Lata, a mother of two children, was admitted to a hospital for acute abdominal pain. Her sister-in-law, Sujatha, accompanied her. Dr. Mansi examined Lata and recommended a diagnostic laparoscopy. Lata's consent was taken to conduct the medical procedure under general anesthesia.
During the laparoscopy, Dr. Mansi's team discovered a tumor in Lata's uterus. A closer examination suggested that the tumor could be malignant.
One option before Dr. Mansi was to extract a sample for biopsy. In that case, if the tumor was malignant, Lata would have to undergo another surgery for removal of the uterus. An alternative was to remove the uterus immediately. Dr. Mansi had to take a quick decision.
As Lata was under general anesthesia, Dr. Mansi explained the situation to Sujatha. Sujatha agreed with Dr. Mansi's recommendations for a hysterectomy, wherein Lata's uterus would be removed to avoid the risk and pain of undergoing another surgery. Dr. Mansi removed Lata's uterus after receiving Sujatha's consent in writing. Lata was informed of this the next day. She was very upset and felt betrayed as she had not consented to the removal of her uterus.
Lata complained to the police who tried to convince her that Dr. Mansi had acted with good intention to help a patient. Sujatha was of the same opinion, however Lata was not convinced and decided to approach the court.
Discuss the ethical issues involved in this case.
Central Dilemma: Beneficence and clinical judgement vs patient autonomy and informed consent.
(a) Ethical Issues:
- Violation of informed consent: Lata consented only to laparoscopy, not hysterectomy — a distinct, life-altering procedure.
- Patient autonomy: Every competent adult has an inviolable right over her body (Article 21; Samira Kohli v Prabha Manchanda, 2008 — Supreme Court held that consent for a diagnostic procedure does not extend to therapeutic surgery).
- Surrogate consent legitimacy: Sister-in-law is not the legal next of kin nor an authorised proxy; her consent has no legal standing where the patient is capable of deciding after regaining consciousness.
- Beneficence vs autonomy: Dr. Mansi acted to spare Lata a second surgery — genuine beneficence — but overrode the patient's right to choose.
- Reproductive rights: Hysterectomy has profound physical, psychological and reproductive consequences meriting personal deliberation.
- Trust in medical profession: Breach undermines doctor-patient trust broadly.
Answered By:
Harsh Raj
Harsh Raj is a successful government exam expert, having cleared multiple stages of SSC CGL, IBPS PO, CDS, RRB NTPC, and Delhi Police SI exams himself and mentored more than 5000 students through direct mentorship. His expertise is in creating well researched content, especially MCQs, which have been directly asked by relevant commissions in multiple exams.
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