Taha Ahmed
DOCTORS occupy a singular place in Pakistani society. A few professions command greater public trust and the title “Dr.” continues to carry immense social prestige. Yet that trust rests upon a surprisingly fragile legal foundation. Pakistan has more than 366,000 registered medical and dental practitioners, but it still lacks a comprehensive statutory framework governing medical liability, informed consent, patient autonomy and institutional accountability. While the Pakistan Medical and Dental Council Act, provincial healthcare legislation and general principles of civil, criminal and constitutional law regulate aspects of healthcare, none constitutes a coherent body of medical law.
When a surgeon operates on the wrong patient, a laboratory issues a false diagnosis with life altering consequences, a hospital fails to obtain informed consent or an artificial intelligence assisted system contributes to a clinical error, what body of law governs responsibility? The answer remains remarkably uncertain. Liability may arise through civil negligence, criminal prosecution, disciplinary proceedings before the Pakistan Medical and Dental Council, provincial healthcare regulators or constitutional litigation.
The Supreme Court has addressed medical negligence, but its jurisprudence remains largely confined to professional fault. In Dr Professor M.A. Cheema v Tariq Zia (2016 SCMR 119), the Court held that negligence cannot be inferred merely because treatment proves unsuccessful. Liability arises only where a practitioner falls below the standard expected of a reasonably competent professional. This reflects the English decision in Bolam v Friern Hospital Management Committee (1957), under which a doctor is generally not negligent if acting in accordance with a responsible body of medical opinion.
Modern medical law has progressed considerably. In Bolitho v City and Hackney Health Authority (1998), the House of Lords held that courts need not accept expert opinion uncritically but must determine whether it is logically defensible. The law evolved further in Montgomery v Lanarkshire Health Board (2015), where the United Kingdom Supreme Court recognized that patients are entitled to decide which risks are worth taking, requiring doctors to disclose material risks and reasonable alternatives. Canterbury v Spence (1972) similarly recognized informed consent as an expression of patient autonomy and bodily integrity.
Pakistan has yet to make this jurisprudential transition. Judicial attention remains focused on individual negligence while largely overlooking informed consent, institutional liability, patient autonomy, telemedicine, artificial intelligence and medical data governance. Yet healthcare today is increasingly delivered through corporate hospitals, multidisciplinary teams, electronic records and AI assisted systems, where systemic failures can be just as significant as individual mistakes.
The Constitution provides a strong foundation for reform. Article 9 has been interpreted to protect the quality of life, while Article 14 guarantees the inviolability of human dignity. Together, these principles support a patient’s right to informed consent, autonomous medical decision making and reasonable standards of care.
Pakistan urgently needs comprehensive legislation. A Medical Liability and Patient Safety Act should preserve the Bolam and Bolitho standards for clinical judgment while incorporating Montgomery’s doctrine of informed consent. It should recognize institutional alongside individual liability, regulate artificial intelligence and telemedicine, strengthen medical data protection and expressly recognize patient autonomy as a constitutional right flowing from Articles 9 and 14. Pakistan’s healthcare crisis is no longer merely medical. It is fundamentally legal and modern medicine can no longer be governed by outdated legal principles.
—The author is currently associated with the University of London.
