HEALTH LAW

RAMANDEEP KAUR

LLB 4TH SEMESTER

RIMT UNIVERSITY (2024)

 Important Questions
1. What is National Ayush mission?

ANS. What is National Ayush Mission?

The National Ayush Mission is a centrally sponsored scheme launched in 2014 by the
Department of Ayush, Ministry of Health and Family Welfare.

 The fundamental objective of the NAM is to promote the AYUSH systems of

medicine through cost-effective services, boosting its educational systems,
quality control of AYUSH drugs and ensuring the sustainable availability of
AYUSH raw materials.
 AYUSH stands for Ayurveda, Siddha, Unani and Homoeopathy systems of
medicine.
 The vision of the Ayush Mission are:
 Providing cost-effective and equitable AYUSH healthcare all over India by
enhancing access to the services.
 Strengthening and revitalising the AYUSH systems enabling them to
become prominent medical streams in the country in the healthcare
sector.
 Improving educational institutions that can impart knowledge in AYUSH
streams.
 Promoting quality control of AYUSH drugs by developing quality standards
and ensuring the availability of AYUSH raw materials.

National AYUSH Mission Objectives

The stated objectives of the National AYUSH Mission are described below.

1. Offering cost-effective AYUSH services to the people through AYUSH hospitals,

dispensaries, and also providing AYUSH facilities in the Primary Health Centres
(PHCs), Community Health Centres (CHCs) and District Hospitals (DHs).
2. Boosting institutional capacities at the state level for AYUSH systems by
upgrading educational institutions, drug testing labs, AS&U pharmacies
(Ayurveda, Siddhi and Unani), and also AS&U enforcement mechanism.
 3. Supporting the cultivation of medicinal plants by adopting Good Agricultural
Practices (GAPs) so as to provide a sustained supply of quality raw materials for
AYUSH drugs.
4. Aiding the establishing of clusters through the convergence of cultivation, value
addition, warehousing, marketing & developing infrastructure for entrepreneurs.

National AYUSH Mission Components

The NAM consists of two broad components: Mandatory and Flexible. The following
image gives the details of the components of the AYUSH Mission.

AYUSH Health and Wellness Centres

In March 2020, the Union Cabinet approved the inclusion of the AYUSH Health and
Wellness Centres (HWCs) component of Ayushman Bharat under the National AYUSH
Mission.

 This inclusion is aimed at setting up a holistic wellness model based on

AYUSH principles and practices with an emphasis on preventive, curative,
promotive, rehabilitative & palliative healthcare through an integration with the
current public healthcare system.
 The National Health Policy 2017 advocates the mainstreaming of the potential of
AYUSH systems within a pluralistic system of integrative healthcare.
 AYUSH HWCs are focused to deliver an expanded range of services that go
beyond maternal and child health care services to include care for non-
communicable diseases, palliative and rehabilitative care, oral, eye and ENT
care, mental health and first-level care for emergencies and trauma, including
free essential drugs and diagnostic services.

Questions related to the National AYUSH Mission for UPSC

Q1

What is the National AYUSH Mission launch date?

The National AYUSH Mission was approved by the Prime Minister for its launch on 15th
September 2014. It was launched during the 12th Five-Year Plan.
2. Duties and rights of Doctors?
ANS. Duties of a Medical Professional or a Doctor

A doctor should uphold the dignity and honor of their profession,1 and their prime
objective should be to render service to humanity. 2 Further, doctors should be upright,
modest, sober, patient, prompt and conduct themselves with propriety in their
profession.3 Legal regulations provide a comprehensive list of a doctor‘s general duties,
which are:

Maintaining a good practice

Doctors should:4

 Take care of each patient and provide proper service and devotion.
 Try continuously to improve medical knowledge and skills. They should also use
this knowledge to benefit both patients and other colleagues.
 Practice methods of healing founded on a scientific basis. A doctor should not
associate professionally with anyone who violates this principle. 5

Maintaining medical records of patients

 Maintaining medical records:6

 Doctors should maintain medical records of patients for a period of 3 years
from the commencement of treatment.7
 Upon a request by the patient, or authorised attendant, or legal authorities,
such medical records shall be produced within 72 hours.8
 A medical practitioner has to maintain a register of all the medical certificates
issued by them. The identification marks of the patient, along with the
signature or thumb impression of the patient shall be collected. The
practitioner has to keep a copy of the same.9
10
 Efforts have to be made to digitalize the records.


General Duties of a Doctor

A doctor has some general duties apart from the ones give above including:

 Displaying registration numbers.11 Upon registration, the State Medical Council

gives the doctor a registration number. This should be displayed in all the
prescriptions, certificates, money receipts given to the patients. 12
 Use of generic names of drugs.13 The Generic Name of a drug refers to its
chemical name, or the chemical makeup of the drug, rather than the assigned
brand name.
 Highest quality assurance in patient care. 14 Further doctors should:
  Aid in safeguarding the profession against the admission of people who don‘t
have the appropriate education or don‘t have the proper moral character.
 Not employ anyone for a professional practice who is neither registered or
enlisted under any of the medical laws. For example, if a doctor is hiring a
nurse, it should be someone who is a registered nurse, qualified to practice
medicine.
 Exposing unethical conduct of other members of the profession. 15
 Doctors should announce their fees before rendering service. For instance,
personal financial interests of a doctor should not conflict with the patient‘s
medical interests.16
 Observing the laws of the country and not helping others in evading the same. 17

Duties towards patients

Although doctors are not bound to treat every patient that comes up to them, they
should always be ready to respond to calls from the sick and injured. A doctor can
advise the patient to go to another doctor, but must treat patients in times of
emergencies. No doctor should arbitrarily refuse to treat their patient. 18

A doctor should be patient, delicate, and must honor the privacy of the patient. 19 While
explaining the condition of a patient, the doctor should neither exaggerate nor minimize
the gravity of the patient‘s condition.20

The patient must not be neglected. Once the doctor has undertaken a case, they should
not neglect the patient or withdraw from the case without giving adequate notice to the
patient and the patient‘s family. Further, doctors should not deliberately commit acts of
negligence that may deprive a patient from necessary medical care.
3. Benefit of Pre-Natal Diagnosis?
ANS. What are the Benefits of Prenatal Testing?

Prenatal testing provides genetic information about the baby while it‘s still in the womb.
These tests detect health problems in the mother, like gestational diabetes, or fetal
abnormalities like spina bifida. In these cases, doctors will administer medical treatment
before the baby is born.

These tests also screen for common genetic disorders such as cystic fibrosis, cancer,
and Down‘s syndrome. If an abnormality is detected, it gives parents more time to
prepare and determine the best course of action in handling a child with a birth defect.
This includes reviewing treatment and management options for the health condition,
reviewing insurance coverage and allocating funds, and other parenting decisions and
childcare planning. In this sense, prenatal testing can be a valuable tool in helping
expectant parents plan for their future with as much information as possible.

Types of Available Prenatal Tests

There are some tests, such as urine analysis and blood pressure checks, that are
routine, and therefore are administered at every checkup. But there are also a series of
screening tests that are performed during certain trimesters of the pregnancy to test for
genetic abnormalities.

Screening tests merely indicate the possible presence of a genetic disorder and do not
indicate which disorder is present, or its severity. If the screening test has a positive
result, the next step is to perform a diagnostic test to determine which genetic disorder
is present.

Many screening tests are non-invasive and some require no more than a blood sample
from the mother. Some are packaged together or are offered as a series of tests in a
single checkup. These include, but are not limited to:

Glucose Tolerance Test: Tests for gestational diabetes in the mother. She consumes
a sugary drink and within an hour her blood is drawn and evaluated on how well her
body processes the sugar.

Blood Screening: Tests for the presence of certain substances in the mother‘s blood
that may indicate genetic disorders, such as Down‘s syndrome or cystic fibrosis.

Prenatal Cell-Free DNA Testing: Evaluates fetal DNA in the mother‘s bloodstream for
certain chromosome conditions and to reveal the sex of the fetus.

Ultrasound: Using sound waves and a digital screen, the doctor can visually inspect
the fetus and placenta for physical abnormalities, as well as determine the fetus‘ age.
Non-Stress Test: Movement and heart rate of the fetus are monitored using special
belts attached to the mother‘s abdomen.

Additional diagnostic tests may require pelvic exams or other fluid samples to determine
if the fetus has a genetic condition. These tests carry a low risk of miscarriage and
include, but are not limited to:

Chorionic Villus Sampling (CVS) : Sampling of the placenta

Amniocentesis : Sampling of the amniotic fluid

In the event that both parents carry a gene that makes the fetus predisposed to a
genetic disorder, certain tests are more likely to be administered.

While prenatal testing can help assess many types of disease early so that parents can
take action accordingly, there are some illnesses and conditions for which there are no
tests. But for many, knowing as much as possible is an important step in preparing for
parenthood.
4. Difference between Negligence and malpractice.

ANS. Meaning

Negligence

The Latin word ―Negligentia,‖ which means ‗to fail to pick up,‘ is the source of the
English word ‗negligence,‘ which refers to a lack of care. It is a common belief that when
someone acts negligently causing injury to another person, that person is legally
responsible for the harm under the legal doctrine of negligence. Both criminal and civil
wrongs can result from negligence.

Negligence is a synonym for carelessness. As a result, we can describe this as an

instance in which one person suffers harm or is hurt as a result of the negligence of
another. Although the careless act does not directly cause harm to the other person, it
nonetheless constitutes a tort. Negligence occurs when one person fails to exercise the
care that any other reasonable person would have exercised if he or she had been in
the other person‘s position and as a result causes harm, damage, injury, or loss to the
other person.

Malpractice

The term ―malpractice‖ has been derived from two Latin terms, ―malus‖ and ―practicare,‖
which mean ―bad‖ and ―to practice,‖ respectively.

Malpractice refers to the tort that occurs when a professional breaches their duty of care
to a client. According to most definitions, a professional‘s obligation to a client is to
uphold generally recognised professional standards. Of course, it is also necessary to
demonstrate the other components of a tort (breach, proximate cause, actual cause,
and damages). Lawyers and doctors are the targets of malpractice claims most
frequently.
Key differences between negligence and malpractice

Basis of
Negligence Malpractice
distinction

Malpractice
Negligence occurs when one person fails to occurs when a
exercise the care that any reasonable person professional
Meaning would have exercised if he or she had been in a breaches their
similar position and as a result causes harm, duty of care
damage, injury, or loss to the other person. towards a
client.

Malpractice
claims are
brought against
Negligence claims can be against anyone who professionals
Claims
has breached his duty of care. who have
breached their
professional
duty of care.

Malpractice is a
Negligence is a wider term, and includes narrow term
Scope
malpractice. that is a part of
negligence.

Negligence is a
Form Negligence is not a form of malpractice. form of
malpractice.

It is the result of
It is the result of an unintentional action that
an
occurs due to a failure to take the necessary
Result unreasonable
steps that should have been taken under the
lack of skill
circumstances to avoid or prevent that harm.
causing harm,
damage, injury,
 or loss.

Malpractice is a
failure to use
the professional
Negligence is a failure to exercise appropriate set standards in
Failure
care. undertaking a
particular
professional
skill.

In cases of
malpractice, the
intent is usually
In cases of negligence, there may or may not
Intent present, i.e.,
be the presence of intent.
knowing that
harm may be
caused.

A doctor not
performing her
duties in
accordance
A driver causing harm to passengers due to his with medical
Example
negligence. standards,
resulting in
harm being
caused to her
patient.
 5. Benefits of having Health Insurance?

ANS. 1. Hospitalization Cost

One of the most pertinent benefits of health insurance policy is that it covers expenses for

hospitalization, whether it is for accidental injury or illness.

Illness hospitalization

Health insurance policies cover for costs incurred while taking treatment in a hospital for any

illness. The expenses covered include any associated costs related to the treatment ranging

from the following:

 Room charges

 Intensive care unit (ICU) charges

 Doctors‘ fees

 Diagnostic tests costs

 Surgery charges

Accidental hospitalization

Any cost incurred for treatment of injury due to an accident are covered in health insurance

policies. These include any associated costs related to the treatment of an accidental injury that

is covered in the health insurance plan such as:

 Room rent

 Doctor/surgeon fees

 ICU charges
 Diagnostic test costs

Capping on room rent

An option to choose a cap on room rent in your health insurance policy is an important

determiner because charges such as diagnostic and doctor fees are directly related to the

category of room one chooses during treatment in the hospital.

This feature involves options such as a fixed amount linked to the total sum insured of an

individual or a single private room and even no limit on room rent while undergoing treatment at

a hospital.

Day care expenses

With advancement in the treatment methodology, there are many procedures that do not

require overnight hospitalization. Health insurance plans are designed to help policyholders in

such cases by covering such treatments as well without customary hospitalization.

Alternative treatment

These days not everyone prefers allopathic treatment and there are certain illnesses that can

be effectively treated through other alternative medical treatment methods such as ayurveda,

siddha, unnani and homeopathy. Certain health insurance plans cover the cost of such

alternative treatment as well.

2. Pre-and Post-Hospitalization Expenses

When an individual takes treatment at a hospital, there are a series of visits by doctors along

with the diagnostic tests that are required to be done for you before you get treated as well as

after. These expenses are considered by certain health covers.

For instance, health insurance plans pay for the expenses incurred in the hospital for treatment

but they also factor paying for the expenses incurred prior to hospitalization for a certain

number of days ranging from 15 to 60 days prior to treatment. They also cover charges of

follow-up visits, medicines and diagnostic tests once you get discharged from the hospital.

Some health insurance plans pay for such expenses ranging from 30 to 90 days from the

discharge of an individual from the hospital.

Transportation cost

This benefit covers the cost of ambulance and is generally offered as a sublimit of about INR

5,000 for each hospitalization you undertake during your policy cycle.

3. Health Check Ups

Health insurance plans are designed to primarily take care of financial stress in case of medical

emergency. However, insurers also want people with good health in their portfolio.

To ensure an individual is aware of their health, most health insurance plans offer preventive

health check-ups on a yearly basis. This helps an individual to know about their health vitals

and take corrective steps to bring changes to their lifestyle. In the long-term, this helps

insurance companies potentially lower their claims outgo.

Waiting period

In a health insurance policy, there are certain specified illnesses for which the coverage is not

available from day one. There is a waiting period of one year to four years for specific illness.

The illnesses that are specifically excluded are considered for coverage after policyholders sign

up for continued renewal of health insurance plans with the same company for a period ranging

from one year to four years depending on their terms and conditions.

Taking a health insurance plan at an early age helps individuals cross the waiting period at that

stage of life where specified illnesses, which are generally excluded during the waiting period,

do not tend to happen to a healthy individual. This enables policyholders to avail full benefit of

the insurance cover at an early age.

4. No Claim Bonus

Health insurance not only covers the medical expenses of those who have to seek

hospitalization for illness or accidental injury but also rewards those who do not have to avail

the benefits of health insurance and do not make a claim in the policy period. Such individuals

are rewarded by way of increasing their insurance cover sum insured without charging any

additional premium.

A ―No Claim Bonus‖ can be earned up to 100% of the original sum insured in the policy. This

feature enables an individual to double the cover without any additional cost and is useful at

older age bands when specified illnesses are likely to happen. These include cancer, diabetes,

hypertension and heart-related complexities.

 5. Income Tax Rebate

While an individual pays the insurance premium for a health insurance, there is an immediate

financial benefit in the form of income tax rebates on premiums paid by an individual. In India,

health premium rebates are as follows:

 Health insurance for self and family (spouse and children) is INR 25,000

 If individual or spouse is 60-years old or more, the deduction available is INR 50,000

 An additional deduction for insurance of parents (father or mother or both, whether dependent

or not) is available to the extent of INR 25,000 if less than 60 years old and INR 50,000 if

parents are 60-years old or more.

The effective cost of a health insurance policy is thus reduced by the deduction that is allowed

in an individual‘s annual income tax. This is a built-in double benefit of protection against

financial strain as well as saving tax.

6. Age No Barrier

Health insurance today is available for all life stages. An individual can combine the base

hospitalization cover with a top-up health insurance cover to manage the cost of insurance and

still get reasonably large protection for medical emergencies.

 At a young age, when tax saving specific products are available with a low hospitalization

cover, an individual can enjoy protection and tax benefits.

 At the family stage, an individual can buy a family floater cover and also look for covers that

offer maternity benefit, preferably with a waiting period. One can look at covers that offer
 outpatient department (OPD) expenses and the expenses for children‘s consultation for

vaccination among others that are available.

 At a mid age, one can look at expanding the sum insured to individuals with a reasonably high

cover as illnesses due to lifestyle habits and growing age start kicking in.

 At a post-retirement age, it is difficult to obtain sufficient and reasonable coverage due to

restrictions on entry age and pre-existing illness. It is advisable for individuals to take a health

insurance cover at an early age to better plan their retirement as post-retirement medical

expenses are one of the few big-ticket items of an individual‘s monthly expenditure.
6. Mental Health Act and Salient feature of this act.
ANS. What is the Background MHA, 2017?

 Before MHA 2017, the Mental Healthcare Act, 1987 existed, which prioritized the
institutionalization of mentally ill people and did not afford any rights to the
patient.
 The Act provided disproportionate authority to judicial officers and mental
health establishments to authorize long-stay admissions, often against
the informed consent and wishes of the individual.
 Consequently, several persons continue to be admitted and languish in mental
health establishments against their will.
 It embodied the ethos of the colonial-era Indian Lunacy Act of 1912, which
linked criminality and madness.
o Asylums were places where ―abnormal‖ and ―unproductive‖ behaviour was
studied as an individual phenomenon, isolating the individual from society.
The intervention is meant to correct an inherent deficit or ―abnormality‖,
thereby leading to ―recovery‖.
 In 2017, the MHA dismantled the clinical heritage attached to asylums.
What is MHA 2017?

 About:
o This Act defined mental illness as ―a substantial disorder of thinking, mood,
perception, orientation, or memory that grossly impairs judgment, behaviour,
capacity to recognize reality or ability to meet the ordinary demands of life,
mental conditions associated with the abuse of alcohol and drugs.
o It also provides the right of patients to access facilities that include
rehabilitation services in the hospital, community, and home, sheltered
and supported accommodation.
o It regulates the research on PMI (Person with Mental Illness) and the use
of neurosurgical treatments.
 Rights under MHA:
o Right to Make an Advance Directive (Patient can state on how to be treated
or not to be treated for the illness during a mental health situation).
o Right to Access to Healthcare Services.
o Right to free of cost healthcare services.
o Right to live in a community.
 o Right to protection from cruel, inhuman and degrading treatment.
o Right not to be treated under prohibited treatment.
o Right to equality and non-discrimination.
o Right to information.
o Right to confidentiality.
o Right to legal aid and complain.
 Attempt to Commit Suicide not an Offence:
o A person who attempts to commit suicide will be presumed to be ―suffering
from severe stress‘‘ and shall not be subjected to any investigation or
prosecution.
 The act envisages the establishment of Central Mental Health Authority and
State Mental Health Authority.
7. Procedure of getting and revocation of license of
Mental health act, 1987?
ANS. Section 7. (1) Every person, who holds at the commencement of this Act, a valid
license authorising that person to establish or maintain any psychiatric hospital or
psychiatric nursing home, shall, if the said person intends to establish or continue the
maintenance of such hospital or nursing home after the expiry of the period referred to
in clause (a) of the proviso to sub-section (1) of section 6, make, at least one month
before the expiry of such period, an application to the licensing authority for the grant of
a fresh license for the establishment or maintenance of such hospital or nursing home,
as the case may be.

[Application for license.]

(2) A person, who intends to establish or maintain, after the commencement of this Act,
a psychiatric hospital or psychiatric nursing home shall, unless the said person already
holds a valid license, make an application to the licensing authority for the grant of a
license.
(3) Every application under sub-section (1) or sub-section (2) shall be in such form and
be accompanied by such fee as may be prescribed.
Section 8 On receipt of an application under section 7, the licensing authority shall
make such inquiries as it may deem fit and where it is satisfied that –
[Grant or refusal of license.]
(a) the establishment or maintenance of the psychiatric hospital or psychiatric nursing
home or the continuance of the maintenance of any such hospital or nursing home
established before the commencement of this Act is necessary;
(b) the applicant is in a position to provide the minimum facilities prescribed for the
admission, treatment and care of mentally ill persons; and
(c) the psychiatric hospital or psychiatric nursing home, will be under the charge of a
medical officer who is a psychiatrist, it shall grant a license to the applicant in the
prescribed form, and where it is not so satisfied, the licensing authority shall, by order,
refuse to grant the license applied for:
Provided that, before making any order refusing to grant a license, the licensing
authority shall give to the applicant a reasonable opportunity of being heard and every
order of refusal to grant a license shall set out therein the reasons for such refusal and
such reasons shall be communicated to the applicant in such manner as may be
prescribed
Section 9 (1) A license shall not be transferable or heritable
[Duration and renewal of license]

(2) Where a licensee is unable to function as such for any reason or where a licensee
dies, the licensee or, as the case may be, the legal representative of such licensee shall
forthwith report the matter in the prescribed manner to the licensing authority and
notwithstanding anything contained in sub-section (1), the psychiatric hospital or
psychiatric nursing home concerned may continue to be maintained and shall be
deemed to be licensed psychiatric hospital or licensed nursing home, as the case may
be:-
(a) for a period of three months from the date of such report or in the case of the death
of the licensee from the date of his death, or
(b) if an application made in accordance with sub-section (3) for a license is pending on
the expiry of the period specified in clause (a), till the disposal of such application.
(3) The legal representative of the licensee referred to in sub-section (2), shall, if he
intends to continue the maintenance of the psychiatric hospital or psychiatric nursing
home after the expiry of the period referred to in sub-section (2), make, at least one
month before the expiry of such period, an application to the licensing authority for the
grant of a fresh license for the maintenance of such hospital or nursing home, as the
case may be, and the provisions of section 8 shall apply in relation to such application
as they apply in relation to an application made under section 7.
(4) Every licence shall, unless revoked earlier under section 11, be valid for a period of
five years from the date on which it is granted.
(5) A licence may be renewed, from time to time, on an application made in that behalf
to the licensing authority, in such form and accompanied by such fee, as may be
prescribed, and every such application shall be made not less than one year before the
date on which the period of validity of the license is due to expire:
Provided that the renewal of a licensee shall not be refused unless the licensing
authority is satisfied that –
(i) the licensee is not in a position to provide in a psychiatric hospital or psychiatric
nursing home, the minimum facilities prescribed for the admission, treatment and care
therein of mentally ill persons; or
(ii) the licensee is not in a position to provide a medical officer who is a psychiatrist to
take charge of the psychiatric hospital or psychiatric nursing home; or
(iii) the licensee has contravened any of the provisions of this Act or any rule made
thereunder.
Section 10. Every psychiatric hospital or psychiatric nursing home shall be maintained
in such manner and subject to such condition as may be prescribed.
[Psychiatric hospital and psychiatric nursing home to be maintained in
accordance with prescribed conditions]
Section 11. (1) The licensing authority may, without prejudice to any other penalty that
may be imposed on the licence, by order in writing, revoke the license if it is satisfied
that
[Revocation of license]
(a) the psychiatric hospital or psychiatric nursing home is not being maintained by the
licensee in accordance with the provisions of this Act or the rules made there under; or
(b) the maintenance of the psychiatric hospital or psychiatric nursing home is being
carried on in a manner detrimental to the moral, mental or physical well-being of the
inpatients thereof;
Provided that no such order shall be made except after giving the licensee a reasonable
opportunity of being heard, and every such order shall be set out therein the grounds for
the revocation of the license and such grounds shall be communicated to the licensee in
such manner as may be prescribed.
(2) Every order made under sub-section(1) shall contain a direction that the inpatients of
the psychiatric hospital or psychiatric nursing home shall be transferred to such other
psychiatric hospital or psychiatric nursing home as may be specified in that order and it
shall also contain such provisions (including provisions by way of directions) as to the
care and custody of such inpatients pending such transfer.
(3) Every order made under sub-section (1) shall take effect:-

(a) where no appeal has been preferred against such order under section 12,
immediately on the expiry of the period prescribed for such appeal; and
(b) where such appeal has been preferred and the same has been dismissed, from the
date of the order of such dismissal.
Section 12 (1) Any person, aggrieved by an order of the licensing authority refusing to
grant or renew a license, or revoking a license, may, in such manner and within such
period as may be prescribed, prefer an appeal to the State Government:
[appeal]
Provided that the State Government may entertain an appeal preferred after the expiry
of the prescribed period if it is satisfied that the appellant was prevented by sufficient
cause from preferring the appeal in time.
(2) Every appeal under sub-section (1) shall be made in such form and accompanied by
such fee as may be prescribed.
8. What is female Feticide and reasons?
ANS. Female foeticide is the selective abortion of female fetuses. It is a deeply
concerning issue in India. With advancements in medical technologies, it has become
easier to determine the sex of an unborn child. This leads to a rise in sex-selective
abortions targeting girls. This practice stems from patriarchal notions that daughters are
financial burdens.

In this article, we will discuss the Status of Female Foeticide in India, its Causes,
Concerns, and various provisions.

What is Female Foeticide?

The abortion of a female foetus is called female foeticide. Female foeticide is the
abortion of a female foetus. Parents who don‘t want a girl child can use ultrasound
technology to discover the sex of the child while the foetus is still in the womb and
subsequently kill the baby in the womb before it is born.

Introduction
One of the greatest dangers to our contemporary human progress is the threat of
skewed sex proportion. The expanding irregularity amongst males and females is
prompting numerous violations, for example, illicit trafficking of ladies, rapes, polygamy
and dehumanization of society. These crimes have been on an increase making this
world dangerous for women. Female foeticide is a standout amongst the most violent
crimes on this planet; maybe what is wretched is that the general population which
carries out this heinous crime is amongst the affluent ones.

Why does female foeticide take place?

These heinous killings of the girl child are advocated mainly on two grounds. One of
them is the preference culture. Many scholars believe that female foeticide takes place
because of the preference of a male child. They are preferred because they provide
manual labor, are the bread earners of the family and succeed the family lineage. The
selective abortion of a female child is most common in the areas where cultural norm
values a male child over a female child. In a family, son is always considered as an
―asset‖ and daughter, a ―liability.‖

The second reason is the financial burden. In India, it is considered that having a
daughter is a great financial burden. A huge amount of money has to be spent on a
daughter‘s marriage. Sometimes people have to mortgage their property or even have
to sell it for a daughter‘s marriage. They sometimes have to take loans that are paid
even by the future generations. Due to this reason, a daughter is considered as a
financial burden which not many want to bear.

Origin
During the 1970s it was widely accepted that the root to many major social and
economic issues India was facing at the time, was due to its growing population.
However, the preference for a male child was predominant in the Indian families and the
common practice then was of producing multiple children until a male child was born in
the family. This practice was seen as a major threat and the cause for the rapidly
increasing population. Aborting female foetuses was viewed as a viable solution to this
problem by the government hospitals. The equipment and procedures at the time being
complicated and not risk-free, there were not many cases of female foeticide. However,
by the late-1980s and the early 1990s, ultrasound techniques gained popularity
throughout India and the practice of female foeticide soon spread to hospitals all over
India. However soon, this practice was opposed by some activists, and Indian
government passed the Preconception and Prenatal Diagnostic Techniques (PCPNDT)
Act, 1994 making sex-selective abortion illegal. However, merely making it illegal did not
stop it.

Causes

Primary causes

The primary causes of female foeticide in India are patriarchal, safety issues and lack of
education

Patriarchy

Patriarchy refers to a social system in which men hold primary power in all spheres of
life, such as political leadership, moral authority, control of property, family affairs, etc.
Most of the societies in India are patriarchal and most of the patriarchal societies are
patrilineal, meaning that the male lineage inherits the property and title. Centuries of
patriarchy in India has led to oppression of females and eventually to female foeticide
since the early 1990s.

 Gender Discrimination- Centuries of patriarchy has resulted in gender

discrimination in all spheres of life. A girl has not been considered as strong,
as smart, as intelligent as a boy since times immemorial. Girls had not been
 allowed to do work such as join the army and police, do heavy-duty jobs,
catholic priests, driving buses & trucks and professional pilots, business
management, etc. Girls have never been given the real opportunity to make
their families proud of themselves.
 A Girl cannot continue the family lineage- According to the patriarchal
structure of the society, girls tend to leave their parental home after marriage
and move to their matrimonial home. Therefore, it is believed that girls cannot
continue the lineage of the family to which they are born. Not only shall the
family lineage come to an end, but also, the parents shall be left on their own
during their old age.
 The desire of a boy/ son- A boy/son is considered to be a prized possession
and a status symbol in the Indian society. It is a prevalent ideology that he will
increase the size of the family, be the bread-earner for the entire family and
will take care of his parents till their last breath. The desire to procure a son is
one of the main causes of female foeticide. Unnecessary and consistent
tampering of the religious ideologies has led to the misconception that birth of
a boy is a path to heaven. Facing the brunt of such faulty ideas, girls are
considered inauspicious and worthless and are therefore killed in the womb.
 Dowry system- The ill-practice of dowry has very deep roots in the India
society. A daughter has been looked at as a liability because of the dowry
system. The day a girl is born in a family, parents start to worry about the
dowry they will have to pay during her marriage and start gathering things and
money for her marriage, from the very beginning. Excessive demands for
dowry by the in-laws and the subsequent failure on the part of girl‘s parents to
fulfil such demands lead to the girl being subjected to continuous harassment
and torture. To free themselves of such burden and distress, families resort to
killing the girls inside the womb.
In the case of the State of H.P. v. Nikku Ram and others, a two-Judge Bench of the
Supreme Court has expressed its agony thus: –

―Dowry, dowry and dowry. This is the painful repetition which confronts, and at times
haunts, many parents of a girl child in this holy land of ours where, in good old days the
belief was : “Yatra Naryastu Pujyante ramente tatra dewatan” (where woman is
worshipped, there is abode of God).”

 Alien money (Paraaya Dhan)- Girls are considered as ‗paraaya dhan‘ by

many parents. They believe that money spent on the upbringing of a girl is
total misspending as she will go to her matrimonial home after her marriage.
She is considered to be the property of her future in-laws, who will consume
various resources of her parental house, but will provide no returns to them.
To prevent the wastage of resources of the family, female foeticide is
considered a viable act.
Safety issues

Increase in the number of crimes against women with the invasion of India by various
intruders, became a cause of concern for families having a girl child. Females have
borne the brunt of the declining standards of humanity, respect and demeanour. Eve
teasing has become a frequent activity throughout India. Many boys tease girls when
they find them alone or even in public places. They pass bad comments regarding their
dresses, characters, physical appearances, etc. Heinous crimes such as sexual
harassment and rape of women, have become common in India. Protection of females
is a major concern of the society. The fear of such crimes being committed with one‘s
own daughter prove detrimental for some families and therefore, they find, killing the
female foetus in the womb of the mother itself, a better option.

Lack of education

Even till date more than 25% of the Indian population continues to be illiterate. Lack of
education among Indians has proven to be detrimental for the development on the
social and psychological front.

The above graph represents the wide disparity between the male and female literacy
ratios and this disparity continues to exist even today. Ill-practices like female foeticide
still prevail in India because due to lack of education, people continue to believe in faulty
ideas.

Secondary causes

Secondary causes of female foeticide in India are as follows:-

 Misuse of Ultrasound technology– The Ultrasound technology was

introduced in India in the early 1990s. Ultrasound scanning machines can be
used to fetch a lot of useful information about the early foetus growth during
the pregnancy. Unfortunately, many IVF specialists started to misuse this
technology to check the sex of the foetus and then abort the unwanted female
foetus.
 Corruption in the Medical Field- Corruption is also a factor responsible for
female foeticide. The medical profession which was once an honest and
respected field of work became corrupt with the passage of time. In an
attempt to satisfy their greed, doctors started taking a lot of money to check
the gender of the foetus using the ultrasound scan technology and then for
abortion of the unwanted female foetus.
 Consequences of female foeticide
As the Newton‘s Third Law of Motion states, ‗for every action, there is an equal and
opposite reaction‘, the after effects of this genocide are fatal and have long term effect.
It is a disaster that many have unwittingly invited in everybody‘s life. Repercussions of
female foeticide are long-term and disastrous in nature. Some of them are-

1. Skewed Sex Ratio

In India, the number of girls per 1000 boys is reducing with each passing decade. From
962 and 945 girls for every 1000 boys in the years 1981 and 1991 respectively, the sex
ratio had plunged to an all-time low of 927 girls for 1000 boys in 2001.

2. Female/Women Trafficking

The sharp decline in the number of girls makes them sparse for the increasing number
of eligible males for marriage. Due to this reason, illegal trafficking of women has
become prevalent in many regions. Women, often young girls who‘ve just hit puberty,
are forced to marry for a price settled by the groom to be. They are normally bought
from neighboring areas, where the number of girls might not be as minuscule as the
host region. Child marriages have become a rage and child pregnancies, a disastrous
consequence.

3. Increase in Rape and Assault

Once women become an imperiled species, it is only a matter of time before the cases
of rape, assault and violence become common. Due to the decline in availability of
females, the surviving ones are faced with the reality of handling a society driven by a
testosterone high. The legal system might offer protection, but many cases might not
even surface because of the fear of desolation and humiliation on the girl‘s part.

4. Population Decline

With no mothers or wombs to bear a child (male or female), there would be fewer births,
leading to a rapid reduction in the country‘s population. Though a control in population is
the goal of many nations like China and India, a total wipe-out of one sex is certainly not
the way to achieve this goal.
Laws that makes female foeticide illegal
Due to all these causes and implications of female foeticide, many laws have been
passed from time-to-time to control this menace.

India passed its first abortion-related law in 1971, the so-called Medical Termination of
Pregnancy Act, which made abortion legit in almost all states of the country, but it was
particularly made for the cases of medical risk to the mother and child conceived by
rape. The law had also established physicians who could legally perform the abortion in
the said scenarios. But the government had not considered the possibility of female
foeticide based on technological advances. Due to this reason, this law proved to be
highly ineffective.

During the 1980‘s, sex screening technologies in India was easily accessible to the
common people. Due to this reason, a large number of reports started pouring in about
the abuse of the sex screening technologies. Considering this problem, the
Government passed the Pre-natal Diagnostic Techniques Act (PNDT) in 1994. This law
was again amended due to various reasons, and it finally became Pre-Conception and
Pre-natal Diagnostic Techniques (Regulation and Prevention of Misuse) (PCPNDT) Act
in 2004. Its main goal was prevention and punishment of prenatal sex screening and
female foeticide.

Implementation of the Law

Many important changes were made in the PCPNDT Act, 2004. It brought ultrasound
and amniocentesis under its ambit. It also led to the empowerment of the Central
Supervisory Board and the formation of State Level Supervisory Board. The rules,
regulations, and punishments are made more stringent.

Despite all these changes, it has been said that the implementation of this act has
turned into a farce. It has been nearly two decades since the law came into force and
despite this, not many changes have taken place in the society. Despite rulings given by
the Supreme Court and various High Courts to make the existing law an impediment,
the courts have shown their hesitancy in sending the offenders off to jail. The convicts in
many cases have been let off only by a mere warning by the judge which has led to a
mass negative reaction from the legal fraternity as well as social and academic activists.
Lawyers and activists have unanimously demanded stringent punishment for the guilty
while also fixing the accountability of the competent authorities handling the cases of
sex detection[2].
Judicial pronouncement

The Judiciary has played and continues to play a vital role in the prevention of atrocities
against women, in general, and female foeticide, in particular.

In the landmark case of Centre For Enquiry Into Health And Allied Themes (CEHAT) v.
Union Of India & Others, petitioners concerned about the implementation of the Act,
moved the Union of India to Court for effective implementation and execution of the
provisions of the Pre-Natal Diagnostic Techniques Act, 1994, which had failed at
achieving its goals of preventing female feticide. The court warned the Centre, States
and Union Territories to effectively comply with the mandates of the Act and also
clarified to the appropriate authorities that it was empowered to take criminal action
against violators. The Court directed for amendment of the Act in view of emerging
technology and the Act was amended in 2003 to Pre-conception and Pre-natal
Diagnostic Techniques (Prohibition of Sex Selection) Act, 1994.The Court also directed
the formation of the National Committee (National Monitoring and Implementation
Committee— NMIC) to monitor the implementation of The Act.

The constitutionality of The PCPNDT Act, 1994 was challenged in Vinod Soni & Anr. v.
Union of India on the ground that it violates Article 21 of the Constitution to the extent it
includes the liberty of choosing the sex of the child. The petition was dismissed by the
Bombay High Court and the Act was held constitutional.

In the case of Voluntary Health Association of Punjab v. Union of India, Petitioner filed a
writ petition before the Supreme Court of India to examine the ways in which the Indian
state governments have addressed the problem of sex-selective abortion in India. The
Court determined that states failed to effectively implement or enforce the Pre-
Conception and Pre-Natal Diagnostic Techniques (Prohibition on Sex-Selection) Act,
1994. Justice K.S. Radhakrishnan issued several orders and directions to map out
unregistered clinics to ensure they did not purchase ultra-sonography machines, seize
illegally sold ultrasonography machines, and hold workshops to inform communities
about the Act‘s obligations. Justice Dipak Misra observed that, in order to enforce these
laws effectively, the awareness campaigns must encompass social and moral impetus
for the Act in order to serve the purpose of implementing legislation effectively and to
maintain ―humanism‖ and also that, for The Act to be successful the society must be
made aware of the equal role of women in society.

Government schemes
Both the Centre and State governments have initiated a range of girl child welfare
schemes with an object of changing the social attitude towards the girls and for their
upliftment. Following are a few such schemes:-
 1. Beti Bachao Beti Padhao- It is a central government scheme to save the girl
child from sex- selective abortions and advance the education of girl children
all over the country. Intitially, the districts having low-sex ratio were targeted.
2. Balika Samriddhi Yojana- It is a scholarship scheme designed to provide
financial aid to young girls and their mothers below the poverty line. The key
objective of the scheme is to improve their status in society and improve the
enrollment as well as retention of girls in schools.
3. CBSE Udaan Scheme- It is administered by the Central Board of Secondary
Education through the Ministry of Human Resource Development,
Government of India. This scheme focuses mainly on increasing the
enrolment of girls in engineering and other technical colleges throughout the
country.
4. Ladli Scheme of Haryana- It is a cash incentive scheme initiated by the
Haryana Government that provides a payout of Rs. 5000 annually for a period
of 5 years to families with a second girl child born on or after 20th August
2015. The money is deposited in a Kisan Vikas Patra. These deposits along
with interest are to be released once the concerned girl child becomes a
major.
5. Karnataka Bhagyashree Scheme- It is a Karnataka government scheme
designed to promote the birth of girl child among families below the poverty
line. Health insurance cover up to a maximum of Rs. 25,000, is provided to
the girl child, annually.

Effectiveness
Despite rulings given by the Supreme Court and various High Courts to make the
existing law a practical reality, the implementation of this act has turned into a farce.
The legality of Medical Termination of Pregnancy Act, 1971 allows for abortions where
pregnancy carries the risk of grave injury to women‘s health, therefore, making
Ultrasound machines continued to be widely available throughout the country. In such
an environment it is very difficult to enforce a law which seeks to control data that
whizzes through informal channels and can exercise discreetly.

The various government initiated schemes for the welfare of the girl child focus on the
people below poverty line and therefore, fail to incentivize the prevention of sex-
selective abortion in comparatively well-off families. Most of the schemes focus on cash-
incentives, but the money given out in this regard is actually fuelling the dowry demand.
The greed being limitless, the demands are insatiable.
Suggestions
Following are some suggestions to check the evil of female foeticide:

1. There is a need to properly implement, not only the laws prohibiting sex-
selective abortion, but also, the laws combating various causes of female
foeticide, such as
o The Dowry Prohibition Act, 1961
o Protection of Children from Sexual Offences Act, 2012
2. However, the statutes are not an absolute solution to prevent this practice of
female foeticide. To prevent this practice public awareness is essential and no
awareness campaign can ever be complete unless there is real focus on the
genius of women and the need for women empowerment.
3. Medical professionals can play an important role by informing and counselling
their patients regarding the gender equality and the impact that a skewed sex
ratio has on the society. Women should be made aware about their rights and
the ill-effects of abortion.
4. More and more States should follow and come up with new ideas such as
U.P. government‘s ‘Mukhbir Yojana’, launched in 2017. Under this scheme
the government provides an incentive of up to Rs 2 lakhs to any person who
would alert the state authorities regarding the involvement of any doctor or a
medical staff in sex determination of the foetus and/or female foeticide.
5. Women empowerment projects, such as Project Shakti and Project Asha
Daan by HUL, Sakhi project by Hindustan Zinc, Underprivileged Girl Child
Education by DB Corp. Limited, etc should be encouraged under the
Corporate Social Responsibility of the business firms.
6. Governments should initiate schemes focusing on the well-off strata of the
society and providing incentives other than cash.

Conclusion
Through many mediums, awareness about female foeticide is being spread throughout
the nation. Let it be plays, soap operas, mass awareness programs, ads, endorsement
by various celebrities, Beti Bachao campaign, rallies, posters, etc. Everyone is trying to
spread the message everywhere. Despite all these efforts, the sex ratio of our country
is not improving.
9. What is Organ Donation and salient feature,
Transplant Procedure.

ANS. Organ donation is when you decide to give an organ to save or transform
the life of someone else.

You can donate some organs while you are alive, and this is called living organ
donation.

However, most organ and tissue donations come from people who have died.

Key facts

 An organ transplant involves removing an organ from a donor and putting it into
someone who is unwell with organ failure.
 Organs and tissues that can be transplanted include the heart, lungs, kidneys,
liver, skin and parts of the eye.
 Most organs are donated after a person dies, but you can donate a kidney or part
of your liver while you‘re alive.
 After having a transplant, you will need to take medicines and be monitored for
the rest of your life, to prevent your body rejecting your new organ.
 Anti-rejection medicines (immunosuppressants) increase your risk of infections
and cancers.
 What is an organ transplant?
 An organ transplant involves removing an organ from a person‘s body and
putting it into someone who may be very ill or dying. It can save the life of the
person who receives the organ.
 The person who gives the organ is called the donor. The person who receives
the organ is called the recipient.
 Types of organ and tissue transplants
 Organs that can be transplanted in Australia include the heart, kidneys, liver,
lungs, intestine and pancreas.
 Body tissue can also be transplanted, including heart valves, bone, tendons,
ligaments, skin, parts of the eye, and bone marrow.
When is a transplant needed?
You may need an organ transplant if one of your organs is not working any more. For
example, you might need:

 a heart transplant if you have heart failure

 a lung transplant if you have cystic fibrosis or emphysema
 a kidney transplant if you have kidney failure
 a liver transplant if you have liver failure
 a pancreas transplant if you have diabetes

An organ transplant is usually only considered after all other treatments have failed and
your medical specialists believe you will benefit from a transplant. This is because there
are not enough of organs available for transplant. Also, receiving an organ transplant
carries risks and has lifelong consequences for your health.
Tissue transplants
A tissue transplant can improve your quality of life. For example:

 If you are going blind, a corneal transplant might help you see.
 If you have an injury, it might be fixed with a bone or tendon transplant.
 If you have suffered severe burns to a sensitive area of skin, it might be repaired
with a skin transplant.

Bone marrow transplants

Bone marrow contains stem cells that make blood cells. If you have a blood cancer
such as leukaemia, a bone marrow transplant can help you make healthy blood cells.

Who can donate organs and tissue?

In Australia, you can donate organs if you die in hospital with healthy organs. Your
family will need to give permission for this.

If you‘re healthy, you can donate a kidney or part of your liver, bone or bone marrow
while you are alive. A living donor is usually a relative or close friend of the person who
needs the transplant. Sometimes, people donate a kidney or tissue to someone they
don‘t know.

Should I have a transplant?

Whether or not you receive an organ transplant is for you and your healthcare team to
decide. It is important to understand your health condition and ask your doctor about the
potential benefits and risks of an organ transplant.

To learn about your choices and what may lie ahead, you might ask your healthcare
team the following questions:

 How long will I need to wait for the organ transplant?

 What are the alternatives to having a transplant?
 What will happen during the procedure?
 What can I expect immediately after the transplant? What can I expect a few
weeks or months after the transplant?
 How much will the transplant cost?
 What treatments will I need after the transplant?
 How long will the transplanted organ last for? What is my life expectancy with a
transplant?

Impact on your emotions

An organ transplant can affect how you feel. It‘s normal to experience many different
emotions. You might feel stressed about possible organ rejection, or feel sad and
anxious as a side effect of your medicines. You might find it difficult to adapt to your
new situation.

It may help to speak with your healthcare team about how you feel following the
procedure. You may also want to meet other people who have had an organ transplant.

Life after an organ transplant

Recovery from transplant surgery
After surgery, you will be in hospital for a week or longer.

Once you go home, you‘ll have regular appointments to check how your transplanted
organ is working. At first, you might have appointments every day. They will become
less frequent as time goes on.

You will usually be advised not to drive or lift anything heavy while you‘re recovering. It‘s
also best to avoid alcohol at first — ask your doctor when it‘s safe to have a drink.

Medicines
If you have had an organ transplant, you will need to take medicines and have regular
medical appointments for the rest of your life. This will help you stay healthy and avoid
organ rejection.

Rejection occurs when your body sees the transplanted organ as ‗foreign‘ and attacks it.
Anti-rejection medicines (also called immunosuppressants) control your immune
system to stop this from happening. However, anti-rejection medicines can cause side
effects and increase your risk of infections and some cancers. You and your healthcare
team will need to work together to balance these risks.

It‘s very important to take your medicines every day and never miss a dose.

Preventing infections
To reduce your risk of infections, it‘s important to:

 wash your hands frequently

 prepare and handle food safely
 avoid unpasteurised milk and undercooked meat, fish or eggs
 keep open wounds covered
 take preventative antibiotics as advised by your doctor
Maintaining a healthy lifestyle
It is also important to live a healthy lifestyle to stay well and help your transplanted
organ last as long as possible. This includes:

 eating healthily
 not smoking
 getting enough physical activity

To reduce your risk of cancer, ask your doctor about screening tests and symptoms to
look out for. Take care to protect your skin from the sun.

Resources and support

If you have had an organ transplant, you can contact your healthcare team with any
questions. To find out more about living with a transplant, visit Transplant Australia,
which supports transplant recipients, donors and their families. They also run physical
activity programs which increase survival rates in transplant recipients.

To find out more about organ or tissue donation or to register as a potential donor,
visit DonateLife. Registering is easy and only takes a few minutes.

The healthdirect website offers further information about heart transplants, kidney
transplants and corneal transplants.

SALIENT FEATURE EXPLAIN BY SELF

Procedure Details

How does the organ donation process work?

The process for deceased organ donation begins with consent and ends with a surgical
organ transplant. Here are the steps:

1. Identifying an eligible donor

Eligible organ donors have been declared deceased by a cause that didn‘t damage their
organs. Usually, they‘ve had a catastrophic brain injury that caused brainstem death, or
they died by sudden cardiac arrest. In these cases, the hospital can preserve their
organs after their death through mechanical ventilation. Medical specialists from the
U.S. Organ Procurement and Transplantation Network (OPTN) evaluate the person‘s
medical status and history to determine whether they can be a donor.
2. Obtaining consent

Many organ donors decide before their death to donate organs after their death. The
OPTN maintains a national database of registered organ donors. After confirming an
eligible donor, they‘ll check their database to see if they‘re registered. If they are, they‘ll
inform their family of their consent to donate. If they‘re not, they‘ll consult with their
family about the opportunity for donation, taking time to answer all their questions. Their
family may choose at this time to donate their organs on their behalf.

3. Matching donors to recipients

The next step is to match donor organs and tissues with the people who need them.
This is mostly a computerized process. The OPTN enters information on the donor‘s
blood type, body size and available organs and tissues into their computer system. The
system will find the closest match possible from its database of hopeful recipients. First,
it matches organs to potential recipients based on physical factors. Next, it ranks the
priority of the potential recipients based on their need, and lastly, their location.

4. Coordinating the transplant

Once a recipient has been identified, their transplant center will receive an electronic
notification offering the donor organ. The transplant team will make the final decision on
whether to accept the organ for their patient. If they accept, they‘ll coordinate the
logistics with the host Organ Procurement Organization (OPO). They‘ll arrange for
operating rooms to be available for both donor and recipient as soon as possible. Then
they‘ll coordinate the arrival and departure of the transplant surgery teams.

5. Recovering the organs

A specialized surgical team recovers organs and tissues from the donor in a respectful,
formal procedure. By federal law, it‘s a different medical team from the one that cared
for the donor at the end of their life. They‘ll leave the donor‘s body in fit condition for the
funeral procedure of their or their family‘s choice. It‘s possible to have an open casket
funeral after organ donation. The team will preserve the organs in special containers
and deliver them to the recipient‘s transplant hospital.

6. Organ transplantation

The organ recipient should be waiting at their transplant hospital when the donor organ
arrives. They‘ll have surgery as soon as possible, while the organ is still viable. Organ
transplant surgery is complex and can take several hours. Some organs are only viable
for six hours after being removed. When the transplant is complete, the OPO follows up
with the family and healthcare team of the donor to let them know. The donor‘s and
recipient‘s identities remain anonymous unless they choose to share them.
10. Unclaimed Bodies Procedure of human Organ and
tissue Transplantation act,1994
ANS. 5. Authority for removal of human organs in case of unclaimed bodies in
hospital or prison.-- (1) In the case of a dead body lying in a hospital or prison and
not claimed by any of the near relatives of the deceased person within forty-eight
hours from the time of the death of the concerned person, the authority for the removal
of any human organ from the dead body which so remains unclaimed may be given, in
the prescribed form, by the person in charge, for the time being, of the management or
control of the hospital or prison, or by an employee of such hospital or prison
authorised in this behalf by the person in charge of the management or control
thereof.

(2) No authority shall be given under sub-section (1) if the person empowered to give
such authority has reason to believe that any near relative of the deceased person is
likely to claim the dead body even though such near relative has not come forward to
claim the body of the deceased person within the time specified in sub-section (1).
 11. Meaning of HIV and Prevention rules law.

ANS. Introduction
An infection caused by the Human Immunodeficiency Virus (HIV) which produces a
series of conditions(influenza-like illness) is called Acquired Immunodeficiency
Syndrome (AIDS). If you catch the virus, then the symptoms may not be visible or there
may be a short period of influenza-like illness. Internally, the virus attacks your immune
system, which could further lead to diseases like Tuberculosis, as well as other
infections or rare tumours. These symptoms are usually discovered late and can also
result in weight loss due to the degradation of health.

Unprotected sex, contaminated blood transfusions, hypodermic needles, from mother to

child during delivery, pregnancy or breastfeeding are the main reasons for the spread of
the disease. Some of the myths of the spread of AIDS is that fluids such as saliva, tears
and sweats spread HIV. There are some prevention methods, to name a few are as
follows:

1. Safe Sex.
2. Giving treatment to those who are infected and then pre and post-exposure
prophylaxis.
3. There is a child antiretroviral medicine that can be given both to the mother
and child. As such, there is no vaccine for AIDS/HIV but after giving such
medicines the life expectancy can be increased, nearly to a normal life span.
Treatment is very important for AIDS/HIV otherwise the life expectancy can be a
maximum of 11 years after being infected.

For controlling the spread of the virus and safeguarding the rights of the infected
people, the Human Immunodeficiency Virus and Acquired Immunodeficiency Syndrome
(Prevention and Control) Act, 2017 was passed on 20th April 2017 by the Parliament.
Lawyers Collective, a non-governmental organization, sent it as a draft bill to
the National AIDS Control Organization. The main goal of the Act is to stop the
discrimination against the infected people and to spread awareness regarding the
illness and its spread.

Objective and scope of the Act

The objectives and scope of the Act are as follows:

1. To stop the stigma revolving around HIV or AIDS.

 2. To stop discrimination involving HIV or AIDS.
3. To punish people who are involved in the stigma development and
discrimination involving HIV or AIDS.
4. To provide equal rights and opportunities to the infected people.

Issues and challenges

There are many issues revolving around the Human immunodeficiency virus (HIV) and
Acquired immunodeficiency syndrome (AIDS). Some are as follows:

1. There is a lot of stigma and discrimination around HIV and AIDS. A good
amount of emphasis should be laid upon the stigma around HIV and AIDS
because it affects a person mentally. The discrimination faced by infected
people in public facilities, the workspace, household, etc was criminalised by
the Act, and they were provided with insurance rights. But there was no
improvement in the reduction of stigma revolving around HIV and AIDS and
the views of the people in 2016 were as same as they were in 2006. Even
after a decade, the mindset of the people has not changed. They are
discriminated against everywhere and it is still prevalent. The women patients
are still prohibited from living with their children and mostly the infected
people were not allowed to share the same household. People usually
thought that they were suffering because they deserve this.
2. One of the most important issues of HIV and AIDS is gender inequality.
Women suffer the most because of the gender imbalance between men and
women. They face violence from their intimate-partner which can also include
sexual violence. In India, according to a study, one in five women face sexual
violence which can end up men not wearing a condom. This situation leads
women to become prone to HIV. The stigma revolving around HIV and AIDS
does not even spare children. Children born with AIDS are not allowed by
their parents to get the diagnosis because of the pressure from society.
3. Data issues are also one of the problems of HIV and AIDS. A proper analysis,
more efficient access and applied use of data is the need of the hour. We are
lagging behind in many ways which are basically regarding quality database,
a lack of structure, key population size estimates, and there is also the
incompetent staff who is unable to monitor the epidemic.
4. HIV testing kits, distribution of ARVs (medication of HIV) and other HIV
commodities have also not been in great supply.
Key provisions of the Act
The provisions of the Act are as follows:

1. The discrimination faced by infected people is prohibited in this Act. This Act
prevents the spread of HIV and AIDS.
2. Without the permission of the concerned person, no HIV test, medical
treatment, or research can be conducted.
3. There is a right to reside in a shared household mentioned in the Act for the
infected person who is below the age of 18.
4. Any person engaged in the publication and advocacy of hate against any
infected person is prohibited against this act.
5. There should be an ombudsman in every state so that he/she can look after
the complaints and necessities regarding HIV and AIDS.
6. A person who is found to spread hatred against any infected person would be
punished with a minimum of three months to a maximum of two years
imprisonment with a fine which may extend up to one lakh.
7. For every infected person, Antiretroviral Therapy (ART) is a legal right.
8. Any person who has been tested positive would qualify for ‗test and treat‘
policy where he will be treated free of cost.
9. HIV prevention, testing, treatment and counselling services are rights of every
infected person under a State‘s guardianship.

Benefits of the Act

1. The Act empowers a person living with HIV to disclose discrimination in

housing, health care, education, public services, property rights, public office
keeping and insurance.
2. It forbids the exclusion of an HIV-positive person from segregation. Every
HIV-person has the right to live in a shared household and use non-
discriminatory facilities.
3. The act reads: ―No person shall, by the expression, either spoken or written,
print, spread, promote or convey the feelings of hatred against any protected
persons or community of protected persons by signs or visible
representations or otherwise.‖
4. No person affected by HIV may undergo medical care, medical procedures or
study without informed consent under the law. Furthermore, without her
 consent, no HIV-positive pregnant woman can be subjected to sterilisation or
abortion.

Penalties on violation of the Act

The penalties faced by people who violate the Act mentioned under Chapter XIII
are as follows:

1. If Section 37 of the HIV and AIDS (Prevention and Control) Act, 2017 gets
violated, the person would be punished with a term of not less than three
months imprisonment to a maximum imprisonment of two years with fine
which may extend to one lakh rupees or both.
2. If a person violates the orders of the ombudsman as mentioned under Section
26 of the Act then he has to pay a fine of up to ten thousand and if he fails to
pay the fine then he has to pay a fine of five thousand every day till he pays
the fine.
3. An individual will be penalised with a fine that can stretch up to one lakh
rupees if he discloses an infected person‘s HIV status without his or her
permission or without a court order, or violates the ombudsman‘s order and
without testamentary guardianship.
4. No person shall subject any other person or persons to any detriment on the
grounds that such person or persons have taken any of the following actions,
namely:

i.made a complaint under this Act;

ii.brought proceedings under this Act against any person;
iii.furnished any information or produced any document to a person exercising any
power or function under this Act; or
iv.appeared as a witness in a proceeding under this Act. Notwithstanding anything
contained in the Code of Criminal Procedure, 1973, offences under this Act
shall be cognizable and bailable.

Role of Central and state governments to ensure relief to infected people

The role played by the Central and state government to ensure relief to infected
people are as follows:

1. Better welfare schemes for the infected people are ensured by the Central
government and every state government.
 2. The property of the infected people will be protected by the central and every
state government.
3. HIV and AIDS-related information, education and communication
programmes which are age-appropriate, gender-sensitive, non-stigmatising
and non-discriminatory programmes have been made by the state and
Central government.
4. Infected children would be taken care of by the Central government under the
set of guidelines for care, support and treatment.
5. The Central government makes sure that without consent, an infected
pregnant woman is not be subjected to sterilisation or abortion.

How does the Act prohibit discrimination against an infected person?

There are various penalties mentioned in the Act regarding discrimination against an
infected person. The penalties have been discussed above. There are certain criteria for
giving the penalty.

 If an infected person is treated unfairly during their employment

 If the infected person(below the age of 18 years) has been denied the right to
reside in a shared household.
 If an infected person has been treated unfairly in healthcare services.
 If an infected person has been treated unfairly at the residing or renting
property.
 If an infected person on a personal or a professional level has been handled
unfairly.
 Where an infected person is handled unfairly in the provision of insurance.

Overview

Human immunodeficiency virus (HIV) is an infection that attacks the body‘s immune
system. Acquired immunodeficiency syndrome (AIDS) is the most advanced stage of
the disease.

HIV targets the body‘s white blood cells, weakening the immune system. This makes it
easier to get sick with diseases like tuberculosis, infections and some cancers.

HIV is spread from the body fluids of an infected person, including blood, breast milk,
semen and vaginal fluids. It is not spread by kisses, hugs or sharing food. It can also
spread from a mother to her baby.
HIV can be treated and prevented with antiretroviral therapy (ART). Untreated HIV can
progress to AIDS, often after many years.

WHO now defines Advanced HIV Disease (AHD) as CD4 cell count less than
200cells/mm3 or WHO stage 3 or 4 in adults and adolescents. All children with HIV
younger than 5 years of age are considered to have advanced HIV disease.

Signs and symptoms

The symptoms of HIV vary depending on the stage of infection.

The disease spreads more easily in the first few months after a person is infected, but
many are unaware of their status until the later stages. In the first few weeks after being
infected people may not experience symptoms. Others may have an influenza-like
illness including:

 fever
 headache
 rash
 sore throat.

The infection progressively weakens the immune system. This can cause other signs
and symptoms:

 swollen lymph nodes

 weight loss
 fever
 diarrhoea
 cough.

Without treatment, people with HIV infection can also develop severe illnesses:

 tuberculosis (TB)
 cryptococcal meningitis
 severe bacterial infections
 cancers such as lymphomas and Kaposi's sarcoma.

HIV causes other infections to get worse, such as hepatitis C, hepatitis B and mpox.

Transmission

HIV can be transmitted via the exchange of a variety of body fluids from people living
with HIV, such as blood, breast milk, semen and vaginal secretions. HIV can also be
transmitted during pregnancy and delivery to the child. People cannot become infected
through ordinary day-to-day contact such as kissing, hugging, shaking hands, or sharing
personal objects, food or water.

It is important to note that people with HIV who are taking ART and have an
undetectable viral load do not transmit HIV to their sexual partners. Early access to
ART and support to remain on treatment is therefore critical not only to improve the
health of people with HIV but also to prevent HIV transmission.

Risk factors

Behaviours and conditions that put people at greater risk of contracting HIV include:

 having condomless anal or vaginal sex;

 having another sexually transmitted infection (STI) such as syphilis, herpes,
chlamydia, gonorrhoea and bacterial vaginosis;
 engaging in harmful use of alcohol and drugs in the context of sexual behaviour;
 sharing contaminated needles, syringes and other injecting equipment and drug
solutions when injecting drugs;
 receiving unsafe injections, blood transfusions and tissue transplantation, and
medical procedures that involve unsterile cutting or piercing; and
 experiencing accidental needle stick injuries, including among health workers.

Diagnosis

HIV can be diagnosed through rapid diagnostic tests that provide same-day results.
This greatly facilitates early diagnosis and linkage with treatment and prevention.
People can also use HIV self-tests to test themselves. However, no single test can
provide a full HIV positive diagnosis; confirmatory testing is required, conducted by a
qualified and trained health or community worker at a community centre or clinic. HIV
infection can be detected with great accuracy using WHO prequalified tests within a
nationally approved testing strategy and algorithm.

Most widely used HIV diagnostic tests detect antibodies produced by the person as part
of their immune response to fight HIV. In most cases, people develop antibodies to HIV
within 28 days of infection. During this time, people are in the so-called window period
when they have low levels of antibodies which cannot be detected by many rapid tests,
but may transmit HIV to others. People who have had a recent high-risk exposure and
test negative can have a further test after 28 days.

Following a positive diagnosis, people should be retested before they are enrolled in
treatment and care to rule out any potential testing or reporting error. While testing for
adolescents and adults has been made simple and efficient, this is not the case for
babies born to HIV-positive mothers. For children less than 18 months of age, rapid
antibody testing is not sufficient to identify HIV infection – virological testing must be
provided as early as birth or at 6 weeks of age. New technologies are now available to
perform this test at the point of care and enable same-day results, which will accelerate
appropriate linkage with treatment and care.

Prevention

HIV is a preventable disease.

Reduce the risk of HIV infection by:

 using a male or female condom during sex

 being tested for HIV and sexually transmitted infections
 having a voluntary medical male circumcision
 using harm reduction services for people who inject and use drugs.

Doctors may suggest medicines and medical devices to help prevent HIV, including:

 antiretroviral drugs (ARVs), including oral PrEP and long acting products
 dapivirine vaginal rings
 injectable long acting cabotegravir.

ARVs can also be used to prevent mothers from passing HIV to their children.

People taking antiretroviral therapy (ART) and who have no evidence of virus in the
blood will not pass HIV to their sexual partners. Access to testing and ART is an
important part of preventing HIV.

Treatment

There is no cure for HIV infection. It is treated with antiretroviral drugs, which stop the
virus from replicating in the body.

Current antiretroviral therapy (ART) does not cure HIV infection but allows a person‘s
immune system to get stronger. This helps them to fight other infections.

Currently, ART must be taken every day for the rest of a person‘s life.

ART lowers the amount of the virus in a person‘s body. This stops symptoms and allows
people to live a full and healthy life. People living with HIV who are taking ART and who
have no evidence of virus in the blood will not spread the virus to their sexual partners.

Pregnant women with HIV should have access to and take ART as soon as possible.
This protects the health of the mother and will help prevent HIV from passing to the
fetus before birth, or to the baby through breast milk.

Antiretroviral drugs given to people without HIV can prevent the disease.
When given before possible exposures to HIV it is called pre-exposure prophylaxis
(PrEP) and when given after an exposure it is called post-exposure prophylaxis (PEP).
People can use PrEP or PEP when the risk of contracting HIV is high; people should
seek advice from a clinician when thinking about using PrEP or PEP.

Advanced HIV disease remains a persistent problem in the HIV response. WHO is
supporting countries to implement the advanced HIV disease package of care to reduce
illness and death. Newer HIV medicines and short course treatments for opportunistic
infections like cryptococcal meningitis are being developed that may change the way
people take ART and prevention medicines, including access to injectable formulations,
in the future.