The Karnataka High Court permitted the parents of a 23-year-old woman suffering from severe intellectual and developmental disabilities to undertake a Total Abdominal Hysterectomy, holding that the procedure was in her best interests after an independent multidisciplinary medical evaluation. The Court exercised its parens patriae jurisdiction after finding that the woman lacked the cognitive capacity to provide informed consent and was unable to independently manage menstrual hygiene.
The petitioners informed the Court that their daughter suffered from Global Developmental Delay, moderate intellectual disability, cerebral palsy and a seizure disorder. According to medical assessments, her social age was approximately five years and four months, her IQ was assessed at 36, and she had a permanent disability of 75%. They contended that her inability to understand or manage menstruation had resulted in recurring infections, fever and prolonged health complications, while placing significant caregiving burdens on her ageing parents.
Given the medical, ethical and legal implications involved, Justice Suraj Govindaraj had earlier directed the constitution of a multidisciplinary Medical Board at Vanivilas Hospital, Bengaluru. The Board comprised specialists in psychology, psychiatry, neurology, obstetrics and gynaecology, radiology and anaesthesiology. After examining the patient, the Board unanimously concluded that she suffered from permanent intellectual and developmental disabilities, could not independently maintain menstrual hygiene, and was a suitable candidate for hysterectomy. The Board further found no medical contraindication to the procedure.
The Court observed that reproductive autonomy and bodily integrity are constitutionally protected rights, including for persons with disabilities, and referred to the Supreme Court’s decision in Suchita Srivastava recognising reproductive choice as an aspect of personal liberty under Article 21. It emphasised that disability by itself can never justify removal of a reproductive organ or curtailment of reproductive rights. However, the present case stood on a different footing because overwhelming medical evidence established that the patient lacked the capacity to make informed medical decisions and was permanently incapable of independently managing her menstrual hygiene.
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Justice Govindaraj noted that the decision was not based on substituted parental consent alone but on a court-supervised determination of the patient’s best interests. The Court found that the proposed intervention was aimed at protecting her health, dignity, safety and quality of life, rather than serving any eugenic, sterilisation or population-control objective. It also noted that no less intrusive and equally effective long-term alternative had been suggested by the Medical Board.
Allowing the petition, the Court authorised the procedure to be conducted at Vanivilas Hospital and directed the Medical Superintendent to ensure compliance with all medical, legal and ethical requirements. The Court further ordered that the patient’s welfare, dignity and safety be protected throughout the treatment process, with appropriate pre-operative and post-operative counselling, psychological support and rehabilitation services. A report on the procedure and the patient’s recovery is to be submitted to the Registrar General of the High Court within eight weeks.
