Dr. Narendra Gupta vs. Union of India & Ors.
Background
In 2013, the petitioner filed a PIL alleging that in Bihar, Chhattisgarh and Rajasthan, many women (disproportionately from Scheduled Castes, Scheduled Tribes and other backward communities) were subjected to medically "unnecessary hysterectomies" under government health insurance schemes, often by private hospitals, when less invasive treatment would have sufficed. Over the years, the Supreme Court directed the Union Health Ministry and the concerned states to investigate. The states confirmed that a real problem existed: Bihar found many complaints of unnecessary hysterectomies were true and blacklisted several hospitals; Rajasthan set up committees and made new regulations; Chhattisgarh's inquiry found the procedures were not entirely unwarranted. In 2022, the Health Ministry issued nationwide "Guidelines to Prevent Unnecessary Hysterectomies."
Decision Breakdown
The Court held that the right to health is intrinsic to the right to life under Article 21, and that the pattern shown (especially among poor, less-educated, and younger rural women) amounted to a serious rights violation. National data cited in the judgment showed about two-thirds of hysterectomies were performed in private facilities, with rising rates among relatively young women (28-36 years), well below the typical age bracket seen in developed countries. Since the Union government had already framed comprehensive Guidelines (including District, State and National Hysterectomy Monitoring Committees, mandatory reporting, and audit mechanisms), the Court directed that all States and Union Territories must adopt these Guidelines within three months, implement them without delay, report compliance to the Ministry, and ensure both public and private hospitals are made aware of them. The Court also directed that states take strict action, including blacklisting, against hospitals that perform hysterectomies without genuine medical necessity or without the patient's informed consent, and it annexed the full Guidelines to the judgment for ease of implementation. With these directions and a functioning grievance/monitoring framework in place, the petition was disposed of.
Lesson Learnt
A woman undergoing (or being advised to undergo) a hysterectomy has a right to informed consent and to have less invasive alternatives considered first; hospitals that skip this can now be reported through a Health Ministry grievance mechanism and monitoring committees created specifically for this purpose, and can face blacklisting.