The Supreme Court of India's landmark decision in “Mr. X v. Hospital Z” (1998) deals with the balance between an individual’s “right to privacy” and society’s “need to protect public health”. The case raised key questions about medical confidentiality, the limits of privacy under Article 21 of the Constitution, and the ethical responsibilities of healthcare organizations. This judgment has played a vital role in shaping the legal understanding of fundamental rights in sensitive health-related situations.

The patient, who needed surgery for an aortic aneurysm, was brought to Chennai by the appellant, who was a doctor employed by the Nagaland State Medical Services. Prior to the surgery, the appellant was invited to donate blood, but pre-donation testing revealed that he was HIV-positive which was informed by the hospital. On the other side of event, on December 12, 1995, the appellant was supposed to be engaged. However, the wedding was cancelled a month prior to the event, stating that a doctor at Hospital Z (Respondent 1) had informed them that Mr. X is HIV positive.

When the appellant approached the hospital administration regarding the unauthorized disclosure of his health status, he did not receive a satisfactory response. He then filed a complaint with the National Consumer Disputes Redressal Commission, seeking compensation and interim relief for the breach of confidentiality. The appellant claimed that the disclosure led to social ostracism, financial loss, and discrimination, as the community became aware of his HIV status following the cancellation of his marriage.

1. Does the Indian Constitution recognize the right to privacy as a fundamental right?
2. If the right to privacy is protected under Article 21, what restrictions or limitations can be applied to it?
3. How can we balance two conflicting rights:

1. An individual’s right to marry despite having an infection, and
2. The potential partner’s right to a healthy life?

4. When is it ethical and legal for medical professionals to disclose a patient’s confidential information?

The Appellant argued that the principle of “duty of care” applied to medical professionals and included the duty to maintain confidentiality; they referred to the “Hippocratic Oath”, the “International Code of Medical Ethics”, and the “Indian Medical Council Act, 1956” in this regard. He also argued that the Respondent infringed upon the Appellant’s right to privacy by disclosing his HIV (+) status. He contended that every man or woman has an absolute right to marriage and the Respondent should have maintained strict secrecy. 

The Court referred to relevant provisions of the Indian Code of Medical Ethics and the General Medical Council of Britain’s guidelines on HIV and AIDS and held that disclosure of medical information is permitted in the public interest, particularly when there is a clear and immediate risk to the health of others. In this case, the appellant's right to confidentiality could not be upheld because the proposed marriage posed a serious health risk to an identifiable individual.

• Right of patients suffering from AIDS to marry

On the issue of whether AIDS patients have the right to marry, the court acknowledged that while individuals have the freedom to marry, this right comes with certain responsibilities. Considering the importance of mental and physical health in marriage, a person with a communicable venereal disease like AIDS cannot claim an absolute right to marry. The court referred to provisions of the Indian Penal Code 1860 that can be applied if someone intentionally spreads venereal diseases, along with divorce grounds related to such conditions. By addressing these points, the court considered the potential and significant harm that the prospective bride might have faced if the patient’s condition had been kept confidential.

• The conflict between fundamental rights of two persons:  right to health v. right to privacy

In this ruling, the court addressed the issue of conflicting rights. It held that rights serving public morality or the public interest would take precedence, likely based on the utilitarian principle. The court stated that certain rights could be overridden when matters of greater public interest or public order are involved.

Future course

This judgment was later overruled in “Mr. X v. Hospital Z (2003) 1 SCC 500”, where the Court held that the earlier Bench had exceeded its authority by commenting on the rights and obligations of HIV-positive individuals regarding privacy and confidentiality. The Court stated that, apart from the finding that revealing the appellant’s HIV-positive status to his fiancée’s relatives did not violate his rights, the other observations made by the Bench were unnecessary.