Medical board absolved of negligence by tribunal ruling

ISLAMABAD: A medical tribunal in Islamabad has overturned disciplinary penalties imposed on four senior forensic experts who examined an exhumed body in a Jacobabad case after finding that their failure to identify a conclusive cause of death did not amount to professional misconduct.

The decision, announced on June 4 by a tribunal comprising retired justices Safdar Saleem Shahid and Azam Qambrani along with technical member Dr Minhajus Siraj, arose from action earlier taken by the former Pakistan Medical Commission (PMC), now the Pakistan Medical and Dental Council (PMDC). The tribunal held that the disciplinary proceedings were not supported by scientific evidence and were marred by procedural defects.

The matter related to Faisal Mugheri, described in the record as a young landlord from Jacobabad who died in 2020 under unexplained circumstances. According to the case history cited in the judgement, no suspicion was raised by family members at the time of his death. About a month later, his second wife approached a local court, alleging that he had been murdered and seeking exhumation and a post-mortem examination. The court ordered the exhumation and constituted a special medical board through the Sindh government.

Disciplinary action challenged

The board, made up of senior specialists in forensic medicine, pathology and medico-legal practice, carried out the exhumation and post-mortem but was unable to determine a definitive cause of death. The woman then approached the PMDC, after which its disciplinary committee suspended the licences of all four doctors for five years and imposed a fine of Rs500,000 on each, accusing them of negligence and misconduct.

In a judgement authored by Justice Safdar Saleem Shahid, the tribunal said the inability of experts to establish the cause of death in an exhumed and decomposed body could not by itself be treated as incompetence, negligence or misconduct. It noted that the exhumation had been conducted around 45 days after burial, by which time the body had undergone advanced decomposition, including severe deterioration of tissues and organs.

The tribunal observed that forensic pathology recognises that decomposition can seriously hinder efforts to identify the cause of death. It further noted that the medical board had recorded its findings, collected samples, obtained laboratory support and explained why it could not reach a final conclusion.

Scientific disagreement not misconduct

The ruling also addressed the PMDC’s reliance on a later expert opinion that disputed parts of the board’s findings. The tribunal held that differences between experts are a normal feature of scientific work and cannot automatically be converted into grounds for disciplinary punishment.

According to the judgement, regulators must distinguish between deliberate falsification and a genuine difference of scientific opinion. It said that unless there is proof of fabrication, dishonesty, manipulation of evidence or bad faith, a professional disagreement over interpretation is not, on its own, enough to justify sanctions. The tribunal added that expert conduct should be assessed on the basis of accepted scientific methodology rather than whether a particular conclusion later becomes more acceptable or popular.

Process found deficient

The tribunal also pointed to weaknesses in the disciplinary process, including vague allegations, procedural irregularities and reliance on expert opinions without sufficient procedural safeguards. It said quasi-judicial bodies are required to issue orders that clearly identify the specific violation, examine the evidence, address the defence of the accused professional and explain the basis for any penalty.

In addition, the tribunal criticised the PMDC for not framing its rules and regulations and directed the body to begin that process within a reasonable time and place the proposed rules before the competent authority for approval in accordance with the law.

The ruling is described in the judgement as one of the first decisions in Pakistan to affirm that scientific uncertainty, on its own, cannot be equated with professional negligence.