R. Ramachandran, Delhi-based Indian science journalist
© Hervé Pinel
|
The best of either sex should be united with the best as often as possible, and the inferior with the inferior as seldom as possible. Plato, Greek philosopher (428-348 BC) |
New sex
pre-determination techniques are likely to reinforce anti-female prejudice.
A single
word on a sign advertises a thriving business in India: ultrasound. Using sound waves
to produce images of foetuses, this diagnostic tool is a common part of prenatal
care. But in India, advertisements for ultrasound carry a hidden message: doctors
will use the tool to reveal the sex of the unborn, opening the way to abort “negative”
results, meaning in effect females.
Clinics have resorted to this disguised advertising since a law enacted in 1996 banned
the use of prenatal testing for sex selection. Doctors are only allowed to test foetuses
for genetic and congenital abnormalities or disease. In principle, they can be prosecuted
for giving the faintest hint as to the sex of a foetus.
Yet the law looks better on paper than in practice, admits S.C. Srivastava, Policy
Director of the central government Health Ministry. Registration of clinics has been
slow and there has not been a single prosecution despite official acknowledgment
of widespread abuse. One reason is that abortion up to the 20th week of pregnancy
is legal, even though sex selection is not. It is hard to prove an abortion is done
for sex selection.
Female
foeticide
Sex determination has
been rampant in India since the 1970s when doctors began misusing amniocentesis (analysis
of uterine fluid). A 1985 survey in Bombay, for example, revealed that 90 per cent
of amniocentesis centres were involved in sex determination, with nearly 96 per cent
of female foetuses aborted. Today, ultrasound is the preferred method, with some
1,500 clinics operating in Punjab alone, a northern state of over 20 million people
where India’s first sex determination clinic was set up. The only thing the law seems
to have done is to raise doctors’ fees from about $10 to $30 a session to compensate
for the risk of criminal prosecution. The situation will even get worse with a new
wave of ultrasound units, says Dr. Sharada Jain, a well-known Delhi gynecologist.
Amniocentesis is effective in sex determination in the 16th to 18th weeks of a pregnancy.
Today, abdominal ultrasound imaging can tell the sex of a foetus with 90 per cent
accuracy at 14 weeks. More advanced trans-vaginal ultrasound—widely-used in Delhi
and spreading elsewhere—has even greater accuracy at 12 weeks. Thus female fœticide
is now possible in the first trimester when abortion is less complicated and there
is less suspicion of sex selection, says Dr. Jain.
The heart of the problem is traditional attitudes towards females, insists Dr. Mira
Shiva of the Voluntary Health Association of India in New Delhi. Daughters are seen
as an expense particularly because of the dowries families pay to marry them off.
Under such circumstances, the law banning sex selection is a “non-starter,” says
Dr. Shiva.
Given this value system, how would people respond to new genetic technologies to
pre-select the sex of embryos? An American fertility institute recently caused a
stir with a new technique, MicroSort, which separates sperm bearing X-chromosomes
(producing females) from those with Y-chromosomes (producing males). Doctors report
a 93 per cent success rate for producing girls and 73 per cent for boys. The current
$5,000 cost of such a procedure is expected to fall and doctors believe it is only
a matter of time before the new sex pre-determination technique hits India.
“I can easily provide the service within months,” says Dr. Anoop Kumar Gupta of Delhi
IVF and Fertility Clinic. “If I do, I will have hundreds of clients queuing outside.”
Some doctors in India, like Dr. T.C. Kumar of Hope Infertility Clinic in Bangalore,
believe the pre-determination technique would stem female fœticide. “The ethical
choice lies between the prevention, and the perpetuation of fœticide, infanticide
and homicide of females,” says Dr. Kumar. “Social change is a long, drawn-out process.
Can we afford to wait until these changes occur?”
But according to Dr. Shiva, sex pre-selection would only feed the “pathological condition
of our society which discriminates and denigrates women.”
