The Karnataka High Court has permitted the parents of a 23-year-old woman with severe intellectual and developmental disabilities to proceed with a Total Abdominal Hysterectomy after concluding that the procedure would serve her health, dignity and long-term welfare. The Court emphasized that the order was not based on the woman's disability alone but on an independent medical assessment showing that she was incapable of giving informed consent and that the surgery was recommended in her best interests.
Background of the Case
The petition was filed by the woman's parents, who stated that their daughter has lived with significant developmental and intellectual disabilities since childhood. According to them, she is completely dependent on them for everyday activities and is unable to understand or manage menstrual hygiene.
They informed the Court that irregular menstrual cycles had led to repeated infections, fever and prolonged medical complications. As they grow older, they feared they would no longer be able to provide the intensive care she requires. They therefore sought permission for a hysterectomy, stating that the request was made solely to safeguard their daughter's health, comfort and dignity.
Medical Board's Findings
Given the sensitive nature of the request, Justice Suraj Govindaraj directed the constitution of a multidisciplinary Medical Board at Vanivilas Hospital, Bengaluru.
The Board examined the woman through specialists in psychology, psychiatry, neurology, obstetrics and gynaecology, radiology and anaesthesiology. It found that she had Global Developmental Delay with moderate permanent intellectual disability, an IQ of 36, a social age of about five years and four months, 75% permanent disability, cerebral palsy and a seizure disorder.
The specialists unanimously concluded that she was unable to independently manage menstrual hygiene and recommended that she could undergo a Total Abdominal Hysterectomy. The anaesthesiologist also found her medically fit for the surgery.
Court's Observations
The High Court stressed that bodily integrity and reproductive autonomy are constitutional rights enjoyed by every individual, including persons with disabilities. It observed that disability alone can never justify the removal of a reproductive organ.
Referring to the Supreme Court's decision in Suchita Srivastava, the Court said that reproductive choices form an essential part of personal liberty under Article 21 of the Constitution.
The bench observed,
"Disability, by itself, can never constitute a ground either to authorise the removal of a reproductive organ or to deprive a person of reproductive autonomy."
However, the Court noted that the present case was materially different because the medical evidence established that the woman lacked the cognitive ability to make an informed decision regarding the surgery.
The bench further observed,
"The permission is being granted only after judicial scrutiny, independent medical evaluation by specialists from multiple disciplines... and a determination that the proposed intervention is in the best interests of the patient."
The Court also clarified that the case did not involve sterilisation for eugenic purposes, population control or any attempt to curtail the rights of a person with disability. Instead, the recommendation was based entirely on concerns relating to health, hygiene, dignity, safety and quality of life.
Court's Decision
Allowing the writ petition, the Karnataka High Court permitted the parents to have the Total Abdominal Hysterectomy performed at Vanivilas Hospital, Bengaluru.
The Court directed the Medical Superintendent to ensure that the procedure is carried out strictly in accordance with the Medical Board's recommendations and all applicable medical, legal and ethical requirements.
It further ordered that the patient's welfare, dignity and safety be protected throughout the treatment, with appropriate pre-operative counselling, psychological support, post-operative care and rehabilitation.
The Medical Board has also been directed to monitor her recovery and submit a report to the Registrar General of the High Court within eight weeks after the procedure.
