The Karnataka High Court recently 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 surgery was necessary for her overall health, dignity and well-being.
The single-judge Bench of Justice Suraj Govindaraj exercised the Court’s parens patriae jurisdiction (legal doctrine that empowers the state or a court to act as a guardian for individuals who cannot protect themselves), holding that the woman lacked the mental capacity to provide informed consent and was unable to independently manage menstrual hygiene due to her medical condition.
According to the petition, the woman suffers from Global Developmental Delay, moderate intellectual disability, cerebral palsy and a seizure disorder. Medical evaluations placed her social age at around five years and four months, while her IQ was assessed at 36. She was also found to have 75% permanent disability.
Her parents informed the Court that her inability to understand or manage menstruation had led to repeated infections, fever and prolonged health issues, causing immense physical discomfort and emotional distress. They also highlighted the difficulties faced by them as ageing caregivers responsible for her daily care.
Considering the serious medical, legal and ethical questions involved, the Court had earlier directed the formation of a multidisciplinary Medical Board at Vanivilas Hospital in Bengaluru. The Board included specialists in psychology, psychiatry, neurology, obstetrics and gynaecology, radiology and anaesthesiology.
After examining the woman, the Board unanimously concluded that she suffered from permanent intellectual and developmental disabilities, could not independently maintain menstrual hygiene and was medically fit for the procedure. It also found no contraindication for the hysterectomy.
The High Court observed that reproductive autonomy and bodily integrity are constitutionally protected rights, including for persons with disabilities. Referring to the Supreme Court’s ruling in Suchita Srivastava, the Court reiterated that disability alone can never justify removal of reproductive organs.
However, in the present case, the Court held that overwhelming medical evidence established that the patient was incapable of making informed medical decisions and that the surgery was necessary to safeguard her health, dignity and quality of life. The single-judge Bench authorised the procedure at Vanivilas Hospital and directed authorities to ensure proper counselling, rehabilitation support and post-operative care throughout the treatment process.
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