H KUSUMA vs CHIEF SECRETARY TO GOVERNMENT
- Court
- Karnataka High Court
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WP No. 14350 of 2026
®
HC-KAR
IN THE HIGH COURT OF KARNATAKA AT BENGALURU
TH
DATED THIS THE 17 DAY OF JUNE, 2026
BEFORE
THE HON'BLE MR. JUSTICE SURAJ GOVINDARAJ
WRIT PETITION NO. 14350 OF 2026 (GM-RES)
BETWEEN:
1. H KUSUMA
C/O NATARAJA K.
AGED ABOUT 43 YEARS,
2. NATARAJA K,
S/O K KRISHNAMURTHY,
AGED ABOUT 52 YEARS,
BOTH RESIDING PRESENTLY AT
NO 12 SRI RENUKA ANCLEVE,
KONDASHETTI HALLI,
HESARAGHATTA HOBLI, YELAHANKA TALUK,
KONDASHETTI HALLI,
SHIVAKOTI POST,
BANGALORE-560089.
…PETITIONERS
(BY SRI. ZULFI SULTANA.,ADVOCATE)
AND:
1. CHIEF SECRETARY TO GOVERNMENT
ROOM NO.320. 3RD FLOOR,
VIDHANA SOUDHA,
BANGALORE.560001.
2. COMMISSIONERATE OF HEALTH AND
FAMILY WELFARE SERVICE
DEPARTMENT OF HEALTH AND FAMILY
WELFARE DEPARTMENT,
AT ANAND RAO CIRCLE,
NEAR CITY RAIWAY STATION,
LAKSHMANPURI, GANDHI NAGAR,
BENGALURU, KARNATAKA 560009
Digitally signed
by SHWETHA
RAGHAVENDRA
Location: HIGH
COURT OF
KARNATAKA
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…RESPONDENTS
(BY SRI. MOHAMMED JAFFAR SHAH., AGA)
THIS WRIT PETITION IS FILED UNDER ARTICLES 226 AND 227
OF THE CONSTITUTION OF INDIA PRAYING TO PERMIT THE
PETITIONERS TO UNDERTAKE HYSTERECTOMY (REMOVAL OF
UTERUS) OF THEIR DAUGHTER, MS. HARSHITHA N AND ETC.
THIS WRIT PETITION, COMING ON FOR ORDERS, THIS DAY,
ORDER WAS MADE THEREIN AS UNDER:
CORAM: HON'BLE MR. JUSTICE SURAJ GOVINDARAJ
ORAL ORDER
1. The petitioners are before this Court seeking for the
following reliefs:
a. Permit the petitioners to undertake hysterectomy
(removal of uterus) of their daughter, Ms.
Harshitha N;
b. Declare that the said procedure is in the best
interest, dignity, health and welfare of the patient;
c. Direct Respondent No.2 to proceed with the
procedure without medico-legal impediment;
d. Pass such other order(s) as deemed fit in the
interest justice.
2. The petitioners, who are the parents and primary
caregivers of their daughter (X), aged about 23
years, are before this Court seeking permission for
conducting a Total Abdominal Hysterectomy on their
daughter. It is their contention that (X) suffers from
severe developmental and intellectual disabilities
which substantially impair her ability to understand,
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manage and perform even basic activities of daily
living.
3. In support of the said contention, the petitioners
have relied upon the medical and psychological
assessments conducted at Neuro Center, Bengaluru.
The evaluation records indicate significant
developmental and social adaptive deficits. The
Denver Developmental Screening Test (DDST)
revealed a developmental quotient of 58, indicative
of developmental delay. The assessment of her
drawing abilities through Gesell's Drawing Test
demonstrated functioning considerably below the
developmental level ordinarily expected of a three-
year-old child. The Vineland Social Maturity Scale
(VSMS) assessed her social quotient at 56,
suggesting substantial deficits in social adaptive
functioning. The cumulative effect of these
assessments, according to the petitioners, is that
though (X) is chronologically 23 years of age, her
cognitive, developmental and adaptive functioning
remains severely compromised.
4. It is further contended that on account of her
intellectual and developmental disabilities, (X) is
incapable of independently understanding or
managing her bodily functions, including menstrual
hygiene. The petitioners submit that despite attaining
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physical adulthood, she remains entirely dependent
upon them for her daily needs and personal care.
They state that she is unable to communicate
effectively regarding her physical discomforts,
medical concerns or menstrual difficulties.
5. The petitioners further submit that the menstrual
cycles of (X) are irregular and unpredictable and that
her inability to maintain personal hygiene during
such periods has resulted in recurring infections,
intermittent episodes of fever and prolonged medical
complications. According to them, the situation has
not only exposed (X) to repeated health risks but has
also imposed considerable physical, emotional and
psychological strain upon the petitioners who are
advancing in age and continue to remain her sole
caregivers.
6. It is their specific apprehension that with the passage
of time and the inevitable decline in their own
physical abilities, it may become increasingly difficult
for them to provide the level of assistance and
supervision presently required by their daughter. The
petitioners therefore contend that the proposed
procedure is intended solely to safeguard the health,
dignity, comfort and long-term welfare of (X) and not
for any collateral purpose.
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7. In view of the aforesaid circumstances, the
petitioners have approached this Court seeking
permission for conducting a Total Abdominal
Hysterectomy on their daughter (X), contending that
the same would substantially alleviate the medical,
hygienic and caregiving difficulties presently faced by
her and would be in her overall best interests.
8. Considering the nature of the relief sought and the
serious medical, ethical and legal issues involved,
this Court, by order dated 02.06.2026, deemed it
appropriate to constitute a multidisciplinary Medical
Board at Vanivilas Hospital to independently evaluate
the medical condition of (X), assess her capacity,
examine the necessity and advisability of the
proposed procedure and furnish its opinion to this
Court.
9. Pursuant to the said order, the petitioners and their
daughter (X) appeared before the Medical Board on
05.06.2026. The Medical Board has thereafter
examined the patient through specialists from
multiple disciplines and has submitted its report for
consideration of this Court.
10. The report of the psychologist indicates that the
social age of (X) is approximately 5 years and 4
months and that her social quotient is 36. The
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psychologist has assessed her as suffering from
moderate intellectual disability and quantified the
permanent disability at 75%.
11. The psychiatrist has opined that the patient is
presently incapable of independently maintaining or
managing her menstrual hygiene and requires
continuous assistance and supervision in relation
thereto.
12. The neurologist has reported that the patient is
suffering from cerebral palsy associated with
intellectual disability and seizure disorder and that
she has been undergoing treatment and medication
for the said condition for approximately thirteen
years.
13. The Obstetrician and Gynaecologist has opined that
the patient suffers from Global Developmental Delay
associated with moderate Intellectual and
Developmental Disability, with an assessed IQ of 36.
The specialist has further recorded that the patient is
unable to independently manage menstrual hygiene
and has specifically opined that, having regard to the
age and medical condition of the patient and the
request and consent furnished by the parents, the
patient may be considered for Total Abdominal
Hysterectomy.
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14. The Radiologist has also recorded that the patient is
unable to independently manage her menstrual
hygiene and has opined that an appropriate decision
may be taken collectively by the Medical Board after
considering all relevant factors.
15. The Anaesthesiologist has opined that the patient is
medically fit to undergo the proposed surgical
procedure subject to the recommendation of the
Medical Board and in compliance with the orders of
this Court.
16. The Medical Board, upon consideration of the
opinions furnished by all specialists, has ultimately
concluded that the patient is suffering from Global
Developmental Delay associated with Moderate
Permanent Intellectual and Developmental Disability,
having an IQ of 36, and is also suffering from a
seizure disorder. The Board has recommended that
the patient may undergo a Total Abdominal
Hysterectomy.
17. This Court has given its anxious consideration to the
report submitted by the Medical Board, the medical
records placed on record, the submissions made on
behalf of the petitioners and the nature of the relief
sought. The issue involved in the present
proceedings is not merely a medical question. It
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concerns the bodily integrity, dignity, autonomy,
health and long-term welfare of a person suffering
from significant intellectual and developmental
disabilities. Any decision in relation to a procedure as
invasive and irreversible as a hysterectomy must
therefore be approached with utmost caution,
sensitivity and circumspection.
18. The law recognises and protects the autonomy and
bodily integrity of every individual, including persons
with disabilities. Ordinarily, any invasive medical
procedure, particularly one involving permanent
removal of a reproductive organ, can be undertaken
only on the basis of the free, informed and voluntary
consent of the person concerned. Such consent
necessarily presupposes the ability of the individual
to understand the nature of the procedure, its
consequences, benefits, risks and long-term
implications.
19. This Court is conscious of the principles laid down by
the Hon'ble Supreme Court in Suchita Srivastava ,
wherein it was held that reproductive choices
constitute an integral facet of personal liberty under
Article 21 of the Constitution of India and that every
woman possesses a right to bodily integrity,
reproductive autonomy and privacy. The Hon'ble
Supreme Court emphasised that the rights of
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persons with disabilities cannot be curtailed merely
on account of their disability and that any medical
intervention affecting reproductive capacity must be
approached with great care and sensitivity.
20. The aforesaid principles are of considerable
significance in the present matter. This Court is
therefore required to ensure that the proposed
procedure is not being permitted merely because the
patient suffers from an intellectual or developmental
disability. Disability, by itself, can never constitute a
ground either to authorise the removal of a
reproductive organ or to deprive a person of
reproductive autonomy. Any such approach would be
inconsistent with the constitutional guarantees
recognised by the Hon'ble Apex Court and with the
dignity accorded to persons with disabilities under
the Constitution and the statutory framework
governing their rights.
21. The present case, however, stands on an entirely
different footing. The material placed on record,
particularly the report of the Medical Board,
establishes that the daughter of the petitioners
suffers from Global Developmental Delay associated
with Moderate Permanent Intellectual and
Developmental Disability. Her social age has been
assessed at approximately 5 years and 4 months,
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her IQ at 36 and her permanent disability at 75%.
The Psychiatrist has specifically opined that she is
unable to independently maintain menstrual hygiene.
The Neurologist has reported that she suffers from
cerebral palsy associated with intellectual disability
and seizure disorder and has been undergoing
treatment for the said condition for over thirteen
years. The Obstetrician and Gynaecologist has also
opined that she is unable to independently manage
menstrual hygiene and has specifically recommended
that she may be considered for Total Abdominal
Hysterectomy.
22. The findings recorded by the Medical Board leave
little room for doubt that the patient lacks the
cognitive and intellectual capacity necessary to make
an informed decision in relation to the proposed
procedure. The Court is therefore confronted with a
situation where the patient is incapable of exercising
meaningful informed consent and is unable to
independently evaluate the consequences of medical
decisions affecting her person.
23. In such circumstances, the Court is required to
exercise its parens patriae jurisdiction and
independently determine whether the proposed
course of action advances the best interests of the
person concerned. The concept of "best interests"
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cannot be construed narrowly. It requires the Court
to undertake a holistic assessment of the medical,
physical, psychological, emotional and social
consequences of the proposed intervention. The
Court is required to balance the patient's bodily
integrity and autonomy with the practical realities
arising from her medical condition, intellectual
limitations, quality of life, health concerns and long-
term welfare.
24. The evidence on record indicates that the patient is
unable to understand the physiological changes
associated with menstruation, unable to
communicate effectively regarding menstrual
discomfort or complications and unable to
independently maintain menstrual hygiene. The
petitioners have placed on record their experience
over several years, indicating repeated difficulties in
managing her menstrual cycles, recurring infections,
episodes of fever and prolonged periods of illness
arising from unhygienic conditions.
25. These assertions are not unsupported parental
apprehensions. They stand corroborated by the
opinions expressed by the specialists comprising the
Medical Board. The Psychiatrist, Neurologist,
Obstetrician and Gynaecologist, as well as the
Radiologist, have all recorded that the patient is
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incapable of independently maintaining menstrual
hygiene. The Board has also taken into consideration
the patient's cerebral palsy, seizure disorder,
intellectual disability and developmental limitations
while arriving at its recommendation.
26. What is significant is that the recommendation has
not been made by a solitary medical practitioner.
Pursuant to the order of this Court dated
02.06.2026, a multidisciplinary Medical Board was
constituted. The patient was independently evaluated
by experts in psychology, psychiatry, neurology,
obstetrics and gynaecology, radiology and
anaesthesiology. The recommendation is therefore
the outcome of a comprehensive multidisciplinary
assessment and not a singular medical opinion.
27. The report also indicates that the patient's condition
is permanent and irreversible in nature. There is
nothing on record to suggest that her intellectual and
developmental impairments are likely to improve to
such an extent that she would, in the foreseeable
future, be capable of independently understanding
and managing menstrual hygiene. The Court is
therefore dealing not with a temporary incapacity but
with a lifelong condition requiring continuing support,
supervision and assistance.
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28. The Court must also take note of the practical
realities confronting the petitioners. They are the
parents and primary caregivers of the patient and
have been providing continuous care and support
throughout her life. There is nothing on record to
indicate that they are motivated by any collateral
consideration. On the contrary, the materials on
record indicate that they have approached this Court
solely out of concern for the welfare, dignity, comfort
and long-term wellbeing of their daughter.
29. The Court is conscious that parental inconvenience,
by itself, can never constitute a justification for
permitting a procedure of this nature. However, the
practical difficulties highlighted by the petitioners are
relevant insofar as they directly impact the quality of
care and health of the patient herself. The petitioners
have specifically expressed concern regarding their
advancing age and their ability to continue providing
the same level of care in future. Such concern
reflects the reality of a lifelong caregiving
responsibility towards a person suffering from severe
developmental and intellectual disabilities.
30. The Court is equally mindful that hysterectomy is an
irreversible procedure. It is for this reason that this
Court did not proceed merely on the basis of the
request made by the parents. Instead, an
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independent Medical Board was constituted so as to
obtain an objective and professional evaluation
before any decision was taken. The report now
placed before this Court indicates that the proposed
procedure has been considered from every relevant
medical perspective.
31. Significantly, the Medical Board has not recorded any
contraindication for the proposed procedure. The
Anaesthesiologist has certified that the patient is fit
to undergo surgery. The Obstetrician and
Gynaecologist has specifically opined that, having
regard to the age and condition of the patient and
the request and consent furnished by the parents,
the patient may be taken up for Total Abdominal
Hysterectomy. The final recommendation of the
Board unequivocally supports the proposed
procedure.
32. This Court also finds it relevant that the present case
does not concern sterilisation for eugenic purposes,
population control measures or any attempt to curtail
the rights of the patient on account of her disability.
The recommendation is founded entirely upon
considerations relating to health, hygiene, dignity,
safety and quality of life. The objective of the
proposed intervention is to address recurring health
concerns arising from a condition which the patient is
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incapable of understanding or managing and which
has consistently exposed her to avoidable medical
complications.
33. The Court also notes that no less intrusive or equally
effective long-term alternative has been suggested
by the Medical Board. The recommendation made by
the Board is therefore based upon its professional
assessment as to what would best serve the interests
of the patient having regard to her peculiar medical,
developmental and social circumstances.
34. The decision of this Court is therefore 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.
35. Thus, the present order is founded upon a court-
supervised best-interests determination and not
upon any assumption that persons with disabilities
may be subjected to invasive medical procedures
merely because of their disability. The constitutional
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values of dignity, bodily integrity and autonomy
Suchita Srivastava
recognised in continue to guide
the exercise undertaken by this Court. It is only
because the patient is demonstrably incapable of
exercising informed decision-making and because the
overwhelming medical evidence indicates that the
proposed intervention would serve her welfare,
health, dignity and safety that this Court considers it
appropriate to grant the permission sought.
36. In exercising its parens patriae jurisdiction, the
paramount consideration for this Court is the best
interests of the person concerned. 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).
37. This Court is therefore of the considered opinion that
the permission sought by the petitioners deserves to
be granted.
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38. As such, this Court passes the following:
ORDER .
i) Writ petition is allowed .
ii) The petitioners are permitted to have a Total
Abdominal Hysterectomy performed on their
daughter (X) at Vanivilas Hospital, Bengaluru.
The Medical Superintendent, Vanivilas Hospital,
shall make all necessary arrangements for
carrying out the said procedure in accordance
with the recommendations of the Medical Board
and in compliance with all applicable medical,
legal and ethical requirements.
iii) The Medical Superintendent shall ensure that
the welfare, dignity, safety and best interests of
the patient are protected at all stages of
treatment. The patient shall be provided such
pre-operative counselling, psychological support
and post-operative counselling, care and
rehabilitation services as may be considered
necessary by the treating team, including the
Psychiatrist and other specialists concerned.
iv) The date and time of the surgical procedure
shall be fixed by the Medical Superintendent in
consultation with the petitioners and the
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treating specialists, having regard to the
medical condition and convenience of the
patient.
v) The Medical Board or such specialists as may be
nominated by the Medical Superintendent shall
monitor the patient's post-operative recovery
and ensure that all appropriate follow-up
treatment and medical support are provided.
vi) A brief report regarding the conduct of the
procedure and the post-operative condition of
the patient shall be placed before the Registrar
General of this Court within a period of eight
weeks from the date of the procedure.
SD/-
(SURAJ GOVINDARAJ)
JUDGE
KTY
List No.: 3 Sl No.: 2