From UPSC perspective, the following things are important :
Prelims level : Hysterectomy
Mains level : Maternal health issues
Central Idea: The Health Ministry in India is concerned about the high incidence of unnecessary hysterectomies, particularly among poor, less-educated women in rural areas.
Why in news?
- The Supreme Court has directed States and Union Territories to implement health guidelines formulated by the Centre to monitor and prevent unnecessary hysterectomies.
What is Hysterectomy?
- Hysterectomy is a surgical procedure to remove the uterus, and sometimes surrounding organs and tissues.
- It can be classified as a partial hysterectomy (removal of the uterus), total hysterectomy (removal of the uterus and cervix), or radical hysterectomy (removal of the uterus, cervix, part of the vagina, and surrounding tissues).
- The procedure can be performed through the vagina or through an incision in the abdomen.
Issues with such surgery
- Overuse and unnecessary procedures: Hysterectomy can be performed without exploring alternative treatments.
- Psychological and emotional impact: The procedure may lead to feelings of loss and changes in body image.
- Surgical risks and complications: Hysterectomy carries risks such as infection and damage to surrounding organs.
- Long-term health effects: Removal of the uterus may have impacts on hormones and bone health.
- Patient autonomy and informed consent: Patients should be fully informed about the procedure and involved in decision-making.
- Access and equity: Disparities in access to healthcare may contribute to overuse, particularly among marginalized communities.
Concerns and Petition
A public interest litigation (PIL) highlighted the occurrence of unnecessary hysterectomies in the states of Bihar, Chhattisgarh, and Rajasthan under government healthcare schemes.
- Marginalized women were targeted: Women from marginalized communities, such as Scheduled Castes, Scheduled Tribes, and Other Backward Communities, were disproportionately affected.
- Misuse and Insurance Fraud: Healthcare institutions were found to be misusing hysterectomies to claim high insurance fees from the government under various health insurance schemes.
Key issue: Violation of Fundamental Rights
- The recent judgement acknowledges that rising hysterectomy rates among young women in India deviate from trends observed in developed countries.
- It recognizes the violation of fundamental rights, stating that unnecessary hysterectomies infringe upon the right to health and the right to life under Article 21 of the Constitution.
Government action and guidelines
- The Health Ministry has closely monitored the issue of hysterectomies and requested States to share data on hysterectomy cases before and after the implementation of guidelines.
- Compulsory audits for all hysterectomies are advised, similar to those conducted for maternal mortality, in both public and private healthcare institutions.
- In 2022, the Health Ministry issued guidelines to prevent unnecessary hysterectomies and urged States to comply with them.
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