Delhi High Court deprecates RML doctors’ board as it advises woman to continue 27-week pregnancy with signs of abnormalities detected in foetus

On May 4, when the petition came up for hearing before Justice Purushaindra Kaurav, the court was informed by the Union government that a medical board has already been formed to look into the matter. The court had then directed Atal Bihari Vajpayee Institute of Medical Sciences (ABVIMS) and RML Hospital to examine the woman “to clearly opine regarding feasibility of termination of pregnancy and the necessary consequences”.

The board’s report, submitted to the court on Wednesday, however, failed to give a clear opinion on the feasibility and consequences of the termination. Instead, it concluded, “The patient has thus been advised to continue expectant management according to standard guidelines. Patient is advised to continue the pregnancy.”

Justice Kaurav, pulling up the board, recorded, “There seems to be complete disregard to statutory mandate under the MTP Act and guidelines thereunder by the team of doctors who examined the petitioner… The court order required the medical board to opine regarding feasibility of termination of pregnancy and the necessary consequences. It was specifically directed that the board bear in mind all aspects as has been noted in the petition. The petitioner has categorically stated that the termination of the pregnancy is necessitated as there exists several fetal abnormalities..”

The board comprised Dr Preeti Sainia and Dr Jaya Chawla from RML Hospital’s Department of Obstetrics, Dr Sarita Jilowa from Department of Radiodiagnosis and Imaging, Dr Bhawna from the Department of Neonatology and Dr Mina Chandra from the Department of Psychiatry.

Noting the risk of death of the foetus in the womb, as has been submitted by the petitioner through her lawyer Rashmi Nandakumar, Justice Kaurav further noted, “There is no consideration bestowed by the medical board to these aspects. The court thus deprecates the act of the doctors who examined the petitioner in ABVIMS and RML Hospital… In the future it is warned that the court directions must be complied with in letter and spirit.”

While recording the board’s “complete disregard” to the court’s directions, Justice Kaurav also remarked orally that the Supreme Court has “very clearly said that reproductive autonomy has to be put on a higher pedestal”.

Addressing the Centre’s counsel, Justice Kaurav said orally, “Either they (the medical board) have to say yes (to termination) or they disagree (with private doctors’ opinion suggesting termination)… We have to say something regarding your doctors’ conduct and we have to refer the matter to Delhi Medical Council because they have abdicated from their statutory responsibilities.”

Initially being treated at a private hospital, mid-March, around the 21st week of pregnancy, a scan had documented severely restricted foetal growth. By early April, the abnormality was further confirmed, and by April-end, the woman made an emergency visit to RML Hospital, where she was informed that the placenta had severely restricted blood flow to the foetus. A private foetal medicine specialist then confirmed that the survival of the foetus even with the most intensive medical intervention, remains gravely uncertain, further recording the risk of sudden foetal death in the womb.

What the law says

Medical Termination of Pregnancy (MTP) Act permits for termination of pregnancy up to 24 weeks subject to the opinion of two registered medical practitioners that continuance of the pregnancy would involve a risk to the life of the pregnant woman or cause grave injury to her physical or mental health. However, the Act specifically provides that the length of pregnancy shall not apply in cases of substantial foetal abnormalities diagnosed by a Medical Board constituted for that purpose.