Allahabad HC Inquiry: C-Section Termination Order Non-Compliance

• The Allahabad High Court ordered an inquiry into a Prayagraj hospital for performing a C-section instead of a court-directed pregnancy termination for a minor rape survivor.
• Justices Ajit Kumar and Garima Prashad found the doctors prima facie guilty of "deliberate negligence" for failing to comply with the September 21 order.
• The court had permitted termination for the minor, aged 13-17, citing the Medical Termination of Pregnancy Act, 1971, as amended by the Medical Termination of Pregnancy (Amendment) Act, 2021, and her expressed desire due to mental health concerns.
• Hospital staff stated an attempted induction failed, leading to the C-section, but no one claimed authorization for the surgery.
• Smt. V. Hekali Zhimomi, Principal Secretary, Medical Health & Family Welfare and Medical Education, Uttar Pradesh, must personally conduct the inquiry and submit a report within two weeks.

The Allahabad High Court's strong condemnation of the hospital's actions, characterizing them as having 'played with the life of a rape victim' and exhibiting 'deliberate negligence,' underscores the severe legal and ethical obligations of medical institutions.

The Allahabad High Court has initiated a high-level inquiry into a government hospital in Prayagraj following its failure to comply with a judicial directive for the medical termination of a minor rape survivor's pregnancy. Instead of carrying out the court-ordered procedure, S.R.N. Hospital performed a Caesarean section after an attempted induction failed, resulting in the birth of the child.

Justices Ajit Kumar and Garima Prashad of the High Court found the doctors involved prima facie guilty of "deliberate negligence" for not adhering to the court's September 21 order. In response, Smt. V. Hekali Zhimomi, Principal Secretary, Medical Health & Family Welfare and Medical Education, Uttar Pradesh, has been mandated to personally conduct the investigation into this Allahabad HC inquiry C-section termination order and submit a comprehensive report within two weeks.

The case concerned a minor girl, whose age was approximately 13 years according to her Aadhaar card, though radiological examination suggested she was between 16 and 17. Her pregnancy was alleged to have resulted from sexual assault. A medical board, constituted under the directions of the Special POCSO Court in Prayagraj, assessed her gestational age at about 29 weeks and two days.

The medical board's report indicated that the foetus had crossed the stage of viability and that the pregnancy was high-risk, presenting medical dangers for both its continuation and termination. Crucially, the minor expressed a clear desire not to continue the pregnancy, stating that its continuation would further harm her mental health, and she demonstrated an understanding of the consequences of termination. Citing the Medical Termination of Pregnancy Act, 1971, as amended by the Medical Termination of Pregnancy (Amendment) Act, 2021, and considering factors such as reproductive choice, bodily autonomy, dignity, mental health, the minor's age, the circumstances of the pregnancy, and the unequivocal wishes expressed by her and her natural guardians, the Allahabad High Court determined that permitting termination was in her best interest. Consequently, the court ordered S.R.N. Hospital to perform the termination on September 22 using the safest medically permissible procedure, with specialist doctors and necessary safeguards, and directed the state to cover all related expenses, including transportation, treatment, and post-procedural care.

Despite the clear judicial directive, the High Court was informed on September 23 that its order had not been fulfilled. This led the court to summon the Head of the Gynaecology Department, the Medical Superintendent, and other medical personnel from the Prayagraj hospital for an explanation regarding the court order non-compliance.

Dr. Vandana Ojha, the acting Head of Department, informed the court that induction for medical termination via the vaginal passage commenced on the evening of September 22. When this induction proved unsuccessful, the hospital proceeded with a Caesarean section delivery, and the newborn was subsequently admitted to the Children's Hospital. Dr. Aiman Abbasi, the surgeon who performed the C-section, testified that conventional medical termination was not feasible due to complications, necessitating the Caesarean delivery. However, Dr. Abbasi could not identify who had authorized the surgical procedure, nor did Dr. Ojha claim to have directed it. The Medical Superintendent confirmed that she had communicated the court's order to the Head of the Gynaecology Department at 11:30 am on September 22, noting that the department head then left the station around midnight.

The Allahabad High Court's strong condemnation of the hospital's actions, characterizing them as having "played with the life of a rape victim" and exhibiting "deliberate negligence," underscores the severe legal and ethical obligations of medical institutions. This ruling highlights the potential for Allahabad High Court medical negligence findings when judicial directives are disregarded, particularly in sensitive cases involving reproductive rights in India and vulnerable individuals.

The directive for Smt. V. Hekali Zhimomi, Principal Secretary, Medical Health & Family Welfare and Medical Education, Uttar Pradesh, to personally oversee the inquiry into the Prayagraj hospital C-section termination highlights the gravity with which the judiciary views non-compliance with its orders. This case serves as a critical reminder to healthcare providers of the imperative to strictly adhere to judicial directives and uphold patient autonomy, especially concerning medical termination of pregnancy for minors under the Medical Termination of Pregnancy Act, 1971, as amended by the Medical Termination of Pregnancy (Amendment) Act, 2021.

This ruling highlights the severe legal and disciplinary consequences for medical institutions and professionals who fail to comply with court orders regarding medical termination of pregnancy. Lawyers should advise healthcare clients on the critical need for strict adherence to judicial directives and robust internal protocols to avoid charges of deliberate negligence and ensure patient rights, especially concerning reproductive choice for minors.

Source: Original reporting via news updates