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[Cites 10, Cited by 0]

Bombay High Court

Jay Sandeep Gore vs State Of Maharashtra Thru The Prin. ... on 11 May, 2021

Bench: K.K.Tated, Abhay Ahuja

                                                    1. WP 1212-21.odt


              IN THE HIGH COURT OF JUDICATURE AT BOMBAY
                     CIVIL APPELLATE JURISDICTION

                          WRIT PETITION NO. 1212 OF 2021

       X                                            ..... Petitioner

               Vs.

       The State of Maharashtra                     ..... Respondent


       Ms. Ruchita Padwal i/b Ms. Aditi Saxena, Advocate for
       Petitioner.
       Mrs. Ashwini Purav, AGP for State/Respondent.


                                  CORAM:     K.K.TATED &
                                             ABHAY AHUJA, JJ

                                  DATED :    MAY 11, 2021

                                 (VACATION COURT THROUGH VC)
       P.C.

       1.      Rule. With the consent of the counsel for the parties,
       Rule is made returnable forthwith.


       2.      The Petitioner has been named 'X' in order to protect
       her identity.


       3.      This Petition is fled by the Petitioner mainly for
       permission to undergo medical termination of pregnancy for
       the fetus diagnosed with complex cyanotic congenital heart
       disease at the medical facility of her choice.


       4.      It is the case of Petitioner that she is into 22 nd / 23rd
       week of pregnancy. The Petitioner underwent the obstetrics

       Nikita Gadgil                                                         1/11..




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       examination at the gestational age of 20 weeks on 24 th April
       2021, where it was found that the axis of the heart was
       abnormal and was placed more to left side, muscular VSD
       was noted, pulmonary artery was small in calibre, there
       was mild dilation of right atrium and detailed fetal echo
       cardiography was advised. Thereafter, on 26th April 2021 at
       the gestational age of 21 weeks, Petitioner underwent fetal
       doppler echocardiagraphy, where the following impression
       was indicated:-
             "a) Cardiac axis is deviated to the left.
              b) A large permembranous VSD.
             c) Common Arterial Trunk (Type I) with dysplastic
                  truncal valve.
             d) Hypertrophied right ventricle.
                  The prognosis was guarded."
       Thereafter, the Petitioner underwent complete obstetrics
       examination on 28th April 2021, where following was
       opined :-
             "These fndings could be sporadic or associated with
       genetic anomalies like 22q11 deletions. The prognosis of the
       heart defect is extremey guarded with baby requiring
       multiple surgeries and limited quality of life. Dr. Rahul Saraf
       shall counsel the couple regarding the same."

       5.      The Pediatric cardiologist's opinion dated 29th April
       2021, refers to existence of complex congenital heart
       disease, where the common arterial trunk with atrial and
       ventricular septal defects have been noticed in the images.
       It has been advised that sometimes such lesions are
       associated with genetic abnormality like 22q11 deletion
       syndrome.



       Nikita Gadgil                                                       2/11..




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       6.      The Petitioner has stated in her Petition that she has
       desire to terminate the pregnancy in view of the aforesaid
       diagnoses. However, even though the amended Section 3(2)
       (b) (ii) of the Medical Termination of Pregnancy Act, 1971
       (the "MTP Act"), permits the same upto a gestation period
       of 24 weeks, but as the effectiveness of the said
       amendments have not yet been notifed, the Petitioner is left
       with no option other than to fle the present petition.


       7.      Learned counsel for the Petitioner has relied on
       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 under the MTP Act.


       8.      In view thereof and considering the ration laid down
       in these judgments, vide order dated 6 th May 2021, this
       Court had directed the Petitioner to approach the Medical
       Board       in     Sasoon   Hospital,   Pune     for     her      medical
       examination. The Medical Board was directed to conduct
       the examination and submit its report. Accordingly, the
       medical examination was conducted and the report dated
       7th May 2021 of the Board was submitted to this Court. The
       concluding paragraph of the report reads thus :-
             "Key recommendations of the panel (if any) with
             justifcation:
             On clinical examination mother has 23 weeks and
             6 days pregnancy and no medical and obstetric
             complication.
             In view of complex cranial and spinal
             abnormalities in the fetus on sonography such

       Nikita Gadgil                                                           3/11..




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             baby carries poor prognosis and if born alive will
             have signifcant morbidity and ortality. Thus
             medical    termination     of    pregnancy     is
             recommended with kind permission of Hon'ble
             High Court."

       9.      In the above backdrop, we have 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.


       10.     The MTP Act was enacted in the year 1971. Section 3
       of the MTP Act reads as under:-
             "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
             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 from such physical or mental


       Nikita Gadgil                                                         4/11..




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             abnormalities as to be seriously handicapped.

             Explanation I.--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 II.--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 of the pregnant woman's actual or
             reasonably foreseeable environment.

             (4)(a) No pregnancy of a woman, who has not
             attained 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."

       11.       Under Section 3 (2) (b) of MTP Act, the maximum
       period during which the pregnancy can be terminated is
       prescribed as 20 weeks. The circumstances under which the
       pregnancy can be terminated are set out in Section 3 of the
       MTP Act. One such circumstance, as mentioned in Section
       3 (2) (b) (ii) is that termination of pregnancy can be

       Nikita Gadgil                                                       5/11..




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       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.


       12.     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 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."

       13.     In the instant case, the Medical Board of the B. J.
       Government Medical College and Sasoon General Hospital,
       Pune, consisting of nine specialists including Gynecologist,
       Pediatrician            as   well   as   Radiologist,      Microbiologist,
       Cardiologist, Medicines, CVTS, Psychiatrist, has opined that
       the     fetal      ultra-sonography       shows     complex          cyanotic
       congenital heart disease, which will require multiple
       complex cardiac surgeries after birth and that there is
       increased risk of morbidity and mortality with each
       surgery, where prognosis remains poor, due to which there
       is risk of mental trauma to the mother. The medical
       termination of pregnancy is recommended subject to the
       permission of the Court.




       Nikita Gadgil                                                               6/11..




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       14.     In the circumstances, we are guided by the law as
       settled by a Division Bench of this Court (Coram: A.S. Oka &
       M.S.      Sonak,        JJ.)     in   Writ     PetitionNos.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 fled in the respective High Courts
       having       territorial       jurisdiction.   In      paragraph-116,            the
       Division Bench has 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.

       15.     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.

       16.     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


       Nikita Gadgil                                                                   7/11..




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       if the pregnant mother is forced to continue with her
       pregnancy, merely because the pregnancy has extended
       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.


       17.     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.

       18.     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

       Nikita Gadgil                                                        8/11..




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       State to constitute Medical Boards for this purpose, which
       direction appears to have found placed in the amendments
       of 2021, though yet to be notifed.



       19.     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.


       20.     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 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.

       Nikita Gadgil                                                           9/11..




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       21.     As mentioned earlier, the Medical Board has opined
       that if this Court permits, the medical termination of
       pregnancy is recommended. It was specifcally reported
       that the fetal ultra-sonography shows complex cyanotic
       congenital heart disease, which will require multiple
       complex cardiac surgeries after birth and that there is
       increased risk of morbidity and mortality with each
       surgery, where prognosis remains poor.


       22.     Considering the above discussion, the following order
       is passed:
                                         ORDER

i. The Petitioner is permitted to undergo medical termination of pregnancy as per Medical Board's opinion dated 7th May 2021, at a medical facility of her choice at the earliest. 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 satisfes 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.

       Nikita Gadgil                                                               10/11..




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iv. Rule is made absolute in the aforesaid terms.

v. Writ Petition is disposed of accordingly.

vi. No order as to costs.

vii. All concerned parties to act on the authenticated copy of this order.

       (ABHAY AHUJA, J.)                           (K.K.TATED, J.)




       Nikita Gadgil                                                       11/11..




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