In a rare instance, the High Court of Karnataka has permitted a 23-year-old woman with severe intellectual and development disabilities to undergo total abdominal hysterectomy, ruling that the procedure is in her “best interests” and essential for her health and dignity.

Justice Suraj Govindaraj passed the order while allowing a petition filed by the woman’s parents and primary caregivers to proceed with the surgery at Vanivilas Hospital, Bengaluru.

Medical board

Earlier, the court constituted a multi-disciplinary medical board comprising specialists in psychology, psychiatry, neurology, obstetrics and gynaecology, radiology, and anaesthesiology after the parents approached the court seeking permission for the surgical procedure.

Medical evaluations revealed the patient suffers from Global Developmental Delay with moderate permanent intellectual disability, an IQ of 36, and cerebral palsy with a seizure disorder. Her social age was assessed at approximately five years and four months, with permanent disability quantified at 75%.

The medical board unanimously recommended the procedure after determining that the patient lacks the cognitive capacity to understand or independently manage menstrual hygiene, resulting in recurring infections and medical complications which posed a larger health risk.

Jusicial scrutiny

“The decision of this court is not based upon substituted consent alone, nor upon the existence of disability per se. The permission is being granted only after judicial scrutiny, independent medical evaluation by specialists from multiple disciplines, consideration of the patient’s inability to provide informed consent, examination of the absence of any contraindication to the proposed procedure, and a determination that the proposed intervention is in the best interests of the patient,” Justice Govindaraj said in his order.

Meanwhile, the court directed the medical superintendent of the hospital to make all necessary arrangements for the procedure and ensure the patient receives pre and post-operative counselling, care and rehabilitation services as may be considered necessary by the treating team, including the psychiatrist and other specialists concerned.