Medical tribunal redefines standards of ‘negligence’

ISLAMABAD: The medical tribunal has delivered two significant judgements redefining the legal standards governing professional negligence, expert medical evidence and disciplinary proceedings against registered medical practitioners.

The judgements, authored by medical tribunal chairman retired justice Safdar Saleem Shahid, while deciding the connected cross appeals arising from disciplinary proceedings before the Pakistan Medical and Dental Council (PMDC), articulated principles of general application extending beyond the facts of the individual dispute to formulate a comprehensive judicial framework governing professional negligence, expert evidence, procedural fairness and proportionality of disciplinary sanctions.

The rulings, both available with Dawn, are expected to influence future proceedings before the PMDC, constitutional litigation and civil claims involving allegations of medical negligence.

Rather than treating the appeals as a disagreement confined to one surgical procedure, the tribunal examined broader questions concerning the legal standards applicable whenever allegations of professional negligence are investigated by statutory regulatory bodies.

Two rulings on appeals may influence future proceedings before PMDC, litigation and civil claims about medical negligence, misconduct

In doing so, it drew on comparative common-law jurisprudence while adapting those principles to Pakistan’s statutory framework.

First principle

The tribunal held that medicine is not an exact science and that recognised diagnostic or surgical procedures may result in known complications despite the exercise of reasonable skill and care. Consequently, an unsuccessful treatment or adverse clinical outcome cannot, by itself, establish professional negligence.

Second principle

In what is regarded as an important clarification of the country’s medical law, the tribunal emphasised that professional negligence and professional misconduct cannot be treated as interchangeable expressions.

Professional negligence concerns whether a doctor exercised reasonable clinical skill and judgement, whereas professional misconduct relates to breaches of ethical, statutory or professional obligations.

Third principle

The judgements have reaffirmed that expert medical evidence ordinarily remains indispensable in cases involving allegations of clinical negligence. However, the tribunal held that expert opinion is not conclusive merely because it originates from medical professionals.

Borrowing from internationally recognised principles governing medical negligence, the tribunal observed that adjudicating authorities must independently determine whether expert opinion is logical, evidence-based and capable of withstanding objective judicial scrutiny before relying on it to impose disciplinary sanctions.

Fourth principle

The tribunal further ruled that disciplinary findings carrying serious professional consequences must be supported by reliable evidence and reasoned decision-making.

Regulatory authorities, it observed, are required to evaluate all relevant material objectively, address the principal submissions advanced by both parties and ensure that conclusions are based upon tested evidence rather than conjecture, assumptions or unsubstantiated allegations.

Fifth principle

The tribunal observed that the purpose of professional discipline is to protect patients, maintain public confidence in the medical profession and uphold professional standards while ensuring fairness to practitioners.

Published in Dawn, July 27th, 2026 ...