Savita Sachin Patil v. Union of India (2017)

Introduction 

This is a landmark judgment which addresses the legal boundaries of medical termination of pregnancy in cases involving severe fetal anomalies, specifically when there is no immediate physical risk to the mother's life. 

• The Judgment was delivered by a 2-judge Bench consisting of Justice S.A. Bobde and Justice L. Nageswara Rao. 

Facts 

• In the present case, a thirty-seven-year-old woman was in the twenty-sixth week of her pregnancy. 
• She approached the Supreme Court via Writ Petition (Civil) No. 121/2017 under Article 32 of the Constitution. 
• Medical examination confirmed that the fetus had been diagnosed with Trisomy 21, commonly known as Down Syndrome, which causes severe physical and mental retardation. 
• The Court directed the examination of the Petitioner by a specialized Medical Board consisting of seven doctors from various specialties including Obstetrics, Psychiatry, Medicine, Anaesthesia, and Radiology from Seth G.S. Medical College & KEM Hospital and LTMG Hospitals in Mumbai. 
• The petitioner sought judicial direction to allow her to undergo medical termination of her pregnancy. 

Issues Involved 

• Whether the Court should grant permission for the medical termination of the pregnancy of Petitioner No. 1, who was 26 weeks pregnant, given the diagnosis of Trisomy 21 (Down Syndrome) in the fetus? 
• Whether the diagnosis of a severe fetal anomaly, without an accompanying immediate physical risk to the mother's life, constitutes sufficient grounds for judicial intervention to permit termination outside the statutory limits? 

Court’s Observations 

Two Primary Considerations in Such Cases: 

• The Court emphasized that cases of this nature involve two primary considerations: danger to the life of the mother, and danger to the life of the fetus. 

Risk Assessment to the Mother: 

• The Medical Board's report explicitly stated that there was no physical risk to the mother from either continuation or termination of pregnancy. 
• The Court found that it was not possible to discern any danger to the life of the petitioner in case she was not allowed to terminate her pregnancy. 

Fetal Prognosis and Severity: 

• The medical report stated that if the baby were born with Trisomy 21, it was likely to have mental and physical challenges. 
• However, the Court observed that the report did not, and possibly could not, confirm that this particular fetus would have severe mental and physical challenges. 
• The report acknowledged that while intelligence among people with Down Syndrome is variable, a large proportion may have an Intelligence Quotient of less than 50 (severe mental retardation). 
• The Court treated the prognosis as a likelihood rather than a certainty of immediate danger or fatality. 

Irreversibility of the Decision: 

• The Court recognized that any permission granted at this advanced stage of pregnancy would be irreversible. 

Strict Interpretation of Medical Necessity: 

• The judicial authority was constrained by the absence of an immediate physical risk to the mother's life. 
• The Court held that the diagnosed condition of the fetus alone, without risk to the mother, was insufficient grounds for granting permission. 

Ratio Decidendi: 

• Based on the finding that there was no discernible danger to the life of the mother and understanding that granting permission would be irreversible, the Court held that it was not possible to grant permission to the petitioner to terminate the life of the fetus. 
• The judgment emphasized that risk to the mother's life outweighs considerations of fetal anomaly in determining whether to permit late-term abortion outside statutory limits. 

Conclusion 

• The Court in this case declined the prayer of the petitioners seeking direction to undergo medical termination of the pregnancy. 
• This is because the Medical Board's finding established that the continuation of the pregnancy posed no physical risk to the mother's life. 
• The judgment underscores the strict interpretation of medical necessity and risk to the mother as key determinants in judicial permissions for late-term abortions concerning fetal anomalies under the Medical Termination of Pregnancy Act, 1971.