The MTP Act, 1971 and the PCPNDT Act, 1994 as controls on medical deviance

1. The Medical Termination of Pregnancy Act, 1971

Background. Causing miscarriage was an offence under the Indian Penal Code (sections 312 to 316, now sections 88 to 92 of the BNS), except to save the woman's life. Unsafe abortions by unqualified persons killed many women. On the recommendation of the Shantilal Shah Committee (1966), the Act of 1971 allowed termination by qualified doctors on stated grounds. It was substantially amended by the Medical Termination of Pregnancy (Amendment) Act, 2021, in force from 24 September 2021.

• Protection of the doctor (section 3(1)). A registered medical practitioner is not guilty of any offence if the pregnancy is terminated in accordance with the Act.
• Up to twenty weeks: on the opinion of one registered medical practitioner (section 3(2)(a)).
• Twenty to twenty-four weeks: only for categories of women prescribed by rules (survivors of rape or incest, minors, women whose marital status changes during pregnancy, women with disabilities, and others), on the opinion of two practitioners (section 3(2)(b)).
• Grounds: risk to the woman's life or of grave injury to her physical or mental health, or substantial risk that the child would be born with serious abnormality. Pregnancy caused by rape is presumed to cause grave injury to mental health (Explanation 2); failure of a contraceptive used by “any woman or her partner” may be treated likewise (Explanation 1, which before 2021 referred to a married woman and her husband).
• Beyond twenty-four weeks: no limit where termination is necessitated by substantial foetal abnormalities diagnosed by a Medical Board (section 3(2B)); each State must constitute Medical Boards (section 3(2C)).
• Consent (section 3(4)): the woman's own consent; a guardian's consent for a minor or a mentally ill woman.
• Place (section 4): a government hospital or a place approved by the Government.
• Emergency (section 5): the time limits and the second opinion do not apply where termination is immediately necessary to save the woman's life.
• Privacy (section 5A): a practitioner who reveals the woman's identity is punishable with up to one year.

Deviance the Act controls: abortion by unqualified persons, in unapproved places, beyond the permitted time or without grounds, which falls back under sections 88 to 92 of the BNS. The practitioner's opinion must be formed in good faith; an opinion that is a cover for a fee is no protection.

Courts: in Suchita Srivastava v. Chandigarh Administration, 2009 INSC 1086, (2009) 9 SCC 1, the Court recognised a woman's right to make reproductive choices as part of personal liberty under Article 21. In X v. Principal Secretary, Health and Family Welfare Department, 2022 INSC 740, it held that the rules must be read to include unmarried women in the twenty to twenty-four week category, since the distinction between married and unmarried women has no basis in the Act's purpose, and that a married woman's pregnancy from forced intercourse by her husband may be treated as rape for the purpose of the Act.

2. The PCPNDT Act, 1994

Background. Ultrasound and amniocentesis, meant to detect genetic abnormalities, were used to determine the sex of the foetus and abort female foetuses, producing a sharp fall in the child sex ratio. The Pre-Natal Diagnostic Techniques (Regulation and Prevention of Misuse) Act, 1994 was renamed and strengthened in 2003 as the Pre-Conception and Pre-Natal Diagnostic Techniques (Prohibition of Sex Selection) Act, to cover pre-conception sex selection as well.

• Registration (sections 3 and 18): genetic counselling centres, laboratories, clinics and ultrasound clinics must be registered, and only qualified persons may conduct the techniques.
• Prohibition of sex selection (section 3A), before or after conception.
• Limited purposes (section 4): pre-natal techniques only to detect specified abnormalities (chromosomal abnormalities, genetic diseases, sex-linked disorders, congenital anomalies), and only on stated indications such as the woman's age over thirty-five or a family history.
• Consent and secrecy (section 5): written consent of the woman, and no one may communicate the sex of the foetus by words, signs or any other manner.
• Determination of sex prohibited (section 6).
• Advertisement (section 22) of sex determination facilities is an offence.
• Machinery: the Central Supervisory Board (section 7), State Supervisory Boards, and Appropriate Authorities with Advisory Committees at State and district level (section 17) with powers of search and seizure.
• Offences (section 23): a doctor or owner or employee of a centre who contravenes the Act, up to three years and fine up to ten thousand rupees, and on subsequent conviction up to five years and fine up to fifty thousand. His name is reported to the State Medical Council, which suspends registration when charges are framed and removes his name for five years on conviction, and permanently on a second conviction. A person who seeks sex selection is also punishable (section 23(3)).
• Presumption (section 24): the pregnant woman is presumed to have been compelled by her husband or relatives, who are liable as abettors; she is not punished unless the contrary is proved.
• Section 27: offences are cognizable, non-bailable and non-compoundable.

Courts: in Voluntary Health Association of Punjab v. Union of India, 2016 INSC 1013, the Supreme Court noted the poor enforcement of the Act and issued directions for maintaining records, sealing unregistered machines, speedy disposal of cases and awareness campaigns.

3. Why they are mechanisms against medical deviance: evaluation

• Both statutes make the doctor the gatekeeper and attach professional consequences (loss of registration) as well as criminal ones.
• Enforcement depends on decoy operations and inspection of records; conviction rates under the PCPNDT Act remain low, because the woman, the family and the doctor all have an interest in silence.
• The MTP Act's reliance on doctors' opinion leaves room for refusal by cautious doctors, which drives women back to unsafe providers.
• There is a tension between the woman's reproductive autonomy under the MTP Act and the prohibition of sex-selective abortion; the law resolves it by targeting sex determination rather than abortion.

How this is examined

January 2026: the MTP Act as a mechanism to prevent deviance in the medical profession (10 marks). June 2025: legal control of pre-natal diagnostic techniques (10 marks). February 2025: salient features of the PCPNDT Act (10 marks). For the MTP essay, give the 2021 time limits and opinions, the grounds, the Medical Board, and the protection and its limits. For the PCPNDT essay, registration, section 4 purposes, the prohibitions, the machinery, section 23 penalties with the Medical Council consequence, and the section 24 presumption.