards. The approach often taken, due to \ninertia or unwittingly, is to assume that a person with disability may \nnot be eligible for pursuing the course and then to put the candidates \nunder tests to prove the assumption. The approach focuses more on \nthe disability of a person than their ability. This turns the principle of \nreasonable accommodation on its head. The question instead that \nthe Board ought to ask itself is this - what measures can be taken \nto ensure that the candidate with disability can start their MBBS \ncourse on an equal footing with their prospective classmates? The \nchange in question brings a change in perspective. The only negative \nanswer to the question would be that - in line with contemporary \nscientific advancements, no devices or accommodations can enable \nthe person with disability before them to compete at a level playing \nfield. Courts must ensure that the sanctity of the principles in the \nRPWD Act and in the Constitution are not violated by the conduct \nor the outcome of the assessment. \n\nE. Building bridges for the nation: principle to practice\n\n“But it taught me, at a very early age, that most things are \npossible when you assume problems can be solved.”\n\n(regarded as the mother of the disability rights movement)\n\n― Judith Heumann22\n\n22 \n\nJudith Heumann & Kristen Joiner (2020). Being Heumann: An Unrepentant Memoir of a Disability Rights \nActivist. Beacon Press : Boston, Massachusetts.\n\nDigital Supreme Court Reports\f[2024] 10 S.C.R. \n\n2215\n\n41. We started by noting that the principle and application of law have \nstood at opposite banks of the river. The true mandate of the law is to \nbe an agent of inclusion and an abettor and executor of justice. Law \nreflects the outlook of its wielder. A parochial legal system will create \nlaws which result in maldistribution of life chances and opportunities. \nIn India, we have adopted an emancipatory Constitution premised \non the fundamental virtues of equal dignity and access. The wielder \nof the law, therefore, is rooted in a progressive grundnorm which \nseeks to eschew from societal prejudices and biases.\n\n42. The window to these progressive virtues is envisioned in the preamble \nto the Constitution. The preamble, along with justice, liberty and \nequality, seeks to secure to all citizens - “FRATERNITY assuring the \ndignity of the individual and the unity and integrity of the Nation.” The \nfundamental postulate of dignity which inheres in all people is intrinsic \nto the idea of fraternity and national integration. Fraternity, far from \nbeing mere collegiality among citizens, imagines a holistic sharing \nof goals and aspirations. It recognizes that to progress together we \nmust join forces in our mutual advancement and emancipation. The \nframing of the preambular virtue of fraternity identifies the dignity of \nall individuals as a pre-condition. Dignity of the individual is assured \nwhen they are given equal opportunity and the freedom to contribute \nto the society - shoulder to shoulder with fellow citizens. \n\n43. No nation can truly progress until all her people realize a stake in \ntheir collective outcome. In one sense discrimination excludes the \naggrieved from the collective imagination of the nation. In another \nsense the nation is deprived of the expertise and brilliance of those \nwho are discriminated. We aspire to have institutions and systems \nwhich reflect the rich diversity of our country. The aspiration is one \nrooted in our commitment to the nation. Diverse institutions are vital \nto ensure the governance of a diverse nation. When persons with \ndisabilities are discriminated against, it not only affects their individual \naspirations and dignity - it strikes a blow to the entire nation and the \ncollective goal of integration and fraternity.\n\n44. Justice PB Sawant concurring with the decision of the nine-Judge \nbench of this Court in Indra Sawhney v. Union of India,23 has opined \nthat inequality ill-favours fraternity. Without equality of opportunity \n\n23 \n\n[1992] Supp. 2 SCR 454 : (1992) Supp. 3 SCC 217\n\nOm Rathod v. The Director General of Health Services & Ors.\f2216 \n\n[2024] 10 S.C.R.\n\nthere can be no fraternity. Justice Sawant has articulated his holding \nas follows:\n\n“411. The aim of any civilised society should be to \nsecure dignity to every individual. There cannot be \ndignity without equality of status and opportunity. \nThe absence of equal opportunities in any walk of social \nlife is a denial of equal status and equal participation \nin the affairs of the society and, therefore, of its equal \nmembership. The dignity of the individual is dented in \ndirect proportion to his deprivation of the equal access to \nsocial means. The democratic foundations are missing \nwhen equal opportunity to grow, govern, and give one’s \nbest to the society is denied to a sizeable section of the \nsociety. The deprivation of the opportunities may be direct \nor indirect as when the wherewithals to avail of them are \ndenied. Nevertheless, the consequences are as potent.\n\n412. Inequality ill-favours fraternity, and unity remains \na dream without fraternity. The goal enumerated \nin the Preamble of the Constitution, of fraternity \nassuring the dignity of the individual and the unity \nand integrity of the nation must, therefore, remain \nunattainable so long as the equality of opportunity \nis not ensured to all.\n\n413. Likewise, the social and political justice pledged \nby the Preamble of the Constitution to be secured to all \ncitizens, will remain a myth unless first economic justice \nis guaranteed to all. The liberty of thought and expression \nalso will remain on paper in the face of economic \ndeprivations. A remunerative occupation is a means \nnot only of economic upliftment but also of instilling \nin the individual self-assurance, self-esteem and self-\nworthiness. It also accords him a status and a dignity \nas an independent and useful member of the society. It \nenables him to participate in the affairs of the society \nwithout dependence on, or domination by, others, and \non an equal plane depending upon the nature, security \nand remuneration of the occupation. Employment is an \n\nDigital Supreme Court Reports\f[2024] 10 S.C.R. \n\n2217\n\nimportant and by far the dominant remunerative occupation, \nand when it is with the Government, semi-Government \nor Government-controlled organisation, it has an added \nedge. It is coupled with power and prestige of varying \ndegrees and nature, depending upon the establishment \nand the post. The employment under the State, by itself, \nmay, many times help achieve the triple goal of social, \neconomic and political justice.\n\n(emphasis supplied)\n\n45. Dr Martin Luther King Jr has famously remarked that “injustice \nanywhere is a threat to justice everywhere.” When we allow \ninjustice to occur, we normalize the idea that fundamental rights and \nfreedoms are violable. The inviolability of our collective commitment \nis weakened. Discrimination cracks open a wedge in the fabric of \nthe society - it violates the Constitution and erodes the humanity of \nthe person discriminated against. The discrimination can manifest \ndirectly or indirectly. Its manifestation eats into our commitment to \neach other and of the State to the people. In Prathvi Raj Chauhan v. \nUnion of India,24 a three-Judge Bench of this Court while dealing \nwith the validity of the Scheduled Castes and the Scheduled Tribes \n(Prevention of Atrocities) Act 1989 has opined that the Constitution is \nalso a pact between the people of India. It is a promise of oneness \nand equality. The Court opined as follows:\n\n“15. The Constitution of India is … a pact between people, \nabout the relationships that they guarantee to each other \n(apart from the guarantee of liberties vis-à-vis the State) \nin what was a society riven along caste and sectarian \ndivisions. That is why the preambular assurance that the \nrepublic would be one which guarantees to its people \nliberties, dignity, equality of status and opportunity and \nfraternity.\n\n16. It is this idea of India, — a promise of oneness of and \nfor, all people, regardless of caste, gender, place of birth, \n\n24 \n\n[2020] 2 SCR 727 : (2020) 4 SCC 727\n\nOm Rathod v. The Director General of Health Services & Ors.\f2218 \n\n[2024] 10 S.C.R.\n\nreligion and other divisions that Part III articulates in four \nsalient provisions : Article 15, Article 17, Article 23 and \nArticle 24. The idea of fraternity occupying as crucial a place \nin the scheme of our nation’s consciousness and polity, \nis one of the lesser explored areas in the constitutional \ndiscourse of this Court. The fraternity assured by the \nPreamble is not merely a declaration of a ritual handshake \nor cordiality between communities that are diverse and \nhave occupied different spaces : it is far more. …”\n\n46. What the movement for disability justice shares with other social \njustice movements - such as the anti-caste movement, feminism \nand queer and trans justice - is that they call into question the \nfundamental arrangement of a society which has created prejudicial \nstructures. Inaccessibility and non-inclusion are taken as suspect \ncategories to question the prevalent social order. In doing so these \nmovements invite us to contribute to the national goal of fraternity \nand integration. Far from being interruptive in the national journey - \ncalls for equal access and equal justice postulate a disruption in the \norder of discrimination and prejudices so that we may carry on the \njourney of national progress. They do not only champion the group \ninterest of a certain class of citizens but instead advocate for a larger \nvision of a justice oriented society. A society where discrimination \nand exclusion are addressed and eliminated will create a just and \nequitable system for all persons regardless of their identities. To be \nintersectional is to see the common goals across vectors of identities \nby eliminating systems of discrimination. It is a call to eschew from \nsimplistic identity reductionism and to imagine meaningful remedies \nfor marginalised groups and persons. It calls for a world with equity \nand justice where our uniqueness forms part of benign differences \namong people and lends vibrance to our diversity. The Constitution \nenables this project of fraternity by guaranteeing rights to life, dignity, \nfreedom, equality and non-discrimination inter alia under Articles 21, \n19, 14, and 15.\n\n47. When reasonable accommodation is denied to a person with \ndisability, it amounts to discrimination and violates the fundamental \nrights of the aggrieved person and the preambular virtue of fraternity \nalong with justice, liberty and equality. Persons with disability are \nnot objects of pity or charity but an integral part of our society and \n\nDigital Supreme Court Reports\f[2024] 10 S.C.R. \n\n2219\n\nnation. The advancement of rights for persons with disabilities is a \nnational project along with eradication of all forms of discrimination. A \ncomponent of this project is the inclusion of persons with disabilities \nin all pursuits of life. \n\n48. \n\nIn Vikash Kumar (supra) this Court opined that the most significant \nloser of a rigid inaccessible system is the system itself. The Court \nresonated the idea of a generation of persons with disabilities who \ntake it as their birthright to access the full panoply of entitlements. \nThis Court has held as follows:\n\n“81. When competent persons with disabilities are unable \nto realise their full potential due to the barriers posed in \ntheir path, our society suffers, as much, if not more, as \ndo the disabled people involved. In their blooming and \nblossoming, we all bloom and blossom. The most significant \nloser as a consequence of UPSC’s rigid approach in this \ncase (of  refusing to provide scribes to those not having \nbenchmark disabilities) is UPSC itself. For it is denying to \nthe nation the opportunity to be served by highly competent \npeople who claim nothing but access to equal opportunity \nand a barrier-free environment.\n\n...\n\n98. Cases such as the present offer us an opportunity \nto make a meaningful contribution in the project of \ncreating the RPwD generation in India. A generation of \ndisabled people in India which regards as its birthright \naccess to the full panoply of constitutional entitlements, \nrobust statutory rights geared to meet their unique needs \nand conducive societal conditions needed for them to \nflourish and to truly become co-equal participants in all \nfacets of life.”\n\n49. When we create avenues for inclusion, we work towards improving \nsystems and institutions. In the context of healthcare, the inclusion \nof persons with disabilities is a vital component of quality healthcare. \nThe guidelines and recommendations which express concern about \n“lowering the standard of medical practice” on account of persons \nwith disabilities miss the fact that these standards may not be \nadequate to begin with. The quality of a system is informed by its \n\nOm Rathod v. The Director General of Health Services & Ors.\f2220 \n\n[2024] 10 S.C.R.\n\nability to empathise with and relate to the recipients. A system without \nadequate number of practitioners who have lived experiences will \nnot be able to fully imagine the obstacles and grievances faced by \na diverse population. Diversity of workforce is crucial for a diverse \nsociety, so that everyone may have a stake in the system and the \nsystem can effectively discharge its duties toward everyone.\n\n50. Section 2525 of the RPWD Act outlines the positive obligation of \nGovernment and local authorities to provide healthcare to persons \nwith disabilities. An affirmative obligation is placed to ensure that \npersons with disabilities receive a barrier free access to all public \nand private healthcare institutions. Removal of barriers can only \nbe achieved if persons with disabilities feel comfortable while \naccessing healthcare. The barriers faced by a person may be \nphysical, psychological and attitudinal. The inclusion of persons \nwith disabilities within medical practice is vital to ensure that the \napproach of the medical community and of hospitals and other \nhealthcare institutes is humane, sensitive and informed by lived \nexperiences. It strengthens our fraternity. Therefore, the process \nthrough which medical aspirants with disability enter the profession \nmust be compatible with constitutional and statutory entitlements \nand guarantees.\n\n25 \n\n“25. Healthcare.—(1) The appropriate Government and the local authorities shall take necessary \nmeasures for the persons with disabilities to provide,— \n(a) free healthcare in the vicinity specially in rural area subject to such family income as may be notified; \n(b) barrier-free access in all parts of Government and private hospitals and other healthcare institutions \nand centres; \n(c) priority in attendance and treatment. \n(2) The appropriate Government and the local authorities shall take measures and make schemes or \nprogrammes to promote healthcare and prevent the occurrence of disabilities and for the said purpose \nshall— \n(a) undertake or cause to be undertaken surveys, investigations and research concerning the cause of \noccurrence of disabilities; \n(b) promote various methods for preventing disabilities; \n(c) screen all the children at least once in a year for the purpose of identifying “at-risk” cases; \n(d) provide facilities for training to the staff at the primary health centres; \n(e) sponsor or cause to be sponsored awareness campaigns and disseminate or cause to be \ndisseminated information for general hygiene, health and sanitation; \n(f) take measures for pre-natal, perinatal and post-natal care of mother and child; \n(g) educate the public through the pre-schools, schools, primary health centres, village level workers \nand anganwadi workers; \n(h) create awareness amongst the masses through television, radio and other mass media on the \ncauses of disabilities and the preventive measures to be adopted; \n(i) healthcare during the time of natural disasters and other situations of risk; \n(j) essential medical facilities for life saving emergency treatment and procedures; and \n(k) sexual and reproductive healthcare especially for women with disability.”\n\nDigital Supreme Court Reports\f[2024] 10 S.C.R. \n\n2221\n\n51. The United Nations Committee on the Rights of Persons with \nDisabilities in its concluding observations on the initial report of \nIndia26 has inter alia identified the medical model of disability as a \nprominent concern. It has stated as follows:\n\n“(a) The prevalence of the medical model of disability in \nlegislation, public policies and attitudes concerning persons \nwith disabilities, particularly in the multiple assessments \nand certification of disability and the requirement \nfor different assessments to access services in the \ncommunity, and in the misunderstanding of disability, \nincluding leprosy, as solely a biological condition requiring \nprevention and rehabilitation;”\n\n(emphasis supplied)\n\n52. The committee has recommended that the concern be remedied with \ninter alia reforming guidelines assessing persons with disabilities \nby adopting a human rights model. The recommendation has also \nopined against the multiplicity of assessments which we have echoed \nabove. The recommendation states as follows:\n\n“(b) Reform the guidelines for assessing and certifying \ndisability to bring them into line with the human rights \nmodel of disability, ensuring that organizations of persons \nwith disabilities are involved in the reform, that multiple \nassessments do not create an undue burden for \napplicants, and that policies and programmes shift from \ncare, treatment and protection towards the removal of \nenvironmental and attitudinal barriers, which prevent \nequality and inclusion;”\n\n(emphasis supplied)\n\n53. We have noted above that Disability Assessment Boards must comply \nwith rule of law principles by injecting transparency, fairness and \nconsistency in their approach. The Boards must further elaborate on \n\n26 UN. Committee on the Rights of Persons with Disabilities (22nd sess). CRPD/C/IND/CO/1. Concluding \nobservations on the initial report of India : Committee on the Rights of Persons with Disabilities. Geneva : \nUN, 29 Oct. 2019.\n\nOm Rathod v. The Director General of Health Services & Ors.\f2222 \n\n[2024] 10 S.C.R.\n\nthe reasons for the outcome of their assessment, in particular when \nthey opine that the candidate is ineligible. The Disability Assessment \nBoards must focus on the functional competence of persons with \ndisabilities and not merely quantify the disability. The quantification \nof disability is a task in need of a purpose within the human rights \nbased model of disability. The functional competency approach to \nassessment for a medical course is globally recognised. To enable \nmembers of the Assessment Boards in effectively applying the \nfunctional competency test, they must be adequately trained by \nprofessionals and persons with disabilities or persons who have \nworked on disability justice. These trainings must be with a view \nto enhance the understanding of the Board members in assessing \npersons with disabilities and must not pathologize or problematize \nthem. \n\n54. The disability of a person is quantified at the time of availing a \nUnique Disability ID Card.27 The quantification of disability is moot \nat the point of admission to educational courses since the eligibility \nfor a person to benefit from reservation may be evaluated using the \nquantification in the UDID Card. If a person with disability wants to \nhave themself re-assessed so as to verify whether their disability falls \nwithin the prescribed parameters for reservation - they may choose \nto do so by updating their UDID Cards. The role of the Disability \nAssessment Boards must be tailored (with a functional competency \napproach) only for the course which the candidate seeks to pursue.\n\n55. Further, the journey of a person with disability to apply for the NEET \nExamination and thereafter pursue medicine at the college must also \ncomply with accessibility norms. The application portal for NEET \nExamination must outline the accessibility compliances of different \ncolleges to enable prospective students with disabilities in making \nan informed decision. Once admitted, the Enabling Units established \nunder the directions of the University Grants Commission must act \nas a point of contact for persons with disabilities to access clinical \naccommodations. Students must be informed about the Enabling \nUnits and Equal Opportunity Cells through the information booklet \ncirculated for new MBBS students, the college website and the Equal \n\n27 \n\n“UDID Card”\n\nDigital Supreme Court Reports\f[2024] 10 S.C.R. \n\n2223\n\nOpportunity Policy under Section 21 of RPWD Act. The second \nrespondent must make appropriate directions in this regard. \n\n56. \n\nIn the UK, the General Medical Council, which regulates medical \neducation, has issued an advisory guidance titled Welcome and \nvalued. The guidance outlines how institutions can comply with their \nduties to afford reasonable accommodation to disabled medical \nstudents. The guidance inter alia lists the steps for supporting medical \nstudents. After addressing student requirements and agreeing on a \nsupport action plan, the guidance outlines the following steps, which \nare indicative and may not be appropriate for all:\n\na. Forming a support group or a lead to deal with support \n\narrangements of incoming students with disabilities;\n\nb. \n\nc. \n\nIdentifying key persons of contact with students with disabilities \nand for each of the services involved in exploring the support \narrangements;\n\nInforming students on how their information will be used \nin compliance with confidentiality. Colleges are further \nrecommended to:\n\ni. \n\nKeep a clear audit trail of decision making for supporting \ndisabled learners as this is likely to help schools make sure \nthey have taken appropriate steps to provide reasonable \nadjustments;\n\nii. Keep a record of all conversations between the support \ngroup and student. Agree on the method of recording such \nconversations and allow the student to see a draft record \nof any discussions;\n\niii. Create a separate file with different access arrangements \nfor confidential information related to health outside of the \ngeneral student record.\n\nd. The lead must thereafter organise a meeting between the student \nand the support group. The group may also arrange meetings \nto evaluate cases and discuss progress; and \n\ne. \n\nLastly, a decision may be made on whether the student with \ndisability can be provided adequate support to enable them in \nmeeting the outcomes desirable in a medical graduate. \n\nOm Rathod v. The Director General of Health Services & Ors.\f2224 \n\n[2024] 10 S.C.R.\n\n57. The provision of an audit trail to assess whether a given accommodation \nrequired by a student with disability places an undue burden on the \ninstitution is a vital safeguard for transparency and fairness. Dr \nSatendra Singh in his report dated 20 October 2024 has made \nsuggestions to (i) rename the Disability Assessment Boards as \nAbility Assessment Boards to align them better with their intended \npurpose; (ii) include a doctor with disability or who is well conversant \nwith disability rights in such Boards; (iii) use a human rights \nmodel of disability for assessment; (iv) issue guidance on clinical \naccommodations; (v) train the Boards in carrying out the disability \ncompetency assessment; and (vi) use the Enabling Units to serve as \na contact point for clinical accommodations. As far as the inclusion \nof doctors with disabilities in the Disability Assessment Boards is \nconcerned - the first respondent has issued a circular on 24 March \n2022 mandating such inclusion. This direction shall be complied \nwith by all Boards.\n\n58. The second respondent has submitted that in light of the judgment \nof this Court in Omkar Gond (supra), it will be constituting a new \ncommittee of domain experts to comply with the directions in that \njudgment. We note the assurance of the second respondent and \ndirect that this committee shall include persons with disability or one \nor more experts who are well conversant with disability rights. The \ncommittee shall recommend fresh guidelines to replace the existing \nguidelines. The above suggestions shall be duly considered by the \ngovernment on its own merits. The recommendations so formulated \nshall comply with this judgment.\n\nF. Conclusions\n\n59. Our conclusions in light of this case are formulated in the following \n\nterms:\n\na. The impugned judgment of the Nagpur bench of the High Court of \nJudicature at Bombay is set aside and the report of the Disability \nAssessment Board of AIIMS, Nagpur dated 13 August 2024 is \nquashed for failing to apply the statutory and regulatory standards \napplicable to the assessment of a person with disability;\n\nb. A supernumerary seat shall be created at the AIIMS, Nagpur \nand the seat shall be allocated to the appellant, provided that \nhe has not already secured a seat at a college of his choosing; \n\nDigital Supreme Court Reports\f[2024] 10 S.C.R. \n\n2225\n\nc. \n\nThe college shall be given the report dated 20 October 2024 \nwhich makes suggestions as to the accommodations which \nmay be extended to the appellant to successfully pursue the \nMBBS course;\n\nd. The appellant shall be protected from victimisation;\n\ne. The judgement shall apply in rem.\n\n60. We further conclude as follows:\n\na. The second respondent shall issue fresh guidelines for admitting \npersons with disabilities into medical courses. The committee \nformulating the guidelines must include experts with disability or \npersons who have worked on disability justice. The guidelines \nshall comply with the judgments of this Court and contemporary \nadvancements in disability justice;\n\nb. The Disability Assessment Boards shall eschew from a \nbenchmark model to test the functional competence of medical \naspirants with disability. The second respondent shall issue \nappropriate guidelines in this regard;\n\na. The Disability Assessment Boards shall include a doctor or \nhealth professional with disability as per the directions of the \nfirst respondent dated 24 March 2022;\n\nb. The conduct of the Disability Assessment Boards shall be fair, \ntransparent and in compliance with principles of the rule of law. \nAttention must be paid to ensure that candidates appearing \nbefore the Board do not feel uncomfortable on account of \nphysical or attitudinal barriers;\n\nc. Reasonable accommodation is a gateway right to avail all \nother fundamental, human and legal rights for persons with \ndisabilities. Non-availability of reasonable accommodation \namounts to discrimination and violates substantive equality of \npersons with disabilities;\n\nd. The inclusion of persons with disability in the medical profession \nwould enhance the quality of healthcare and meet the \npreambular virtue of fraternity and the guarantees in Articles \n21, 19, 14 and 15 of the Constitution;\n\ne. Applicants to the NEET examination must be informed about the \ncompliance of accessibility norms and provisions of reasonable \n\nOm Rathod v. The Director General of Health Services & Ors.\f2226 \n\n[2024] 10 S.C.R.\n\naccommodation available at colleges. The respondents shall \nissue appropriate directions to create a database with relevant \ninformation on accessibility and reasonable accommodation; and\n\nf. \n\nEnabling Units at medical colleges shall act as points of \ncontact for persons with disability desirous of accessing clinical \naccommodations.\n\n61. A copy of this Judgment will be transmitted to the Secretaries of all \n\nconcerned Ministries of the Government of India. \n\n62. The appeal is allowed in the above terms. \n\n63. Pending applications, if any, shall stand disposed of.\n\nResult of the case: Appeal allowed.\n\n†Headnotes prepared by: Divya Pandey\n\nDigital Supreme Court Reports\f"}