IN A significant administrative recognition of queer relationships, the Health Ministry has told the Delhi High Court that a competent adult can nominate or authorise his/her partner to take medical decisions on their behalf in case of incapacity — irrespective of sex, gender or sexual orientation.
"Where a competent adult has nominated or otherwise authorised his/her partner to act on his/her behalf in the event of incapacity, there appears to be no medical or ethical rationale for excluding such person merely on account of sex, gender or sexual orientation of the partners, or because their union does not fall within the conventional understanding of marriage, subject always to applicable law and appropriate safeguards," it has said.
It, however, maintained that the term "spouse" under Indian marriage laws only applies to heterosexual couples, relying on Supreme Court's 2023 five-judge bench decision against legalising same-sex marriage.
The ministry cited that Ministry of Finance in 2024 had clarified no restriction on same-sex couples opening joint bank accounts, and the Department of Food and Public Distribution had enabled them to be treated as members of same household for ration cards.
"These measures demonstrate a consistent administrative recognition that relationships of care, dependence and mutual responsibility are not necessarily confined to formally recognised marital or blood relationships," the ministry said.
Earlier, Income Tax department had opposed pleas in Bombay and Karnataka High Courts seeking to declare 'spouse' under IT Act as unconstitutional for tax exemption on gifts between spouses, holding marriage laws recognise only heterosexual couples as spouses.
This is the government's new template: No to same-sex marriage, yes to queer citizenship. Since the Supriyo verdict in 2023, ministries have been quietly unbundling rights from marriage — joint accounts, ration cards, now ICU decisions. Medical proxy is perhaps the most intimate. It respects patient autonomy without opening the marriage code. Legally astute, politically safe. It acknowledges what hospitals see daily: care does not come only from husband, wife, or blood, but from who is actually there. The test will be implementation — will hospitals accept a nomination letter when families object?