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Published : September 09, 2014 | Author : admin
Category : Medico legal | Total Views : 442 | Unrated

Editor In Chief

Skewed Sex Ratio: Not a Myth but Reality
Analysis of Pre-Conception and Pre-natal Diagnostic Techniques Act

We Are a Nation of Daughter-Killers affirms India’s 2011 Census. This is the message that India’s just released 2011 census data sends out. The data reveals that in the age group 0-6 years, the gender ratio is 914 girls to 1000 boys; the lowest gender ratio recorded since India’s independence. We are inviting a mass genocide of girl child this coming decade. Who is to be held responsible for this catastrophic situation? When will our society be freed from this vulnerable condition? Even after the enactment of PC-PNDT Act and amendments, the declining sex ratio continues. In an alarming trend girl children numbers in India have shown a steep decline compared to number of male children leading to a skewed child sex ratio. Nearly three million girls have gone “missing” in 2011 compared to 2001 .Though, the overall sex ratio of the country is showing a trend of improvement but the child sex ratio is showing a declining trend which is a matter of serious concern. According to the report female child population in the age group of 0-6 years was 78.83 million in 2001 which has declined to 75.84 million in 2011.The population of girl child was 15.88 per cent of the total female population of 496.5 million in 2001, which declined to 12.9 per cent of total number of 586.47 million women in 2011.Rising India has left the girl child behind. The country may be marching shoulder to shoulder with the world’s top economies with a remarkable growth story. But its 1.21 billion strong population has still to shake off its bias against the girl child.

Declining Child Sex Ratio:

Pursue this fragment of an otherwise innocent conversation
Doctor (female): It’s a little late. Besides, IT has grown too large in size to eliminate.
Woman: Does that mean you can’t do anything to get rid of IT?
Doctor: Hmm, maybe a timely pill or an injection can still kill IT. The money charged will increase, of course.
Woman: That’s hardly a matter of concern. I just want IT done with. (Pause)What will we do with the body though?
Doctor: Do I need to spell it out to you? (Chuckles) There’s a graveyard close by. Bury IT there. Or maybe you could pack IT in a plastic bag and toss IT into the river nearby. Nobody will know.
Woman: Sounds like a feasible plan. Thank you.

The above dialogue is not in fact, a hypothetical conversation. This was part of a sting operation conducted by a team of journalists in one of the leading hospitals in India. The woman is a mother to be, while the doctor is a highly acclaimed medical practitioner. If you were wondering about the annoying repetition of the pronoun ‘it’, be ready to understand that the thing being so dispassionately discussed is the woman’s unborn girl child. This is the talk between an aspiring parent and her gynecologist.

We detest our daughters. This is the fate of a girl child. There is systematic killing of girls through sex-selected feticide. The girl child’s discrimination begins before birth in the form of female feticide. Sex selection has been argued as the consequence of technology. Child sex ratio statistics in the 0-6 age group for the last four decades show a continuous decline which has been the sharpest from 1981 onwards. The fall to 914 female per 1000 male in the 2011 census has been alarming especially since the country seems to be showing an upward growth in other areas. This clearly indicates that economic prosperity and education have no bearing on the sex ratio. The traditional preference for sons over daughters still continues. In a natural world, without sex selective abortion, the sex ratio should be approximately 980 females per 1000 males. Things get worse when we delve into statistics concerning infants and children. There are 12 million less females in India. The child sex ratio (0-6 years) is 914 girls per 1000 boys, an alarming decline from 927 in 2001 and 945 in 1991 and 962 in 1981 the lowest recorded since Independence. States like Punjab and Haryana have child sex ratio as low as 846 and 830 respectively. And the worst of them all the secondary sex ratio i.e. at birth in India is 893 girls per 1000 boys, whereas the natural sex ratio at birth is estimated to be 943. According to a recent study in Mehsana district in Gujarat and Kurukshetra district in Haryana, undertaken with the support of Health Watch Trust the last births had a stronger preponderance of boys than all other births. More than twice as many boys as girls were reported among the last births by most groups of women. There were more than 240 males for every100 girls in the last births among those women who belonged to upper caste whose families were landed and who were literate. This distortion was very likely due to the use of sex-selective techniques which helped parents get rid of unwanted daughters and to avoid having children once the minimum desired numbers of sons were born. In either case the preference for sons was evident. The Gujarat and Haryana study also noted that as the birth order increased the preponderance of male children increased. The preponderance of boys among the second and the third child was much greater for women who were educated beyond primary level, who were not engaged in any economic activity or who reported themselves as housewives, who belonged to upper castes and those whose families were landed. Today, the north-western states, where the sex-determination clinics first made their presence have the lowest child sex ratios. Census reveals that rich states like Punjab and Haryana have deplorable child sex ratios 798 and 820 respectively. States such as Gujarat, Delhi and Himachal Pradesh too have shown a drastic decline in the child sex ratio. In southern India, Salem is one of the worst districts in the country in terms of juvenile sex ratio. It is the fifth most prosperous district in Tamil Nadu. In Maharashtra the child sex ratio has declined from 946:1000 in 1991 to 917:1000 in 2001. In eight districts in Maharashtra the child sex ratio is below 900 girls per 1000 boys. Even Mumbai, has shown a decline from 942 in 1991 to 898 in 2001. It is worth noting that in most states it is the better off districts which have the most adverse child sex ratios thus confirming the assertion that the economically better off are the leaders in this new form of discrimination against the girl child.

These figures are seriously startling and establish this issue as a major cause of worry. India’s figures lie far below what they should be, naturally. India’s sex ratio is lower than the world average of 990 female per 1000 male and it ranks third in lowest secondary sex ratios in the world and fourteenth in lowest primary sex ratios. These statistics are enough to call for immediate and severe action.

Causes Attributing To Female Feticide:

Like many societies around the world, India too is patriarchal in nature. A set hierarchical system prevails in all tiers of the social order leading to fanatic obsession with the male child which is one of its kinds. Right from the ancient scriptures one finds instances where men are glowingly praised as the key to continue the family lineage. A girl is forced to undergo multiple pregnancies and abortions until she fulfills her lifelong goal of being a breeding machine that produces male offspring as per the needs of the family. Sadly a majority of female feticide cases involve an enthusiastic participation of women both old and young. As Justice Y.K Sabharwal, the Chief Justice of India, in his speech about Eradication of Female Feticide, delivered in Patiala on December 17, 2006 said that “Investing in a daughter they say is like ‘watering your neighbor’s lawn.’” A boy shall grow up to be the head of the family and he shall offer a sense of security to his aging parents, take care of them, serve them and take over the responsibility of running the family. He shall also continue the name of the family whereas; the girl shall take up her husband’s last name. A male is considered to be a producer, whereas a female is considered to be a consumer”. All this is mainly due to the patriarchal form of the Indian society. One simple assumption that can be made is that this preference is based on the form of society and families, a couple of decades back a male was expected to work and earn whereas a female was supposed to sit at home cook and manage the house and children. This made a male child desirable as he was then the only source of income and respect. Today women work nearly as much as men but the thinking has remained unchanged.

• Most couples prefer a male child over a female one. The root lies in our very own traditions, customs, beliefs and above all, our thinking. It is a general perception that the birth of a male child is beneficial and advantageous to the family. A male in the family is traditionally considered to be a source of money, source of respect, source of name and fame. A man is expected to work and earn for his family in the process repaying all that was cost to bring him up. A woman is considered a financial obligation as money spent on bringing her up, educating her, marrying her will not be repaid as she will go to her husband’s house after marriage and the benefits of all that ‘investment’ shall go to his family.

• Another major cause and arguably the most prominent one is the age-old dowry system. Dowry is the money, goods and or property a woman brings into a marriage. It is basically a payment done by the bride’s family to the groom’s family during marriage. Reasons for dowry include provision of base funds for the husband to start a new family establish his household and to feed and protect the family. Another reason is to support the woman and her children if the husband were to die especially since women have a better average life-expectancy than men. However in most cases dowry is seen to be payment to the groom’s family for accepting the woman and for taking responsibility of her there on. Dowry is very common in South-Asian countries like India. In India, expected dowries are huge hundreds of thousands in cash, cars, some property. It is well beyond the capacity of many families to afford this especially in rural area where the expectancy remains the same. Dowry is illegal in India but this has not stopped families all over the nation from giving and accepting it. Also in most cases the bride’s family is expected to arrange and sponsor the wedding. There immense amount of effort, money and glamour put in. Therefore the birth of a female child indicates huge amounts of expenditure later in her life when she shall be married which incidentally is considered the most important time of a woman’s life. Couples do not wish to have such financial burdens. Many small clinics that perform illegal sex-determination tests and help couples abort female fetuses advertise using the slogan, “500 now, or 5, 00,000 later” the former indicating the price of an abortion, and the latter that of the dowry.

• Another reason for not preferring a female child is regarding her safety. Incidences of girls subjected to rape, molesting, sexual abuse, domestic violence, trafficking, etc. are growing every day, and parents don’t want to risk their girl child’s safety.

• Another reason is illiteracy. It is assumed that people are illiterate and not educated, and hence they commit this heinous act. However, logical as it may sound, this cannot be safely established. Numbers tell us that, this practice of female feticide is equally prevalent, if not more, in urban parts of India as in rural areas. Clinics are flocked in huge numbers in urban areas to facilitate the ‘facility’ of illegal sex determination.

• Another reason is industrialization of the health sector. It has strengthened the selective sex abortion quarter. With the advent of CVS, Amniocentesis and Ultrasound sex determination of the fetus has become much easier than it was earlier. This goes on to show how the manufacturers of high-tech equipment and gadgets used to run these tests. Many hospitals are known to sign long term contracts with the firms involved in the production of these types of medical machinery. Often, a healthy percentage of the profit is shared with the hospital .As opposed to CVS and amniocentesis, the ultrasound technology is cheaper and within easy reach of the economically backward strata of society. It is also easily accessible in a hospital/clinic nearby with mediocre credentials. And shocking fact is that doctors use the trust placed upon them for their own benefits. Knowing that the couple will abort the fetus if it is female, the doctors proclaim a female fetus even if the tests show a male fetus to avail the extra fee they receive for abortion.

These are the major and most prevalent reasons for female feticide in Indian society.
Understanding these reasons behind this practice of female feticide, it is evident that the change has to be in the thinking and mentality of the people, and also the laws of our country to abolish and eradicate immoral and unjustified customs like dowry. These reasons have to be addressed immediately, if any change and improvement is desired it cannot be expected that female feticide be stopped without changing anything else. Major and instantaneous changes are required in the way our country and its people basically function. Only then we can think about bringing about a change, and making India a better and safer nation for the fairer sex.

Analysis Of Pre-Conception And Pre-Natal Diagnostic Techniques Act:

May you be the mother of a hundred sons! The popularity of sex determination tests in India has its roots in the strong son-preference that has the sanction of religion, tradition and culture. Elders still bless newlyweds with words that imply: “May you bear many sons”. This simple sounding blessing has an ugly underbelly, visible in the legacy of biases against the girl child, the most brutal form of which is female feticide. Today technology provides sophisticated methods of sex selection, the advertisements for which are crude and direct: “Spend only Rs. 500 now, save Rs. 5, 00,000 (on dowry) later”
In 1988, the state of Maharashtra became the first in the country to ban pre-natal sex determination through the enactment of the Maharashtra Regulation of Prenatal Diagnostics Techniques Act. At national level the Pre-natal Diagnostic Techniques (Regulation and Prevention of Misuse) Act (PC & PNDT Act) was enacted on September 20, 1994. The Act provides for the regulation of the use of prenatal diagnostic techniques for the purpose of detecting genetic or metabolic disorders, chromosomal abnormalities or certain congenital malformations or sex-linked disorders and for the prevention of misuse of such techniques for the purpose of prenatal sex determination leading to female feticide and for matters connected therewith or incidental thereto. Except under certain specific conditions, no individual or genetic counseling center or genetic laboratory or genetic clinic shall conduct or allow the conduct in its facility of pre-natal diagnostic techniques including ultra-sonography for the purpose of determining the sex of the fetus; and “no person conducting prenatal diagnostic procedures shall communicate to the pregnant women concerned or her relatives the sex of the fetus by words, signs or in any other manner.” The Act provides for the constitution of a Central Supervisory Board (CSB) whose function is mainly advisory and for the appointment of an Appropriate Authorities (AAs) in States and Union Territories to enforce the law and penalize defaulters and Advisory Committee/s (ACs) to aid and advise the AAs.

The ban on sex selection and some vehement advocacy by women’s groups and others has only muted the perpetrators it hasn’t silenced or stopped them. Doctors continue to communicate the sex of the fetus clearly banned by the Act through an innovative coded language:
“It is time to buy blue clothes” — if the fetus is of a boy; “It is time to buy pink” – if it is a girl’
“Go buy burfis” — if it is a girl; “Go buy pedas” —if it is a boy
“Jai Shri Krishna” - if it is a boy; “Jai mata di” — if it is a girl.

The law was amended in 2003 following a Public interest Litigation (PIL) filed in 2000 to improve regulation of technology capable of sex selection and to arrest the startling decline in the child sex ratio as revealed by the Census 2001. The amended Act now called “The Pre-Conception and Pre-Natal Diagnostic Techniques (Prohibition of Sex Selection) Act” not only prohibits determination and disclosure of the sex of the fetus but also bans advertisements related to preconception and pre-natal determination of sex. All the technologies of sex determination, including the new chromosome separation technique have come under the ambit of the Act. The Act has also made mandatory in all ultra sonography units; the prominent display of a signboard that clearly indicates that detection/revelation of the sex of the fetus is illegal. Further all ultrasound scanning machines have to be registered and the manufacturers are required to furnish information about the clinics and practitioners to whom the ultrasound machinery has been sold. Prior to the disposal of the PIL, among other things, the Supreme Court in its order dated December 11, 2001 directed 9 companies to supply the information of the machines sold to various clinics in the last 5 years. Details of about 11200 machines from all these companies were fed into a common database. Addresses received from the manufacturers were also sent to concerned States and UTs to launch prosecution against those bodies using ultrasound machines who had failed to get themselves registered under the Act. The Court in its order dated January 9, 2002 directed that ultrasound machines/scanners be sealed and seized if they were being used without registration. Three associations viz. the Indian Medical Association(IMA), Indian Radiologists Association(IRA) and the Federation of Obstetricians and Gynecologists Societies of India(FOGSI) were asked to furnish details of members using these machines. Since the Supreme Court directive of 2001 to March 2006, 28,422 facilities offering ultrasound tests have been registered across the country as per information received.384 cases are currently filed for various violations under the Act, including the communication of the sex of the fetus, non-maintenance of records and non-registration. Diagnostic Techniques such as ultra sonography are capable of determining the sex of the fetus i.e. whether it is male or female. This process is called sex determination. The process where the family selects the child of a particular sex it would like to have and eliminates that which is unwanted, is called sex selection. In most cases, sons are wanted while daughters are eliminated.

The Pre-Natal Diagnostic Techniques (Regulation and Prevention of Misuse) Act 1994 has since been amended with effect from 14.2.2003. Amendments to the Act mainly cover to:
1. Bring the technique of pre-conception sex selection within the ambit of this Act so as to prevent the use of such technologies which significantly contribute to the declining sex ratio.
2. Bring the use of ultrasound machines within the purview of this Act more explicitly so as to curb their misuse for detection and disclosure of sex of the fetus.
3. Empower the Central Supervisory Board for monitoring the implementation of the Act.
4. Introduce State level Supervisory Board for monitoring and reviewing the implementation of the Act in States/UTs
5. Constitute a multi member State Appropriate Authority for better implementation and monitoring of the Act in the States
6. Make punishments prescribed under the Act more stringent so as to serve as a deterrent for minimizing violations of the Act
7. Empower the Appropriate Authorities with the powers of Civil Court for search, seizure and sealing the machines, equipment and records of the violators of law including sealing of premises and commissioning of witnesses
8. Making mandatory the maintenance of proper records in respect of the use of ultrasound machines and other equipment capable of detection of sex of fetus and also in respect of tests and procedures leading to pre-conception selection of sex
9. Regulate the sale of ultrasound machines only to the bodies registered under the Act.

Based on the amendments made to the Act, the Rules framed there under have also been amended under the amended Rules
1. A provision for appeal has been made: Any person having grievance against the sub-district level Appropriate Authority can make an appeal to the district level Appropriate Authority and similarly for grievance against the district level Appropriate Authority an appeal can be made to the state/UT level Appropriate Authority.
2. 23 indications, prescribed by ICMR, have been included in the PNDT Rules for which ultrasound scanning can be conducted during pregnancy for the well-being of the pregnant woman and her fetus.
3. Forms have been simplified. Consent is required only in case of invasive techniques
In India, the policy environment is supportive of the reproductive choices of women and men. The medical termination of pregnancy is legal under certain conditions. The Medical Termination of Pregnancy Act(1971) allows for induced abortion in instances where pregnancy carries the risk of grave injury to a woman’s physical/or mental health that endangers her life or when it is a result of contraceptive failure or rape. However, as mentioned earlier, the PC & PNDT Act is aimed at curbing sex selection through the misuse of technology and therefore should not be confused with the MTP Act that allows legal abortion as per conditions under the Act.

Analysis of PC and PNDT ACT:

What are pre-natal diagnostic techniques or procedures?
“Pre-natal” means before birth. Techniques used for the detection or diagnosis of any physical or mental conditions in a fetus are known as pre-natal diagnostic techniques or procedures or tests. These techniques involve the study of any body fluid, blood, cells or any tissue from a pregnant woman or the fetus. This can also be done through a visual image, as is done in ultra sonography.

Uses of Pre-natal and Pre-conception Genetic Testing:

Pre-natal diagnosis of medical disorders can detect a potential threat for the mother and the fetus, thereby equipping the healthcare provider with information in case medical intervention is required. It also empowers the parents to make an informed choice of continuing the pregnancy or not in case of such a threat to the life of the mother or the child.
For example, knowing the Rh status (a blood grouping system) of the fetus in case of an Rh- negative mother is important to take steps in preventing damage to the red blood cells, liver and brain of the fetus. Genetic disorders detected pre-natally include Down’s syndrome (a leading cause of mental retardation); blood disorders like Thalassemia, Hemophilia, and Sickle Cell Anemia; some degenerative muscular diseases; and metabolic disorders leading to mental retardation. In many cases, genetic counselors can provide information and guidance regarding inheritance patterns, recurrence risk and medical consequences before the parents plan the pregnancy.

Genetic counseling should be considered in the following situations:

• Family history of late onset disorders with genetic component (e.g. Neuro-degenerative disorders like Huntington’s disease, mental illnesses like schizophrenia)
• History of the birth of a child with a birth defect or genetic disorder
• History of a relative with a birth defect or genetic disorder.
• History of stillborn infant
• Exposure to chemicals, drugs or other agents known to cause birth defects
• Mothers above the age of 35
Commonly used diagnostic techniques which have potential for misuse in sex selection


After conception, the fetus in the womb is suspended in a sac filled with a liquid. This liquid is called amniotic fluid. Amniocentesis involves the removal of a small amount of amniotic fluid from inside the sac with the help of a long needle inserted into the abdomen. The fluid contains cells belonging to the fetus that are then separated from the fluid. These cells are taken for chromosomal analysis (a study of chromosomes) through which any genetic abnormalities can be identified. The sex chromosomes are also present and hence it is possible to identify the sex of the fetus.

Chorionic villi biopsy

This technique involves the removal of a part of the elongated tissue (chorionic villi) surrounding the fetus through the lower opening of the uterus. This tissue is then tested for genetic defects; it can also reveal the sex of the fetus. It enables sex determination very early — between the 6thand the 13thweek of pregnancy. Though detection is possible in the first trimester itself, this technique carries a risk of bleeding, pain and spontaneous abortion.


Sonography, as it is popularly known, is one of the most widely and commonly used diagnostic technique. The medical fraternity – doctors as well as technicians – use it for a variety of health problems. During pregnancy it is used for the detection of any problems with the fetus and to generally monitor its growth. Sonography has become a part of the routine checkup done during the course of pregnancy. It basically uses sound waves not audible to the human ear to get a visual image of the fetus on a screen. The sex is determined based on the presence of the male genitalia which may be visible on the screen after the fourth month, depending on the position of the fetus. Since sex detection is possible only in a later stage in pregnancy, abortion can be very risky and may lead to infertility.

Ericsson Method

This technique, used for pre-conception sex selection, involves the separation of X- chromosome bearing sperms and Y-chromosome bearing sperms through a filtration process. The ovum is then fertilized with a high concentration of the sperm bearing the desired chromosome.

Pre-implantation Genetic Diagnosis

This is one of the latest technologies that have potential for misuse for sex-selection It involves the removal of a few early divided cells from a test tube embryo that are then tested directly by chromosomal analysis to identify the sex of the embryo.

The Law and Responsibilities
Legally these techniques can be used to detect genetic and metabolic disorders, chromosomal abnormality, etc. in the fetus that could arise before birth and could be linked to a family history of any such condition and the sex of the fetus. These techniques however cannot be used for sex selection.
Certain pre-natal diagnostic tests such as sonography are widely used to monitor the growth of the fetus and are now part of the routine ante-natal check up during the course of pregnancy. However, they cannot be used for sex determination or selection. The Act makes it imperative for the medical practitioner carrying out the tests to take the written consent of the pregnant woman for such tests and inform her about their side effects. A copy of the consent obtained must be given to the woman. In case of ultrasound tests, the pregnant woman has to sign a declaration stating that she does not want to undergo the test for the purpose of determining the sex of the fetus. Most importantly, the consent and explanation has to be done in a language that she understands. If the practitioner does not take her consent for such tests and if his/her clinic is not registered, then conducting the test is illegal. The medical practitioner cannot communicate the sex of the child to the parents or anyone else, even if he/she finds it out during these tests.

Who can conduct these tests?
Only the persons specified in the Act and described below can conduct these tests:

A medical geneticist– a person who possesses a degree or diploma in genetic science or has experience of not less than two years in such field after obtaining any one of the medical qualifications recognized under the Indian Medical Council Act (102 of 1956)or a post- graduate degree in biological sciences.
A gynecologist– a person who has a post-graduate qualification in gynecology and obstetrics.
A pediatrician–a person who has a post-graduate qualification in pediatrics.
Sonologist /radiologist or imaging specialist–a person who possesses any one of the medical qualifications recognized under the Indian Medical Council Act or who possesses a post-graduate qualification in ultrasonography or imaging techniques or radiology.

These tests can be conducted at the following premises provided they are registered under the Act:
i) Genetic Counselling Centre which means an institute, hospital, nursing home or any place, by whatever name called, which provides for genetic counselling to patients;
ii) Genetic Clinic which means a clinic, institute, hospital, nursing home or any place, by whatever name called, which is used for conducting pre-natal diagnostic procedures;
iii) Genetic Laboratory, which means a laboratory and includes a place where facilities are provided for conducting analysis or tests of samples received from Genetic Clinic for pre-natal diagnostic test.

Genetic Counselling Centres, Genetic Clinics, Genetic Laboratories, and Ultrasound Clinics or Imaging Centres having ultrasound machines or imaging machines capable of sex determination have to be registered. All fertility centresusing techniques capable of preconception sex selection have to be registered. Any vehicle using ultrasound techniques has to be registered.

Dealing with Violations

Any medical practitioner as specified under the law – medical geneticist, gynaecologist, sonologist, radiologist, registered medical practitioners , Genetic Counselling Centre, a Genetic Clinic or Laboratory or is employed in any such place and renders his or her professional services is liable for punishment for violation of provisions of the Act.
Any person who seeks the aid of any of the above establishments and professionals for conducting a pre-natal diagnostic technique on any pregnant women for the purpose of sex selection would be punished. Women who of their own volition undergo such a test for the purpose of sex selection are also liable for punishment. Women who are compelled to undergo such a test for the purpose of sex selection would not be punished but the persons compelling her would be liable for punishment as prescribed under the Act. Any person who advertises techniques capable of sex-selection before or after conception through any sex determination mode is also liable for punishment.


A medical practitioner may get an imprisonment for a term that may extend to three years and with a fine that may extend up to Rs. 10,000 and on any subsequent conviction, he/she may get an imprisonment that may extend to five years and with a fine that may extend to Rs. 50,000. The name of the medical practitioner would be reported to the State Medical Council by the Appropriate Authority for taking necessary action ,including removal of his/her name from the register of the Council for a period of five years for the first offence and permanently for the subsequent offence. Any person who seeks the aid of any establishments and professionals for conducting a pre-natal diagnostic technique on any pregnant women for the purpose of sex selection would be punishable with imprisonment for a term that may extend to three years and with a fine that may extend to Rs. 50,000 and on subsequent conviction with imprisonment that may extend to five years and with a fine that may extend to Rs. 100,000.

An offence under this law is Cognizable – A police officer may arrest the offender without warrant
Non-bailable– Getting bail is not the right of the accused. The courts have discretion to grant bail.
Non-compoundable- Parties to the case cannot settle the case out of court and decide not to prosecute.

Ban on advertisement
No person, organization, Genetic Counseling Centre, Genetic Clinic or Genetic Laboratory shall issue, publish or distribute a published advertisement in any manner regarding sex selection.
An advertisement includes electronic or print and in any form such as notice, circular, label, wrapper or other document. This also includes any visible representation made by means of any hoarding, wall painting, signal, light, sound or through the Internet. Any person found guilty is imprisoned for a period that may extend to three years and with a fine that may extend to Rs. 10,000.

Public and State Responsibility
A complainant can approach the designated Appropriate Authority of the State or district or sub district. The Appropriate Authority at the State level is a high ranking health department official above the rank of Joint Director of Health and Family Welfare. But there are also officials at local level in rural and urban areas who can be approached – the civil surgeon or the chief medical officer at the district level; the chief health officer or a ward health officer in a city; and the medical superintendent of the rural hospital in rural areas.

How to lodge a complaint?

A written complaint has to be made to the Appropriate Authority (AA), which has to acknowledge receipt. AA has to take action within 15 days of lodging the complaint.

Action taken:
The Appropriate Authority will initiate an investigation. If there is information or a reason to believe that the practice of sex selection is taking place, the premises in question may be searched and examined for any record, register, document etc. Anything that could be furnished as evidence of the offence may be seized and the unit may be sealed. If the AA feels that it is in public interest, it may suspend the registration without issuing any notice. A case would then be filed and once the offence has been proved, the guilty would be punished, as per the provisions of the Act.
If the AA takes no action within 15 days, the complainant can go to Court with the acknowledgment receipt. Alternatively the complainant can also approach a social organization like an NGO working on women’s rights issues in the area or State.

Implementation of the Act:
The implementing machinery for this Act comprises of:
• Central Supervisory Board (CSB)
• State Supervisory Board (SSB) and Union Territory Supervisory Board (UTSB)
• State Advisory Committee (SAC) and Union Territory Advisory Committee (UAC)
• Appropriate Authority (AA) for the whole or a part of the State/Union Territory
• Advisory Committees (AC) for designated areas (part of the State)

Functions and powers:
The Appropriate Authority is responsible for the implementation of the Act.
• It can grant, suspend or cancel registration of Genetic Clinics, Counseling Centre or Laboratories.
• In the case of breach of provisions of the Act, it is meant to investigate complaints and take immediate action.
• It has the powers to search premises, examine any record, register, document etc
• It also has the powers to seize any of the above that may furnish as evidence

Stricter rules are framed to curb Female feticide. The recent amendments to the act show the drive to curb sex determination tests. Doctors conducting ultrasound examinations will have to restrict themselves to two ultrasound centre as per a new notification of the Government of India. The government has notified three amendments to the Pre-Conception and Pre Natal Diagnostic Techniques (PC-PNDT) Act that include the hike from Rs 3,000 to Rs 25,000 for registration of an ultrasound centre and informing a month in advance of any changes like purchase of a new machine at the centre.

The State governments must use the mass communication media, print and audio-visual for public education and to spread awareness about the required ethical conduct of medical professionals. Program on the subject must appear in radio, television and newspapers and magazines. Moreover, it should also legitimize the concern through issuing public education advertisements, posters and official writings on the subject. Within your community or neighborhood if you get to know any sex selection being done, a complaint should be lodged to the Appropriate Authority with appropriate evidence. The drive to curb sex determination tests has been intensified through effective implementation of the PC-PNDT Act. While 17 states with the most skewed sex ratio at birth have been identified for concerted attention, as per the new amendment. After the relevant amendments to the act 127 cases have been registered for violation of the act.

Amendments made to PC- PNDT Act are not sufficient. The recent census report has proved it. The skewed child sex ratio in the country should be a major concern. Stringent punishment for such acts and permanent cancellation of practice should be enforced. And also penalize parents and individuals who go in for sex selection. If this evil is not annihilated from the societal roots then we might be responsible for the murders of our own flesh. There are numerous causes for the spread of female feticide and it is not dowry alone which is responsible for this social malice. Female feticide will lead to increasing crime against women. It would be manifestly wrong if we conclude that female feticide is a matter of medical technology alone. There is no doubt that easy access to ultrasonography has been largely responsible for the spread of female feticide throughout the country. This calls for a good look at gender issues in all their ramifications in our increasingly dysfunctional society. Female feticide is a sign of our civilization collapse. Be socially responsible and make others aware and spread the message about the illegality of the practice of sex selection and the implications of such a practice. Creation of a healthy society is our responsibility. STOP FEMALE FOETICIDE, THINK A WORLD WITHOUT A GIRL CHILD
# Answers to Frequently Asked Questions: A Handbook for Public
Ministry of Health and Family Welfare, Government of India

The author can be reached at: banashris@legalserviceindia.com

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