MEERA SANTOSH PAL AND ORS.versusUNION OF INDIA AND ORS.

                         [2017] 1 S.C.R. 261



                MEERA SANTOSH PAL AND ORS.                                  A
                                   v.
                   UNION OF INDIA AND ORS.
                  (Writ Petition (C)No. I 7 of2017)
                         JANUARY 16, 2017
                                                                            13
       · [S.A. BOBDE AND L. NAGESWARA RAO, JJ.]
        Medical Termination of Pregnancy Act, 1971 ~ s.3(2)(i) -
Womans right to make reproductive choices and bodily integrity -
Writ petition seeking direction to the respondents to allow petitioner
no. l to undergo medical termination of her pregnancy as she
apprehended danger to her life, having discovered that .her foetus          c
was diagnosed with Anencephaly, a defect that leaves foetal skull
bones unformed and is both untreatable and certain to cause the
infants death during or shor1ly after birth - Held: Report of the
Medical Board clearly warrants the inference that continuance of
the pregnancy involves ~Tsk to the life of petitioner no. l and a           D
possible grave injury to her physical or mental health as required
by s.3{4}(i) of the Medical Termination of Pregnancy Act - Though,
the pregnancy is into the 24'" week, having regard to the danger to
the life and Jhe certain inability of the foetus to survive extra uterine
life, it is appropriate in the interests ofjustice to permit petitioner
no. l to undergo medical termination of her pregnancy under the             E
 provisions of Medical Termination of Pregnancy Act - The overriding
consideration is that she has a right to take all such steps as
necessary to preserve her own life ag(Jj!'st the avoidable danger to
 it, particularly since she has made an informed choice - The exercise
 of her right' seems to be within the limits of reproductive autonomy -     F
 Constitution of India - Arts. 21 & 32 - Personal liberty.
       Suchita Sriva~tava and Anr. v. Chandigarh
       Administration (2009) 9 SCC 1- referred to.
                       Case Law Reference
(2009) 9 SCC 1                    referred to                 Para 9        G
      CIVIL ORIGINAL JURISDICTION: Writ Petition (Civil) No.
17 of2017.
       Under Article 32 of The Constitution of India.
       Colin Gonsalves, Sr. Adv., Ms. Sneha Mukherjee, Satya Mitra,
                                                                            H
                                  261
262             SUPREME COURT REPORTS                           [2017] I S.C.R.


A     Advs., with him for the Petitioners.
             Ranj it Kumar, SG. R. K. Rathore, Ms. Swaruprana Chaturvadi,
      G. S. Makker, Nishant Ramakantrao Katneshwarkar, Advs., with him
      for the Respondents.
            The following Order of the Court was delivered
B                                    ORDER
             I. Petitioner- No. I - !Vleera Santosh Pal, is 22 years old, has
      approached this Court under Article 32 of the Constitution oflndia seeking
      directions to the respondents to allow her to undergo medical tennination
      of her pregnancy. She apprehended danger to her life, having discovered
      that her fetus was diagnosed with Anencephaly, a defect that leaves
c     foetal skull bones unformed and is both untreatable and certain to cause
      the infant's death during or shortly after birth. This condition is also
      known to endanger the mother's life.
             2. By order dated 11.1.2017, while issuing notice to the respondents,
      this Court gave a direction for examination of petitioner no. I by a Medical
      Board consisting of the following seven Doctors :
D               l. Dr.Avinash N. Supe, Director(Medical Education & Major
                   Hospitals) & Dean (G&K) - Chairman
                2. Dr. Shubhangi Parkar, Professor and HOD, Psychiatry,
                   KEM Hospital
                3. Dr. Amar Pazare, professor and HOD, Medicine, KEM
E                  Hosptial
                4. Dr. Indrani Hemantkumar Chincholi, Professor and HOD,
                   Anaesthesia, KEM Hospital
                5. Dr. Y.S. Nandanwar, Professor and HOD, Obstetrics, KEM
                   Hospitals
                6. Dr. Anahita Chauhan, Professor and Unit Head, Obstetrics
F
                   & Gynecology, LTMMC and LTMG Hospitals
                7. Dr. HemanginiThakkar,Addl. Professor, Radiology, KEM
                   Hospital.
            3. As on 12. I .2017, she was into her 24" week of pregnancy.
      This is also borne by the report dated 12. l.2017, received from the
G     Director (ME & MH)'s Office, Seth G.S. Medical College & KEM
      Hospital, Parel, Mumbai-400 012.
             4. By its report dated 12.1.2017, the Medical Board has examined
      petitioner no. I with specific ·reference to their special expertise for-
      general, medical, radiological, psychiatric and anaesthetic evaluation. An
      obstetric evaluation was done by two Obstetricians. Ultrasonography
H     was performed at KEM Hospital on 12. l.2017 by the Additional
 MEERA SANTOSH PAL ANO ORS. v. UNION OF INDIA AND                               263
                      ORS.

Professor, Radiology. The said Board has further reported that obstetric A
examination shows 24 weeks pregnancy, external ballottement present,
fetal parts not well felt with mild polyhydramnios. On internal examin~tion,
the cervix is posterior and OS is closed. Ultrasonography d1agnos1s has
revealed a single live fetus with anencephalywith mild polyhydramnios
with hypotelorism.
        5. We have been informed that the fetus is without a skull and B l
would, therefore, not be in a position to survive. It is also submitted that
petitioner no.1 has undergone psychiatric evaluation. She is reported to
be coherent, has average intelligence and with good comprehensiori. 1
She understands that her fetus is abnormal and the risk of fetal mortality
is high. She also has the support ofher.hus.t>and in her decision making.
      6. Upon evaluation of petitioner nb~l, the aforesaid Medical Board         c
has concluded that her current pregnancy is of about 24 weeks. The
condition of the fetus is not compatible with extra-uterine life. In other
words, the fetus would not be able to survive outside the uterus.
       7. Importantly, it is reported that the continuation of pregnancy
can gravely endanger the physical and mental health of petitioner no. I
and the risk of her tennination of pregnancy is within acceptable limits         0
with institutional back up.
       8. This Court, as at present being advised, would not enter into the
medico-legal aspect of the identity of the fetus but consider it appropriate
to decide the matter from the standpoint of the right ofpetitionerno. l to
preserve her life in view of the foreseeable danger to it, in case she
allows the current pregnancy to run its full course. The medical evidence
clearly suggests that there is no point in allowing the pregnancy to run its     E
full course since the fetus would not be able to survive outside the uterus
without a skull.
       9. In Suchita Srivastava and Anr. vs. Chandigarh Administration
[(2009) 9 SCC I], a bench of three JLidges held "a woman's right to
make reproductive choices is-also a dimension of 'personal liberty' as
understood under Article 2·1 of the Constitution". The Court there dealt         F
with the importance of the consent of the pregnant woman as an essential
requirement for proceeding with the termination of pregnancy. The Court
observed as follows:-
       "22. There is no doubt that a woman's right to make reproductive
       choices is also a dimension of"personal liberty" as understood
       under Article 21 of the Constitution of India. It is important to         G
      ·recognise that reproductive choices can be exercised to procreate
       as well as to abstain from procreating. The crucial consideration
       is that a woman's rightto privacy, dignity and bodily integrity should
       be .respected. This means that there· should be. no restriction
       whatsoever on the exercise of reproductive choices such as a
       woman's right to refuse participation in sexual activity or               H
264             SUPREME COURT REPORTS                            [2017] l S.C.R.



A           alternatively the insistence on use of contraceptive methods.
            Furthermore, women are also free to choose birth control methods
            such as undergoing sterilisation procedures. Taken to their logical
            conclusion, reproductive rights include a woman's entitlement to
            carry a pregnancy to its full term, to give birth and to subsequently
            raise children ..... "
B             l 0. The crucial consideration in the present case is whether the
      right to bodily integrity calls for a permission to allow her to terminate
      her pregnancy. The report of the Medical Board clearly warrants the
      inference that the continuance of the pregnancy involves the risk to the
      life of the pregnant woman and a possible grave injury to her physical or
      mental health as required by Section 3 (2)(i)ofthe Medical Termination
      of Pregnancy Act, 1971. Though, the pregnancy is into the 24'h week,
c     having regard to the danger to the life and the certain inability of the
      fetus to survive extra uterine life, we consider it appropriate to permit
      the petitioner to terminate the pregnancy. The overriding consideration
      is that she has a right to take all such steps as necessary to preserve her
      own life against the avoidable danger to it.
             l l. In these circumstances given the danger to her life,. there is no
D     doubt that she has a right to protect and preserve her life and particularly
      since she has made an informed choice. The exercise of her right seems
      to be within the limits ofreproductive autonomy.
            12. In the circumstances, we consider it appropriate in the interests
      ofjustice and particularly, to permit petitioner no. l to undergo medical
      tem1ination of her pregnancy under the provisions of Medical Tennination
E     of Pregnancy Act, 197 l. The learned Solicitor General Mr. Ranjit Kumar
      who took notice on the last date of hearing has not opposed the petitioners
      prayer on any ground, legal or medical. We order accordingly.
            13. The termination of pregnancy of petitioner no. l will be
      perfonned by the Doctors of the hospital where she has undergone
      medical check-up. Further, termination of her pregnancy would be
F     supervised by the above stated Medical Board who shall maintain complete
      record of the procedure which is t0 be performed on petitioner No. I for
      termination of her pregnancy.
             14. With the aforesaid directions, the instant writ petition is allowed
      in terms of prayer (a) seeking direction to the respondents to allow
      petitioner no. l to undergo medical termination of her pregnancy.
G            15. Mr. Colin Gonsalves, learned Senior Counsel appearing for
      the petitioners, submits that the petitioners do not press other prayers in
      the instant writ petition.
           16. We take on record the aforesaid submission made by Mr.
      Gonsalves, learned counsel appearing for the petitioners.
H     Bibhuti Bhushan Bose                                          Petition allO\YCd.