India plans new legislation to prevent sex selection

GANAPATI MUDUR / British Medical Journal 2002;324:385 16feb02

The Indian health ministry has drafted legislation to regulate reproduction technologies in a fresh attempt to curb the widespread preference for male children in India.

The legislation will ban the use of preimplantation genetic diagnosis and other reproductive technologies for sex selection through amendments to an existing law that prohibits fetal sex determination. The amended legislation will allow genetic diagnosis for detecting medical conditions, however.

India outlawed fetal sex determination for sex selection eight years ago, but prenatal sex determination through ultrasonography continues. The practice, stemming from traditional prejudices against girls in Indian society, leads to the selective abortion of female fetuses and has contributed to India’s declining sex ratio.

"It’s sad that instead of acting as agents of social change, doctors in India continue to collude with parents for sex determination," says Sumita Menon, a research officer with the Centre for Enquiry into Health and Allied Themes, a non-governmental organisation in Bombay.

In the absence of records or complaints, health authorities have found it difficult to prosecute anyone.

India’s census last year had shown that the number of girls per 1000 boys under 6years of age had declined substantially in several states—the national average dropped from 945 in 1991 to 927 in 2001.

A nationwide survey by the International Institute of Population Sciences in Bombay has shown that the sharpest decline in the sex ratio in the under 6 age group has occurred in cities and towns with good health services.

"Economic development, access to health care, and higher levels of female literacy have not diluted the traditional preference for sons," Dr Faujdar Ram, associate professor at the institute’s infertility department of told the BMJ.

The amended legislation, to be introduced in parliament later this year, will make it illegal to apply reproductive technologies for the sole purpose of sex selection.

Clinics providing preimplantation genetic diagnosis have sprouted in some cities. "We need to check the abuse of this technology for sex selection," says Ravindra Pandharinath, a member of a technical committee set up by the health ministry to help draft the amendments.

Some doctors have criticised the proposed changes in the legislation saying that they will violate the right of couples to choose the sex of their child. Practitioners of preimplantation genetic diagnosis also say that its high cost—150,000 rupees ($3000; £2200; €3500) per cycle—makes it accessible to only a small fraction of the population and will not have any impact on the sex ratio.

"The solution doesn’t lie in policing technology through legislation, but in addressing the issues that lead to this bias for boys in Indian society," said Dr Aniruddha Malpani, director of an infertility clinic in Bombay that offers preimplantation sex selection. Dr Malpani has filed a petition in the Indian supreme court to block the new legislation.

"Legislation will only drive the practice underground, leading to a black market and unethical practices," Dr Malpani said.

source http://bmj.com/cgi/content/full/324/7334/385/b 14feb02