Tapasya Umesh Pisal v. Union of India (2017)

Introduction 

This is a landmark judgment addressing the constitutional rights of pregnant persons seeking medical termination beyond the statutory twenty-week limit under the Medical Termination of Pregnancy Act, 1971, particularly in cases involving severe foetal abnormalities incompatible with normal life. 

Facts 

• Tapasya Umesh Pisal, a 24-year-old woman, approached the Supreme Court under Article 32 of the Constitution seeking permission to undergo medical termination of her pregnancy. 
• The foetus was diagnosed with tricuspid and pulmonary atresia, a severe cardiac anomaly, and the petitioner apprehended danger to her life. 
• At the time of medical examination on August 7, 2017, the petitioner was in her 24th week of pregnancy, exceeding the twenty-week statutory limit under the MTP Act, 1971. 
• A Medical Board was constituted by the Court consisting of specialists from B.J. Government Medical College, Pune, including experts in obstetrics and gynecology, pediatric cardiac surgery, pediatrics, and radiology. 
• The Medical Board examined the petitioner and confirmed the fetus had hypoplastic right heart with tricuspid and pulmonary atresia with small size pulmonary arteries. The Board reported that necessary surgeries would carry high morbidity and mortality, and even after corrective surgeries, such children do not achieve normal oxygen levels, remain physically incapacitated, and have limited life spans. 
• An eminent cardiac surgeon, Dr. Devi Shetty of Bangalore, opined that most such children do not survive to adult life and face precarious lives due to low oxygenation problems. 
• The Medical Board concluded there was a near certain chance of severe handicap or sudden death of the baby after birth, and the baby would require several surgeries associated with high morbidity and mortality. 

Issues Involved 

• Whether the Court should permit medical termination of pregnancy beyond the statutory twenty-week limit under Section 3(2)(b) of the Medical Termination of Pregnancy Act, 1971, in cases where the foetus suffers from severe physical abnormalities that would result in serious handicap? 
• Whether the petitioner's right to undergo medical termination should be upheld despite the pregnancy exceeding the statutory gestational age limit, considering the substantial risk that the child if born would suffer from physical abnormalities rendering it seriously handicapped? 

Court's Observations 

Applicability of MTP Act Provisions: 

• The Court observed that except for the time period limitation, the case clearly fell under Section 3(2)(b) of the Medical Termination of Pregnancy Act, 1971, which permits termination when there is substantial risk that if the child were born, it would suffer from such physical or mental abnormalities as to be seriously handicapped. 

Medical Evidence and Foetal Prognosis: 

• The Court noted the comprehensive medical evidence establishing that the fetus, if allowed to be born, would have a limited life span with serious handicaps that cannot be avoided. The medical consensus indicated the baby would certainly not grow into an adult. 

Interests of Justice: 

• The Court emphasized that in the interests of justice, and considering the certain severe handicaps and limited life span of the child, it would be appropriate to permit medical termination despite exceeding the statutory time limit. 

Ratio Decidendi: 

• The judgment established that in exceptional cases involving severe foetal abnormalities incompatible with normal life, where medical opinion unanimously confirms substantial risk of serious handicap and limited life span, courts may permit medical termination of pregnancy beyond the statutory gestational age limits in the interests of justice, particularly when such termination falls within the substantive criteria of Section 3(2)(b) of the MTP Act, 1971. 

Conclusion 

The Court allowed the writ petition and granted permission to the petitioner to undergo medical termination of her pregnancy under the provisions of the Medical Termination of Pregnancy Act, 1971. The termination was to be performed by doctors at the hospital where the petitioner had undergone medical check-up, under the supervision of the Medical Board constituted by the Court. The Medical Board was directed to maintain complete records of the procedure. This judgment reinforces the constitutional rights of pregnant persons and demonstrates judicial flexibility in applying statutory time limits when confronted with severe fetal abnormalities and comprehensive medical evidence supporting termination.