A 23-year-old woman.
Unable to speak for herself.
Unable to manage her own body.
And her parents — exhausted, desperate — walked into the Karnataka High Court asking for permission to remove her uterus.
This is one of the hardest cases a court can hear.
She lives with Global Developmental Delay, moderate intellectual disability, cerebral palsy and seizures.
Every menstrual cycle had become a medical event.
Recurring infections. Prolonged complications. Pain she couldn't explain.
Her parents weren't asking for convenience.
They were asking for relief.
Indian law doesn't let caregivers casually decide on procedures that end fertility.
It can't.
Because history is ugly:
So Section 10 of the Rights of Persons with Disabilities Act, 2016 drew a hard line:
No infertility-causing procedure without free and informed consent.
Full stop.
This is where the law twists into itself.
She can't say yes. She can't say no.
She can't understand the question.
So the court reached for a centuries-old doctrine:
👉 parens patriae — "the state as the parent."
The judge doesn't substitute their own opinion.
They ask one question only:
What is genuinely in her best interest?
A multidisciplinary medical board examined her, confirmed she lacked capacity, and recommended the surgery.
The court agreed.
In 2023, the Supreme Court was forced to crack down on a darker pattern.
Women — mostly poor, mostly marginalised — were having their uteruses removed under government insurance schemes they barely understood.
The court ordered:
The Karnataka ruling sits inside that same uneasy conversation.
Reproductive autonomy is sacred.
The Suchita Srivastava case (2009) said it clearly — a woman's reproductive choice is part of personal liberty under Article 21.
Even if she has a mild disability. Even if the state thinks it knows better.
But what about when there is no choice to be made?
When autonomy itself is locked behind a door no one can open?
That's where parens patriae steps in.
Not as a hammer.
As a last, careful guardian.
And that's exactly what happened in Karnataka last week.
That's all for now!
