Maneka's pre-natal sex-determination test idea is novel, but moral, ethical holes abound

By Dr Nikhil Datar

Mr and Mrs Nirarka, and the mother-in-law were sitting before me in my clinic. The patient was pregnant on the second occasion. She already had a beautiful daughter but the whole family was longing for a male child. Till then this was all fare. Then the question came, "Doctor, can you help us to know the sex of the baby?" They were in no mood to listen to me. They did not care even if sex determination/sex-selective abortion was unethical, immoral and criminal. Upon my refusal and almost stern (they actually found it rude) preaching cum urging that they should not get into this ugly stuff, they got up from the seat and walked away. I could see clearly that they were going to shop around and ultimately get the sex-determination done from elsewhere.

I picked up the phone and spoke to a government authority and asked if they could track this patient so that firstly, the crime of sex determination could be prevented and secondly, the culprits involved in the heinous crime could be caught. But the senior officer said that there was no mechanism for doing so. (This incident happened almost 8 years ago).

Maneka Gandhi's latest comment on the PCPNDT Act reminded me of this incident.

She has suggested a similar mechanism. Her suggestion is that all patients should be told about the sex of the baby beforehand. But those who have a female foetus should be specifically tracked to ensure that they are taken care of well. Through various programmes, the government of India and various state governments are running a great system in which all expectant mothers seeking pre-natal health care are thoroughly tracked on various health parameters. The machinery including AHSA workers ensure that timely care is delivered to them. This intervention has really improved the outcomes and has been successful in reducing the maternal mortality significantly. This robust mechanism can be easily used to track pregnant women with female foetuses. It is like identifying a smaller subset and targeting that selected population. Determining and disclosing the sex of the baby is almost a norm in most of the foreign countries. The difference lies in the way this information is processed. In other countries this information is consumed for further planning of the arrival of the new born. In Indian society it may be used for sex-selective abortion and female foeticide.

Representative image. Reuters

Representative image. Reuters

I must state some undoubted facts here. We, as a society, have miserably failed to remedy the problem of gender inequality. PCPNDT Act was always a "misfired missile". It had a great aim and objective but the methodology was always going to be a failure. The Act never addressed the most important issue of gender inequality and changing the societal culture. The Act only focussed on doctors and sonography machines. It restricted doctors from doing sonographies at multiple places, made clinics create illogical and mundane records, put up sign boards of certain specifications. It created complex licensing and reporting mechanism.

All this was never going to solve the original problem. Imagine a situation wherein a man suffers from high grade fever due to malaria. The doctor treats him thinking that it is pneumonia. Naturally the fever does not subside. To achieve the objective of controlling the fever the doctor prescribes stronger medicines for pneuomonia. This is exactly what is happening with the PCPNDT Act. Since the skewed male and female ratio did not improve, the government further tightened the noose to catch doctors and to stop sonography centres. The latest data on convictions under the PCPNDT Act is shocking. It shows that most of the cases filed against the doctors are actually for administrative and clerical errors.

So when the problem is well-known and existing methods of curbing the problem have failed, Maneka ji has thought out of the box! Bravo ManekaJi!

Now, women will be tracked and the right of privacy will be at a toss. The right of privacy that flows from Article 21 of our constitution that ensures personal liberty to the citizens of India. Does the state have the liberty to abrogate this right?

I distinctly remember a few judgments delivered by various high courts including the Mumbai High Court on this subject, for example the case of Vinod Soni versus The Union of India. In one case, a couple had approached the court with an interesting plea. The couple had two sons and were keen to continue the pregnancy only if the woman was a carrying a female foetus. Had it been a male foetus they would have considered abortion. They wanted the court to direct the doctor/ hospital to declare the sex of the child. The court observed that the couple has a right to procure. The said right does not include right to procure a child of a specific sex. So, now it is a complete U-turn!

This new system may be administratively easy to manage. But it will still not solve the basic problem of societal inequality and gender bias. What if family stop sending pregnant woman to hospital or clinics after the sex determination? What if these women are taken to unqualified 'zola chap' (quack) doctors for illegal abortions?

Imagine a peculiar situation. The sex is already known. Now, the pregnant woman develops some genuine complication and medically needs termination of pregnancy. Or imagine that there is a serious malformation in the foetus and woman wants to terminate the pregnancy. In such a situation there is a likelyhood that the doctor may shy away from the surgery especially when the doctor knows that it is a female foetus. Ultimately it is the mother who suffers.

In a nutshell Manekaji’s idea although seems to be interesting, impressive and out of the box, it needs to really be checked on the ethical, moral, legal and practical grounds. Any intervention without addressing the gender inequality is never likely to yield result. Let us be sure that we don’t create another 'misfired missile' like PCPNDT Act.

Updated Date: Feb 03, 2016 10:10 AM

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