In a heartfelt courtroom scene on Thursday, the Madras High Court stepped in to safeguard a 13-year-old boy's life, directing the Government Stanley Medical College and Hospital to carry out his kidney transplant without insisting on the estranged father's consent.
Justice M. Dhandapani delivered the order while hearing a writ petition filed by the boy's mother, A. Kasthuri, who said the bureaucratic insistence on the father’s signature had left her son’s treatment in limbo.
Background
Kasthuri married Ayyappan in 2010, and their only child, Joshua, was born a year later. But in 2017, Ayyappan deserted the family, and since then Kasthuri has been single-handedly raising Joshua with support from her brother. Earlier this year, the family's world turned upside down when Joshua was diagnosed with end-stage chronic kidney disease (Stage V).
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Doctors at Stanley Medical College put him on continuous ambulatory peritoneal dialysis (CAPD), a temporary measure to keep him alive. However, when Kasthuri pushed for a kidney transplant - the only permanent treatment - hospital authorities refused to proceed without the father's written consent, citing the Transplantation of Human Organs and Tissues Act, 1994.
"The letter from the nephrology department said the father's signature was mandatory. But he's been missing for years. How can we get his consent?" Kasthuri’s counsel argued, calling the hospital's stance "arbitrary" and "a violation of the child’s right to life under Article 21 of the Constitution."
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Court's Observations
The courtroom was silent as Justice Dhandapani acknowledged the urgency of the situation. The judge noted that the mother had been the sole caregiver since 2017 and the father had completely abandoned the family.
The bench observed,
"When the father has long deserted the child, denying treatment on the ground of his absence would amount to denying the very right to life of the minor," a lawyer present told this reporter after the hearing.
The Judge also took note of the government's willingness to cooperate. Government Advocate E. Sundaram assured the court that a meeting was already scheduled at Stanley Medical College on September 19 to discuss the case and that "appropriate care will be given" to Joshua.
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Decision
Recording these assurances, Justice Dhandapani disposed of the writ petition with a clear directive. The court ordered the Dean and the Head of the Nephrology Department at Stanley Medical College to proceed with Joshua's renal transplantation "forthwith" and "without insisting on any unreasonable demand from the petitioner."
They were directed to complete the process within two weeks from the receipt of the order. The judge made it clear that Joshua's treatment must not be held hostage to paperwork, especially when the child’s survival is at stake.
With that, the petition was allowed, and the court refrained from imposing any costs. The order brought visible relief to Kasthuri, who quietly folded her hands towards the bench before leaving the courtroom.
Case Title: A. Kasthuri vs The State of Tamil Nadu & Others
Case Number: W.P. No. 35940 of 2025
Date of Order: 18 September 2025
