Non-Therapeutic Hysterectomy in Intellectually and Physically Disabled Girls and Women- A Critical Analysis

Abstract

The non-therapeutic hysterectomy is a significant ethical and legal dilemma in healthcare systems worldwide when it is performed in intellectually or physically disabled girls and women for reasons of menstrual hygiene management or caregiver convenience. This narrative review integrates literature to critically analyse clinical justifications, inherent ethical dilemmas and increasingly related legal issues surrounding this controversial matter, particularly in relation to institutional constraints in India. We explore the inconsistencies between accepted bioethical principles of autonomy, non-maleficence, and justice and the continuing rationalisations for the procedure. The recent Maharashtra government’s position in favour of the practice is read as a pivotal example of institutional betrayal. In contrast, international legal trends indicate a definite, although unreconciled, movement towards protective care, including judicial review as well as multiprofessional control. The article argues non-therapeutic hysterectomy is an ethical and human rights violation. We call for a shift in the model towards supported decision-making, to an exhaustive search for non-surgical options, and to the establishment of strong legal protection for the body and reproductive autonomy of this at-risk population.