Karnataka High Court allows hysterectomy for woman with severe disabilities

The Karnataka High Court has allowed a 23-year-old woman with severe developmental and intellectual disabilities to undergo a total abdominal hysterectomy, saying the procedure is intended to protect her welfare, health, dignity and best interests. Justice Suraj Govindaraj passed the order on June 17 on a petition filed by her parents, who are also her primary caregivers.

The court said it had considered the findings of a Medical Board, the woman’s inability to manage menstrual hygiene on her own, the recurring medical complications raised by her parents, and the absence of any medical contraindication before permitting the surgery at Vanivilas Hospital in Bengaluru.

A total abdominal hysterectomy is a surgical procedure involving the complete removal of the uterus and cervix through an open abdominal incision.

In its order, the court said, "In exercising its parens patriae jurisdiction, the paramount consideration of this Court is in the best interests of the person concerned."

It further said, "Having regard to the findings recorded by the Medical Board, the nature and extent of the patient's intellectual and developmental disabilities, her inability to independently manage menstrual hygiene, the recurring medical complications highlighted by the petitioners, the absence of any medical contraindication and the unanimous recommendation of the Medical Board, this Court is satisfied that the proposed procedure is intended to advance the welfare, health, dignity and best interests of (X)."

The court added, "This Court is therefore of the considered opinion that the permission sought by the petitioners deserves to be granted."

It allowed the parents to have the procedure performed on their daughter at Vanivilas Hospital and directed the Medical Superintendent to make all necessary arrangements in line with the Medical Board’s recommendations and all applicable medical, legal and ethical requirements.

The judge said the Medical Superintendent must ensure that the patient’s welfare, dignity, safety and best interests are protected at every stage of treatment.

The order also said the patient should be given such pre-operative counselling, psychological support, post-operative counselling, care and rehabilitation services as the treating team, including the psychiatrist and other specialists, may consider necessary.

The court said the date and time of the surgery would be fixed by the Medical Superintendent in consultation with the parents and the treating specialists, keeping in mind the patient’s medical condition and convenience.

It also directed that the Medical Board, or specialists nominated by the Medical Superintendent, should monitor her recovery after the operation and ensure that all appropriate follow-up treatment and medical support are provided.

A brief report on the procedure and the patient’s post-operative condition must be submitted to the Registrar General of the High Court within eight weeks from the date of the procedure.

In their petition, the parents said their daughter’s severe developmental and intellectual disabilities had significantly affected her ability to understand, manage and perform even basic daily activities.

Relying on medical and psychological assessments, they said that although she is 23 years old, her cognitive, developmental and adaptive functioning remains severely compromised.

They also said she is incapable of independently understanding or managing bodily functions, including menstrual hygiene, and expressed concern that as they grow older, it may become increasingly difficult for them to provide the level of assistance and supervision she currently needs.

The parents told the court that the proposed procedure was intended only to safeguard their daughter’s health, dignity, comfort and long-term welfare, and not for any collateral purpose.

Given the serious medical, ethical and legal issues involved, the court had on June 2 set up a multidisciplinary Medical Board at Vanivilas Hospital to independently assess the woman’s medical condition, capacity, and the need for the proposed surgery.

The Board later examined her through specialists from multiple disciplines and reported that she has global developmental delay associated with moderate permanent intellectual and developmental disability, with an IQ of 36, and also suffers from a seizure disorder. It recommended that she may undergo a total abdominal hysterectomy.

In sum, the High Court granted the parents permission for the surgery after accepting the Medical Board’s recommendation and said the procedure should be carried out with safeguards to protect the patient’s welfare, dignity, safety and long-term interests.

- Ends