New Delhi – In response to mounting concerns over the ethical implications of broadcasting live surgical procedures, the Ethics and Medical Registration Board (EMRB) of the National Medical Commission (NMC) has issued comprehensive guidelines regulating the conduct and broadcast of live surgeries.
The move comes after a plea filed in the Supreme Court in 2023 alleged that private hospitals were commercially exploiting patients by showcasing them as models during live surgeries at medical conferences. The petition raised serious questions about patient safety, informed consent, and the commercialization of healthcare.
Background
The issue was brought to national attention by a Delhi-based ophthalmologist who petitioned the apex court, arguing that live surgical demonstrations, especially in front of large audiences, diverted the surgeon’s attention and compromised patient care. During the hearings, the court bench led by Chief Justice D.Y. Chandrachud issued notices to the Centre and the NMC. Subsequently, NMC sought feedback from healthcare professionals and the public on whether live surgeries should be allowed at all.
A committee was constituted by the NMC to examine the matter. Based on the committee’s recommendations, the Commission released detailed guidelines to govern the practice, emphasizing ethical conduct, patient safety, and transparency.
🔹 Key Highlights of the Guidelines:
A. Major Concerns Identified:
- Live surgeries may lack educational depth compared to recorded sessions.
- Patients are often unaware that surgeons may be distracted during live demos.
- Ethical and legal risks arise if complications occur mid-procedure.
- The practice has been banned by several medical associations due to pressure on surgeons.
- Commercial motives may override educational intent, putting patients at risk.
B. Who Can Organize and Supervise:
- Only recognized institutions or authorized professionals can host live surgeries.
- Organizers must be under indemnity insurance.
- Foreign Medical Practitioners (FMPs) must seek temporary permission from NMC and the respective State Medical Council.
C. Who Can Perform Live Surgeries:
- Only Registered Medical Practitioners or FMPs with minimum five years of specialty experience are allowed.
- FMPs require NMC and State approval.
D. Approved Locations:
- Live surgeries must only be conducted in accredited hospitals with:
- Fully equipped OTs
- Emergency backup systems
- Contingency and complication management protocols
E. Method of Execution:
- Patient selection should exclude high-risk or incomplete cases.
- No financial incentives to patients.
- Informed consent must clearly explain the nature, risks, and purpose of the broadcast.
- Surgeons must not engage with the audience during the operation to preserve focus.
- Moderators may provide commentary without real-time audience interaction.
F. Responsibilities:
- Organizers are accountable for ensuring patient safety, informed consent, and adherence to privacy and ethical norms.
- Surgeons must oversee patient care pre- and post-operatively for at least 24 hours.
G. Mandatory Regulatory Approvals:
- Prior permissions required from State Medical Councils or institutional deans.
- Oversight by an apex committee to ensure adherence to ethical standards.
H. Additional Directives:
- All broadcasts must strictly serve educational purposes—no commercial promotion allowed.
- Recordings should be stored for at least two years in non-litigation cases.
- Established procedures should be taught via recordings, reserving live demos for new or evolving techniques only.
🔸 Exemption
The only exception to these rules applies to institutions listed under the NMC Act, 2019, where live surgeries are conducted exclusively for internal teaching involving their own students and medical staff.
