Ramakant Rai v. Union of India, W.P ( C) No 209 of 2003

Public Interest Litigation (PIL) petition requesting the Indian Supreme Court to direct the Union of India and all Indian state governments to implement the Ministry of Health and Welfare’s Guidelines on Standards of Female Sterilization, enacted in October 1999.  The petition further sought compensation for victims of medical negligence in sterilization procedures, as well as accountability for violations of the guidelines.  Reproductive Rights, Right to Health, Women’s Rights.

Date of the Ruling: 
Dec 6 2007
Supreme Court of India
Type of Forum: 

The petition in this public interest litigation (PIL) case cited data from the States of Uttar Pradesh, Bihar, and Maharashtra, regarding government practices regarding female sterilization, which lacked counseling or informed consent, lacked pre- and post-operative care, and included unhygienic and un-anesthetized operating conditions, sterilization of minors, coercion and cruelty.  The PIL requested the Court to direct the state governments to comply with the Ministry of Health and Welfare’s Guidelines on Standards of Female Sterilization, enacted in October 1999 (“the Guidelines”). They asserted that the current sterilization conditions violated not only the Guidelines, but patients’ reproductive rights, women’s rights, and health rights as articulated in international instruments ratified by India, including the Alma Alta Declaration, CEDAW, the ICPD Program of Action, and the Beijing Platform for Action.  They further contended that the current conditions violated patients’ constitutional right to health, part of the right to life enshrined in Articles 14, 15, 21, and 47 of the Indian Constitution. 

In March 2005, the Court issued an interim order finding a lack of uniformity of procedures and norms to ensure that the guidelines were followed, and leaving the case open. The Court ordered all States in India to establish “an approved panel of doctors…to carry on sterilization procedures,” “prepare and circulate a checklist” with information on the patient, “circulate uniform copies of the proforma of consent,” “set up a Quality Assurance Committee,” “maintain overall statistics,”  “hold an inquiry into every case of breach of the Union of India guidelines…[and] take punitive action against them,” and “bring into effect an insurance policy.” The Union of India was directed to, within four weeks, outline “uniform standards to be followed by the State Governments,” including “the norms for compensation, the format of the statistics, check list and consent proforma and insurance.” All respondents were directed to report back to the Court within eight weeks.

(Ramakant Rai v. Union of India, W.P ( C) No 209 of 2003 , Supreme Court of India, 12/06/2007)

Enforcement of the Decision and Outcomes: 

States reported to the Court on compliance with the March 2005 order. The central government stressed that a plan to   award monetary compensation to those injured had been produced.  The Ministry of Health and Family Welfare submitted that directions issued by the Court were complied with and requisite guidelines were framed by the Ministry of Health and Family Welfare of the central Government.

Following compliance, the matter was disposed on December 6, 2007. 

Groups involved in the case: 


Human Rights Law Network

Center for Reproductive Rights

Significance of the Case: 

First, the Court issued directives not only for the States highlighted in the petition but to the entire country. Second, the case is also significant as the Court underscored the need for uniform guidelines in performance of sterilization procedures for women and men, including requirement of informed consent, punitive action for violations, and compensation for victims. 

Updated on june 2013