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2022 Supreme(SC) 1774
SUPREME COURT OF INDIA
Dhananjaya Y Chandrachud, CJI., J B Pardiwala, J.
Dr Narendra Gupta - Petitioner
Versus
Union of India & Ors. – Respondents
Writ Petition (Civil) No 131 of 2013
Decided On : 05-04-2023
Headnote:(A) Constitution of India - Article 21 - Right to health is an intrinsic element of the right to life; serious violation of fundamental rights; unnecessary hysterectomies under government healthcare schemes were identified predominantly affecting disadvantaged women - The Union Ministry of Health and Family Welfare directed to ensure compliance by all States and Union Territories regarding guidelines for preventing unnecessary hysterectomies. (Paras 5, 13-24)
(B) Administrative Action - Guidelines mandate the establishment of District, State, and National Monitoring Committees to oversee hysterectomy procedures, ensuring accountability and addressing unlawful practices. (Paras 9, 25)
Facts of the case:
Petitioner filed a public interest litigation citing unnecessary hysterectomies performed under government healthcare schemes detrimental to the health of primarily backward community women in States. The involvement and regulation of private hospitals were also highlighted. (Paras 1, 3)
Findings of Court:
The Court acknowledges that the allegations raised are substantial and ordered further action to rectify the situation, along with establishing monitoring committees for better oversight. (Paras 3, 21)
Issues: Whether unnecessary hysterectomies are being performed under healthcare schemes and the adequacy of the existing regulations to prevent them. (Paras 1, 19)
Ratio Decidendi: The Court upheld the right to health under Article 21, ruling that unnecessary hysterectomies pose a grave threat to health and indicated a legal obligation to prioritize women's health in India. Compliance with new guidelines is mandated. (Paras 5, 21)
Result: The petition is disposed of directing the establishment of proposed guidelines and monitoring committees.
| Table of Content |
|---|
| 1. highlighting the issue of unnecessary hysterectomies in specific states. (Para 1) |
| 2. states took steps to investigate and regulate unnecessary hysterectomies. (Para 3 , 4) |
| 3. right to health as a part of the right to life. (Para 5) |
| 4. guidelines to prevent unnecessary hysterectomies established. (Para 6 , 7 , 8) |
| 5. details of the action plan proposed by the union government. (Para 10 , 12) |
| 6. directive for all states to adopt guidelines and ensure compliance. (Para 19 , 20) |
| 7. conclusion and directions issued by the court. (Para 22 , 23 , 24) |
JUDGMENT :
Dhananjaya Y Chandrachud, CJI.
1. A public interest litigation has been instituted by Dr Narendra Gupta in 2013 highlighting the fact that in the States of Bihar, Chhattisgarh and Rajasthan, in particular, “unnecessary hysterectomies” were carried out under the Rashtriya Swasthya Bima Yojana as well as other government schemes related to healthcare. The petition also highlights the involvement of private hospitals in performing such hysterectomies. The Union Ministry of Health and Family Welfare1[“MoHFW”] is the first respondent, while the States of Bihar, Rajasthan and Chhattisgarh are impleaded as the second, third and fourth respondents respectively. Based on his field work, the petitioner has brought to our notice the fact that women, who should not have been subjected to hysterectomies and to whom alternative treatment could have been extended, were subjected to hysterectomies, seriously endangering their health in the process. The petitioner also submitted that most women who were subjected to hysterectomies of this kind belonged to the Scheduled Castes, Scheduled Tribes, or Other Backward Communities.
2. On 13 December 2022, this Court directed the Secretary, MoHFW to examine the grievance which was raised in the petition and to file a response after collating relevant information.
3. Before we advert to the status report which has been filed by the Union of India, it must be recorded, at the outset, that from the counter affidavits filed by the States of Rajasthan, Bihar and Chhattisgarh, it emerges that there is a considerable degree of substance in the facts which have been highlighted in the petition. For instance, the affidavit filed by the State of Bihar indicates that steps were taken by the district authorities in Kishanganj, Madhubani, Samastipur and Saran to enquire into complaints regarding unnecessary hysterectomies. Finding that many of the allegations in regard to the performance of unnecessary hysterectomies were true, the State has taken consequential action. It issued a circular inter alia directing that empanelled hospitals must obtain permission from the concerned insurance provider before conducting hysterectomies on women aged forty or below. This Court has been apprised of the fact that several hospitals have been blacklisted and de-empanelled from the Rashtriya Swasthya Bima Yojana pursuant to the investigation conducted in the state. In certain cases, First Information Reports have been filed.
4. The State of Rajasthan has placed on the record the steps which were taken by the District Collector, Dausa for constituting committees to enquire into the alleged incidents. The State of Rajasthan framed the Rajasthan Government Clinical Establishments (Registration and Regulation) Rules 2013. The State of Chhattisgarh constituted a High Powered Committee which found that the hysterectomies in the state could not be termed as “wholly unneeded.”
5. The right to health is an intrinsic element of the right to life under Article 21 of the Constitution. Life, to be enjoyed in all its diverse elements, must be based on robust conditions of health. There has been a serious violation of the fundamental rights of the women who underwent unnecessary hysterectomie
