Traditional Medicine and Legal Boundaries

A recent online exchange between a hepatologist and a chess Grand Master has reignited debate over the status and legal scope of Ayurvedic and other traditional medicine practitioners in India.

Historical Context and Regulatory Framework

• Bhore Committee’s Scientific Orientation (1946): The Bhore Committee endorsed evidence-based modern medicine and advised that states independently determine the role of traditional medicine within their public health systems.
• Response through Indigenous Systems Committee (1948): Traditional medicine proponents, invoking cultural nationalism, led to the formation of a committee that equated Ayurveda with ancient Vedic wisdom and framed its marginalization as a result of colonial suppression.
• Statutory Recognition of Traditional Medicine (1970–2020): The Indian Medicine Central Council Act (1970) and its successor, the National Commission for Indian System of Medicine Act (2020), formally recognized and regulated Ayurvedic, Siddha, and Unani practitioners.

Legal Ambiguities and Scope of Practice

• Conflict over Prescriptive Authority (Rule 2(ee), 1945): State governments have used Rule 2(ee) of the Drugs and Cosmetics Rules to empower Ayurvedic and Unani practitioners to prescribe modern medicine, despite a 1998 Supreme Court ruling disallowing such practice.
• Judicial Interpretation in Mukhtiar Chand Case: The Supreme Court held that the right to prescribe allopathic medicines is inseparable from the right to practice modern medicine, thereby restricting such rights to formally trained MBBS practitioners.
• Surgeries and Procedural Scope Notification (2020): A central notification allowed postgraduate Ayurvedic practitioners to perform 58 types of surgeries; its constitutional validity remains under judicial scrutiny amid serious concerns over competence and safety.

Political Dimensions and Public Health Implications

• Politicisation through Cultural Nationalism: Political parties have embraced traditional medicine in policy rhetoric, driven more by identity politics and “Hindu pride” than scientific rationale or public health safety.
• Fiscal and Institutional Expansion of AYUSH: Government expenditure on AYUSH research and institutional integration—such as inclusion in Ayushman Bharat—has reached ?20,000 crore, despite limited empirical outcomes.
• Risks to Public Health and Consumer Rights: Cases of misrepresentation and litigation highlight the public health risks and ethical dilemmas arising from blurring boundaries between evidence-based medicine and traditional practices.

Practice Question:

“In the context of India's pluralistic medical landscape, critically examine the legal, ethical, and public health implications of allowing traditional medicine practitioners to prescribe and perform procedures based on modern medical science.”