Dr. (Prof.) Mahesh Baldwa,
M.D,D.C.H, FIAP
MBA, LL.B,LL.M , Ph. D(law)
SENIOR PEDIATRICIAN & MEDICOLEGAL ADVISOR
Formerly Assistant Professor of Pediatrics at T.N. Medical College and Nair Hospital, Mumbai-400008
Ex. Asst. Professor JJ Hosp, Grant medical college
Professor, paper setter & examiner of law to postgraduate students of University Department of Law, University of Mumbai
Baldwa Hospital, Sumer Nagar,S.V. Road,
Borivali (West)Mumbai 400 092
Q.1. A pregnant adolescent girl wants a gynaecologist to perform MTP. What should the gynaecologist do?
As per Indian law, the girl is a minor, so she is not capable of giving consent for MTP. A possible complication is described below.
She must get her father/mother to give a valid consent. For this, she has to disclose her pregnancy to her parents.
Most adolescents do not want to tell their parents about a pregnancy out of wedlock.
To keep her parents out of the picture, she lies to the doctor about her age.
Later, if she or her parents want to file a case of rape (such a case can be registered at the police station as one of rape, as per the legal definition of rape under Section 375 of the IPC[1]) against her boyfriend, the police will go to the doctor to find out who signed the consent, and it is invalid if the girl has signed it.
Now the doctor is in trouble. The doctor will have to defend herself/himself in court.
Q.2. Can an adolescent be seen without parental permission?
Yes.
Q. 3. Can we promise confidentiality to an adolescent?
Yes, on all issues except the following.
Confidentiality cannot be promised when it comes to examination to ascertain sexual abuse, sterilization, contraception, promiscuity, HIV infection and related matters. Counselling and tactful handling are required in these cases to prevent social stigma and parental admonition/ wrath because of disclosure to parents morally about sensitive matters.
In tackling cases of attempted suicide, one needs to weigh the advantages and risks before making a disclosure.
Exceptions to disclosure are where surgical procedures for MTP are involved, as Indian law considers pregnancy among adolescents as the outcome of rape. Rape is an offence under Sections 375 and 376 of the IPC. Therefore under section 202 of IPC, MTP needs to be disclosed to parents and/ or police.
Q.4. What do we do if we come across an adolescent with (i)STD (ii) HIV (iii) adolescent habitually engaed in sexual activity (iv)teenage pregnancy?
The best course of action is appropriate treatment along with counselling the adolescent to minimize social stigma. Also doctor may evaluate the benefits of disclosure to the parents or authorities as per the desire and psychological status of adolescent
One must prevent suicide, and not perform an illegal or septic abortion.
MTP is permitted after obtaining the signatures of one of the parents and the adolescent, in the presence of two witnesses.
Q.5. How to tackle an HIV-infected adolescent?
Treat the adolescent for HIV. Counsel him/her to prevent suicide and those who surround him/her to minimize social discrimination due to the patient’s HIV status.
Q.6. What to do when faced with an adolescent who has been raped or sexually molested?
Inform the police. Doctors should submit only a medical report and a treatment report to the police.
- If they do not submit these reports, they may be hauled up for hiding crime under Sections 120A, 201,202, 212, 375, 376 Of IPC.If a pregnant adolescent secures abortion without valid permission, the doctor is liable under Sections 312, 313, 314, 315 of the IPC and Section 156 of the CrPC.
Q.7. What to do when an adolescent expresses suicidal tendencies?
If there is no history of attempted suicide and only suicidal ideation, refer the adolescent to a psychiatrist.
If suicide has been attempted, inform the police. We are doctors and not law enforcers.
- We may be hauled up for hiding crime under Sections 120A, 201, 202,212, 306 of the IPC and Section 156 of the CrPC.
Q.8. What to do when an adolescent confesses to a crime?
Inform the police. We are doctors and not law enforcers.
We may be hauled up for hiding crime under Sections 120A, 201,202, 212 of the IPC and Section 156 of the CrPC.
Indian legal philosophy is very much endorsed by our culture, which has traditionally given the parents more or less complete authority over their children. This ethos persists even today. Children are expected to obey their parents and are punished by them or other law enforcers, such as the police, for disobedience.
