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Five years ago, the Supreme Court in a landmark judgment upholding the patient’s right to information and informed consent, had declared that performing hysterectomy (removal of uterus) without the patient’s informed consent was “an unauthorised invasion and interference” with the woman’s body , amounting to “ a tortuous act of assault and battery and, therefore, a deficiency in service.” (Samira Kohli vs Dr Prabha Manchanda, Appeal (Civil) No 1949 of 2004). The court had also in this judgment clearly established the norms for “valid and real” consent that doctors had to follow before any such surgery. However, a number of doctors around the country are guilty of violating the standard set by the highest law court in the country on patients rights and performing not jut unauthorised, but also unwarranted hysterectomy on thousands of young women, unmindful of its adverse consequences on the patients. While earlier, the victims of such unscrupulous medical practitioners were the rich and the middle class who went to private hospitals, in recent years, the poorest of poor have become the targets, thanks to private hospitals exploiting the government sponsored health insurance schemes such as the Rashtriya Swasthya Bima Yojana, which allow the beneficiaries to avail of medical treatment at private hospitals. The extent of the greed and avarice of these doctors can be gauged from the fact that uteruses of even young women-as young as 18 have been removed for no apparent reason, except to make a fast buck. Meanwhile, health activists have been demanding a registry of all hysterectomies performed in the country, besides stringent guidelines for such surgeries and strict action against doctors and hospitals for violations. A public interest litigation (Narendra Gupta vs Union of India) seeking compensation for the victims and appropriate policy changes is also pending before the Supreme Court. In this scenario comes an extremely important order of the National Consumer Disputes Redressal Commission, highlighting the right of the women who are subjected to such unwarranted surgery, to claim damages from the perpetrators. By directing a hospital and its gynaecologist to pay jointly and severally, a compensation of Rs 13 lakh to a 36-year old victim of unjustified removal of ovaries and fallopian tubes, the Commission has sent out a stern warning to all those medical professionals who value money more than the health of their patients. The order of the two-member Bench of the Commission, consisting Justice J.M.Malik and Dr
S.M. Kantikar, also expresses deep concern over the misuse of government-sponsored health insurance schemes by unscrupulous hospitals, at the cost of the health of thousands of women. Emphasizing that so long as doctors and hospitals are not held accountable, such exploitation of women would continue, the Commission has directed the union ministry of health and the Medical Council to initiate stringent action against such doctors. “Data of hysterectomy surgeries should be made mandatory for all private and government hospitals in the country”, the Commission has said. In this case, the complainant’s wife, Kusuma Reddy ’s consultations with the gynecologist for a complaint of abdominal pain and menstrual disturbances, culminated in a surgery for the removal of her uterus, ovaries and the fallopian tubes, thereby not only affecting her chances of having a second child, but also resulting in several health problems requiring lifelong hormonal therapy. After examining the investigation reports, Dr Kantikar, the first medical doctor to become a member of the apex consumer court, held that the patient’s condition did not require the drastic action resorted to by the doctor. The case was decided ex-parte as neither the gynecologist nor the hospital responded to the notice (Mr C. Jayapal Reddy vs Yashoda Group of Hospitals and Others, CC No 54 of 2013).
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According to rough estimates, over 30,000 such poor and mostly illiterate women from different parts of the country, including Rajasthan, Bihar, Chhattisgarh, Andhra Pradesh, have been subjected to such illegal and unjustified hysterectomy in the last few years. The number, however, could well be much more. The real extent of the menace would be known only after the fourth round of the National Family Health Survey (which begins next January and includes information on hysterectomy) submits its report. 