In a society where hospitals are revered as sanctuaries of life and healing, the trafficking of newborns from these very institutions strikes at the heart of public trust and human dignity. The Supreme Court of India, in a landmark judgment in Pinki v. State of Uttar Pradesh & Ors. (2025 INSC 482), brought national attention to an organised interstate child-trafficking racket that revealed systemic failures in law enforcement, hospital administration, and child protection mechanisms.
One of the most alarming revelations was that several newborns and young children were kidnapped and sold, some directly from hospital premises.
This raises an urgent legal and moral question: Should hospitals implicated in such heinous crimes be allowed to function without immediate regulatory action? The answer is a resounding no. The licence of any hospital found involved, either through complicity or negligence, in the trafficking of newborns must be immediately suspended pending full investigation and accountability.
The Case that Shook the Nation
The case of Pinki v. State of Uttar Pradesh originated from a series of First Information Reports (FIRs), including FIR No. 201/2023, FIR No. 193/2023, and FIR No. 50/2023. These FIRs revealed a horrifying child-trafficking network operating across several states, including Uttar Pradesh, Jharkhand, Bihar, Rajasthan, and West Bengal. Infants and toddlers, mostly from impoverished families or street dwellers, were kidnapped—some from hospitals or their vicinity—and sold to childless couples for prices ranging from ₹50,000 to over ₹4 lakhs.
The Supreme Court noted with alarm that the traffickers were technologically savvy, using smartphones to coordinate sales and transfers of children across state lines. Many accused, after being released on bail by the High Court, absconded and evaded arrest for months, even after non-bailable warrants were issued.
What emerged from the Court’s detailed judgment was a portrait of systemic failure at multiple levels—including hospitals, which served as either the points of abduction or the false legitimisation of custody.
Hospitals as Facilitators: Complicit or Careless?
Hospitals hold the unique responsibility of recording births, verifying parentage, issuing discharge summaries, and ensuring that only authorised persons take custody of newborns. However, the findings in the Pinki case revealed that some hospital personnel, such as nurses and administrative staff, were not only negligent but actively involved in the trafficking network.
The accused Anuradha Devi, for instance, was a nurse who confessed to buying and selling multiple children through this racket. She admitted to purchasing newborns and young children, some of whom had likely been taken from hospital wards or misrepresented as surrendered or abandoned children.
This pattern points to either gross institutional negligence or active collusion. In either case, such hospitals cannot be allowed to continue operations under the guise of healthcare providers. The presence of any trafficked child originating from a hospital must trigger automatic regulatory review and immediate suspension of the institution’s operating licence.
Existing Legal Framework and Its Shortcomings
Constitutional and Statutory Provisions
Article 23 of the Constitution of India expressly prohibits trafficking in human beings. The Indian Penal Code, under Sections 370 and 370A (now mirrored in Sections 143 and 144 of the Bharatiya Nyaya Sanhita, 2023), criminalises trafficking and exploitation. The Juvenile Justice (Care and Protection of Children) Act, 2015, lays down a strict procedure for the surrender, adoption, and placement of orphaned or abandoned children.
Furthermore, guidelines issued by the Central Adoption Resource Authority (CARA) mandate that any child declared free for adoption must undergo detailed scrutiny and documentation, and must be reported by Specialised Adoption Agencies, not hospitals.
However, there remains a glaring regulatory blind spot: no mandatory mechanism exists to suspend or cancel a hospital’s licence immediately upon suspicion or discovery of newborn trafficking, unless criminal conviction is secured. This delay undermines justice and allows institutions to destroy or manipulate evidence.
Global Legal Framework on Child Trafficking and Illegal Adoptions
1. International Legal Instruments
The UN Convention on the Rights of the Child (CRC), 1989 recognizes the child’s right to grow up in a family environment, and imposes obligations on States to prevent the separation of children from their parents unless such separation is necessary in the best interests of the child (Articles 7 and 8).
2. The Hague Convention on Inter-Country Adoption (1993)
To combat illegal adoptions, the Hague Convention on Protection of Children and Co-operation in Respect of Intercountry Adoption was adopted. It introduced a regulatory framework to ensure that adoptions, especially across borders, are:
- Conducted via accredited authorities,
- Carried out only after exhausting domestic adoption avenues, and
- Not driven by financial exploitation of biological families.
- The principle of “subsidiarity” under this convention stresses that international adoption should be a last resort.
3. The Palermo Protocol (2000)
The Protocol to Prevent, Suppress and Punish Trafficking in Persons, Especially Women and Children, supplementing the UN Convention Against Transnational Organised Crime, provides the most accepted international definition of trafficking. It includes:
- The recruitment, transportation, and transfer of persons (especially children),
- By means of force, fraud, deception, or abuse of vulnerability,
- For purposes such as exploitation, forced labour, slavery, or organ removal.
Critically, for children under 18, even the absence of coercive means is irrelevant—the mere act of transferring a child for exploitation qualifies as trafficking.
Precedent from the Supreme Court
In Lakshmi Kant Pandey v. Union of India (1984), the Supreme Court had earlier set down procedural safeguards to prevent commercialisation and trafficking under the garb of inter-country adoption. It emphasised that children’s welfare and safeguards must override bureaucratic formalities. The 2025 Pinki case echoes this spirit but goes further in revealing how hospitals and hospital staff can be nexus points for trafficking.
Why Immediate Suspension of Licences Is Necessary
1. To Prevent Tampering of Evidence
Once a trafficking incident becomes public, there is a significant risk that hospital authorities will destroy, forge, or manipulate records to protect their personnel or reputation. Immediate suspension prevents further tampering of delivery registers, identification documents, discharge slips, or CCTV footage.
2. To Ensure Child Protection
Allowing an institution to continue operations while under serious suspicion of child trafficking compromises the safety of other newborns under its care. Suspension ensures that no further harm is done until the full extent of the racket is unearthed.
3. To Uphold Public Trust
Healthcare is based on trust. Once a hospital is suspected of such gross violations of human rights, it forfeits the moral and professional license to operate. Public confidence in maternal and child health institutions is critical and must be preserved.
4. To Send a Deterrent Message
Immediate licence suspension acts as a strong deterrent to other healthcare institutions. It signals that negligence or collusion in child trafficking will not be met with bureaucratic delay but swift action.
Towards a Legal Reform: What Must Be Done
The Pinki judgment and the concurrent FIRs, serve as a wake-up call for both central and state governments. The following legislative and policy reforms must be considered:
1. Amendment to the Clinical Establishments Act and State Medical Laws
The Clinical Establishments (Registration and Regulation) Act, 2010 should be amended to provide a statutory basis for the immediate suspension of any hospital’s licence if found involved or complicit in the trafficking of newborns or children, pending investigation. A clear clause must allow suspension without waiting for a final conviction.
2. Mandatory Surveillance and Audit of Maternity Wards
Hospitals must be required to maintain CCTV surveillance in maternity wards and neonatal care units. All footage must be archived for a minimum of 6 months and produced on demand by law enforcement authorities.
3. Linkage with Child Welfare Committees (CWCs)
Any child who is not discharged into the custody of the biological mother or father must be reported to the local Child Welfare Committee. Hospitals should not be allowed to hand over children to third parties without formal verification and CWC permission.
4. Establishment of a Rapid Response Unit
Each district should have a Rapid Response Unit under the Department of Health and Family Welfare, authorised to immediately inspect, seal, and suspend hospital operations if trafficking is suspected.
5. Blacklisting of Individuals and Institutions
Any hospital personnel found involved—whether nurses, administrators, or doctors—must be permanently barred from employment in healthcare facilities. Institutions that have failed in their duty must be blacklisted from receiving any government scheme, grant, or insurance tie-ups (such as Ayushman Bharat).
What the Court Emphasised in Pinki and Related Appeals
The Supreme Court, in its ruling, observed:
“The traffickers are operating with impunity and have deftly adapted to the advances in technology, using it to their benefit. Their operations and the relative ease with which they are able to procure buyers for selling children indicate that this is no ordinary crime—it is organised, commercialised, and requires a systemic response from all institutions, including hospitals.”
The Court also directed law enforcement agencies to take serious note of the failure of several accused to surrender even after cancellation of bail, observing that the police showed “unusual leniency” in failing to act for months. If police delay arrests, how can hospitals be trusted to discipline their own?
Conclusion
The trafficking of a child is one of the gravest crimes against humanity, and when it originates from a hospital, it becomes an institutional betrayal of life itself. The judgment in Pinki v. State of Uttar Pradesh & Ors. is a clarion call for systemic reform, institutional accountability, and zero tolerance against trafficking from healthcare institutions.
Immediate suspension of hospital licences upon any confirmed incident of newborn trafficking must be made mandatory through legislative reform. Only then can we hope to reclaim the sanctity of our hospitals, protect our most vulnerable citizens, and restore faith in our health systems.
References
[1] Pinki v. State of Uttar Pradesh & Ors., 2025 INSC 482
[2] Lakshmi Kant Pandey v. Union of India (1984) 2 SCC 244
[3] Juvenile Justice (Care and Protection of Children) Act, 2015
[4] The Hague Convention on Inter-country Adoption, 1993
[5] CARA Guidelines on Adoption
