Madras HC Sets Aside Rejection of Bangladeshi Minor's Kidney Transplant Application, Directs Immediate Permission for Mother to Donate

Justice G. R. Swaminathan held that the Authorisation Committee erred by fixating on the parents' marital relationship instead of the only relevant question: whether the donor was the recipient's mother.

The High Court of Judicature at Madras, on 29 May 2026, set aside an order by which the Authorisation Committee under the Transplantation of Human Organs and Tissues Act, 1994 had refused to permit a Bangladeshi mother to donate a kidney to her minor son. Justice G. R. Swaminathan, sitting singly, found that the Committee had rejected the application on an entirely irrelevant ground — a perceived inconsistency in the parents' account of where their wedding took place — while never seriously doubting that the donor was in fact the recipient's mother. The court directed the Committee to grant permission immediately, holding that the impugned order suffered from “misdirection in law and utter non-application of mind.”

The Petitioners and Their Medical Situation

The three petitioners are Bangladeshi nationals who reside permanently in Kashinathupur, Pabna, Bangladesh. The first petitioner, Minor Atonu Saha, suffers from end-stage renal chronic kidney disease and was on dialysis when the matter came before the court. His parents — the second petitioner, Sreemati Monika Rani Saha, and the third petitioner, Sree Akhil Kumar Saha — brought him to Chennai on medical visas after medical facilities in Bangladesh were found to be inadequate.

Atonu was admitted to Apollo Hospitals, Chennai. His nephrologists advised kidney transplantation as early as November 2025. The family could not immediately proceed because unstable political conditions in Bangladesh prevented them from obtaining the e-Apostille certificate required from the Ministry of Foreign Affairs. That certificate was eventually obtained on 15 February 2026. Compatibility tests confirmed that Monika Rani Saha could donate one of her kidneys to her son.

Under Section 9(1A) of the Transplantation of Human Organs and Tissues Act, 1994, prior approval of the Authorisation Committee is mandatory where the donor or recipient being a near relative is a foreign national. The family submitted an application in Form 11 on 30 March 2026.

The Committee's Rejection

The Authorisation Committee conducted an inquiry with the assistance of an interpreter, as the petitioners spoke only Bangla/Bengali. During the inquiry, the second and third petitioners gave varying answers to a question about where their wedding had taken place. The Committee treated this inconsistency as fatal and rejected the application on the ground that the spousal relationship between the second and third petitioners had not been established. The rejection was formalised in order K.Dis.No.24075/H and DII/4/2026 dated 2 April 2026.

The State, appearing through the Government Counsel, urged the court to sustain the order, pointing to the risk of large-scale trafficking in human organs and arguing that the court should not ordinarily review decisions of an expert committee constituted for that purpose.

The Legal Framework

Justice Swaminathan identified the applicable provisions as Sub-sections 1A, 5 and 6 of Section 9 of the Act and Rule 20 of the Transplantation of Human Organs and Tissues Rules, 2014, which govern cases where the proposed donor or recipient is a foreign national. Rule 20 requires, among other things, that a senior Embassy official of the country of origin certify the relationship between the donor and the recipient in Form 21.

The expression “near relative” is defined in Section 2(i) of the Act to include spouse, son, daughter, father, mother, brother, sister, grandfather, grandmother, grandson and granddaughter. The mother-son relationship therefore squarely falls within the definition.

Rule 18 of the 2014 Rules sets out the procedure for evaluating near-relative claims. Sub-rule 1 requires the Authorisation Committee to evaluate documentary evidence of relationship — birth certificates, marriage certificates, identity documents, family photographs — as well as documentary evidence of identity and residence. Sub-rule 2 permits the Committee, in its discretion, to direct a DNA test if the relationship is not conclusively established after evaluating that evidence. The court emphasised that this discretion “has to be exercised with utmost care” and cannot be invoked lightly.

How the Bench Reasoned

Justice Swaminathan addressed the standard of proof that the phrase “conclusively establish” in Sub-rule 2 demands. He held that the expression carries no technical evidentiary meaning. An Authorisation Committee is not a court of law and is not expected to apply legal standards of proof or presumption. Instead, it must approach the question from a commonsense standpoint, satisfying itself that the documents produced are genuine and then considering them cumulatively. No document should be examined in isolation. If the net effect of all the documents satisfies a reasonable person's commonsense, the relationship is conclusively established. Drawing on the Supreme Court's observations in Gangadhar Behera v. State of Orissa (2002) 8 SCC 381 on the rule of benefit of doubt, the court observed that the Committee must not nurture fanciful doubts or lingering suspicion.

The court also stressed the Committee's obligation under Rule 17(2) to adopt a dialogic approach — reverting to applicants for clarification rather than treating gaps in oral testimony as grounds for rejection. Where oral testimony varies from documentary evidence and the documents favour the applicant, it is the documents that should be preferred. Language barriers and unfamiliarity with official proceedings are real factors that can produce inconsistent oral answers without any underlying dishonesty.

Turning to the specific documents the petitioners had filed, the court listed twelve categories of material: passports issued by the Government of Bangladesh, visas, the donor's Form I application, a notarised affidavit, an HLA/DNA report in Form 5, the first petitioner's birth registration certificate issued by the Government of Bangladesh, his 10th standard/SSC result, National ID Cards issued to the second and third petitioners, the e-Apostille certificate dated 15 February 2026 certified by the Assistant Secretary, Ministry of Foreign Affairs, a Family Certificate dated 15 October 2025 issued by the Kashinathpur Union Parishad, a Form 21 relationship certificate and no-objection certificate issued by the Bangladesh Deputy High Commission in Chennai, and family photographs along with blood grouping and psychiatrist fitness reports. The petitioners had also voluntarily submitted a DNA report.

On the e-Apostille certificate specifically, Justice Swaminathan set out the relevant provisions of the Hague Apostille Convention, 1961, to which India is a signatory. He referred to the Ministry of External Affairs (CPV Division) office memorandum No. Q/OI/433/2/2020 dated 18 November 2020, which clarified that no further attestation or legalisation of an apostilled document should be required in India. He also cited the Bombay High Court's decision in Thakur Infraprojects Pvt. Ltd. v. State of Maharashtra, 2025 (4) MhLJ 757, and the Allahabad High Court's decision in Naromattie Devi Ganpat v. Union of India, 2024 (2) ADJ 130, both of which held that an apostilled document must be treated as a legalised document in India. Since the petitioners had produced the e-Apostille certificate, their documents had to be treated as authenticated and worthy of credence.

The Irrelevant Consideration That Vitiated the Order

The court identified the central flaw in the Committee's reasoning. The only relevant question before the Committee was whether the first petitioner (the recipient) was the son of the second petitioner (the donor). The Committee did not appear to have entertained any real doubt on that score. Instead, it developed doubts about the marital relationship between the second and third petitioners based on their inconsistent answers about where their wedding took place.

Justice Swaminathan held that whether the third petitioner was the husband of the second petitioner was entirely irrelevant to the question of whether the donor was the recipient's mother. It is well settled that if an administrative decision is vitiated by an irrelevant consideration, it is liable to be set aside. The impugned order was set aside on this ground alone.

The court went further and examined whether the materials on record did establish the mother-son relationship. The birth certificate of the first petitioner named the second petitioner as his mother and the third petitioner as his father. The marriage certificate of the second and third petitioners had been filed. The DNA report had been submitted voluntarily. From these materials, the court found it easy to conclude that the petitioners 2 and 3 are wife and husband and that the first petitioner was born through their wedlock.

The court also observed that the Committee's approach had effectively stigmatised a minor child. The consequence to the first petitioner of the rejection — continued dialysis and denial of a transplant — ought to have been taken into account. Justice Swaminathan referred to his own earlier decision in Rita Chaurasia v. Government of Tamil Nadu, W.P. No. 20047 of 2026, decided on 21 May 2026, where he had held that a donor-mother cannot be called upon to undergo a DNA test when abundant evidence already establishes the mother-son relationship. He also referred to his earlier decision in Sudha Mathesan v. Authorisation Committee (Transplantation), 2024 SCC Online Mad 1633, where he had held that in the absence of any credible reason, a statement by a non-near-relative donor that the donation is made out of love and affection must be accepted at face value. In the present case, the donor was not even a non-near relative but the recipient's own mother.

Outcome

Justice G. R. Swaminathan allowed Writ Petition No. 20140 of 2026 and set aside order K.Dis.No.24075/H and DII/4/2026 dated 2 April 2026 passed by the Authorisation Committee. The Committee was directed to grant permission to the second petitioner to donate one of her kidneys to the first petitioner immediately. Connected miscellaneous petitions — WMP No. 21551 of 2026, WMP No. 21554 of 2026 and WMP No. 21555 of 2026 — were closed. No costs were awarded.