New Delhi, India — Technology can be as effective in killing conscience as in killing human beings. It has permitted India and China to graduate from female infanticide to female feticide.Murder of the girl child had been prevalent in India. It was however restricted to certain caste groups in some parts of India, but female feticide is now cutting across caste and geographical boundaries. In the past, there might have been some remorse or sense of guilt in murdering a baby after birth, but technology-assisted murder before birth is seen as no more than a procedure.
A generation ago, both India and China convinced themselves, assisted by the international wisdom of the day, that their, and the world’s, biggest problem was their large population. In 1971, as part of its family planning program, the Indian government bestowed legal status and social sanction on abortion, permitting its hospitals to determine and disclose the sex of the fetus. In India, families were balanced because they were large. It soon became clear that for people in general a small family meant a girl-free family, and only female fetuses were being aborted.
Accordingly, the arrangement was discontinued in 1978, but now private players were ready to fill the vacuum. India’s first commercial sex-determination clinic opened in early 1979. The era of the ethics-free greed-driven medico had begun. The same year China introduced its one-child policy, effectively meaning a son-only family.
The development in the West of ultrasound imaging technique, though primarily meant for detecting genetic disorders, provided a convenient and non-invasive way of sex-determination. In 1990 the American General Electric Medical Systems set up an ultrasound machine production unit in Bangalore in collaboration with vegetable oil maker turned software giant WIPRO. About the same time GEMS made its appearance in China. A comment on the corporate strategy of GEMS may not be out of place here. Its units in the United States are meant to produce “leadership products” for advanced university hospitals, while Japan provides machines for top as well as smaller hospitals in Europe and Japan.
India and China are the hub for “low-cost segment, mainly aimed at the mega-markets in Asia.” As the technology has become more and more user-friendly, cheaper and impersonal, the cult of the murder of the girl child has assumed alarming proportions.
We are better informed on the Indian rather than Chinese efforts to curb feticide.
In 1996, the Indian government banned the use of ultrasound for determining the sex of the fetus, but the 2001 census data showed that the law had been ineffective. Finally, responding to public interest litigation, the Supreme Court issued orders for overhauling the earlier act and ensuring its enforcement. The modified law, which came into effect in 2003, absolves the pregnant woman of any crime, but seeks to punish the husband or relatives who pressure the woman. It asks the clinics to maintain proper records and specifically bans sex determination and sex-selective abortion.
There have been some success stories in implementing the law: Nawanshahr in Punjab and Hyderabad have earned well-deserved praise for their efforts. But these successes have been personality-driven rather than systemic.
Female feticide is a crime that is socially acceptable. The criminals are not social riff-raff, but respectable members of society whose education, affluence, social and political connections make it difficult if not impossible to touch them. The law asks the district medical officer to discipline erring radiologists. It would be better to vest this power in administrators rather than doctors.
The administration has a difficult task at hand. The sex determiners and the fetus exterminators are merrily doing their work, while the government officials and the social activists have to be on high alert all the time. The extant laws are based on the assumption that ultrasound technology is sacrosanct and only administrative forces can be marshaled to combat its misuse. This assumption is not valid. Ultrasound no doubt is a powerful diagnostic tool in the hands of a doctor. It is nobody’s case that the technology be banned because it is being misused. At the same time its wide applicability should not be used to condone or divert attention from its abuse as a murder weapon.
It is quite obvious that abortion economy is driving the low-tech end ultrasound industry. The mega-market GE and other companies are targeting in India and China is the sex-determination market and not the health care market. There is a need to make a distinction between the two. A high-powered commission comprising medical scientists and other experts should ascertain the need for ultrasound machinery for genuine purposes and suggest steps for regulating and even controlling the machinery’s technical specifications, manufacture and installation. Sufficiently high minimum academic and professional qualifications should be laid down for opening an ultrasound clinic. It can even be mandated that stand-alone clinics will not be permitted and that they must necessarily be part of a hospital or a polyclinic. There is a need to continually assess the genuine need for and the economics of ultrasound and other medical technologies, especially because rapid technological developments can quickly overtake legal and administrative measures.
The universal outrage at the large-scale female feticide in India and China is fully justified. But let us not forget that barely 20 years ago, the world was lauding these two countries for using technology to control their population growth.
(Prof. Rajesh Kochhar is the former director of India’s National Institute of Science, Technology and Development Studies and former professor at the Indian Institute of Astrophysics in Bangalore. ©Copyright Rajesh Kochhar.)