The recent Supreme Court ruling on MTP at 28 weeks highlights the tension between reproductive rights and medical ethics. Analyse the constitutional and ethical dimensions of this judgment.

Q. The recent Supreme Court ruling on MTP at 28 weeks highlights the tension between reproductive rights and medical ethics. Analyse the constitutional and ethical dimensions of this judgment. (15 marks, 250-350 words)

The Medical Termination of Pregnancy (Amendment) Act, 2021 permits abortion up to 24 weeks for special categories such as minors, rape survivors and differently-abled women [1]. The Court's recent order allowing termination at 28 weeks pushes beyond this statutory ceiling, setting a woman's bodily autonomy against the moral claims of a viable foetus.

Constitutional dimension - Article 21 — reproductive choice and bodily integrity are read into the right to life and personal liberty; the ruling extends this autonomy jurisprudence to late-gestation pregnancies, especially for adolescent petitioners. - Statute versus judicial discretion — Parliament fixed 24 weeks; the Court relaxed it case-by-case. This protects the individual but raises questions of separation of powers and of predictability for Medical Boards, which the amended Act empowers only for substantial foetal abnormality [1]. - The POCSO paradox — the POCSO Act, 2012 sets the age of consent at 18 years, criminalising even consensual adolescent sexual activity [2]. Fear of mandatory reporting delays care-seeking, so pregnancies surface late — the very delay the Court must then remedy. - Substantive equality — access to safe, timely abortion remains uneven, making the right formally available but practically unequal.

Ethical dimension - Autonomy versus non-maleficence — clinicians argued a 28-week foetus delivered alive faces serious neo-natal complications and long-term co-morbidities; honouring choice may impose harm on a viable third party. - Clinical autonomy — overriding an expert medical board's opinion unsettles the doctor's professional and conscientious position. - Ethics of silence — WHO stresses adolescent-friendly, confidential sexual and reproductive health services [3]; India's weak comprehensive sexuality education and thin uptake of Adolescent Friendly Health Clinics under RKSK (2014) [4] convert a preventable situation into a courtroom dilemma.

The judgment is best read not as autonomy defeating ethics, but as a signal that late-stage dilemmas are symptoms of upstream failure. Strengthening RKSK counselling, revisiting POCSO's treatment of consensual adolescent conduct, and issuing clear Medical Board guidelines would let dignity under Article 21 be secured through health systems rather than through litigation.

(~330 words)

Sources: 1. Rajya Sabha passes The Medical Termination of Pregnancy (Amendment) Bill, 2021 — PIB, MoHFW — 24-week upper gestational limit for special categories; Medical Board for substantial foetal abnormality 2. The Protection of Children from Sexual Offences Act, 2012 — India Code — statutory age of consent at 18 years; criminalisation of adolescent sexual activity 3. Adolescent Sexual Reproductive Health — WHO South-East Asia — need for adolescent-friendly, confidential SRH services and information 4. National Health Mission, Ministry of Health and Family Welfare — Rashtriya Kishor Swasthya Karyakram (2014) and Adolescent Friendly Health Clinics