Supreme Court Sets Gross Negligence Test for Doctors
The Supreme Court medical negligence ruling sets a clear limit on when doctors in Pakistan can face criminal charges. A doctor cannot be held criminally liable merely because a patient is injured or dies during treatment; the prosecution must prove gross negligence.
The court gave the ruling in a six-page judgment authored by Justice Ishtiaq Ibrahim. A division bench headed by Justice Muhammad Hashim Kakar dismissed an appeal against the acquittal of doctors accused of medical negligence.
Supreme Court medical negligence ruling: the three-part test
The judgment sets out three elements the prosecution must prove for a charge under section 319, which covers death by a rash or negligent act. First, a duty of care must exist. Second, that duty must have been breached in a way that caused the death. Third, the breach must amount to gross negligence by the medical professional.
The court said the mere fact that injury or death occurred during treatment cannot substitute for proof of that heightened degree of negligence. An error or undesirable outcome alone does not establish negligence; the act or omission must be connected with the injury.
The ruling also draws a line between an ordinary mistake and criminal conduct. A doctor cannot be held liable merely because another course of treatment was available, or because a more experienced practitioner might have acted differently.
What standard will courts apply
The test, the court said, is that of an ordinarily competent practitioner exercising ordinary professional skill in the relevant field. It is not the standard of the most highly skilled specialist, and the law does not demand perfection.
The judgment also separates civil liability from criminal liability. Conduct enough for civil negligence does not necessarily amount to a criminal offence, which needs a substantially higher degree of negligence, marked by grossness or recklessness.
The court explained negligence in plain terms: the omission of something a reasonable and prudent person would do, or the commission of an act such a person would avoid. For doctors, the question is whether the practitioner followed a practice accepted as proper by the profession at the time.
The Shifa case behind the ruling
The case arose from the death of a woman at Shifa International Hospital in Islamabad, where she delivered twin girls after being admitted with labour pain.
The petitioner, her husband, alleged that doctors administered spinal anaesthesia instead of an epidural injection, contrary to his request. He said his wife later developed back pain that worsened until her death.
The complaint was dismissed, and the Islamabad High Court later upheld the doctors’ acquittal. The Supreme Court has now dismissed the appeal against that acquittal, and its reasoning sets the standard for similar cases.
Why the ruling matters for patients and doctors
For patients and families, the ruling does not close the door on complaints. It defines which complaints can lead to a criminal case: duty, breach, causation, and gross negligence must all be shown. Claims short of that bar belong in civil or professional forums, not a criminal trial.
For doctors, the ruling gives protection against prosecution based on outcome alone. A poor outcome, or a choice that looks wrong in hindsight, is not enough.
The ruling also matters beyond this case. Trial courts across Pakistan hear medical negligence complaints, and the three-part test now gives them a common frame for what prosecutors must prove.
The judgment was reported on Tuesday, 3 November 2026, alongside other recent court decisions, including the apex court’s review rules and a Lahore High Court petition seeking a government reply. Daily-wage health workers also won a Lahore High Court order in a separate case.
What is the Supreme Court medical negligence ruling?
It holds that a doctor faces criminal liability only when the prosecution proves a duty of care, a breach causing death, and gross negligence, under section 319.
Does a patient’s death during treatment prove medical negligence?
No. The court said injury or death during treatment, by itself, does not prove negligence, and an error of judgment alone is not enough.
What is the difference between civil and criminal medical negligence?
Civil negligence can be established on a lower threshold. Criminal liability needs a substantially higher degree of negligence, marked by grossness or recklessness.
What happened in the Shifa International Hospital case?
A woman died after delivering twin girls at the hospital. Her husband alleged the wrong form of anaesthesia was used. The complaint was dismissed, the Islamabad High Court upheld the acquittal, and the Supreme Court has now dismissed the appeal.
Who wrote the Supreme Court judgment?
Justice Ishtiaq Ibrahim authored the six-page judgment, and a division bench headed by Justice Muhammad Hashim Kakar heard the appeal.
