Health legislation and its impact
S.G. Kabra
There is a large number of laws related to health care delivery systems in India. But if non-implementation of legal provisions is lawlessness, the health sector is the most lawless of them all.
The basic law to regulate and maintain the professional standards of the medical profession was the Indian Medical Council Act. However, in the zeal to encourage 'Indian systems of medicines' and 'traditional systems of medicines', these essentially complementary systems have been projected and established as alternative systems of medicine. In the name of 'integrated medicine', a totally chaotic, unregulated and unregulatable system has come to exist.
Worse still, in the name of providing 'barefoot doctors' for the suffering 'rural poor', anybody, irrespective of their basic qualifications or capability, can be provided with a legal license, after the so-called 'basic training', to practice as a Registered Medical Practitioner (RMP). An RMP, legally, can do anything that a regularly trained physician is permitted to do. And, a trained doctor can do anything that he chooses. There is no question of any norms, standards or ethics.
Contradictions in the laws and their implementationPlacing jaggery inside a woman's uterine cavity to stop severe bleeding after she has given birth is a criminal act for a doctor registered under Medical Council Act. The same act would be termed 'life saving' for a registered practitioner of traditional medicine. To instill anything unsterile in an eye after a cataract operation would be gross criminal negligence on the part of a modern opthalmologist, but using cow's urine after a couching operation for cataract would be a fully justified procedure under the Indian system of medicine. An acupuncturist is permitted to attempt to cure a cleft palate case by assuring the parents that electric stimulation from a needle 'strategically' placed in the body will stimulate growth of issue across the cleft, though such a promise by others would attract penal provisions.
In the case of malignancies that are today identified as treatable or eminently controllable, not giving approved drug therapy would render a modern oncologist (cancer specialist) liable to legal action, but a practitioner of any other system of medicine claiming himself to be a 'cancer specialist' could give anything or deny anything to 'cure' patients, without any consequence of law.
Institutionalised quackeryIf acting beyond one's training, competence and skill is quackery, in India today we have virtually institutionalised quackery, where, irrespective of which system of medicine one is trained in, including self-training in the name of traditional medicine, one may do what appeals to whim and fancy.
It is no surprise that the Medical Council of India and other medical councils are ineffective and dead as far as their function of regulating the standards of different systems of medicine is concerned.
The Drugs and Cosmetics Act, with all its provisions to regulate the manufacture, distribution and safe use of the myriad products of one of the largest industries in the country - the pharmaceutical industry - is followed only for its money-spinning licensing provisions. Even this is in a distorted form. The state drug controllers, the implementing agencies of the Act, operate only as licensers. Under the loan licensing provisions, the State Drugs Controller can license anybody to prepare and market a medicine. As a result, one can see 'tonics', 'herbal medicines' and other such substances being prepared inkadhaiin the streets of Jaipur and Indore.
Spurious drugsAccording to a report of the drug control authorities, 20 per cent of such medicines were found to be spurious. It is anybody's guess what the actual extent of spurious drugs in the market is. Concoctions under the label of traditional and home remedies are now being marketed by organised national and international pharmaceutical companies. For herbal, ayurvedic, siddha and other such preparations, there is no method of quality control.
There is no evolved method of post- market surveillance, not even for newly licensed drugs. A licensed abortificent paste, the 'Fetex paste', killed hundreds of women, without the Drugs Controller being aware of it, let alone having to account for it, as the licensing authority.
Yet another Act is the Drugs and Magic Remedies (Objectionable) Advertisement Act. This Act makes advertising of sex tonics and sex stimulants, uterine tonics and menstrual disorder regulators a cognisable offence. It also prohibits advertisements about the diagnosis, cure, mitigation or prevention of 54 diseases and disorders listed in the Act such as cancer, diabetes, epilepsy, leucoderma, paralysis, sexual impotence. However, billboards in Delhi, the local train compartments in Mumbai, advertisements in newspapers and glossy and not so glossy magazines, and now the electronic media, openly mock the law-making and law-enforcing agencies.
Reproductive 'rights'Another Act that has permitted mass butchery in the killing fields of medicare is the Medical Termination of Pregnancy Act. Intended to provide women the reproductive right of safe abortion (upto 12 weeks of pregnancy), the time span within which a legal pregnancy could be performed was increased to 20 weeks to accommodate population planners, though it was specifically stated that the Act was not meant for population control. The elaborate safety provisions of the Act and the Rules and the Regulations framed under it are overlooked with impunity.
As a result, induced abortions are one of the main killers of pregnant women in the country. Thousands of women become its victims every year. This has been going on for over the last 20 years. And of course it not only legalises 5 million foeticides every year but also makes it a laudable effort in nation building. The whole cultural ethos of the family and value for human life is shaken. Sects that used to abhor even killing an ant today think nothing when a foetus is dumped in the bucket to die.
Pesticides for household useThe Insecticides Act is intended to provide access to safe pesticides. Yet thousands of persons die every year, 20 per cent of them children, due to just one pesticide - aluminium phosphide, a product which is not to be sold in the market or be available as a household pesticide. Deaths by this pesticide have been reported in the medical literature, by forensic experts and in the lay press in the country. However, no authority has felt the need to act under the Act.
The Dangerous Machines (Regulation) Act is intended to prevent maiming of farm workers by agricultural machinery. Though thousands of labourers get their limbs chopped and mutilated by thrashers and chaff cutters and hundreds of women get descalped, the provisions of this central Act have not been implemented almost a decade since its passing by Parliament.
Amongst the silent killers are radiation-induced cancers, congenital defects and body damage caused by X- ray radiation. The thousands of improperly used X-ray units in the country, functioning without the mandatory safety provisions prescribed under the Atomic Energy Act, are collectively and continuously doing what the atomic bomb once did. But since the ill effects of X-ray radiation manifest after 10-15 years, or manifest in the progeny, they cannot be traced to the X-ray radiation that caused it. An X-ray exposure in woman's childhood may lead to cancer of the breast when she is a mother. Radiation of a man's gonads may cause acute childhood blood cancer in his son or daughter.
The Atomic Energy Act is a central Act but is to be implemented by the state governments. They just have not done it.
The rule of lawThe rule of law apparently does not include welfare law. Bypassing a law is not breaking a law. Indifference of statutes is not statutory indifference. Welfare of people is good for public posturing; otherwise, to fare well is the bureau-politician's overwhelming instinct.
There are several other laws that aid and abet activities in the killing fields, by default or design. Non- implementation of laws is no contempt of the parliament or the judiciary, and litigation leave little scope for the law enforcing authorities to effectively monitor and implement welfare laws.
Dr S G Kabra,
Monday, April 28, 2008
Wednesday, March 19, 2008
NON-THERPEUTIC SECOND TRIMESTER TERMINATION OF PREGNANCIES IS GROSS HUMAN RIGHTS VIOLATION
ABATTOIRS AND ABETTORS
MERCENARIES AND MISSIONARIES
On the occasion of signing the Partial Birth Abortion Act 2003 on November 5, 2003, President Bush stated, “For years, a terrible form of violence has been directed against children who are inches from birth, while the law looked the other way. Today, at last, the American people and our government have confronted the violence and come to the defense of the innocent child.”
What is to be noted is that the implied distinction between infanticide and partial birth abortion is “children who are inches from birth’.
Alluding to the compelling evidence that led the members of the House and Senate to pass the legislation, President Bush stated:-.
“The best case against partial birth abortion is a simple description of what happens and to whom it happens. It involves the partial delivery of a live boy or girl, and a sudden, violent end of that life. Our nation owes its children a different and better welcome.”
The description of partial birth abortion in terms of what happens and to whom it happens is illustrated in the following pictures:-
MERCENARIES AND MISSIONARIES
On the occasion of signing the Partial Birth Abortion Act 2003 on November 5, 2003, President Bush stated, “For years, a terrible form of violence has been directed against children who are inches from birth, while the law looked the other way. Today, at last, the American people and our government have confronted the violence and come to the defense of the innocent child.”
What is to be noted is that the implied distinction between infanticide and partial birth abortion is “children who are inches from birth’.
Alluding to the compelling evidence that led the members of the House and Senate to pass the legislation, President Bush stated:-.
“The best case against partial birth abortion is a simple description of what happens and to whom it happens. It involves the partial delivery of a live boy or girl, and a sudden, violent end of that life. Our nation owes its children a different and better welcome.”
The description of partial birth abortion in terms of what happens and to whom it happens is illustrated in the following pictures:-
A parallel Second-trimester termination-of-pregnancy permitted by law upto the 20th week of pregnancy and practiced in the country is Dilatation & Evacuation. A medical doctor who practiced the procedure for long describes it in graphic details thus:-
“Imagine for a moment that you are a "pro-choice" obstetrician-gynecologist as I once was. Your patient today is seventeen years old and she is twenty weeks pregnant. At twenty weeks, her uterus is up to her umbilicus and she has been feeling her baby kick for the last two weeks. If you could see her baby, she would be as long as your hand from the top of her head to the bottom of her rump not counting the legs. Your patient is now asleep on an operating room table with her legs in stirrups. Upon entering the room after scrubbing, you dry your hands with a sterile towel and are gowned and gloved by the scrub nurse.”
“The first task is remove the laminaria that had earlier been placed in the cervix to dilate it sufficiently to allow the procedure you are about to perform. With that accomplished, direct your attention to the surgical instruments arranged on a small table to your right. The first instrument you reach for is a 14-French suction catheter. It is clear plastic and about nine inches long. It has a bore through the center approximately ¾ of an inch in diameter. Picture yourself introducing the catheter through the cervix and instructing the circulating nurse to turn on the suction machine which is connected through clear plastic tubing to the catheter. What you will see is a pale yellow fluid the looks a lot like urine coming through the catheter into a glass bottle on the suction machine. This amniotic fluid surrounded the baby to protect her.”
“With suction complete, look for your Sopher clamp. This instrument is about thirteen inches long and made of stainless steel. At one end are located jaws about 2 ½ inches long and about ¾ on an inch wide with rows of sharp ridges or teeth. This instrument is for grasping and crushing tissue. When it gets hold of something, it does not let go.”
“A second trimester D&E abortion is a blind procedure. The baby can be in any orientation or position inside the uterus. Picture yourself reaching in with the Sopher clamp and grasping anything you can. At twenty weeks gestation, the uterus is thin and soft so be careful not to perforate or puncture the walls. Once you have grasped something inside, squeeze on the clamp to set the jaws and pull hard – really hard. You feel something let go and out pops a fully formed leg about 4 to 5 inches long. Reach in again and grasp whatever you can. Set the jaw and pull really hard once again and out pops an arm about the same length. Reach in again and again with that clamp and tear out the spine, intestines, heart and lungs.”
“The toughest part of a D&E abortion is extracting the baby’s head. The head of a baby that age is about the size of a plum and is now free floating inside the uterine cavity. You can be pretty sure you have hold of it if the Sopher clamp is spread about as far as your fingers will allow. You will know you have it right when you crush down on the clamp and see a pure white gelatinous material issue from the cervix. That was the baby’s brains. You can then extract the skull pieces. If you have a really bad day like I often did, a little face may come out and stare back at you.”
“Congratulations! You have just successfully performed a Suction D&E abortion. You just affirmed her right to choose. You just made $600 cash in fifteen minutes.”
Dr. Tony Levatino, M.D.
For more medical information on D&E abortion, see the following texts:
Abortion Practice, by Warren M. Hern, M.D., M.P.H. (1990: Alpenglo Graphics, Inc., 1130 Alpine, Boulder, CO 80304), ISBN 0-9625728-0-2.
Second Trimester Abortion: Perspectives After a Decade of Experience, Edited by Gary S. Berger, William E. Brenner, and Louis G. Keith (1981: Martinus Nijhoff Publishers, PO Box 566, 2501 CN The Hague, The Netherlands and John Wright, PSG, Inc., 545 Great Road, Littleton, MA 01460), ISBN 90-247-2487-2.
A pictorial presentation of D & E procedure is reproduced below for you to visualize and understand the same.
“Imagine for a moment that you are a "pro-choice" obstetrician-gynecologist as I once was. Your patient today is seventeen years old and she is twenty weeks pregnant. At twenty weeks, her uterus is up to her umbilicus and she has been feeling her baby kick for the last two weeks. If you could see her baby, she would be as long as your hand from the top of her head to the bottom of her rump not counting the legs. Your patient is now asleep on an operating room table with her legs in stirrups. Upon entering the room after scrubbing, you dry your hands with a sterile towel and are gowned and gloved by the scrub nurse.”
“The first task is remove the laminaria that had earlier been placed in the cervix to dilate it sufficiently to allow the procedure you are about to perform. With that accomplished, direct your attention to the surgical instruments arranged on a small table to your right. The first instrument you reach for is a 14-French suction catheter. It is clear plastic and about nine inches long. It has a bore through the center approximately ¾ of an inch in diameter. Picture yourself introducing the catheter through the cervix and instructing the circulating nurse to turn on the suction machine which is connected through clear plastic tubing to the catheter. What you will see is a pale yellow fluid the looks a lot like urine coming through the catheter into a glass bottle on the suction machine. This amniotic fluid surrounded the baby to protect her.”
“With suction complete, look for your Sopher clamp. This instrument is about thirteen inches long and made of stainless steel. At one end are located jaws about 2 ½ inches long and about ¾ on an inch wide with rows of sharp ridges or teeth. This instrument is for grasping and crushing tissue. When it gets hold of something, it does not let go.”
“A second trimester D&E abortion is a blind procedure. The baby can be in any orientation or position inside the uterus. Picture yourself reaching in with the Sopher clamp and grasping anything you can. At twenty weeks gestation, the uterus is thin and soft so be careful not to perforate or puncture the walls. Once you have grasped something inside, squeeze on the clamp to set the jaws and pull hard – really hard. You feel something let go and out pops a fully formed leg about 4 to 5 inches long. Reach in again and grasp whatever you can. Set the jaw and pull really hard once again and out pops an arm about the same length. Reach in again and again with that clamp and tear out the spine, intestines, heart and lungs.”
“The toughest part of a D&E abortion is extracting the baby’s head. The head of a baby that age is about the size of a plum and is now free floating inside the uterine cavity. You can be pretty sure you have hold of it if the Sopher clamp is spread about as far as your fingers will allow. You will know you have it right when you crush down on the clamp and see a pure white gelatinous material issue from the cervix. That was the baby’s brains. You can then extract the skull pieces. If you have a really bad day like I often did, a little face may come out and stare back at you.”
“Congratulations! You have just successfully performed a Suction D&E abortion. You just affirmed her right to choose. You just made $600 cash in fifteen minutes.”
Dr. Tony Levatino, M.D.
For more medical information on D&E abortion, see the following texts:
Abortion Practice, by Warren M. Hern, M.D., M.P.H. (1990: Alpenglo Graphics, Inc., 1130 Alpine, Boulder, CO 80304), ISBN 0-9625728-0-2.
Second Trimester Abortion: Perspectives After a Decade of Experience, Edited by Gary S. Berger, William E. Brenner, and Louis G. Keith (1981: Martinus Nijhoff Publishers, PO Box 566, 2501 CN The Hague, The Netherlands and John Wright, PSG, Inc., 545 Great Road, Littleton, MA 01460), ISBN 90-247-2487-2.
A pictorial presentation of D & E procedure is reproduced below for you to visualize and understand the same.
Obviously, an obstetrician or other physician who is required to, or opts to do the aforesaid procedures has to be desensitized to the tender feelings one expects for a tender life in the womb. One has to be totally indifferent, if not callous, to the life in the womb. Over enthusiastic and zealous abortionists are likely to be totally dehumanized.
Of the total of 96,79,84 registered Medical Terminations of Pregnancy done and reported since the MTP Act came into being, in a period from 1977 – 1997, 13 lakh 39 thousand i.e. approximately 14 % were performed for second trimester abortion. Presently it is estimated that 4 0 to 50 lakh pregnancy terminations, registered and reported, unreported and clandestine, are being done in the country. All methods for second trimester abortion cause violent death of the live child in the womb.
Of the total of 96,79,84 registered Medical Terminations of Pregnancy done and reported since the MTP Act came into being, in a period from 1977 – 1997, 13 lakh 39 thousand i.e. approximately 14 % were performed for second trimester abortion. Presently it is estimated that 4 0 to 50 lakh pregnancy terminations, registered and reported, unreported and clandestine, are being done in the country. All methods for second trimester abortion cause violent death of the live child in the womb.
Thursday, January 31, 2008
dr s g kabra publications
Issues Med Ethics. ;10 (2):24 16334925
Gender disparity: need to look beyond 'female foeticide'.
[My paper] S G Kabra
[Pubmed] [Scholar] [EndNote] [BibTex]
Other papers by authors:
Issues Med Ethics. ;11 (3):79-80 16335513
Unsafe abortions and experimental excesses.
[My paper] S G Kabra
Issues Med Ethics. ;8 (3):70 16323365
Abortion in India: not a right but a state-sponsored programme.
[My paper] S G Kabra
Health Millions. ;22 (4):21-3 12320666
Violence against the silent most.
[My paper] S G Kabra
Health Millions. 1993 Apr ;1 (2):10-1 12286465
The myth of brain tonics.
[My paper] S G Kabra
Lancet. 1994 Jan 15;343 (8890):179-80 7904030
What is happening to caesarean section rates?
[My paper] S G Kabra , R Narayanan , M Chaturvedi , P Anand , G Mathur
Indian J Exp Biol. 1981 Nov ;19 (11):1050-3 7338361
Histochemical analysis of urinary stone: part I--specificity & sensitivity of microchemical staining reactions to identify chemical constituents.
[My paper] V Kabra , S G Kabra , R P Chaturvedi , A P Bhargava , P Banerji , A Bhargava , M S Rathore
Indian J Ophthalmol. 1982 Jul ;30 (4):367-9 7166421
Tear glucose in uncontrolled and chemical diabetics.
[My paper] M S Gaur , G K Sharma , S G Kabra , P K Sharma , L K Nepalia
J Bone Joint Surg Br. 1983 Mar ;65 (2):195-8 6826630
The trabecular pattern of the calcaneum as an index of osteoporosis.
[My paper] N L Jhamaria , K B Lal , M Udawat , P Banerji , S G Kabra
Indian J Ophthalmol. 1983 Jul ;31 (4):447-9 6677607
Estimation of trimethoprim and sulfamethoxazole levels in tears after systemic administration.
[My paper] G K Sharma , S G Kabra , R P Garg , P K Sharma , L K Nepalia
Indian J Ophthalmol. 1983 Sep ;31 (5):563-5 6671761
Tear glucose in ocular inflammations and its enzymatic lysis as a possible therapeutic adjunct in treatment of ocular infections.
[My paper] G K Sharma , S G Kabra , P K Sharma , L K Nepalia , S Bharadwaj , A Mehra
Gender disparity: need to look beyond 'female foeticide'.
[My paper] S G Kabra
[Pubmed] [Scholar] [EndNote] [BibTex]
Other papers by authors:
Issues Med Ethics. ;11 (3):79-80 16335513
Unsafe abortions and experimental excesses.
[My paper] S G Kabra
Issues Med Ethics. ;8 (3):70 16323365
Abortion in India: not a right but a state-sponsored programme.
[My paper] S G Kabra
Health Millions. ;22 (4):21-3 12320666
Violence against the silent most.
[My paper] S G Kabra
Health Millions. 1993 Apr ;1 (2):10-1 12286465
The myth of brain tonics.
[My paper] S G Kabra
Lancet. 1994 Jan 15;343 (8890):179-80 7904030
What is happening to caesarean section rates?
[My paper] S G Kabra , R Narayanan , M Chaturvedi , P Anand , G Mathur
Indian J Exp Biol. 1981 Nov ;19 (11):1050-3 7338361
Histochemical analysis of urinary stone: part I--specificity & sensitivity of microchemical staining reactions to identify chemical constituents.
[My paper] V Kabra , S G Kabra , R P Chaturvedi , A P Bhargava , P Banerji , A Bhargava , M S Rathore
Indian J Ophthalmol. 1982 Jul ;30 (4):367-9 7166421
Tear glucose in uncontrolled and chemical diabetics.
[My paper] M S Gaur , G K Sharma , S G Kabra , P K Sharma , L K Nepalia
J Bone Joint Surg Br. 1983 Mar ;65 (2):195-8 6826630
The trabecular pattern of the calcaneum as an index of osteoporosis.
[My paper] N L Jhamaria , K B Lal , M Udawat , P Banerji , S G Kabra
Indian J Ophthalmol. 1983 Jul ;31 (4):447-9 6677607
Estimation of trimethoprim and sulfamethoxazole levels in tears after systemic administration.
[My paper] G K Sharma , S G Kabra , R P Garg , P K Sharma , L K Nepalia
Indian J Ophthalmol. 1983 Sep ;31 (5):563-5 6671761
Tear glucose in ocular inflammations and its enzymatic lysis as a possible therapeutic adjunct in treatment of ocular infections.
[My paper] G K Sharma , S G Kabra , P K Sharma , L K Nepalia , S Bharadwaj , A Mehra
Friday, January 18, 2008
Female feticide & Neural Tube Defects
Dear Dr. Meeta Singh,
Please consider the following and favor with an early reply
NEURAL TUBE DEFECT
4 Dr. Kabra’s study ( Medicine Deranged 1998) Panchsheel Prakashan, Jaipur
4 May 1992—April 1993 Zanana and Mahila Chikatsalya, Med. Coll. Jaipur
4 Total Births-- 15346
4 Live Births 14,682
4 Still Births 724 (50/1000 live births)
4 Cong. Anomalies 115 (8/1000 live births)
4 Neural Tube Defect (NTD) 96 (83%) F = 62(65%)
4 M = 30(31%)
4 NR = 4
4 Other 19(17%)
I. There is prevalent rate of 50 still births per 1000 live births in the premier hospitals.
- Intra uterine death occurs in late third trimester.
- The dead child is aborted and disposed off.
- Almost half of them are female fetuses.
- Does it constitute female feticide under the MTP Act. ?
II. About 100 children are born with gross neural tube defect (NTD) i.e. brainlessness (anencephaly)
- They die after birth and are allowed to die.
- Almost 70 of them are females.
- Does delivering and disposing off these brainless female feticides constitute female feticide under the MTP Act.
CONG. ANOMALY & NTD.
4 24 Maternity Centre Jaipur including Zanana and Mahila Chikitsalya
4 Total Deliveries 23450
4 Live Births 22618
4 Still Births 832(37/1000 live births)
4 Cong. Anomalies 143(6/1000 live births)
4 Ultra Sound May 1992-April 1993
4 Total 111,127
4 Cong. Anomalies 55 (5/1000 Ultra Sound)
4 Neural Tube Defect 52
4 Other 3
- At the two premier zanana hospitals of the state, for about 1 lakh sonography
examinations done every year, about 50 NTDs (mostly brainless) are detected in
second trimester of pregnancy.
- 70-80% of them are known on ultrasound examination to be females.
- Does the medical termination of these known female fetuses constitute violation
of the PCPNDT Act/ the MTP Act/ IPC 312 ?
Since you have a very powerful legal cell in your organization advising state authorities in the matter I seek your clarification so that the doctors authorized to undertake MTPs are advised accordingly.
Thanking you
Yours truly,
Dr.S.G.Kabra
Please consider the following and favor with an early reply
NEURAL TUBE DEFECT
4 Dr. Kabra’s study ( Medicine Deranged 1998) Panchsheel Prakashan, Jaipur
4 May 1992—April 1993 Zanana and Mahila Chikatsalya, Med. Coll. Jaipur
4 Total Births-- 15346
4 Live Births 14,682
4 Still Births 724 (50/1000 live births)
4 Cong. Anomalies 115 (8/1000 live births)
4 Neural Tube Defect (NTD) 96 (83%) F = 62(65%)
4 M = 30(31%)
4 NR = 4
4 Other 19(17%)
I. There is prevalent rate of 50 still births per 1000 live births in the premier hospitals.
- Intra uterine death occurs in late third trimester.
- The dead child is aborted and disposed off.
- Almost half of them are female fetuses.
- Does it constitute female feticide under the MTP Act. ?
II. About 100 children are born with gross neural tube defect (NTD) i.e. brainlessness (anencephaly)
- They die after birth and are allowed to die.
- Almost 70 of them are females.
- Does delivering and disposing off these brainless female feticides constitute female feticide under the MTP Act.
CONG. ANOMALY & NTD.
4 24 Maternity Centre Jaipur including Zanana and Mahila Chikitsalya
4 Total Deliveries 23450
4 Live Births 22618
4 Still Births 832(37/1000 live births)
4 Cong. Anomalies 143(6/1000 live births)
4 Ultra Sound May 1992-April 1993
4 Total 111,127
4 Cong. Anomalies 55 (5/1000 Ultra Sound)
4 Neural Tube Defect 52
4 Other 3
- At the two premier zanana hospitals of the state, for about 1 lakh sonography
examinations done every year, about 50 NTDs (mostly brainless) are detected in
second trimester of pregnancy.
- 70-80% of them are known on ultrasound examination to be females.
- Does the medical termination of these known female fetuses constitute violation
of the PCPNDT Act/ the MTP Act/ IPC 312 ?
Since you have a very powerful legal cell in your organization advising state authorities in the matter I seek your clarification so that the doctors authorized to undertake MTPs are advised accordingly.
Thanking you
Yours truly,
Dr.S.G.Kabra
AIDS programme in whose aid
AIDS PROGRAM IN WHOSE AID
S.G.Kabra
Senior Scientist, IIHMR, Jaipur
-----------------------------------------------------------------
Of late, there has been a great deal of activity on AIDS awareness and control. Anybody who is somebody in the health sector, NGOs et al., appears to be concerned about AIDS.. Yet, it seems that all sponsored, funded and media hyped activities concretize to no specific guidelines or mandatory protocols when a seropositive HIV case is identified. Identification of such a case takes place in a hospital or, more specifically, in a testing laboratory. And there is no mechanism that the identifying doctor can put in motion to prevent the identified HIV positive person from spreading it. What is more, seropositivity with HIV is not even declared a notifiable condition about which it is mandatory to inform a designated nodal agency. A medical man confronted with an HIV positive case finds all the hyped awareness and prevention campaign measures farcical, and ends up just counseling the carrier, hoping against hope that good sense will prevail. Here are the details of a recent case to substantiate the point.
A 21 year old young man suffering from low grade fever, loss of body weight and generalized lymph node enlargement of the body was suspected to be a case of lymphoma (a type of cancer of lymph nodes). He had been referred to a reputed hospital laboratory for histopathological examination of his lymph node that had been removed (biopsied) elsewhere.
The pathologist did not find evidence of lymphoma in the lymph node. But, by the microscopic changes seen in the section of the node, he got suspicious of the possibility of HIV infection in the case.
The young man was taken into confidence and it was suggested that the pathologist would like to rule out the possibility of HIV, and for this he would need to do a blood test on him. The young man's blood was tested for HIV by the Elisa Method. It turned out to be positive.
When the patient returned after a couple of days to learn about the test findings, he was informed that he had tested positive for HIV. Being an educated person, he immediately understood what it meant and implied.
When asked about his sex life, he flatly denied any exposure and said he was unmarried. He was asked if he had had any transfusion of blood; he said had not. He was asked about any injections that he had taken, and he had taken no injections.
The young man was told about the Elisa method by which the test had been done in the laboratory. It was explained to him that the test gave false positive results in 3 - 5 % cases. To be certain that the test result in his case was correct, he was advised to get the test done by a more specific method i.e. the Western Blot Test.
The young man returned after a week. He apologized to the doctor and said he was sorry he had lied. He admitted that he along with four of his friends had visited “a place” and had sex with a girl. He further confided to the doctor that he had also lied about his marital status. He was married. However, he told the doctor that as yet `Gauna'(*) ceremony had not been performed and, therefore, his `wife' had not yet come to his place. He also confided that the girl (wife) was still studying and only on completion of her study would Gauna take place.
He asked the doctor for his advice. He wanted to know what his fate would be . "Is it certain that I am doomed to die of the disease ?", was his specific question. To this, the doctor's reply was that it usually took 5 - 10 years for the disease to manifest itself in its fatal form, and hopefully, by that time a cure for the disease would be found out. He was apprised of the likely course and progress of the disease. The possibility of his transmitting the disease to his sex partner was explained to him. He was told to disclose the fact of his HIV positivity to his `wife-to-be' and take her informed consent. He was advised about safe and protected sex life, and was warned not to donate his blood for anybody. He was also informed about transmission of infection through unsterilised needles.
The identifying doctor had done all that the was required to do. The farce of the situation is that this is all that he was required to do. Consider the following points in this regard :
1. Did the doctor do all that he was required to do ethically, morally and legally?
2. Was the doctor ethically, morally, legally and socially responsible to ensure that his patient did not transmit the disease to innocent persons ? If yes, how was the doctor to ensure it ?
3. Considering the nature of the infection , the doctor should have found out about the patient’s friends who had visited the source of infection and subjected them to the same test. Did he have the power to do it ? Could the boy be compelled to disclose the names of his friends ?
4. The doctor should have found out the source of the infection and then conducted the test on that woman. Was he empowered to do it ? Could the woman be compelled to submit to the test ?
5. Supposing the doctor did locate the source of the infection and confirm that the woman was HIV positive, how was he, then, to ensure that she did not transmit the disease any further ?
6. Did the doctor have any duty towards the girl betrothed to the HIV positive patient, whose name and address he had not been told ? Knowing that the girl was at prime risk what should he do ?
7. What about the implications of the recent Supreme Court Judgment ( (1998) 8 SCC 296) declaring that transmission by a seropositive HIV person to another (in the instant case his wife-to-be), would amount to be an offence under Sections 269 and 270 of the IPC ? Also to be considered is the relevance and import of Sec. 39 of Cr.P.C. in this context. Having come to know that a person is going to commit a cognizable offence, not informing the appropriate authority about it is a crime. __________________________________________________________________
P.S.
IPC Section 269 and 270 are excluded from the purview of Sec. 39 Cr.P.C.
However, Sec. 116 of IPC and other sections of IPC related to abatement, are relevant in the context of offence committed or to be committed under Ss.269 & 270 of IPC. Where does the physician having knowledge of the patient's intention to commit offence under IPC 269 and 270 stand in the light of the Supreme Court judgment ? What should he do to avoid becoming an abettor in the crime ?
Gauna = A mandatory ceremony essential to be performed to complete the marriage ritual (including child marriage) before the bride is sent to the bridegroom’s place and cohabitation is permitted. It is performed after the girl has attained puberty ( in case of child marriage), and when the parents of the girl consider it fit and appropriate.
Dr.S.G.Kabra
MBBS,LLB,MSc,MS (Anat.),MS (Gen.Surg)
Senior Scientist
IIHMR
Jaipur
S.G.Kabra
Senior Scientist, IIHMR, Jaipur
-----------------------------------------------------------------
Of late, there has been a great deal of activity on AIDS awareness and control. Anybody who is somebody in the health sector, NGOs et al., appears to be concerned about AIDS.. Yet, it seems that all sponsored, funded and media hyped activities concretize to no specific guidelines or mandatory protocols when a seropositive HIV case is identified. Identification of such a case takes place in a hospital or, more specifically, in a testing laboratory. And there is no mechanism that the identifying doctor can put in motion to prevent the identified HIV positive person from spreading it. What is more, seropositivity with HIV is not even declared a notifiable condition about which it is mandatory to inform a designated nodal agency. A medical man confronted with an HIV positive case finds all the hyped awareness and prevention campaign measures farcical, and ends up just counseling the carrier, hoping against hope that good sense will prevail. Here are the details of a recent case to substantiate the point.
A 21 year old young man suffering from low grade fever, loss of body weight and generalized lymph node enlargement of the body was suspected to be a case of lymphoma (a type of cancer of lymph nodes). He had been referred to a reputed hospital laboratory for histopathological examination of his lymph node that had been removed (biopsied) elsewhere.
The pathologist did not find evidence of lymphoma in the lymph node. But, by the microscopic changes seen in the section of the node, he got suspicious of the possibility of HIV infection in the case.
The young man was taken into confidence and it was suggested that the pathologist would like to rule out the possibility of HIV, and for this he would need to do a blood test on him. The young man's blood was tested for HIV by the Elisa Method. It turned out to be positive.
When the patient returned after a couple of days to learn about the test findings, he was informed that he had tested positive for HIV. Being an educated person, he immediately understood what it meant and implied.
When asked about his sex life, he flatly denied any exposure and said he was unmarried. He was asked if he had had any transfusion of blood; he said had not. He was asked about any injections that he had taken, and he had taken no injections.
The young man was told about the Elisa method by which the test had been done in the laboratory. It was explained to him that the test gave false positive results in 3 - 5 % cases. To be certain that the test result in his case was correct, he was advised to get the test done by a more specific method i.e. the Western Blot Test.
The young man returned after a week. He apologized to the doctor and said he was sorry he had lied. He admitted that he along with four of his friends had visited “a place” and had sex with a girl. He further confided to the doctor that he had also lied about his marital status. He was married. However, he told the doctor that as yet `Gauna'(*) ceremony had not been performed and, therefore, his `wife' had not yet come to his place. He also confided that the girl (wife) was still studying and only on completion of her study would Gauna take place.
He asked the doctor for his advice. He wanted to know what his fate would be . "Is it certain that I am doomed to die of the disease ?", was his specific question. To this, the doctor's reply was that it usually took 5 - 10 years for the disease to manifest itself in its fatal form, and hopefully, by that time a cure for the disease would be found out. He was apprised of the likely course and progress of the disease. The possibility of his transmitting the disease to his sex partner was explained to him. He was told to disclose the fact of his HIV positivity to his `wife-to-be' and take her informed consent. He was advised about safe and protected sex life, and was warned not to donate his blood for anybody. He was also informed about transmission of infection through unsterilised needles.
The identifying doctor had done all that the was required to do. The farce of the situation is that this is all that he was required to do. Consider the following points in this regard :
1. Did the doctor do all that he was required to do ethically, morally and legally?
2. Was the doctor ethically, morally, legally and socially responsible to ensure that his patient did not transmit the disease to innocent persons ? If yes, how was the doctor to ensure it ?
3. Considering the nature of the infection , the doctor should have found out about the patient’s friends who had visited the source of infection and subjected them to the same test. Did he have the power to do it ? Could the boy be compelled to disclose the names of his friends ?
4. The doctor should have found out the source of the infection and then conducted the test on that woman. Was he empowered to do it ? Could the woman be compelled to submit to the test ?
5. Supposing the doctor did locate the source of the infection and confirm that the woman was HIV positive, how was he, then, to ensure that she did not transmit the disease any further ?
6. Did the doctor have any duty towards the girl betrothed to the HIV positive patient, whose name and address he had not been told ? Knowing that the girl was at prime risk what should he do ?
7. What about the implications of the recent Supreme Court Judgment ( (1998) 8 SCC 296) declaring that transmission by a seropositive HIV person to another (in the instant case his wife-to-be), would amount to be an offence under Sections 269 and 270 of the IPC ? Also to be considered is the relevance and import of Sec. 39 of Cr.P.C. in this context. Having come to know that a person is going to commit a cognizable offence, not informing the appropriate authority about it is a crime. __________________________________________________________________
P.S.
IPC Section 269 and 270 are excluded from the purview of Sec. 39 Cr.P.C.
However, Sec. 116 of IPC and other sections of IPC related to abatement, are relevant in the context of offence committed or to be committed under Ss.269 & 270 of IPC. Where does the physician having knowledge of the patient's intention to commit offence under IPC 269 and 270 stand in the light of the Supreme Court judgment ? What should he do to avoid becoming an abettor in the crime ?
Gauna = A mandatory ceremony essential to be performed to complete the marriage ritual (including child marriage) before the bride is sent to the bridegroom’s place and cohabitation is permitted. It is performed after the girl has attained puberty ( in case of child marriage), and when the parents of the girl consider it fit and appropriate.
Dr.S.G.Kabra
MBBS,LLB,MSc,MS (Anat.),MS (Gen.Surg)
Senior Scientist
IIHMR
Jaipur
Second Trimester Abortions are Cruel Violation of Human Rights
NON-THERPEUTIC SECOND TRIMESTER TERMINATION OF PREGNANCIES IS GROSS HUMAN RIGHTS VIOLATION.
ABATTOIRS AND ABETTORS
MERCENARIES AND MISSIONARIES
On the occasion of signing the Partial Birth Abortion Act 2003 on November 5, 2003, President Bush stated, “For years, a terrible form of violence has been directed against children who are inches from birth, while the law looked the other way. Today, at last, the American people and our government have confronted the violence and come to the defense of the innocent child.”
It may be noted that the implied distinction between infanticide and partial birth abortion is “children who are inches from birth’.
Alluding to the compelling evidence that led the members of the House and Senate to pass the legislation, President Bush stated:-.
“The best case against partial birth abortion is a simple description of what happens and to whom it happens. It involves the partial delivery of a live boy or girl, and a sudden, violent end of that life. Our nation owes its children a different and better welcome.”
The description of partial birth abortion in terms of what happens and to whom it happens is:-
A parallel Second-trimester termination-of-pregnancy permitted by law upto the 20th week of pregnancy and practiced in the country is Dilatation & Evacuation. A medical doctor who practised the procedure for long describes it in graphic details thus:-
A Medical Doctor describes the Dilation and Evacuation Procedure
-- Dr. Tony Levatino, M.D.
Imagine for a moment that you are a "pro-choice" obstetrician-gynecologist as I once was. Your patient today is seventeen years old and she is twenty weeks pregnant. At twenty weeks, her uterus is up to her umbilicus and she has been feeling her baby kick for the last two weeks. If you could see her baby, she would be as long as your hand from the top of her head to the bottom of her rump not counting the legs. Your patient is now asleep on an operating room table with her legs in stirrups. Upon entering the room after scrubbing, you dry your hands with a sterile towel and are gowned and gloved by the scrub nurse.
The first task is remove the laminaria that had earlier been placed in the cervix to dilate it sufficiently to allow the procedure you are about to perform. With that accomplished, direct your attention to the surgical instruments arranged on a small table to your right. The first instrument you reach for is a 14-French suction catheter. It is clear plastic and about nine inches long. It has a bore through the center approximately ¾ of an inch in diameter. Picture yourself introducing the catheter through the cervix and instructing the circulating nurse to turn on the suction machine which is connected through clear plastic tubing to the catheter. What you will see is a pale yellow fluid the looks a lot like urine coming through the catheter into a glass bottle on the suction machine. This amniotic fluid surrounded the baby to protect her.
With suction complete, look for your Sopher clamp. This instrument is about thirteen inches long and made of stainless steel. At one end are located jaws about 2 ½ inches long and about ¾ on an inch wide with rows of sharp ridges or teeth. This instrument is for grasping and crushing tissue. When it gets hold of something, it does not let go.
A second trimester D&E abortion is a blind procedure. The baby can be in any orientation or position inside the uterus. Picture yourself reaching in with the Sopher clamp and grasping anything you can. At twenty weeks gestation, the uterus is thin and soft so be careful not to perforate or puncture the walls. Once you have grasped something inside, squeeze on the clamp to set the jaws and pull hard – really hard. You feel something let go and out pops a fully formed leg about 4 to 5 inches long. Reach in again and grasp whatever you can. Set the jaw and pull really hard once again and out pops an arm about the same length. Reach in again and again with that clamp and tear out the spine, intestines, heart and lungs.
The toughest part of a D&E abortion is extracting the baby’s head. The head of a baby that age is about the size of a plum and is now free floating inside the uterine cavity. You can be pretty sure you have hold of it if the Sopher clamp is spread about as far as your fingers will allow. You will know you have it right when you crush down on the clamp and see a pure white gelatinous material issue from the cervix. That was the baby’s brains. You can then extract the skull pieces. If you have a really bad day like I often did, a little face may come out and stare back at you.
Congratulations! You have just successfully performed a Suction D&E abortion. You just affirmed her right to choose. You just made $600 cash in fifteen minutes.
For more medical information on D&E abortion, see the following texts:
Abortion Practice, by Warren M. Hern, M.D., M.P.H. (1990: Alpenglo Graphics, Inc., 1130 Alpine, Boulder, CO 80304), ISBN 0-9625728-0-2.
Second Trimester Abortion: Perspectives After a Decade of Experience, Edited by Gary S. Berger, William E. Brenner, and Louis G. Keith (1981: Martinus Nijhoff Publishers, PO Box 566, 2501 CN The Hague, The Netherlands and John Wright, PSG, Inc., 545 Great Road, Littleton, MA 01460), ISBN 90-247-2487-2.
A pictorial presentation of D & E procedure is reproduced below for you to visualize and understand the same.
Obviously, an obstetrician or other physician who is required to, or opts to do the aforesaid procedures has to be desensitized to the tender feelings one expects for a tender life in the womb. One has to be totally indifferent, if not callous, to the life in the womb. Over enthusiastic and zealous abortionists are likely to be totally dehumanized.
Of the total of 96,79,484 registered Medical Terminations of Pregnancy done and reported since the MTP Act came into being, in a period from 1977 to 1997, 13 lakh 39 thousand i.e. approximately 14 % were performed for second trimester abortion. Presently it is estimated that 40 to 50 lakh pregnancy terminations, registered and reported, unreported and clandestine, are being done in the country every year. All methods for second trimester abortion cause violent death of the live child in the womb.
ABATTOIRS AND ABETTORS
MERCENARIES AND MISSIONARIES
On the occasion of signing the Partial Birth Abortion Act 2003 on November 5, 2003, President Bush stated, “For years, a terrible form of violence has been directed against children who are inches from birth, while the law looked the other way. Today, at last, the American people and our government have confronted the violence and come to the defense of the innocent child.”
It may be noted that the implied distinction between infanticide and partial birth abortion is “children who are inches from birth’.
Alluding to the compelling evidence that led the members of the House and Senate to pass the legislation, President Bush stated:-.
“The best case against partial birth abortion is a simple description of what happens and to whom it happens. It involves the partial delivery of a live boy or girl, and a sudden, violent end of that life. Our nation owes its children a different and better welcome.”
The description of partial birth abortion in terms of what happens and to whom it happens is:-
A parallel Second-trimester termination-of-pregnancy permitted by law upto the 20th week of pregnancy and practiced in the country is Dilatation & Evacuation. A medical doctor who practised the procedure for long describes it in graphic details thus:-
A Medical Doctor describes the Dilation and Evacuation Procedure
-- Dr. Tony Levatino, M.D.
Imagine for a moment that you are a "pro-choice" obstetrician-gynecologist as I once was. Your patient today is seventeen years old and she is twenty weeks pregnant. At twenty weeks, her uterus is up to her umbilicus and she has been feeling her baby kick for the last two weeks. If you could see her baby, she would be as long as your hand from the top of her head to the bottom of her rump not counting the legs. Your patient is now asleep on an operating room table with her legs in stirrups. Upon entering the room after scrubbing, you dry your hands with a sterile towel and are gowned and gloved by the scrub nurse.
The first task is remove the laminaria that had earlier been placed in the cervix to dilate it sufficiently to allow the procedure you are about to perform. With that accomplished, direct your attention to the surgical instruments arranged on a small table to your right. The first instrument you reach for is a 14-French suction catheter. It is clear plastic and about nine inches long. It has a bore through the center approximately ¾ of an inch in diameter. Picture yourself introducing the catheter through the cervix and instructing the circulating nurse to turn on the suction machine which is connected through clear plastic tubing to the catheter. What you will see is a pale yellow fluid the looks a lot like urine coming through the catheter into a glass bottle on the suction machine. This amniotic fluid surrounded the baby to protect her.
With suction complete, look for your Sopher clamp. This instrument is about thirteen inches long and made of stainless steel. At one end are located jaws about 2 ½ inches long and about ¾ on an inch wide with rows of sharp ridges or teeth. This instrument is for grasping and crushing tissue. When it gets hold of something, it does not let go.
A second trimester D&E abortion is a blind procedure. The baby can be in any orientation or position inside the uterus. Picture yourself reaching in with the Sopher clamp and grasping anything you can. At twenty weeks gestation, the uterus is thin and soft so be careful not to perforate or puncture the walls. Once you have grasped something inside, squeeze on the clamp to set the jaws and pull hard – really hard. You feel something let go and out pops a fully formed leg about 4 to 5 inches long. Reach in again and grasp whatever you can. Set the jaw and pull really hard once again and out pops an arm about the same length. Reach in again and again with that clamp and tear out the spine, intestines, heart and lungs.
The toughest part of a D&E abortion is extracting the baby’s head. The head of a baby that age is about the size of a plum and is now free floating inside the uterine cavity. You can be pretty sure you have hold of it if the Sopher clamp is spread about as far as your fingers will allow. You will know you have it right when you crush down on the clamp and see a pure white gelatinous material issue from the cervix. That was the baby’s brains. You can then extract the skull pieces. If you have a really bad day like I often did, a little face may come out and stare back at you.
Congratulations! You have just successfully performed a Suction D&E abortion. You just affirmed her right to choose. You just made $600 cash in fifteen minutes.
For more medical information on D&E abortion, see the following texts:
Abortion Practice, by Warren M. Hern, M.D., M.P.H. (1990: Alpenglo Graphics, Inc., 1130 Alpine, Boulder, CO 80304), ISBN 0-9625728-0-2.
Second Trimester Abortion: Perspectives After a Decade of Experience, Edited by Gary S. Berger, William E. Brenner, and Louis G. Keith (1981: Martinus Nijhoff Publishers, PO Box 566, 2501 CN The Hague, The Netherlands and John Wright, PSG, Inc., 545 Great Road, Littleton, MA 01460), ISBN 90-247-2487-2.
A pictorial presentation of D & E procedure is reproduced below for you to visualize and understand the same.
Obviously, an obstetrician or other physician who is required to, or opts to do the aforesaid procedures has to be desensitized to the tender feelings one expects for a tender life in the womb. One has to be totally indifferent, if not callous, to the life in the womb. Over enthusiastic and zealous abortionists are likely to be totally dehumanized.
Of the total of 96,79,484 registered Medical Terminations of Pregnancy done and reported since the MTP Act came into being, in a period from 1977 to 1997, 13 lakh 39 thousand i.e. approximately 14 % were performed for second trimester abortion. Presently it is estimated that 40 to 50 lakh pregnancy terminations, registered and reported, unreported and clandestine, are being done in the country every year. All methods for second trimester abortion cause violent death of the live child in the womb.
Tuesday, January 15, 2008
Female feticide
Femal feticide and abortion
Legal termination of pregnancy is ‘abortion’.
Illegal termination of ‘pregnancy’ is feticide.
Destruction of fetus is precondition of pregnancy termination.
Feticides and female feticides take place by contravention of the MTP Act.
Statutory authority to implement the provisions of MTP Act is the Chief Medical Officer.
CMOs are to ensure that feticides and female feticides do not take place by contravention of the MTP Act.
They are not doing it and hence the feticides and female feticides.
To prevent female feticides the MTP Act must be rigorously implement, supervised and monitored.
Female feticides take place in second trimester abortions i.e. between 13 to 20 weeks.
Second trimester abortions are riskier and violent methods of termination and are permitted in law only for medically assessed and certified life threatening or grave injuring causing conditions.
Second trimester abortion is not permitted for pregnancy due to contraceptive failure.
Irresponsible second trimester abortions are a grave human rights violations.
Abortion and Feticide
Therapeutic and Non-therapeutic abortions
Abortion on medical grounds and on non-medical grounds
Legal abortion and illegal or criminal abortion
Abortion as a personal (fundamental) right of woman
Dr.S.G.Kabra, SDM Hospital and IIHMR, Jaipur
Legal termination of pregnancy is ‘abortion’.
Illegal termination of ‘pregnancy’ is feticide.
Destruction of fetus is precondition of pregnancy termination.
Feticides and female feticides take place by contravention of the MTP Act.
Statutory authority to implement the provisions of MTP Act is the Chief Medical Officer.
CMOs are to ensure that feticides and female feticides do not take place by contravention of the MTP Act.
They are not doing it and hence the feticides and female feticides.
To prevent female feticides the MTP Act must be rigorously implement, supervised and monitored.
Female feticides take place in second trimester abortions i.e. between 13 to 20 weeks.
Second trimester abortions are riskier and violent methods of termination and are permitted in law only for medically assessed and certified life threatening or grave injuring causing conditions.
Second trimester abortion is not permitted for pregnancy due to contraceptive failure.
Irresponsible second trimester abortions are a grave human rights violations.
Abortion and Feticide
Therapeutic and Non-therapeutic abortions
Abortion on medical grounds and on non-medical grounds
Legal abortion and illegal or criminal abortion
Abortion as a personal (fundamental) right of woman
Dr.S.G.Kabra, SDM Hospital and IIHMR, Jaipur
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