The implementation of the PNDT Act continues to be debated among policymakers and the industry. Has the PC-PNDT Act become a source of harassment for doctors? Or is it the right tool to curb malpractices in radiology? Dr Vaseem Anjum Ansari, Consultant Radiologist, Kohinoor Hospital shares his views on the controversial Act and on the Supreme Court’s ruling on curbing malpractices, in conversation with Raelene Kambli
What are the requirements as per the PC-PNDT Act?
The Pre-conception and Pre-natal Diagnostic Techniques (Prohibition of Sex Selection) Act, 1994 generally referred to as the PNDT Act, is intended for regulation of genetic counselling centres, genetic laboratories and genetic clinics which include institutes, hospitals and nursing homes. As per the Act, it is mandatory to register genetic counselling centres, genetic laboratories and genetic clinics. The minimal requirements include qualifications of employees, requirement of equipment, etc.
It also mandates maintenance and preservation of records in relation to genetic counselling, pre-natal diagnostic procedures or pre-natal diagnostic tests such as Chorionic Villus sampling and ultrasonography etc.
What is your opinion on the impact and implications of the Act?
The Act is a step towards the right direction. In view of the skewed female to male sex ratio in our country , this Act is an initiative for protection of the unborn girl child. Strict interpretation and implementation of the Act is helping create a positive trend with respect to the female child sex ratio in several districts of the country, but it is also putting radiologists under constant pressure. The issue is a social one wherein the age-old prejudices and traditions are the main culprits which promote the practice of female infanticide (killing of new-born female child). With availability of ultrasonography (USG) a shift has occurred from infanticide to female foeticide (killing of the female foetus). This is a gross oversimplification of a much deep-seated social problem. The scope to misuse the technology is very real.
However, over zealous use of this PNDT Act has pressurised radiologists. Radiologists are held even for incomplete forms filled by the patients. Recently, an effort was made to restrict radiologists from performing ultrasonography at more than two centres/ hospitals which directly affects livelihood of the doctors.
Are you convinced that a Supreme Court order will help in curbing sex determination?
The individual interpretation and implementation of the Act lacked uniformity, making the process non-transparent. The Supreme Court ruling hence tries to bring uniformity to it and also provides uniform guidelines for genetic counselling centres, genetic laboratories and genetic clinics as well as the appropriate authority for monitoring the process.
Are there any other ways that can curb malpractices in radiology?
The PNDT Act is one of the tools for preventing malpractice. However, there is a need for a more complete legislation with wider scope. Identification of centres carrying out such malpractices by the responsible radiologist community themselves, restricting ultrasound practice to qualified and experienced radiologists and gynaecologists preventing quacks and paramedics of questionable training are few of the steps that need to be implemented.
What is your message to the industry and policy makers?
We radiologists form a select group within the community and should identify our responsibilities as ‘men from a noble profession’. Apart from our medical duties we have to do our bit to help in combating this social issue.
Also, the policy maker ought to realise the roots of the issue and rather than putting the onus solely on doctors, the government should try to educate and create awareness among the masses regarding sexual discrimination which is widely prevalent in our society. This is a long process but continuous and concerted effort is needed. The implementation of the various laws should be transparent otherwise valuable diagnostic modalities like ultrasonography will fall in gradual disuse and ultimately it will be the patients who will suffer the most.
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