The Supreme Court verdict in the Kunal Saha case has left the medical fraternity worried. Doctors say they often operate amid serious constraints which makes the going all the more difficult. Doctors in western countries do not have to face such handicaps.

The verdict, they say, could demoralize the medical fraternity. "It’s a black day for the health sector. After this, you should forget lowcost healthcare," Dr Devi Shetty, founder and chairman, Narayana Hrudayalaya, Bangalore said. "We cannot compare with US healthcare standards. If such penalties are levied, how will doctors risk admitting critically–ill patients or administering emergency treatment,’ he asked.

Former head of Medical Council of India Dr S K Sarin said: "First, there is need to bring parity in standard of care, only then can we decide if treatment provided for a particular condition is in conformity with it or not. In many cases, there are major differences in medical education standards. This impacts quality of medical care. Medical graduates must go through a common licentiate exam before they can practice."

Still, the medical fraternity failed to convincingly answer why no punitive action was ever taken against doctors against whom charges of neglect were proven. The Delhi Medical Council gets 20–30 complaints of medical negligence every month. Most of these are either disposed of for lack of evidence or the accused is let off with a warning. "No doctor has been barred from practice ever," Dr Girish Tyagi, registrar of DMC, confirmed.

Aman Jesani, editor of the Indian Journal of Medical Ethics, conceded there were several instances of doctors being saved by their peers. "Getting an honest expert opinion is next to impossible. In many cases experts collude or sympathize with the accused and try to save him. Also, not all patients are aware of technical issues involved as Dr Kunal Saha was," he said. "Remember, Saha had to wait 15 years to get the judgment. This highlights how difficult it is to get justice here."