On Friday, as the strike called by the Indian Radiological and Imaging Association entered its second day, civil society members came together to call the strike “unethical”. More than 20,000 radiologists in India have stopped performing ultrasound procedures to protest the 1994 law that to penalises doctors found performing ultrasounds for the purpose of sex-selection.
Ultrasound technology allows the doctor to determine the gender of a foetus. In India, ultrasound technology is meant to be used only to detect medical anomalies in the unborn child but has been highly misused in India to determine the gender of the baby and in selective abortions of girl children. India's dwindling sex ratio has been a matter of great concern with just 943 girls born for every 1,000 boys as per the 2011 census data. The sex ratio is even lower in certain states of India such as Haryana.
What doctors want
The Indian Radiological and Imaging Association called the Pre-Conception Pre-Natal Diagnostic Technique Act a “draconian law”. The law penalises doctors for not maintaining records as prescribed under the Act. A doctor performing an ultrasound on a pregnant woman has to fill an F-form that contains details about the gestational age among other medical details.
“Most doctors are nabbed by the appropriate authorities for clerical errors,” said Dr Jignesh Thakker, former president of the association. “How ethical it is to penalise a doctor because he forgot to fill something in the form.”
Under the Act, every state has an appropriate authority to implement the Act.
Not just the radiologists but gynaecologists and other medical specialists have extended their support to the stir. But activists are not sympathetic to the doctors' demands. “They don’t want any monitoring as such,” said Sabu George, a girl child activist in Delhi. “It is as simple as filling your tax returns. The doctors are expected to fill the forms every time they perform an ultrasound on a pregnant woman. Why is maintaining records so difficult?”
Senior officials from the union health ministry said that the apprehensions of doctors are baseless since only 350 doctors have been convicted under the Act since it was passed in 1994. “If the doctor is found not maintaining the records, first a show-cause notice is served,” said an official from the ministry. “We take action only if there is solid evidence indicating his involvement in sex-selection.”
No other system
Officials said that the issue with sex-selection is that there will never be a complainant. “The pregnant woman and her family as well as the doctor doing the ultrasound are part of the crime. They will not alert the authorities as both have some vested interest,” added the official.
The obvious way for the appropriate authority to detect malpractice is by scanning a doctor's records. Another option is to perform decoy or sting operations to catch doctors red-handed. Such operations that rely on a decoy patient's evidence often fail in court.
Toothless law?
Women groups have identified sex-selection as a form of violence. “After such laborious work, the law was drafted,” said Jagmati Sangwan, secretary of the All India Democratic Women’s Association. “Now that the Act is being implemented the doctors are protesting. It is actually working as a deterrent.”
Sangwan gave the example of Haryana where the sex ratio has marginally improved recently and where Prime Minister Narendra Modi launched the "Beti bachao Beti padhao" scheme. “The improvement is because of the implementation of the law. If the ministry bows down to the pressure of the medical lobby we will again lose our unborn daughters,” she said.
More than 40 women's rights activist groups have come together to protest what they call doctors blackmailing the government refusing to conduct ultrasounds. “Any dilution of the law will only lead to tens of millions of girls being eliminated in the coming decades,” said George. “Today’s strike will legitimise these genocidal crimes and encourage the new generation [of doctors] to flout laws.”
