Hon.
Speaker, Sir before entering into the discussion, I would like to submit to you
that you should consider the point of order raised by the senior Member. The
clarification given by the hon. Minister does not have sufficient relation with
Rule 66 of the Rules of Procedure. Even though I support the intention of the
Bill, I would like to submit some suggestions and criticisms which have come
from the various corners of the society and have also been published in the
medical journals. I think the hon. Minister will consider all the suggestions
and the criticism in this regard at the time of clause-by-clause consideration.
All other Members who spoke earlier pointed it out that the Bill excludes120
same sex couples and the live-in couples from accessing ART. The Bill missed an
opportunity to recommend that the reproductive rights, 140 (1) which are internationally and constitutionally recognized as
universal, be extended to live-in couples and same sex couples.160
It
is noteworthy that the eligibility for access to surrogacy under the Surrogacy
(Regulation) Bill includes a medically necessitated condition, but the ART Bill
restricts it only to infertility. It has failed to fully address the right of
donors, especially egg donors. This is despite the fact that hormonal treatment
is necessary for an egg donor, and the procedure for extraction of eggs is
invasive and can potentially be deadly too. The Bill recommends insurance
coverage for the donor for240 12 months and also social security
insurance, the parameters of which are not clear. It also recommends the
payment of maternity benefits to an egg donor who suffers from miscarriage.
This recommendation is really perplexing. Since the donor is not carrying a
pregnancy,280
the question of a miscarriage does not arise. (2) There is no provision for donor compensation or even the
reimbursement of expenses for loss of salary, time, and effort. The labour
involved in producing and sharing biomaterial for the320 benefit of third
parties is not recognised. Any compensation is available only when there is an
untoward medical incident by way of a miscarriage. This is justified in keeping
with the humanitarian nature of the ART Bill. The crucial360 definitions in both the
Bills remain unsynchronised. For example, the Surrogacy (Regulation) Bill does
not define ART clinics or banks. The ART Bill defines these terms. Then, there
are terms defined in the Surrogacy (Regulation) Bill, but not in the ART Bill, like,
fertilisation, implantation, foetus, and sex selection. The definition of
infertility differs between the two Bills. Given the overlap between surrogacy420
and ART procedures, precision in the individual Bills as well as consistency
between the two is critical, especially when it comes to medical terms. Several
stakeholders have criticised the (3) ART
Bill for prescribing long prison sentences with punishment being
disproportionately high in relation to the offence committed. Differential
treatment of defendants who have committed the same offences under480
both the Bills will constitute arbitrary executive action, which is
unconstitutional. The Bill has omitted intervening on significant issues with
constitutional ramifications such as access to ART and compensation for the egg
donor. As some of my previous speakers pointed out, permitting medical tourism
and access for foreigners changes the economics of the ART market. In the
absence of pricing regulation for ART clinics and banks, these organizations
will have unchecked growth and only the wealthiest will be able to access ART.560
It will be very disappointing for millions of people who aspire to form
families but cannot afford to have access to ART. Meanwhile, women who
provision reproductive materials and labour, will continue to be devalued,
uncompensated, and unprotected as600 underground markets for egg donors and
surrogacy would thrive. (4) There is
one more point which is totally missing in the ART Bill. The point is about the rights of children born
out of ART to know their parentage,640 which is crucial to their best
interests, and is increasingly accepted as a norm globally and was protected
under previous drafts of the ART Bill.
Hon.
Speaker, Sir, I stand here to support this Bill. Many previous Speakers have
highlighted many points. While listening to the speech of the senior Member who
spoke before me, I felt like I was sitting in a700 gynaecology class
during my post-graduation days. It is a pleasure that I am here with you all.
Sir, I want720
to make a few points about the Bill. The ART Bill provides for the regulation
and supervision of the ART clinics and banks. So, this Bill is for regulation,
prevention of misuse, safe and ethical practice of ART services and the matters
connected therewith. Sir, this Bill also intends (5) to protect the affected women and children from exploitation, to
support donor with an insurance cover, to regulate multiple embryo implantation
and protect the children born through ART.800 The Bill further aims to regulate
preservation of sperms and embryo by the ART Banks and intends to make
pre-genetic testing mandatory for pre-existing diseases only for the benefit of
the child born through ART. India’s fertility industry is an integral part of840
the country’s growing medical tourism industry which experienced 30 per cent
growth in the year 2000 and 15 per cent growth between the years 2005 and 2010.
Despite so much activity in India, there are no standardisation protocols yet
and reporting is still very inadequate. Furthermore, there are only guidelines
on ART and no law still exists. There has been debate on the medical, ethical
and legal aspects of the ART. That is why, this Bill has come to regulate all
these things. So, to mention a few points, (6)
the Bill provides that every ART clinic and bank must be registered under
the National Registry of Banks and Clinics of India. The National Registry will
be established960 under the Bill and will act as a central
database with the details of all ART clinics and banks in the country.980
State Governments will appoint Registration Authorities for facilitating the
registration process.
Hon.
Chairperson, Sir, a child born through ART will be deemed to be a biological
child of the commissioning couple and will be entitled to the rights and
privileges available to a natural child of a commissioning couple. A donor will
not have any parental rights over the child. These are the few regularisation
points that I wanted to make. The other point is about the establishment of
Boards. With regard to the National Board and State Boards, the Bill provides
that the National Board and State Boards for1080 surrogacy
constituted under the Surrogacy (Regulation) Bill will act as National Board
and (7) State Boards respectively
for the regulation of the ART services also. The key powers and functions of
the National Board include advising the Central Government on ART related1120
policy matters and reviewing and monitoring the implementation of the
provisions of the Bill. Any clinic or bank advertising or offering sex
selective ART will be punishable with imprisonment between five and ten years,
or fine between Rs. 10 lakh and Rs. 25 lakh, or both. No court will take
cognizance of offences under the Bill except on a complaint made by the National
Board or State Boards or by any officer authorised by the Boards.
The
Standing Committee also1200 made some recommendations. The Committee
noted that the cost of ART services varies across clinics. It recommended that
a Standard Operating Procedure should be formulated to ensure the uniform cost
of ART services and there should be adherence to global quality
standards. Further, a monitoring mechanism should be set up under the (8) National Board to prohibit
commercialisation of ART1260 services by the private sector
providers. Sir, I would like to submit that the Bill is a welcome
legislation and the1280 impact of it would be that it
would bring about the registration of all the clinics; it would control
unethical ART practices; it would improve the quality of ART services; it would
facilitate framing of requisite policies as we would be having all the data;
and most importantly, the needy couples would be assured of the ethical
practice of ART. At present, there are only six IVF clinics in the Government
sector while the remaining thousands of IVF centres are in the private sector.
So, the Government should ensure that each medical college or premier
Government hospital or institute must have IVF as part of ART facilities so as
to enable the common poor masses to avail the services of ART.1400
(9) Sir, finally, from our State of
Andhra Pradesh, I would like to highlight that after the bifurcation of State, absence
of tier I cities in the State has resulted in no scope for private healthcare
sector to provide super-speciality1440 healthcare services in the State. This
is only possible through setting up of public sector institutions. Hence, I
would like to request the Government to approve the proposal for setting up of
13 new medical colleges that have been submitted already by our hon. Chief
Minister.
Madam
Chairperson, at the outset I would like to congratulate the hon. Minister for
bringing this comprehensive legislation. It is a good attempt to fill up a
legislative vacuum and a good attempt at providing a legislation for a subject which
is important and which required a legislation. The urge to have a child is
there for religious or psychological reasons because there (10) is a belief that one survives through a child. So, in that
background, people who are not blessed with a child are prone to exploitation
or vulnerable to exploitation. They have been exploited in the absence of a
valid law to regulate ART. It is a right law.1600 It is a step in the
right direction.
