I draw your attention to the distribution and marketing of Mifepristone and Misoprostol by Sun, Cipla and Zydus Alidac Pharmaceuticals. These drugs for abortion are supplied to practising gynaecologists to be given to patients after obtaining their consent. The money is to be collected from the patient by the physician, who in turn turns it over to the drug representative. This is highly irregular, unethical and illegal and cannot be equated with drug dispensing by primary physicians at their dispensary.
Second, the drug is meant for the medical termination of pregnancy (MTP). This must be done according to the MTP Act, 1971, only by an approved physician, in an approved centre and for approved conditions (threat to mother’s life, congenital anomalies, rape-induced pregnancy and pregnancy due to contraceptive failure, the last only in the case of married women).
According to the promotional literature, the pill is to be distributed for abortion at home. This is contrary to the provisions of the MTP Act. It makes no difference that in the consent form circulated by drug companies and to be signed by the patient, the patient agrees to take the pill in the physician’s clinic. According to the MTP Act, a gynaecologist’s consulting chamber is not recognised for the purpose of MTP. In any case, the abortion takes place at home and is not in conformity with the MTP Act. The possibility of failure and profuse bleeding is substantial. This would expose the patient to grave risks, especially in rural settings. The risk is greater for unwed women for whom pregnancy is looked down upon, and who may therefore not contact proper services and may abort and bleed at home. Besides, the pill is being distributed through qualified and unqualified medical practitioners in the country, though under the MTP Act only a practitioner registered with the appropriate Medical Council can terminate a pregnancy. This is virtually marketing murder for paltry monetary gains with the open connivance of medical professionals.
Also, the distribution of full-text articles reproduced from the New England Journal of Medicine, British Journal of Obstetrics and Gynaecology and the Journal of American Medical Women’s Association as promotional material, with or without the permission of the journals and the authors, is unethical. It amounts to lending the name by authors for promotion of a brand/drug and amounts to ‘association’ under the MCI Act.
This marketing strategy to promote the abortion pill as an ‘in-house’ abortion method is dangerous and will claim hundreds of lives in the prevalent health care scenario in India. Unsafe abortion under the garb of MTP is already claiming many lives in the country.
S G Kabra, Indian Institute of Health Management Research, 1, Prabhu Dayal Marg, Sanganer Airport, Jaipur 302 011.