The Supreme Court on October 13, 2025, summoned the senior health officials of 28 States and Union Territories to chastise them for adopting a “casual approach” towards its order on uniform guidelines for patient management in hospital intensive and critical care units (ICUs and CCUs) by October 5.
Noting that several States had either failed to comply or submitted their reports well past the deadline, a Bench of Justices Ahsanuddin Amanullah and N. Kotiswar Singh expressed displeasure over the delay. “It is now time for this court to take serious cognisance of the casual approach displayed by the States,” the Bench remarked.
Issuing notices to the Additional Chief Secretary or the senior-most official handling the Health portfolio in each defaulting State and Union Territory, the Bench directed them to appear personally before the court on November 20 with “personally affirmed show cause affidavits” explaining why action should not be taken against them for their laxity.
‘No excuses’
The court made it clear that no justification for absence would be entertained. “The officers who have been directed to appear shall not cite any excuse, including prior engagements or official commitments, which shall be rescheduled to give priority to this order,” it said.
Cautioning against further delay, the Bench warned that “if there is non-compliance or casual compliance by the next date, the court will take a strict view against such States and their officers.”
Appearing for the Union government, Additional Solicitor General Aishwarya Bhati informed the Bench that despite its September 18, 2025 order, a number of States and UTs were yet to file their responses. The defaulters are: Gujarat, Jharkhand, Madhya Pradesh, Mizoram, Arunachal Pradesh, Odisha, Rajasthan, Sikkim, Tamil Nadu, Uttarakhand, West Bengal, Delhi, Jammu and Kashmir, Ladakh, Chandigarh, Lakshadweep, Andaman and Nicobar Islands, and Dadra & Nagar Haveli and Daman and Diu.
State input needed
Under the court’s earlier direction, the States were required to furnish their responses to a three-member committee comprising Ms. Bhati, advocate Karan Bharioke, who was assisting the court as amicus curiae, and Dr. Nitish Naik of AIIMS. The panel was tasked with collating and reviewing the submissions to prepare a consolidated report.
During the proceedings, the committee informed the court that the preparation of the guidelines for admission, treatment, and discharge from ICUs and CCUs was not possible till all States submit their responses.
On August 19, 2025, the top court had noted that although the Centre had formulated model ICU/CCU guidelines in 2023, they could not be implemented without the recommendations of the States, since health is a State subject. Accordingly, it had directed the States to identify parameters that are both universally applicable and tailored to the specific needs of hospitals serving local populations or treating particular medical conditions. To determine these factors, the court had instructed the States and UTs to hold consultations with all stakeholders, including private healthcare institutions, through State-level or regional conferences.
Medical negligence case
The order was passed in a 2015 petition arising out of a medical negligence case instituted by Asit Baran Mondal seeking compensation for the death of his wife in a Kolkata hospital in 2013 due to alleged medical negligence. Subsequently, the Supreme Court in 2016 recognised that there are no guidelines for the treatment of patients in the ICU/CCU, nor proper care during operations, or during the post-operative stage.
Pursuant to the court’s directions, the Union government in 2023 set up a committee chaired by the Director General of Health Services (DGHS) with a defined mandate to “formulate guidelines for admission to ICUs and CCUs, provide for palliative care of non-salvageable patients withdrawn from ventilator support, and lay down criteria for withdrawal of treatment.” The panel, comprising several medical experts and practitioners, undertook extensive consultations, culminating in the finalisation of a set of model guidelines in 2023.
Published – October 15, 2025 11:06 pm IST
