Shivaji Rathore 7 April 2026
In a significant ruling, the Supreme Court of India reaffirmed the legal protection afforded to medical professionals while exercising clinical judgment. In Dr. S. Balagopal v. State of Tamil Nadu & Anr., the Court quashed criminal proceedings against a paediatric surgeon accused of performing an orchidectomy (removal of a testicle) on a minor child without proper consent. The judgment provides important clarity on the scope of consent, the role of medical expertise, and the limits of criminal prosecution in cases involving medical decisions. The case arose from allegations made by the father of a 1.5-year-old child who was admitted for treatment of an undescended testicle. According to the complainant, consent had been given only for orchidopexy, a procedure to reposition the testicle, but the surgeon proceeded to perform orchidectomy. It was further alleged that the consent form had been manipulated to include permission for the removal of the testicle. Based on these allegations, an FIR was registered invoking multiple provisions of the Indian Penal Code, including those relating to negligence and forgery, and a charge sheet was subsequently filed against the surgeon.
During the course of the proceedings, a Medical Board was constituted to examine the matter. The Board found that the affected testicle was small, cystic, and dysplastic, and therefore did not serve any functional purpose. It further opined that undescended testis carries a risk of malignant transformation and that orchidectomy is a medically accepted and appropriate procedure in such circumstances. The Board concluded that the procedure performed by the surgeon was consistent with medical ethics, though it ideally ought to have been carried out with informed consent of the parents.
The central issue before the Supreme Court was whether the absence of specific consent for orchidectomy, coupled with allegations of interpolation in the consent form, justified continuation of criminal proceedings. The Bench comprising Justice P. S. Narasimha and Justice Manoj Misra examined the material on record, including the consent form and the expert medical opinions. The Court noted that the consent form explicitly mentioned “Orchidopexy/Orchidectomy,” indicating that both procedures were contemplated as possible alternatives. Importantly, there was no forensic or other evidence to suggest that the term “orchidectomy” had been inserted later or that the document had been tampered with.
The Court emphasized that a surgeon, while performing an operation, is often required to take decisions based on intra-operative findings and medical necessity. It observed that the operating surgeon is the best judge of which procedure is to be adopted, particularly when such decision is supported by expert medical opinion. In the present case, the Medical Board had clearly stated that orchidectomy was an appropriate course of action given the condition of the testicle and the potential risk of malignancy in future.
The Court also reiterated the principles governing criminal liability of medical professionals, as laid down in Jacob Mathew v. State of Punjab, wherein it was held that a doctor can be prosecuted for criminal negligence only when the conduct is grossly negligent and falls below the standard expected of a reasonably competent practitioner. In the present case, there was no allegation of malice, nor was there any material to suggest that the surgeon had acted in a manner that could be described as rash or grossly negligent.
While the issue of consent was raised, the Court found that a consent form had indeed been executed prior to the surgery and that it included both procedures as alternatives. The absence of clear evidence of manipulation, coupled with the medical opinion supporting the procedure, led the Court to conclude that the allegations did not disclose the commission of any criminal offence. The Court observed that continuing the prosecution in such circumstances would amount to an abuse of the process of law.
Accordingly, the Supreme Court allowed the appeal, set aside the order of the High Court, and quashed the criminal proceedings pending against the surgeon. The ruling underscores the need to protect medical professionals from unwarranted criminal prosecution when they act in good faith and in accordance with accepted medical standards. At the same time, it highlights the importance of obtaining informed consent, while recognizing that medical practice often involves complex decisions that cannot always be confined within rigid procedural expectations.
Case details;-
SLP (CRL ) No. 14803/2023
