India’s problem with the girl child


Anandiben Patel has set the wrong example for approaching the issue


Illustration: Jayachandran/Mint

Illustration: Jayachandran/Mint

It is difficult to know exactly what Gujarat chief minister Anandiben Patel had in mind when—speaking at a public event on Saturday—she played up the role a new woman and child hospital, provided for in the state budget, would have in “research on why, for what reason, back-to-back daughters are born”. Perhaps, her intentions can be given a charitable spin; she did speak of the unfairness of women being blamed for having daughters and allow that some families might have only sons and want a daughter. But even so, framing the issue in terms of whose “fault” a daughter’s birth is and implicitly legitimizing the quest for children of a specific sex is problematic.

Parsing every public utterance made by politicians is usually a fruitless endeavour. There is much that is tailored to the moment. Patel, however, has disregarded the sex preference that has become a pressing sociocultural, humanitarian and economic issue in India. And in also bringing up DNA testing and modification in the context of babies born with mental and physical challenges, she has ventured into an area where governments and scientists are still struggling to frame the ethical terms of the debate.

United Nations Department of Economic and Social Affairs data for 150 countries over four decades shows that India is one of only two countries—China is the other—where female infant mortality is higher than male infant mortality in the 21st century. And when it comes to child mortality sex ratio, India is, by some distance, the worst in the world. Given the strong biological advantage that girls enjoy in early childhood, this can only be explained by “differential treatment or access to resources… putting girls at a disadvantage”, according to the report.

And these are the visible figures. Foetal sex determination and selective abortion are endemic problems nationwide. The Preconception and Prenatal Diagnostic Techniques Act (PCPNDT), 1994, has proved ineffective. In 2011, British medical journal Lancet estimated that up to 12 million female foetuses had been aborted in India over the previous three decades. Yet, in the majority of states, not a single case has been registered under the PCPNDT Act. Of the handful that have been charged in cities such as New Delhi, there have been no convictions.

The consequences are as predictable as they are depressing: a decline in child gender ratio from 945 girls per 1,000 boys in 1991 to 927 girls per 1,000 boys in 2011 as per census data; sociocultural upheaval in states such as Rajasthan, Haryana and Punjab with particularly low ratios; destructive practices such as “buying” brides from other states; human trafficking; human rights abuses.

The rapid advances related to DNA research and genetic testing over the past quarter century have profound ethical implications in a country such as India with its tangle of economic compulsions and regressive sociocultural practices. Choosing the sex of a baby is now consumer-grade technology, if not yet in India. This, whether she intended to or not, is what Patel spoke of. The implications of such technology in a society where the girl child is still considered a liability are troubling—particularly when legislation and enforcement dealing with existing technology have been so lacking.

Nor is sex selection the only vector for ethical concerns. Prenatal genetic screening and testing for birth defects and genetic conditions such as Down’s Syndrome are useful when it comes to making an informed choice about carrying a pregnancy to term. But the more the field advances, the greater the tension between utilitarianism and traditional norms that see a utilitarian approach as harmful to a healthy society.

Will the majority of parents also choose to terminate a pregnancy where autism has been detected as they do with Down’s Syndrome, for instance? If so, what point on the spectrum would be considered a red line? For that matter, where would the line be drawn for which conditions justify termination? Who would draw it?

These are difficult—indeed, taboo—questions. And the CRISPR technique developed in 2013 that allows specific genes to be altered—Chinese scientists have announced that they had used it to edit human embryo genes—means that such questions will multiply.

Patel’s speech was a neat summary of the dangers inherent in casual disregard for such issues. Bioethics is perhaps too abstract an area to easily gain popular currency. But it is also becoming too important to be left to politicians. There must be a wider debate examining this intersection of science and Indian society.

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