No criminal proceedings against doctor for prescribing costly medicines, rules Orissa High Court

The Orissa High Court dismissed criminal charges against Dr. Rabindra Kumar Jena, a former haematology professor accused of favouring pharmaceutical companies by prescribing expensive chemotherapy drugs to cancer patients.

In a significant ruling delivered on April 16 and released on Monday, Justice Aditya Kumar Mohapatra emphasised that doctors cannot be criminally prosecuted for prescribing costlier medicines unless the drugs are proven to be “hazardous, substandard, or restricted by the government.”

Case Background: Allegations of Undue Favouritism

In December 2017, the Odisha Vigilance Department filed an FIR against Dr. Jena, alleging he abused his position as head of Cuttack SCB Medical College’s haematology department (2013–2017) to violate guidelines under the Odisha State Treatment Fund (OSTF).

The OSTF scheme, designed to aid Below Poverty Line (BPL) patients with terminal illnesses, was allegedly misused by Dr. Jena to prescribe costlier drugs like Atgam and Hamsyl instead of cheaper alternatives (Thymogam and L-Asparaginase).

Prosecutors claimed this caused financial losses to the state and pressured economically vulnerable patients. Dr. Jena challenged the charges in 2024, calling them procedurally flawed.

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Court’s Findings: Upholding Medical Autonomy

Justice Mohapatra dismissed the allegations, stressing that “prescribing any chemo drug is the sole prerogative and expertise of treating doctors.”

The court noted the OSTF guidelines “never restrict prescribing costlier medicine if better for treatment” and do not mandate cheaper drugs regardless of efficacy.

The judgment highlighted that patients under the OSTF scheme paid for medications voluntarily, with no complaints of coercion. The prescribed drugs were of “standard quality and produced better results,” with no evidence of harm.

Procedural Lapses in Prosecution

The court criticised the investigation for bypassing due process. An inquiry committee, formed to probe the allegations, included non-specialists in blood cancer treatment and failed to follow principles of natural justice.

“The accused were neither served with notices nor given a hearing,” Justice Mohapatra observed, rendering the inquiry “unsustainable in law.” The court also noted that departmental proceedings had exonerated Dr. Jena of ethical violations, with the only upheld charge relating to delayed property returns.

Broader Implications: Protecting Doctors’ Professional Ties

The ruling warned against criminalising doctors’ interactions with pharmaceutical firms, such as attending conferences or seminars.

“Otherwise, every doctor in India would face criminal charges,” the court stated, clarifying that such engagements are often essential for career growth. It reaffirmed that the state cannot compel patients to opt for cheaper drugs if alternatives are clinically superior, emphasising doctors’ “ethical and legal obligation to prioritise patient survival.”

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Verdict Condemns Arbitrary Prosecution

Quashing the case as “ex-facie illegal,” Justice Mohapatra condemned the prosecution for “arbitrariness, discrimination, and mala fide intent,” noting that other doctors prescribing similar drugs were not targeted.

The judgment concluded that continuing the case would amount to an “abuse of process of law,” safeguarding medical professionals from liability for good-faith clinical decisions.