The Karnataka High Court has allowed a hysterectomy for a 23-year-old woman with severe intellectual disabilities after concluding that she lacked the capacity to make an informed decision and that the surgery was in her best interests.In an order dated June 17, Justice Suraj Govindaraj said, “It is only because the patient is demonstrably incapable of exercising informed decision-making and because the overwhelming medical evidence indicates that the proposed intervention would serve her welfare, health, dignity and safety that this Court considers it appropriate to grant the permission sought.”The court said the decision was based on a “best interests” assessment supported by independent medical evaluations and should not be viewed as permitting invasive procedures merely because a person has a disability.Also Read | Court says people with Down Syndrome entitled to protections, quashes order denying father guardianshipAdvocate Zulfi Sultana, appearing for the woman’s parents, relied on the woman’s medical and psychological assessments, which indicated that though she is chronologically 23, her cognitive, developmental, and adaptive functioning remains severely compromised.Sultana said she is entirely dependent upon her parents for her daily needs and personal care as she cannot “c”ommunicate effectively regarding her physical discomforts, medical concerns or menstrual difficulties.“Her inability to maintain personal hygiene during such periods has resulted in recurring infections, intermittent episodes of fever and prolonged medical complications. The situation has not only exposed (daughter) to repeated health risks but has also imposed considerable physical, emotional, and psychological strain upon the petitioners, who are advancing in age and continue to remain her sole caregivers,” she added.The parents said in the petition that the proposed procedure is “intended solely to safeguard the health, dignity, comfort and long-term welfare of (X) and not for any collateral purpose.”Medical board’s opinionStory continues below this adThe bench directed the constitution of a medical board to examine the woman at the Vanivilas Hospital to independently evaluate her medical condition, assess her capacity, and determine the necessity and advisability of the proposed procedure, and to give its opinion.After the examination, the medical board said the woman has Global Developmental Delay associated with Moderate Permanent Intellectual and Developmental Disability. Her social age was assessed at approximately 5 years and 4 months, her IQ at 36, and her permanent disability at 75 per cent.Also Read | Provide all amenities to visually impaired man and his mother living in poverty, Supreme Court tells OdishaWhile the psychiatrist on the board said the woman is unable to independently maintain menstrual hygiene, the neurologist reported she has cerebral palsy, associated with intellectual disability and seizure disorder and has been undergoing treatment for over 13 years.The obstetrician and gynaecologist said she is unable to independently manage menstrual hygiene and has specifically recommended that she may be “considered for Total Abdominal Hysterectomy.”Story continues below this adTaking note of the medical board’s report, the bench said the woman lacks the cognitive and intellectual capacity to make an informed decision regarding the proposed procedure.‘Dignity, safety and quality of life’The bench said the court has to balance the woman’s bodily integrity and autonomy with the practical realities arising from her medical condition, intellectual limitations, quality of life, health concerns, and long-term welfare.It noted that her parents and primary caregivers have been providing continuous care and support throughout her life.“There is nothing on record to indicate that they are motivated by any collateral consideration. On the contrary, the materials on record indicate that they have approached this court solely out of concern for the welfare, dignity, comfort and long-term well-being of their daughter.”Story continues below this adAlso Read | ‘Truth can’t be suppressed in her silence’: Sikkim High Court upholds 10-year jail for rape of woman with cerebral palsy“The present case does not concern sterilisation for eugenic purposes, population control measures or any attempt to curtail the rights of the patient on account of her disability. The recommendation is founded entirely upon considerations relating to health, hygiene, dignity, safety and quality of life.”“The permission is granted only after judicial scrutiny, independent medical evaluation by specialists from multiple disciplines, consideration of the patient’s inability to provide informed consent, examination of the absence of any contraindication to the proposed procedure and a determination that the proposed intervention is in the best interests of the patient.”“This Court is satisfied that the proposed procedure is intended to advance the welfare, health, dignity and best interests of (X).”