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Researched by Sidheswar Jena, Ph.D. (Law) Scholar

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Abstract

This paper examines the intersection of professional autonomy and political authority through two case studies: a hospital incident in the United Kingdom in 2011 and a suspension order against a doctor in India in 2025. By analyzing these events in the light of constitutional principles, case law, and existing scholarship, the paper argues that the strength of a democracy lies not only in its electoral processes but also in the resilience of its institutions. The comparison reveals the divergence between mature democracies, where institutional autonomy is respected, and developing democracies, where executive authority often prevails over professional independence.

Keywords: Professional Autonomy, Political Authority, Rule of Law, Natural Justice, Democracy, Comparative Constitutional Law

I. Introduction

Democracy is more than a system of elections; it is the practice of fairness, accountability, and institutional respect in everyday governance. Institutions such as hospitals, universities, and courts often become spaces where the boundaries of political authority and professional autonomy are tested.

Two incidents—one in the United Kingdom in 2011 and another in India in 2025—offer a lens to study this dynamic. While both involved doctors and political leaders, the differing responses illuminate broader questions of constitutionalism, the rule of law, and the maturity of democratic institutions.

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II. Literature Review

Scholars have long debated the relationship between executive authority and institutional autonomy.

A.V. Dicey’s classic exposition of the rule of law emphasized equality before the law, underscoring that political leaders should not enjoy privileges above ordinary citizens.¹ H.W.R. Wade and C.F. Forsyth similarly argue that the rule of law depends upon curbing arbitrary power and enforcing procedural safeguards.²

Indian constitutional commentators, such as M.P. Jain and Upendra Baxi, have highlighted how executive dominance has historically strained the autonomy of institutions, particularly in moments of political expediency.³ Comparative constitutional scholarship suggests that mature democracies internalize checks and balances into everyday institutional life, while developing democracies often exhibit patterns of “executive centralism.”⁴

Existing studies on medical professionalism and politics also emphasize that safeguarding professional independence is essential not only for institutional credibility but also for protecting fundamental rights such as dignity and health.⁵

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III. Legal and Theoretical Framework

A. Professional Autonomy and Democracy

Professional autonomy refers to the ability of individuals within specialized fields—such as medicine, law, or academia—to perform their duties without undue interference. In democratic theory, this autonomy safeguards expertise and ensures that decision-making is based on professional standards rather than political expediency.

B. The Rule of Law and Natural Justice

The rule of law demands that all authority, including the executive, is subject to established procedures and norms. Arbitrary state action undermines democracy. In India, the Supreme Court in E.P. Royappa v. State of Tamil Nadu held that arbitrariness and equality are antithetical.⁶ Similarly, in Maneka Gandhi v. Union of India, the Court expanded Article 21 to require fairness, non-arbitrariness, and due process in all state actions.⁷

The principles of natural justice, particularly audi alteram partem (“hear the other side”), were articulated in A.K. Kraipak v. Union of India, establishing that administrative actions must respect fairness and impartiality.

IV. Case Studies

A. The United Kingdom, 2011

In 2011, during a hospital visit in London, political leaders entered a patient ward accompanied by media crews. A senior doctor interrupted the visit, citing breaches of infection-control protocols.⁹ No disciplinary action was taken against the doctor.

This incident reflected a constitutional culture where professional norms are upheld against political symbolism. It also demonstrated the embeddedness of institutional autonomy in the everyday practices of a mature democracy.

B. India, 2025

In 2025, at a state-run hospital in India, a minister publicly ordered the suspension of a senior doctor after a complaint alleging refusal to administer an injection in the casualty ward. The suspension was immediate, public, and without inquiry.¹⁰

This raised significant constitutional concerns. By bypassing established disciplinary procedures, the suspension appeared to violate Articles 14 and 21 of the Constitution, as interpreted in Royappa and Maneka Gandhi. The lack of a hearing before suspension contravened the principles of natural justice affirmed in Kraipak.

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V. Comparative Analysis

The two cases illustrate distinct democratic trajectories:

In the UK, professional independence prevailed. The doctor could assert institutional norms against political leaders without retaliation, reinforcing public trust in democratic institutions.

In India, executive authority prevailed. The doctor’s suspension, ordered without inquiry, exemplified how political influence can overshadow due process, weakening institutional credibility.

The contrast highlights a broader issue: in mature democracies, checks and balances are internalized within everyday institutional practices, whereas in developing democracies, executive dominance often overrides professional autonomy.

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VI. Conclusion

Development cannot be assessed solely in terms of GDP or infrastructure. It must also be evaluated by the strength of institutions and the dignity of professionals who operate within them.

The UK incident of 2011 reflects the resilience of institutions, where professional standards prevailed over political presence. The Indian incident of 2025 reveals the fragility of institutional autonomy when confronted by executive authority.

For India, the lesson is clear: constitutional principles—rule of law, non-arbitrariness, and natural justice—must guide not only legislative or judicial actions but also everyday administrative practice. A truly developed democracy is one where power bows before professionalism, ensuring that institutions, not individuals, define the nation’s dignity.

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Footnotes

1. A.V. DICEY, INTRODUCTION TO THE STUDY OF THE LAW OF THE CONSTITUTION 193–95 (10th ed. 1959).

2. H.W.R. WADE & C.F. FORSYTH, ADMINISTRATIVE LAW 16–20 (11th ed. 2014).

3. M.P. JAIN, INDIAN CONSTITUTIONAL LAW 102–07 (8th ed. 2018); UPENDRA BAXI, THE INDIAN SUPREME COURT AND POLITICS 56–62 (1980).

4. See Bruce Ackerman, The New Separation of Powers, 113 HARV. L. REV. 633, 640–45 (2000).

5. DANIEL SPERLING, MEDICAL LAW AND ETHICS 85–90 (2007).

6. E.P. Royappa v. State of Tamil Nadu, (1974) 4 S.C.C. 3.

7. Maneka Gandhi v. Union of India, (1978) 1 S.C.C. 248.

8. A.K. Kraipak v. Union of India, (1969) 2 S.C.C. 262.

9. Laura Donnelly, Leading Surgeon Interrupts Hospital Visit of Prime Minister and Deputy Prime Minister, TELEGRAPH (June 9, 2011), https://www.telegraph.co.uk/news/health/news/8566637/Leading-surgeon-interrupts-hospital-visit-of-Prime-Minister-and-Deputy-Prime-Minister.html.

10. Express News Service, Minister Orders Suspension of Doctor at State Hospital, INDIAN EXPRESS (June 4, 2025), https://indianexpress.com/article/cities/mumbai/maharashtra-minister-orders-suspension-doctor-2025.