1. Nature of Marriage Medical Decision Authority Disputes

These disputes usually arise in the following situations:

(A) Emergency Medical Treatment

One spouse is unconscious or incapacitated, and the other attempts to authorize/deny treatment.

(B) Reproductive Decisions

Conflicts over:

• Abortion
• Contraception
• IVF or surrogacy choices
• Sterilization

(C) End-of-Life Decisions

• Withdrawal of life support
• “Do Not Resuscitate” (DNR) decisions
• Passive euthanasia debates

(D) Consent and Refusal of Treatment

A competent spouse refuses treatment, but family insists on intervention.

(E) Medical Privacy vs Spousal Access

Whether a spouse has automatic right to medical information.

2. Core Legal Principles

Courts generally rely on these principles:

• Informed consent is mandatory
• Competent adults have the right to refuse treatment
• Spouse is not automatic legal guardian
• Best interest standard applies only when patient lacks capacity
• Right to privacy and bodily autonomy prevails

3. Key Case Laws (at least 6)

1. Samira Kohli v. Dr. Prabha Manchanda & Anr. (2008, Supreme Court of India)

Principle: Informed consent is essential

• A patient’s consent must be specific and informed.
• Doctors cannot rely on general consent or spousal approval.
• Even in marital context, husband’s consent cannot substitute patient’s consent.

Held:
Medical procedures without valid informed consent are unlawful.

2. Suchita Srivastava v. Chandigarh Administration (2009, Supreme Court of India)

Principle: Reproductive autonomy is part of personal liberty

• The Court held that a woman’s reproductive choice is protected under Article 21.
• Even state or family cannot override her decision.

Held:
Reproductive decisions belong to the individual, not spouse or guardians.

3. Aruna Ramchandra Shanbaug v. Union of India (2011, Supreme Court of India)

Principle: Passive euthanasia and best-interest standard

• Addressed withdrawal of life support.
• Recognized “next friend” but emphasized judicial oversight.

Held:
Spousal or familial wishes are not final; court approval is required.

4. Common Cause v. Union of India (2018, Supreme Court of India)

Principle: Right to die with dignity & advance directives

• Recognized living wills and passive euthanasia.
• Authority shifts to medical board and court if patient incapacitated.

Held:
Spouse may participate, but cannot unilaterally decide life support withdrawal.

5. Airedale NHS Trust v. Bland (1993, House of Lords, UK)

Principle: Withdrawal of life support in persistent vegetative state

• Court allowed withdrawal based on best interests.
• Family views considered but not decisive.

Held:
Medical and judicial assessment overrides spousal preference.

6. Re T (Adult: Refusal of Treatment) (1992, UK Court of Appeal)

Principle: Valid refusal of treatment must be respected

• A competent adult’s refusal is binding even if family disagrees.

Held:
Spouse cannot override a mentally competent patient’s refusal.

7. Schloendorff v. Society of New York Hospital (1914, US case)

Principle: Bodily autonomy doctrine

• “Every human being of adult years has the right to determine what shall be done with their body.”

Held:
Medical treatment without consent is battery.

8. Canterbury v. Spence (1972, US Court of Appeals)

Principle: Full disclosure & informed consent

• Patients must be informed of risks before consent.

Held:
Consent must come from patient—not spouse or relatives.

4. Key Legal Issues Emerging from These Cases

(1) Is spousal consent legally required?

➡️ Generally NO, unless the patient is legally incapacitated.

(2) Can a spouse override medical refusal?

➡️ No, if the patient is competent.

(3) Can spouse make decisions if patient is unconscious?

➡️ Only as surrogate, subject to:

• “best interest” test
• medical board approval (in some jurisdictions)

(4) Who has final authority?

➡️ Courts + medical ethics frameworks, not automatic marital authority.

5. Conclusion

Marriage does not create automatic medical decision-making authority over a spouse. Modern jurisprudence strongly establishes that:

• Autonomy of the individual is supreme
• Spouses may assist but cannot dominate decisions
• Courts intervene in disputed or life-altering cases
• Informed consent is the legal foundation of all treatment