Individuals in same-sex and queer relationships cannot be excluded from nominating their partners to make medical decisions on their behalf during health emergencies or periods of incapacity simply due to their sex, gender, or sexual orientation, the Union Ministry of Health and Family Welfare has submitted before the Delhi High Court.
In an affidavit filed on September 9, the health ministry informed the court that medical and legal frameworks already permit adults to designate trusted individuals outside conventional familial structures to manage their healthcare choices. The submission arrived ahead of a scheduled hearing on Thursday, following an August 20 session in which the high court had questioned the Union government over its delay in responding to the matter.
The proceedings stem from a petition moved in July 2025 by a same-sex couple who married in New Zealand in December 2023. The petitioners approached the court highlighting the absence of an explicit regulatory mechanism recognizing the authority of non-heterosexual partners to act as medical representatives during treatments or critical emergencies.
Statutory Framework And Ethical Rationale
Responding to the plea, the health ministry stated that both judicial rulings and statutory provisions, such as the Mental Healthcare Act of 2017, already establish that a nominated medical representative does not strictly need to be a spouse or a biological relative. The law permits any designated individual chosen by a patient to fulfill that responsibility.
The ministry explained that when a competent adult selects a partner to act on their behalf if they become incapacitated, there is no ethical or medical basis to disqualify that nominee based on sexual orientation or because their relationship falls outside traditional definitions of marriage, provided appropriate legal safeguards are maintained.
Administrative Precedents And Patient Autonomy
To support its position, the health ministry pointed to prior administrative decisions across Union government departments acknowledging non-traditional households. In 2024, the Ministry of Finance clarified that same-sex partners face no legal bar against opening joint bank accounts. Similarly, the Department of Food and Public Distribution authorized such couples to be treated as members of the same household for ration card distribution.
The ministry submitted that these administrative steps reflect an established pattern of recognizing relationships of mutual dependency and care beyond formal marital or blood ties. Extending this principle to allow adults to appoint their queer partners as medical decision-makers represents a logical continuation that safeguards patient autonomy.
Distinction From Marital Recognition
While supporting healthcare proxy rights, the ministry clarified that its stance does not alter statutory marriage definitions. Citing the Supreme Court’s 2023 five-judge Constitution bench ruling that declined to grant legal status to same-sex marriages, the ministry maintained that the term spouse under Indian marriage legislation remains confined exclusively to heterosexual unions.
This distinction aligns with positions taken by other central agencies. The Income Tax Department had earlier opposed petitions in the Bombay and Karnataka High Courts seeking to expand the definition of spouse under tax legislation for gift tax exemptions, reiterating that statutory marital benefits under Indian law are limited to heterosexual couples.
