By Nihit Nagpal and Manmeet Singh Marwah
To declare any act as a criminal offence, it must consist of two elements – Actus Reus (a guilty act) and Mens Rea (intention or knowledge of wrong-doing). Actus Reus is divided into two parts. The first part is the conduct which includes an act and its subsequent commission, and the second part is the consequences or result of that act. Mens Rea, on the other hand, includes knowledge of that act, the intention behind that act, and the condition that the act must be a voluntary act and not involuntary. These all constituents can be combined so as to constitute a ‘guilty mind’. Actus Reus is an external element, and Mens Rea is an internal element. If any one of the elements is missing, then that act is not considered to be a criminal offence except in some special circumstances.
The Hon’ble Supreme Court vide its order dated August 06, 2021 in Prabhat Kumar Singh v. State of Bihar has recently made it clear that the absenteeism of Mens Rea i.e. malicious or bad intent is not a significant element in cases of medical negligence. The Court at the same time has also emphasized that proper procedure needs to be followed while trying any criminal complainant pertaining to medical negligence.
The Appellant had filed a complaint before the Additional Chief Judicial Magistrate, Patna against private Respondents for an offence punishable under Section 304, Section 316 / Section 34 of the Indian Penal Code, 1860. After hearing the evidence of the three witnesses and analyzing other documentary evidence, the Trial Court issued summons to the Respondents on December 24, 2016. Thereafter, the Respondents challenged the summoning order before the Hon’ble High Court of Patna. The Hon’ble High Court vide its order dated August 14, 2020 set aside the summoning order passed by the Court of Additional Chief Judicial Magistrate, Patna on the ground that there was no evidence presented before the Court which reflected the presence of Mens Rea to show malicious or bad intent of the Respondents. Thereafter, Appeal was filed before the Hon’ble Supreme Court and the issue before them was whether Mens Rea is necessary in the case of medical negligence to determine the guilt of an accused or not?
JUDGEMENT BY THE HON’BLE SUPREME COURT
The Apex Court set aside the impugned judgment and order of the Hon’ble High Court as well as summons order dated December 24, 2016 issued by the Trial Court on the grounds that according to the guidelines provided in the case of Jacob Mathew v. State of Punjab & Anr., the Trial Court should have insisted on medical evidence or examination of professional doctor by the complainant in support of his case made out in the complaint.
The Apex Court further observed that the decision given by the Hon’ble High Court is erroneous because, in the case of medical negligence, there is no requirement to show Mens Rea as intent. Sans Mens Rea also constitutes the offense of medical negligence. The Apex Court referred the matter back to the Trial Court for reconsideration of the issue afresh.
To fully understand the judgment, we have first to understand the meaning of medical negligence. A health care provider’s conduct or omission that deviates from accepted medical standards of practice and causes injury to a patient is known as medical negligence. Similarly, negligence is described as failing to do something that a prudent and reasonable person would do or doing something that a prudent and reasonable person would not do, based on the principles that typically govern the conduct of human affairs.
In criminal law, the presence of Mens Rea is frequently required for responsibility. It means that no one can be penalized unless he knew he was doing something improper or if a reasonable person in his position could have prevented the detrimental consequence by exercising reasonable caution. However, in civil law, if someone causes harm to another person, he must pay for it, whether he did it intentionally, negligently, or by chance. In such circumstances, he has caused harm and must compensate the plaintiff/victim because the primary goal of civil actions is to remedy the plaintiff’s harm, not to punish for their wrongdoing.
The liability under Section 304 of the Indian Penal Code, 1860 is based on the idea that the effects of an unlawful act can be predicted. Thus, if a medical practitioner performs an act that he did not intend or even anticipate but that a reasonable medical practitioner would have predicted as likely to cause death under comparable circumstances, he might be held liable for Medical Negligence according to the facts and circumstances of the case.
 Prabhat Kumar Singh Vs. State of Bihar SLP(Crl.) Nos. 2395-2396 of 2021
 Section 304 of the Indian Penal Code, 1860. Punishment for culpable homicide not amounting to murder.—Whoever commits culpable homicide not amounting to murder, shall be punished with 1 [imprisonment for life], or imprisonment of either description for a term which may extend to ten years, and shall also be liable to fine, if the act by which the death is caused is done with the intention of causing death, or of causing such bodily injury as is likely to cause death; or with imprisonment of either description for a term which may extend to ten years, or with fine, or with both, if the act is done with the knowledge that it is likely to cause death, but without any intention to cause death, or to cause such bodily injury as is likely to cause death.
 Section 316 of the Indian Penal Code, 1860. Causing death of quick unborn child by act amounting to culpable homicide.—Whoever does any act under such circumstances, that if he thereby caused death he would be guilty of culpable homicide, and does by such act cause the death of a quick unborn child, shall be punished with imprisonment of either description for a term which may extend to ten years, and shall also be liable to fine.
 Section 34 of the Indian Penal Code, 1860. Acts done by several persons in furtherance of common intention.—When a criminal act is done by several persons in furtherance of the common intention of all, each of such persons is liable for that act in the same manner as if it were done by him alone.
 (2005) 6 SCC 1
 Denning Lord MR. The Discipline of Law. New Delhi; Aditya Books Private Limited: 1993