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The Usual Mess - the PNDT Act

PNDT Act - A Discussion

Date: 23 rd June,2002
Topic: PNDT Act - A discussion
Venue : KEM Hospital Main Lecture Theatre
Timing: 9.30AM to 12.30PM
Participants: Knowledgeable ultrasonologists, bureaucrats and lawyers
All are welcome. There is no pre-registration. There will be spot registration at the counter.
Tea and biscuits will be served.

The PNDT act came into being in 1994. PNDT stands for pre-natal sex determination act; it was passed to prevent pre-natal sex determination, and by extension, selective abortion of female fetuses. Like most radiologists, I had no clue this Act had even been passed. This was partly because in the original act, there
was no mention of the word "radiologist"; the only specialties mentioned were gynecologists, geneticists and pediatricians.

Sometime last year, the press started covering the PNDT act, because the Supreme court had given an
ultimatum to the authorities to implement its provisions. That is the first time I heard about the act. One
of our radiology colleagues, Dr. Prashant Gupta made some noise about the act and emailed me about six
months ago, but eventually nothing much happened.

Reality struck some three months ago, when we received a circular from the Bombay Municipal Corporation
(BMC) saying that we had to register our ultrasound machine. This we did within 48 hours paying Rs 3000.
None of us in our practice had read the act till then; all the radiologists I spoke to said that all ultrasound machines had to be registered as per the provisions of the PNDT act.

At the 3rd AURC meeting in the first week of May, some of the radiologists practicing in the Ambarnath-Kalyan area started talking about how they need to fill up forms F and G whenever they scan an obstetric patient. Again,
I had no clue about this and when I inquired with the other radiologists, I found that some knew about this,
but were not doing anything and many others, like me had no knowledge about these forms. We also found that many other radiologists in other states were routinely filling up these forms.

I finally went through the Act today. Nowhere in the act even now is a radiology diagnostic centre mentioned.
The only reason ultrasound scanners have to be registered is because they come under the heading of "Genetic Clinic". According to the Act, no pre-natal genetic testing should be performed without proper documentation; since ultrasound is a modality that allows pre-natal fetal evaluation, it has been included in the list of pre-natal tests, and thus all people who perform such ultrasounds are covered by the act.

From all this, what I have finally gathered is the following:

1.All ultrasound machines need to be registered provided obstetric scans are being performed on them.

2.Each obstetric scan being performed needs to be documented with forms F and G.

3.The sex is not to be mentioned orally or in writing to the patients, under any circumstances whatsoever.

The gray areas are as follows:

1.If a centre has multiple ultrasound machines do all machines need to be separately registered. My interpretation of the Act is that a "centre" has to be registered not a machine. Accordingly if one individual
goes to multiple centres carrying his portable machine, each centre probably needs to be separately registered.

2.Do all patients need to have referral notes from referring doctors? Can we take self-referrals?

3.If a 4D or 3D USG of the lower half of the body shows a penis in the video file, is that equivalent to having mentioned the sex?

4.What happens if a patient aborts the fetus anyway? Are we in any situation, liable?

We are left searching for answers. Ideally, we would have expected our apex associations such as the state radiology associations and the IRIA to have done something about it. The office-bearers should have contacted the ministry, obtained representation and then clarifications from the concerned individuals. Circulars should have been sent to each IRIA member regarding the act and the steps that need to be followed. Instead what do we have? Complete silence from the apex body. Some of the state associations have done something and some radiologists in some states are on the advisory committees....but that is not enough.