System of holding sterilization camps should be halted in order to strengthen the Primary Health Care centres across the country

Supreme Court: In the matter highlighting the important issues concerning the entire range of conduct and management of sterilization procedures wherein women and occasionally men are sterilized in camps or in accredited centres, the Court directed the Union of India to ensure strict adherence to the guidelines and standard operating procedures in the various manuals issued by it. The Sterilization program is not only a Public Health issue but a national campaign for Population Control and Family Planning. The Court said that the Union of India has overarching responsibility for the success of the campaign and it cannot shift the burden of implementation entirely on the State Governments and Union Territories on the ground that it is only a public health issue.

Expressing sadness at the fact that the National Health Policy, 2015 has not yet been finalized despite the passage of more than one and a half years, the bench of Madan B. Lokur and U.U. Lalit, JJ directed the Union of India to take a decision on or before 31st December, 2016 on whether it would like to frame a National Health Policy or not. In case the Union of India thinks it worthwhile to have a National Health Policy, it should take steps to announce it at the earliest and keep issues of gender equity in mind as well.

In order to ensure that the proposed patient has given an informed consent for undergoing the sterilization procedure and not an incentivized consent, the Court said that the contents of the checklist prepared pursuant to the directions given in Ramakant Rai (I) v. Union of India, (2009) 16 SCC 565, should be explained to the proposed patient in a language that he or she understands and the proposed patient should also be explained the impact and consequences of the sterilization procedure. The said checklist should be prepared in the local language of the concerned State. Also, sufficient breathing time of about an hour or so should be given to a proposed patient so that in the event he or she has a second thought, time is available for a change of mind

Considering that as many as 363 deaths have taken place due to sterilization procedures during 2010-2013, the Annual Report prepared by the Quality Assurance Committee must indicate the details of all inquiries held and remedial steps taken as there is a need for transparency coupled with accountability and the death of a patient should not be treated as a one-off aberration.

The Court also directed the Union of India to persuade the State Governments to halt the system of holding sterilization camps as has been done by at least four States across the country. In any event, the Union of India should adhere to its view that sterilization camps will be stopped within a period of three years. This will necessitate simultaneous strengthening of the Primary Health Care centres across the country both in terms of infrastructure and otherwise so that health care is made available to all persons.

Pained by the casual approach of certain States, the Court directed the Registry of this Court to transmit a copy of this judgment to the Registrar General of the High Court in the States of Madhya Pradesh, Maharashtra, Rajasthan and Kerala for being placed before the Chief Justice of the High Court and requested the Chief Justice to initiate a suo moto public interest petition to consider the allegations made in respect of the sterilization camp(s) held in these States (the allegations not having been specifically denied) and any other similar laxity or unfortunate mishap that might be brought to the notice of the Court and pass appropriate orders thereon. [Devika Biswas v. Union of India, 2016 SCC OnLine SC 936, decided on 14.09.2016]

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