The Usual Mess - the PNDT Act
PNDT Act - A Discussion
Act - A discussion
Hospital Main Lecture Theatre
ultrasonologists, bureaucrats and lawyers
are welcome. There is no pre-registration. There will be spot
registration at the counter.
and biscuits will be served.
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.
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,
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.