Criminal Abortions and Professional Ethics

CRIMINAL ABORTIONS AND PROFESSIONAL ETHICS

All cases of maternal mortality due to unsafe and unlicensed abortions are
cases of double homicide (murder) and are required under law (Criminal Procedure Code Section 39 and 174 read with Indian Penal Code Sections 201, 299, 312 and 314) to be reported to the police, subjected to inquest and criminal prosecutions launched. Although a doctor’s primary duty is towards her patient and nothing she does should interfere with or delay treatment, it is her public duty, once the patient is under treatment, to report the incidence to the authorities at the earliest so that the perpetrator of a criminal abortion is prevented from repeating it. If she fails in this duty, the doctor is presumed, in the eyes of the law, to be siding with the criminal with a view to shielding him.

If a doctor submits any case material connected with the criminal abortion for publication in a professional journal, the details of criminal investigation and the action, if any, taken against the criminals must be mentioned. The editor of the journal also has a special responsibility here. He must be satisfied that the author(s) reporting the case study have done all that they were legally required to do in that particular case. How they ensure this will depend on the journal's policy and their concern and commitment to prevent criminal
abortions. They certainly should not publish a report whose tone suggests concealing the criminal or condoning the crime. A professional medical journals cannot publish reports, singly or as compilations, of these cases without such details. If it does so, it would amount to documented defiance of law (having identified the crime, the criminal and the place of its occurrence in the report neither the doctor nor the journal can plead ignorance and innocence). Yet, in what may be construed as defiance of the law, the Journal of Obstetrics and Gynaecology of India has been regularly publishing compiled or single accounts of these ghastly murders as “rare”, “unusual”, and interesting” case reports.

"There are graphic details of the horrors inflicted by the criminal acts of
the illegal abortionists in the individual reports from Muzaffarpur,
Murshidabad, Patna, Guahati, Madras, Thanjavur and Ranchi, published in the
last two years of The Journal of Obstetrics and Gynaecology of India, but in
none of the reports is there any mention of the steps taken against the
culprits." (SG Kabra: Miscarriage of Medicine)

However, illegal abortions are apparently not considered criminal and are not
reported to the police as required by the law, even when they prove fatal. The law, further, requires that all unnatural deaths of women within 7 years of their marriage should be reported. This attitude is exemplified by the observations of the attending doctors in a case where an illegal abortion done by a 'dai' with the help of stick resulted in deadly gas gangrene sepsis. The case was reported in the Journal of Obstetrics and Gynaecology of India and the author, Shakuntala Sahey, states: "As her relatives were not willing, autopsy could not be done". This is despite the fact that that the abortion was done by an unauthorized person and it was a case of unnatural death with manifest evidence of foul play. Exactly the same assertion has been made a recent publication: "Autopsy was advised in all these cases, but refused by relatives”.