The Supreme Court on 13 October 2025 summoned senior health officials of 28 states and union territories to reprimand them for adopting a “casual approach” to its order on uniform guidelines for the care of patients in intensive care and intensive care units (ICUs and CCUs) in hospitals till 5 October.
A bench of Justice Ahsanuddin Amanullah and N. Kotiswar Singh expressed displeasure over the delay, noting that several states either failed to comply or submitted their reports well after the deadline. “It is now time for this Court to take serious notice of the informal approach shown by the States,” the Bench observed.
Issuing a notice to the next chief secretary or top official in charge of the health portfolio in each defaulting state and Union territory, the Bench directed them to appear in court on November 20 in person with “personally verified affidavits” explaining why action should not be taken against them for their laxity.
‘no excuses’
The court made it clear that absences would not be excused. “Officers who have been ordered to appear will not make any excuse, including prior engagements or official engagements, which will be rescheduled to take precedence over this order,” it said.
The bench cautioned against further delay and warned that “if there is non-compliance or casual compliance by the next date, the court takes a stern view against such states and their officers”.
Additional Solicitor General Aishwarya Bhati, appearing for the Union government, informed the Bench that despite its order dated September 18, 2025, a number of states and UTs have not yet responded. 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 Nagar, Haveli and Daman and Diu.
A status is required
As per the court’s earlier directions, the states were required to submit their replies to a three-member committee comprising Ms. Bhati, advocate Karan Bharioke, who assisted the court as amicus curiae, and Dr. Nitish Naik of AIIMS. The panel was tasked with collating and reviewing submissions to prepare a consolidated report.
During the proceedings, the committee informed the court that the preparation of guidelines for admission, treatment and discharge from the ICU and CCU is not possible until all states submit their responses.
On August 19, 2025, the apex court observed that though the Center had formulated model guidelines for ICUs/CCUs in 2023, they cannot be implemented without the recommendations of the states as health is a state subject. Accordingly, it directed states to determine parameters that are both universally applicable and tailored to the specific needs of hospitals that serve local populations or treat specific medical conditions. To determine these factors, the court directed the states and UTs to hold consultations with all stakeholders, including private health facilities, through state or regional level conferences.
A case of medical negligence
The order was passed in a 2015 petition arising out of a medical malpractice case filed 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 recognized that there were no guidelines for the treatment of ICU/ICU patients, nor proper care during operations or in the post-operative stage.
As directed by the court, 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 ICU and CCU, provide palliative care for non-salvageable patients withdrawn from ventilator support and set criteria for termination of treatment”. A panel of several medical experts and practitioners conducted extensive consultations, culminating in the finalization of a set of model guidelines in 2023.
Published – 15 Oct 2025 23:06 IST
