Source: The Hindu 

Introduction  

The Maharashtra Government in a recent directive allowed homeopathic practitioners to prescribe allopathic medications. This is also known as crosspathy. 

What is Crosspathy? 

• Crosspathy refers to the practice of medical professionals using treatments or prescribing medications outside the system of medicine in which they are formally trained and license. 
• For example, a homeopath prescribing allopathic (modern medicine) medications, or vice versa. 
• Crosspathy involves the crossing or mixing of different medical systems (e.g., homeopathy, allopathy, Ayurveda) by practitioners who are not formally qualified in the system they are practicing. 
• Crosspathy is only allowed in certain states of India where specific governments have issued general or special orders authorizing such practices.

What is the Directive Issued by Maharashtra Food and Drugs Administration?  

• The Maharashtra Food and Drugs Administration (FDA) recently issued a directive permitting homeopathic practitioners who have completed a certificate course in modern pharmacology to prescribe allopathic medications. 
• In 2017, the Maharashtra Medical Education and Drug Department issued a notification allowing homeopathic practitioners with the Licentiate of the Court of Examiners of Homeopathy degree (obtained between 1951 and 1982) to practice modern medicine, provided they were registered with the Maharashtra Medical Council. 
• This 2017 notification was challenged by the Indian Medical Association (IMA) in the Bombay High Court, which issued a stay on the directive, citing potential risks to patients if homeopathic practitioners were allowed to practice allopathy. 
• Following the Bombay High Court’s stay, homeopathic practitioners are not legally permitted to prescribe allopathic medications until the final court ruling. 
• Former IMA Maharashtra secretary Parthiv Sanghvi highlighted that the issue was inaccurately portrayed as government approval for homeopaths to practice modern medicine, which remains stayed. 
• He questioned the FDA’s authority to issue such a directive, particularly when the High Court had already stayed the previous order. 

What is the Landmark Case of Supreme Court on Crosspathy? 

• The Supreme Court addressed the issue in the case of Poonam Verma v. Ashwin Patel and Others (1996). 
• Facts of the case were as follows: 
  • Mr. Pramod Verma complained of fever and was treated by Dr. Ashwin Patel, a homeopath with a Diploma in Homeopathic Medicine and Surgery. 
  • Dr. Ashwin Patel prescribed allopathic medicines and intramuscular injections for what he diagnosed as viral fever and later typhoid, but the treatment failed to improve Mr. Pramod Verma's condition. 
  • Dr. Ashwin Patel advised him to seek further treatment under Dr. Rajeev Warty, an allopathic practitioner running Sanjeevani Maternity and General Nursing Home in Bombay. 
  • After being treated by Dr. Ashwin Patel advised him to seek further treatment under Dr. Rajeev Warty from 12th  to 14th July, 1992, Mr. Pramod Verma was transferred in an unconscious state to Hinduja Hospital on 14th July. He died later that evening at the age of 35, leaving behind his wife, two children, and parents. 
  • Mrs. Poonam Verma, Mr. Pramod Verma's wife, filed a petition with the National Consumer Disputes Redressal Commission on 14th August, 1992, seeking compensation and damages for the alleged negligence of Dr. Ashwin Patel and Dr. Ashwin Patel advised him to seek further treatment under Dr. Rajeev Warty. 
  • The National Consumer Disputes Redressal Commission dismissed the petition on 8th November, 1994, due to the lack of expert evidence provided by the appellant. Mrs. Poonam Verma subsequently challenged this dismissal in the Supreme Court. 
• Findings of the Supreme Court in this case were as follows: 
  • The Supreme Court held Dr. Ashwin Patel (Respondent 1) liable for actionable negligence as he prescribed allopathic medicines despite being qualified only as a homeopath under the Bombay Homeopathic Practitioners' Act, 1959. His actions breached his statutory duty to practice homeopathy exclusively. 
  • The Court found that Respondent 1’s practice of allopathy without requisite qualifications constituted negligence per se, as it violated laws designed for the protection of public health, including the Indian Medical Council Act, 1956, and the Maharashtra Medical Council Act, 1965. 
  • The Court directed Respondent 1 to pay ₹3,00,000 as compensation and ₹30,000 as legal costs to Mrs. Poonam Verma, recognizing the financial and emotional loss suffered by Mr. Pramod Verma 's family due to Respondent 1’s negligent acts. 
• Further, a 2015 research paper by Suresh Bada Math states that “Across judgments, the judiciary has held that cross-system practice is a form of medical negligence; however, it is permitted only in those states where the concerned governments have authorised it by a general or special order.”

What is Medical Negligence under Bharatiya Nyaya Sanhita, 2023 (BNS)? 

• Section 106 (1) of BNS provides: 
  •  If someone causes death through rash or negligent acts (not amounting to culpable homicide), they may face up to five years imprisonment, a fine, or both. 
  • If a registered medical practitioner causes death during a medical procedure due to negligence, the maximum punishment is reduced to two years imprisonment, a fine, or both. 
  • The term "registered medical practitioner" refers to a doctor whose qualifications are recognized under the National Medical Commission Act, 2019, and whose name is listed in the national or state medical register. 
• Section 106 (2) of BNS provides: 
  • Negligent Driving and Hit-and-Run: If someone causes death by rash and negligent driving and then escapes without reporting the incident to the police or a Magistrate, they may face up to ten years imprisonment, a fine, or both. 

Conclusion

Crosspathy is a mechanism whereby a doctor qualified in homeopathy is allowed to prescribe allopathic medicines. This falls under the category of medical negligence.