1. Petition under Article 32 seeking medical termination of pregnancy due to fetal cardiac anomalies and associated high morbidity and mortality. (Para 1 )
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2017 Supreme(SC) 734
SUPREME COURT OF INDIA
S. A. Bobde, L. Nageswara Rao, JJ.
Tapasya Umesh Pisal – Petitioner
Versus
Union of India and Ors – Respondents
Writ Petition (Civil) No.635 of 2017
Decided On : 10-08-2017
Advocates Appeared:
For the Petitioner:- Ms. Sneha Mukherjee, Mr. Satya Mitra, Advs.
For the Respondents:- Ranjit Kumar, Ld. SG, Ms. Sadhana Sandhu For G.S. Makker, Nishant R. Katneshwarkar, Ms. Deepa Kulkarni, Advs.
For the Petitioner:- Ms. Sneha Mukherjee, Mr. Satya Mitra, Advs.
For the Respondents:- Ranjit Kumar, Ld. SG, Ms. Sadhana Sandhu For G.S. Makker, Nishant R. Katneshwarkar, Ms. Deepa Kulkarni, Advs.
Important Points
IMPORTANT POINT
Section 3(2)(b) of Medical Termination of Pregnancy Act, 1971 can be invoked in advanced stages also in exceptional circumstances.
Section 3(2)(b) of Medical Termination of Pregnancy Act, 1971 can be invoked in advanced stages also in exceptional circumstances.
Subject
Medical Law - Medical Termination of Pregnancy
Act Referred
Headnote
Medical Termination of Pregnancy Act, 1971 – Section 3(2)(b) – Medical Board concluding that baby if delivered alive, would have to undergo several surgeries after birth which is associated with a high morbidity and mortality – Case falls under Section 3(2)(b) but for the time period – Medical termination permitted. (Para 9, 10)
Facts of the case;
This case relates to medical termination of 24th week’s pregnancy.
Finding of the Court;
Case falls under Section 3(2)(b) but for the time period.
Result: Petition allowed, medical termination permitted.
Legal Category Hierarchy
Table of Contents
2. Petitioner sought termination based on fetal anomalies; the respondents did not oppose the prayer on legal or medical grounds. (Para 1 , 10 )
3. Medical Board and expert opinions confirmed the fetus had severe cardiac anomalies, ensuring a limited life span and severe physical handicap if born alive. (Para 4 , 5 , 6 , 7 , 9 )
4. Medical termination of pregnancy is permissible where fetal anomalies ensure a limited life span and severe handicaps, serving the interests of justice. (Para 9 , 10 )
5. Writ petition allowed; directions issued to permit medical termination of pregnancy supervised by a Medical Board. (Para 10 , 11 , 12 )
6. When can a pregnancy be terminated under the Medical Termination of Pregnancy Act, 1971, regarding fetal abnormalities?
Termination is permissible if not less than two registered medical practitioners form an opinion in good faith that there is a substantial risk that the child, if born, would suffer from physical or mental abnormalities as to be seriously handicapped. (Para 8 )
7. Can the court permit medical termination of pregnancy beyond the statutory limit if the fetus has severe anomalies?
Yes, the court may permit termination in the interests of justice when medical evidence establishes that the fetus would have a limited life span and unavoidable serious handicaps. (Para 9 , 10 )
8. What role does a Medical Board play in court-ordered medical termination of pregnancy?
A Medical Board examines the petitioner to diagnose fetal anomalies and assess morbidity and mortality risks, and subsequently supervises the termination procedure while maintaining complete records. (Para 2 , 4 , 11 )
ORDER
Petitioner - Tapasya Umesh Pisal, aged 24 years, has approached this Court under Article 32 of the Constitution of India seeking directions to the respondents to allow her to undergo medical termination of her pregnancy. She apprehended danger to her life, having discovered that her fetus was diagnosed with tricuspid and pulmonary atresia, a cardiac anomaly in the fetus.
2. By order dated 04.08.2017, while issuing notice to the respondents, this Court gave a direction for examination of the petitioner by a Medical Board consisting of Dr. Sambare, HOD, Gynaecology and Dr. Nityanand Thakur, Paediatric Cardiac Surgeon of B.J. Govt. Medical College, Pune, and authorised it to appoint other necessary doctors, if required, for the said purpose.
3. As per the report dated nil, received from the Dean, B.J. Govt. Medical College & Sassoon General Hospital, Pune, Maharashtra, the following members of the said hospital were included in the Committee/Board :
1) Dr. Ajay Chandanwale, Dean BJGMC, Pune.
2) Dr. Pradip Sambarey, Professor & Head, Obstetrics and Gynecology, BJG MC Pune.
3) Dr. Nityanand Thakur, CVTS Department BJGMC Pune.
4) Dr. Aarti Kinikar, Professor & Head, Department of Pediatrics BJGMC Pune.
5) Dr. Shephali Pawar, Professor, Department of Radiology, BJGMC Pune.
4. The aforesaid Medical Board has examined the petitioner and stated that as on 07.08.2017, she was into her 24th week of pregnancy. She was accompanied by her husband and they are aware of the cardiac anomaly and the associated morbidity of the baby if born alive. The salient features of the said report are as under :
1) The fetus is diagnosed as having hypoplastic right heart with tricuspid and pulmonary atresia with small size pulmonary arteries.
2) The surgeries that will be necessary on the fetus have been reported to carry high morbidity and mortality.
3) It is also reported that in spite of the surgeries, such children do not achieve normal oxygen level and would remain physically incapacitated. The life span of these children even after corrective surgeries is limited as described in medical literature.
4) The Paediatrician has reported that it appears to be an isolated complex congenital heart disease with increased morbidity and mortality post delivery.
5) The Radiologist has reported a complete absent of right ventricle and pulmonary and tricuspid valve atresia.
5. We also have on record the opinion of an eminent surgeon Dr. Devi Shetty of Bangalore who has stated that most of these children do not live till the adult life. Their life is precarious because of the problems resulting from low oxygenation in the body.
6. According to Dr. Nityanand Thakur, Cardiac Surgeon, and member of the Medical Board, there is a near certain chance of severe handicap or sudden death of the baby after birth.
7. Upon evaluation of the petitioner, the aforesaid Committee/Medical Board has concluded that the baby if delivered alive, would have to undergo several surgeries after birth which is associated with a high morbidity and mortality.
8. But for the time period, it appears that the case falls under section 3(2)(b) of the Medical Termination of Pregnancy Act, 1971, which reads as under:
"3.When pregnancies may be terminated by registered medical practitioners.- (1)....
(2)(b) Where the length of the pregnancy exceeds twelve weeks but does not exceed twenty weeks, if not less than two registered medical practitioners are, of opinion, formed in good faith, that -
(i) the continuance of the pregnancy would involve a risk to the life of the pregnant woman or of grave injury to her physical or mental health; or
(ii) there is a substantial risk that if the child were born, it would suffer from such physical or mental abnormalities as to be seriously handicapped."
9. In these circumstances, it is difficult for us to refuse the permission to the petitioner to undergo medical termination of pregnancy. It is certain that the fetus if allowed to born, would have a limited life span with serious ha
