Wednesday, July 10, 2019

Courts should make guidelines and leave it to the medical boards and not handle the cases themselves?

Dr KK Aggarwal & Advocate Ira Gupta

Now and then women approach the courts for termination for pregnancy on medical grounds. Instead of approaching the courts, the government should come out with clear cut guidelines, based on which the medical board can take a decision in such cases.

Like in MCI ethics regulation 6.7 “ …the question of withdrawing supporting devices to sustain cardio-pulmonary function even after brain death, shall be decided only by a team of doctors and not merely by the treating physician alone…”

The following two cases illustrate this.

Terminations under 20 weeks isn’t our business: High Court

Unwanted pregnancies under 20 weeks can be medically terminated by doctors directly, and the woman need not be referred to medical board nor be asked to approach courts for remedy, the Madras high court has said. The court also said doctors & police officials need to be sensitized to the issues surrounding unwanted pregnancies as they often misconstrue the provisions of Termination of Pregnancy Act.

Coming to the rescue of a woman who wanted to terminate her eight-week-old fetus forced on her by a man known to her, Justice Anand Venkatesh said if a criminal case is pending, samples will be taken for DNA test of both mother & the conceptus (fetus & placenta).

In all cases, where a victim girl suffers an unwanted pregnancy & where the length of pregnancy does not exceed 20 weeks, the victim girl need not be referred to the medical board & the termination of pregnancy can be done as per the provisions of Act. The victim girl should not be unnecessarily made to knock the doors of this court.

Madras High Court allows termination of 26-week pregnancy

The Madras high court has allowed the termination of a woman’s 26-week pregnancy after medical tests revealed that the fetus had health complications and the child would require multiple and extensive surgeries with a remote chance of survival.

The Trichy woman moved the court seeking permission to terminate the pregnancy after the legally permissible gestation time of 20 weeks. Scan reports during the 18th week of her pregnancy revealed that the fetus seemed to have dilated ventricles — a brain condition.

The court, subsequently directed her to appear for a medical examination at the Tuticorin Government Medical College Hospital, where a medical board comprising a paediatrician, neurosurgeon, neurologist, cardiologist & obstetrician assessed her previous medical reports & subjected her to various tests & filed a report before the court.

The medical board was of the unanimous opinion that the woman should be allowed to abort the fetus. The bench cited the medical expert’s opinion & said, “Even if the child in the womb is born, its survival will be medically remote as it has to confront numerous surgeries, which cannot assure its longevity.” In such circumstances, if the pregnancy is not ordered to be terminated, the woman would be subjected to mental trauma & hardship, the court ruled.

Dr KK Aggarwal
Padma Shri Awardee
President Elect Confederation of Medical Associations in Asia and Oceania   (CMAAO)
Group Editor-in-Chief IJCP Publications
President Heart Care Foundation of India
Past National President IMA

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