'Both hands intact' rule in MBBS admissions glorifies ableism: Supreme Court

New Delhi: The Supreme Court on Friday said flexibility in answering individual needs and requirements is an essential component of reasonable accommodation under the Rights of Persons with Disabilities Act, 2016 as there cannot be a “one size fits all” approach.

A bench of Justices B R Gavai and K V Vishwanathan also strongly objected to 2019 guidelines on admission of students with “specified disabilities” to MBBS course, which stated "Both hands intact, with intact sensations, sufficient strength and range of motion are essential to be considered eligible for medical course”.

"In our view, this prescription of “both hands intact…” is completely antithetical to Article 41 of the Constitution; the principles enshrined in the United Nations Convention on the Rights of Persons with Disabilities and the salutary provisions of the RPwD Act," the bench said.

The court opined, it also indicates a classification which is overbroad and glorifies ‘ableism’. It propagates that persons with typical abilities and with faculties similar to what the majority may have or somehow superior, the bench said.

"This is precisely what the Directive Principles of State Policy, the United Nations Convention and the RPwD Act abhor," the bench said

The judgment, authored by Justice Vishwanathan on behalf of the bench, spelled out reasons for its previous direction for admission of Anmol, a person with 58 per cent disabilities in MBBS course at the government medical college in Rajasthan under PwD (OBC) quota.

The bench rejected the AIIMS' medical board report and went by a separate member recommendation.

"Accepting the report of five members and denying the admission of the appellant would be upholding the theory of ableism which we are not prepared to do," the bench said.

The court also decided to examine on March 3 whether the National Medical Commission has formulated the revised guidelines in accordance with the judgments of this Court, in Omkar Ramchandra Gond (on October 15, 2024) and Om Rathod (on October 25, 2024). The court directed the NMC to file an affidavit explaining the current status before the hearing date.

Focussing again on NMC guidelines, the bench said, "A prescription such as “both hands intact…” reeks of ableism and has no place in a statutory regulation. In fact, it has the effect of denuding the rights guaranteed under the Constitution and the RPwD Act and makes a mockery of the principle of reasonable accommodation".

In the case, the five-member of the board did not find the candidate 'fit' owing to the NMC guidelines, which it said, perhaps need revision. However, Dr Satendra Singh concluded that the appellant can successfully navigate the MBBS Course with clinical accommodations and assistive technologies.

The court said, the “both hands intact…” prescription has no sanctity in law as it does not admit of a functional assessment of the individual candidate, a matter which is so fundamental in protecting the rights of persons with disabilities.

In fact, the court pointed out, it was the Union government, through the Ministry of Social Justice and Empowerment which took the lead in issuing the communication of January 24, 2024 pursuant to the directions in a judgment.

The Centre's letter had then mandated the review of regulations by the National Medical Commission (NMC), which were recorded by this court.

In the case, the bench said, the correct approach in such cases is the one that Dr Singh has adopted viz, to not bar a candidate at the threshold but grant the candidate the choice after completing the MBBS Course, to decide whether he whishes to specialize in a nonsurgical or medical branch or continue as a General Duty Medical Officer.

"It will be unfair to presume incompetence at the threshold without first providing an opportunity to the candidate and ensuring the availability of accommodations and assistive products," the bench said.