Bombay High Court
Pratibha Natha Chavan vs State Of Maharashtra Through Principal ... on 20 December, 2019
Bench: K. K. Tated, Sarang V. Kotwal
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IN THE HIGH COURT OF JUDICATURE AT BOMBAY
CIVIL APPELLATE JURISDICTION
Writ Petition NO. 12876 OF 2019
Pratibha Natha Chavan ...Petitioner
Versus
State Of Maharashtra ...Respondent
Mrs. Bhavana Mhatre i/b. Archana Rupwate, Advocate for the
Petitioner.
Mr. Y.S. Khochare, AGP, for the Respondent - State.
__________
CORAM : K. K. TATED &
SARANG V. KOTWAL, JJ.
DATED : 20th DECEMBER, 2019 PC :
1. Rule. With consent of the parties, Rule is made returnable forthwith.
2. This petition is filed by the petitioner mainly for permission to undergo medical termination of pregnancy at the medical facility of her choice.
3. It is her case in the Petition that she is more than 28 weeks pregnant. After medical examination and ultrasound sonography it was found that the fetus was having serious anomalies, viz, :Deshmane (PS) 1/13 ::: Uploaded on - 20/12/2019 ::: Downloaded on - 21/12/2019 04:20:24 :::
2 wp-12876-2019 "a) A large meningo-myelocele [6.1 x 1.3 cm] is seen at L1-L5 level.
b) Another meningo-myelocele is [3.1 x 3.4 cm] seen at D9 level.
c) Moderate ventriculomegaly [20.4 mm] is seen." . The medical opinion was that those anomalies would be associated with :
"a) Paresis/paralysis below the thoracic region and lower limbs.
b) Lack of control of bladder (urine) and rectum (stools) with incontinence.
c) Need for ventriculoperitoneal shunting for hydrocephalus soon after birth along with repair of meningomyelocele. (Both very major operations)
d) Variable amount of neurological damage to brain with resultant intellectual disability."
. It is the case of the petitioner that the petitioner has gross danger to her mental and physical health if she has to deliver a fetus with no potential to survive. According to her forcing the petitioner to go through an unwanted pregnancy violates her right to dignity and sexual and reproductive freedom as guaranteed under Article 21 of the Constitution of India.
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4. We have heard Ms.Bhavana Mhatre, learned counsel for the petitioner and Mr. Y. S. Khochare, learned A.G.P. for the respondent.
5. Learned counsel for the petitioner relied on a few Judgments passed by the Hon'ble Supreme Court, as well as, passed by different Division Benches of this Court dealing with the issue of granting permission for termination of pregnancy even after a statutory period of 20 weeks, provided under the MTP Act was over.
6. Considering the ratio laid down in these judgments, this Court had directed the petitioner to approach the Medical Board in Sir J.J. Hospital, Mumbai for examination. The Medical Board was directed to conduct the examination and submit its report. One of the members of the Board was directed to remain present in the Court. Accordingly, the medical examination was conducted and the report of the Board was submitted to this court. The concluding paragraph of the report reads thus:- Deshmane (PS) 3/13 ::: Uploaded on - 20/12/2019 ::: Downloaded on - 21/12/2019 04:20:24 :::
4 wp-12876-2019 " COMMITTEE OPINION AFTER CAREFUL EXAMINATION OF THE PATIENT AND STUDY OF THE ULTRASONOGRAPHY, THE COMMITTEE CONFIRMS THAT THE FETUS HAS NUEROLOGICAL STUDY OF THE ABNORMALITIES IN THE FORM OF MODERATE VENTRICULOMEGALY AND LUMBOSACRAL AND DORSAL MENINGOMYELOCELE WHICH MAY LEAD TO SEVERE NEUROLOGICAL DEFICITS, MENTAL RETARDATION, DEVELOPMENTAL DELAY AND LOCOMOTOR DISABILITIES.
THE SAID CONDITION OF THE FETUS FULFILS THE CRITERIA OF "SUBSTANTIAL RISK OF SERIOUS PHYSICAL HANDICAP WITH A VERY HIGH MORBIDITY AND MORTALITY."
THE WOMAN HAS EXPRESSED HER DESIRE TO TERMINATE THE PREGNANCY AND IS WELL INFORMED ABOUT THE NATURE OF THE CONDITION OT THE FETUS AND IT'S OUTCOME.
IN VIEW OF THE FETAL NUEROLOGICAL ABNORMILITIES SHE IS ANGUISHED WITH THE CONDITION OF THE FETUS IN THE UTERO.
SINCE THE PREGNANCY HAS ADVANCED TO 29 WEEKS AND IS BEYOND 20 WEEKS CUT OF THE MEDICAL TERMINATION OF PREGNANCY ACT, SHE HAS APPROACHED HONOURABLE COURT FOR TERMINATION OF PREGNANCY.
AT THIS STAGE OF PREGNANCY, THE RISK OF TERMINATION REMAINS THE SAME AS THAT Deshmane (PS) 4/13 ::: Uploaded on - 20/12/2019 ::: Downloaded on - 21/12/2019 04:20:24 ::: 5 wp-12876-2019 OF DELIVERY AT TERM.
AND IF THE COURT PERMITS THE PREGNANCY CAN BE TERMINATED WITH DUE RISK IN ANY TERTIARY CENTRE AS DESIRED BY THE PREGNANT WOMAN.
THE HONOURABLE COURT IS HEREBY REQUESTED TO INSTRUCT THE PARENTS TO TAKE THE RESPONSIBILITY OF THE CHILD IF BORN ALIVE"
7. In this background, we considered various aspects of the matter in the light of ratio of the various Judgments of the Hon'ble Supreme Court and of this Court.
8. The MTP Act was enacted in the year 1971.
Section 3 of the MTP Act reads thus :
"3. When pregnancies may be terminated by registered medical practitioners. - (1) Notwithstanding anything contained in the Indian Penal Code (45 of 1860), a registered medical practitioner shall not be guilty of any offence under that code or under any other law for the time being in force, if any pregnancy is terminated by him in accordance with the provisions of this Act.
(2) Subject to the provisions of sub- section (4), a pregnancy may be terminated by a registered medical practitioner,--
(a) where the length of the pregnancy does not Deshmane (PS) 5/13 ::: Uploaded on - 20/12/2019 ::: Downloaded on - 21/12/2019 04:20:24 :::
6 wp-12876-2019 exceed twelve weeks, if such medical practitioner is, or
(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 form such physical or mental abnormalities as to be seriously handicapped.
Explanation 1.--Where any pregnancy is alleged by the pregnant woman to have been caused by rape, the anguish caused by such pregnancy shall be presumed to constitute a grave injury to the mental health of the pregnant woman.
Explanation 2.-- Where any pregnancy occurs as a result of failure of any device or method used by any married woman or her husband for the purpose of limiting the number of children, the anguish caused by such unwanted pregnancy may be presumed to constitute a grave injury to the mental health of the pregnant woman.
(3) In determining whether the continuance of a pregnancy would involve such risk of injury to the health as is mentioned in sub- section (2), account may be taken to the pregnant woman's actual or reasonably foreseeable environment. (4)(a) No pregnancy of a woman, who has not attained Deshmane (PS) 6/13 ::: Uploaded on - 20/12/2019 ::: Downloaded on - 21/12/2019 04:20:24 ::: 7 wp-12876-2019 the age of eighteen years, or, who, having attained the age of eighteen years, is a mentally ill person, shall be terminated except with the consent in writing of her guardian.
(b) Save as otherwise provided in clause (a), no pregnancy shall be terminated except with the consent of the pregnant woman."
9. Under Section 3(2)(b) of the MTP Act, the maximum period of pregnancy which can be terminated is prescribed as twenty weeks. The circumstances under which the pregnancy can be terminated are set out under this Section. One such circumstance, as mentioned in Section 3(2)(b)(ii) is that, the termination of pregnancy can be allowed if there was a substantial risk that, if the child were born, it would suffer from such physical or mental abnormality as to be seriously handicapped.
10. Sub Section (1) of Section 5 of the MTP Act carves out an exception, which reads thus:
"5. Sections 3 and 4 when not to apply. -
(1) The provisions of section 4, and so much of the provisions of sub-section (2) of section 3 as relate to the length of the pregnancy and the opinion of Deshmane (PS) 7/13 ::: Uploaded on - 20/12/2019 ::: Downloaded on - 21/12/2019 04:20:24 ::: 8 wp-12876-2019 not less than two registered medical practitioners, shall not apply to the termination of a pregnancy by a registered medical practitioner in a case where he is of opinion, formed in good faith, that the termination of such pregnancy is immediately necessary to save the life of the pregnant woman."
11. In the instant case, however, the Board has not opined that the termination of the pregnancy was immediately necessary to save the petitioner's life. The petitioner is more than 20 weeks into her pregnancy.
12. This very issue is discussed and is dealt with by a Division Bench of this Court (Coram: A.S. Oka & M.S. Sonak, JJ.) in Writ Petition Nos.10835/2018, 9748/2018 & OS Writ Petition (L) No.3172/2018, decided on 3.4.2019. The Division Bench considered various judgments passed by the Hon'ble Supreme Court and discussed many issues. First and foremost, the Division Bench referred to the order of the Hon'ble Supreme Court passed in Writ Petition (Civil) No.928/2017, wherein it was observed that such cases could be filed in the respective High Courts having territorial jurisdiction. In paragraph-116, the Division Bench has Deshmane (PS) 8/13 ::: Uploaded on - 20/12/2019 ::: Downloaded on - 21/12/2019 04:20:24 ::: 9 wp-12876-2019 observed that in such cases Writ Petition under Article 226 of the Constitution of India will have to be instituted in this Court if the petitioner resides within the territorial jurisdiction of this Court or if the cause of action arises within the territorial jurisdiction of this Court to seek permission for termination of her pregnancy if such termination is not immediately necessary to save her life, but, where she alleges that the circumstances set out in clauses (i) & (ii) of Section 3(2)(b) of the MTP Act exist.
13. The Division Bench also considered whether expression 'life' in Section 5 of the MTP Act was to be construed narrowly as antithesis to death or physical survival or whether it had to be liberally interpreted adopting the principles of purposive interpretation.
14. In paragraph 79, the Division Bench observed that, in a situation where there was substantial risk that if the child were born, would suffer from deformities and diseases, and if the pregnant mother is forced to continue with her pregnancy, merely because the pregnancy has extended Deshmane (PS) 9/13 ::: Uploaded on - 20/12/2019 ::: Downloaded on - 21/12/2019 04:20:24 ::: 10 wp-12876-2019 beyond the ceiling of 20 weeks, there would arise a serious affront to the fundamental right of such mother to privacy, to exercise a reproductive choices, to bodily integrity, to her dignity. It was further observed that the principle of liberal or purposive construction will harmonize the provision in section 5 of the MTP Act with the constitutional provisions. Based on some Supreme Court Judgments, the Division Bench went on to observe that, the right to life enshrined in Article 21 included right to live with human dignity. The Division Bench ultimately held that, where a pregnant woman, the length of whose pregnancy has exceeded 20 weeks, seeks to terminate such pregnancy on the ground that its continuance would involve grave injury to her physical or mental health or where 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, such pregnant woman will have to seek permission from the High Court and unless such permission is granted, no registered Medical Practitioner can terminate such pregnancy. Deshmane (PS) 10/13 ::: Uploaded on - 20/12/2019 ::: Downloaded on - 21/12/2019 04:20:24 :::
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15. It was further held that, this Court, in exercise of its extraordinary jurisdiction under Article 226 of the Constitution of India, can permit medical termination of pregnancy the length of which exceeds 20 weeks, in contingencies set out in clauses (i) and (ii) of Section 3(2)(b) of the MTP Act. The Division Bench had directed the State to constitute Medical Boards for this purpose.
16. The Division Bench had further held that if medical termination of pregnancy was permitted and inspite of that if the child was born alive, then the registered Medical Practitioner and the hospital concerned was required to assume full responsibility to ensure that such child was offered best medical treatment available in the circumstances and in such cases if the parents of such child were not willing to or were not in a position to assume the responsibility for such child, then, the State and its agencies will have to assume full responsibility for such child in the best interests of such child and in accordance with the statutory provisions of the Juvenile Justice Act.
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17. In view of the observations made in the aforesaid judgment of the Division Bench in W.P Nos.10835/2018, 9748/2018 & OS W.P. (L) No.3172/2018, applying the ratio, guidelines and directions of this judgment to the facts of the case, we are of the considered view that the petitioner will have to be permitted to undergo medical termination of pregnancy. In forming our opinion, we are also relying on the judgments passed by the Hon'ble Supreme Court in the case of X and others Vs. Union of India and others, reported in (2017) 3 SCC 458 and in the case of Meera Santosh Pal and others Vs. Union of India and others in Writ Petition (Civil) No.17/2017 decided on 16.1.2017.
18. As mentioned earlier, the Medical Board has opined that the pregnancy can be terminated with permission of this Court. It was specifically reported that the condition of the fetus fulfills the criteria of substantial risk of serious physical handicap with a very high morbidity and mortality.
19. Considering the above discussion, the following order is passed:
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13 wp-12876-2019 i. The petitioner is permitted to undergo medical termination of pregnancy as per Medical Board's opinion, at a medical facility of her choice. However such procedure shall be conducted at the Medical Center which has all the necessary permissions issued under the Maharashtra Termination of Pregnancy Rules, 2003 and the procedure shall be conducted by a Medical Practitioner who satisfies the conditions laid down under those Rules.
ii. In case, if the child is born alive, the Medical Practitioner who conducts the procedure will ensure that all necessary medical facilities are made available to such child for saving its life.
iii. In case, if the child is born alive and if the petitioner is not willing to take responsibility of such a child then the State and its agencies will have to assume full responsibility for such child.
iv. Rule is made absolute in the aforesaid terms. v. All concerned parties to act on the authenticated copy of this order.
(SARANG V. KOTWAL, J.) (K.K.TATED, J.)
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