FEDERATION OF OBSTETRICS AND GYNECOLOGICAL SOCIETIES OF INDIA (FOGSI) SECRETARY GENERAL vs. UNION OF INDIA

Case Type: Writ Petition Civil

Date of Judgment: 03-05-2019

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Full Judgment Text

1 REPORTABLE IN THE SUPREME COURT OF INDIA CIVIL ORIGINAL JURISDICTION WRIT PETITION (CIVIL) NO.129 OF 2017 Federation of Obstetrics and Gynecological Societies of India (FOGSI)      ..Petitioner Versus Union of India and others                         ..Respondents J U D G M E N T  Arun Mishra, J. 1. The instant writ petition has been filed by the Federation of Obstetrics   and   Gynaecological   Societies   of   India   (FOGSI) (hereinafter referred to as ‘the Society’) highlighting the issues and   problems   affecting   the   practice   of   obstetricians   and gynaecologists across the country under the Pre­conception and Pre­natal   Diagnostic   Techniques   (Prohibition   of   Sex   Selection) Act, 1994 (hereinafter referred to as ‘the Act’) and challenging the constitutional validity of Sections 23(1) and 23(2) of the Act and seeking   direction   in   the   nature   of   certiorari/mandamus   for Signature Not Verified Digitally signed by NARENDRA PRASAD Date: 2019.05.03 17:08:57 IST Reason: decriminalising anomalies in paperwork/record keeping/clerical errors in regard of the provisions of the Act for being violative of 2 Articles 14, 19(1)(g) and 21 of the Constitution of India.   The Society is the apex body of obstetricians and gynaecologists of the country and is concerned for the welfare of its members. 2. The case set up on behalf of the petitioner­Society is that the   Act   was   enacted   with   the   objective   to   prohibit   pre­natal diagnostic   techniques   for   determination   of   sex   of   the   foetus leading   to   female   foeticide.     But   unfortunately,   its implementation is more in letter and less in spirit.  The problem of sex determination and gender selection is a serious issue and is   one   of   the   biggest   social   problems   faced   by   our   society. Despite enactment of the Act and subsequent amendments, the Child Sex Ratio has not shown significant improvement, hence, putting   sufficient   concern   and   questions   on   the   proper implementation of the Act.  It is contended that equating clerical errors   on   the   same   footing   with   the   actual   offence   of   sex determination shows the inherent weakness in the language of the Act. 3. It   is   further   contended   that   the   Appropriate   Authority appointed   under   the   Act   conducts   inspections   and   raids   in various districts and cities and even if there are mere anomalies 3 in the paperwork, it seals the sonography machine and files a criminal case under the Act.   As a result, doctors who do not conduct   sex   determination   and   gender   selection   are   being targeted   on   the   basis   of   aforesaid   anomalies.     The   inherent infirmity in the Act as it stands currently in its present form amounting to treating unequals as equals.  The Act has failed to distinguish   between   criminal   offences   and   the   anomalies   in paperwork like incomplete ‘F’­Forms, clerical mistakes such as writing NA or incomplete address, no mentioning of the date, objectionable   pictures   of   Radha   Krishna   in   sonography   room, incomplete   filling   of   Form   ‘F’,   indication   for   sonography   not written, faded notice board and not legible, striking out details in the Form ‘F’ etc., thereby charging the members of the petitioner­ Society   for   heinous   crime   of   female   foeticide   and   sex determination and that too merely for unintentional mistakes in record   keeping.     The   Act   provides   same   punishment   for   the contravention   of   any   provision   of   the   Act,   thus   equating   the anomalies in paperwork and the offence of sex determination and gender selection on the same pedestal.  The sealing of machines directly deprives a woman in that vicinity of a critical medical aid and   thereby   putting   the   lives   of   the   women   in   danger.     The 4 unreasonable   sealing   of   the   sonography   machine   not   only impacts the welfare of the women as such, but it also amounts to undue harassment and mental torture of the members of the petitioner­Society. 4. It   is   further   contended   that   the   ambiguous   wording   of Section   23(1)  of   the   Act  has   resulted   in   grave   miscarriage   of justice   and   the   members   of   the   petitioner­Society   have   faced grave hardships and have undergone criminal prosecution for act, which cannot be equated with the acts of sex determination.    5. It is averred that even the smallest anomaly in paperwork which is in fact an inadvertent and unintentional error has made the   obstetricians   and   gynaecologists   vulnerable   to   the prosecution by the Authorities all over the country. 6. Section 23(2) of the Act empowers the State Medical Council to   suspend   the   registration   of   any   doctor   indefinitely,   who   is reported   by   the   Appropriate   Authority   for   necessary   action, during the pendency of trial.   The petitioner­Society submitted that Section 23(2) of the Act is ultra vires the Constitution as it assumes the  guilt of the alleged  accused  even before  his/her conviction   by   a   competent   court   and   hence   violates   the 5 fundamental   right   guaranteed   under   Article   21   of   the Constitution.  7. It is contended that presumption of innocence is a cardinal principle of rule of law for which petitioner­Society has placed reliance on Article 14(2) of the International Covenant on Civil and Political Rights, 1966, which states that everyone charged with   a   criminal   offence   shall   have   the   right   to   be   presumed innocent until proved guilty according to law.  Article 14(2) of the International Covenant on Civil and Political Rights, 1966 reads thus:  “Article 14 1. * 2. Everyone charged with a criminal offence shall have the right to be presumed innocent until proved guilty according to law.” 8. It is contended that the Act fails to distinguish between the cases   of   presence   and   absence   of   mens   rea   during   the commission   of   minor   clerical   mistakes.     Mens   rea   is   not   be presumed   at   the   time   of   taking   cognizance   and   must   be established as held by this Court in   Arun Bhandari v. State of U.P.,  (2013) 2 SCC 801.   6 9. The petitioner­Society has further placed reliance on the decisions rendered by this Court in cases of penal statues to give proper effect to the scheme of the Act concerned and to balance various   interests   involved   by   striking   down/reading   down/ diluting the concerned penal provisions. 10. It   is   further   contended   that   suspension   of   the   medical licence at the stage of framing of charges is highly improper and harsh, which results in loss of livelihood of not only the members of the Society, but also his family as well as the dependents, who are deprived of financial security and well­being.  The vague and ambiguous wordings of Section 23(1) renders Section 25 totally redundant.  11. It is further submitted that Form­F as it stands today does not serve the purpose for which it was made and there is no substantive evidence which proves that errors in Form­F have any   direct   nexus   with   the   offence   of   sex   selection   and determination. 12. Respondent   Nos.1   to   4   has   refuted   the   claims   of   the petitioner­Society altogether.   It is contended that the Act is a social   welfare   legislation   with   a   social   objective   to   prevent 7 elimination   of   girls   before   birth   and   it   is   not   a   general   law providing any general right to practice medicine.   The specific choice of legislature cannot be called arbitrary and is in no way ultra vires  or violative of the Constitution.  The Act is a Central legislation; however, its implementation lies primarily with the States, who are required to enforce the law through the statutory bodies in the State, constituted under the Act.  The Act empowers the   Central   Government   to   regulate   the   use   of   pre­natal diagnostic   techniques.     The   proliferation   of   the   technology   is resulting in a catastrophe in the form of female foeticide leading to severe imbalance in child sex ratio and sex ratio at birth.  The Centre is duty bound to intervene in such a case to uphold the welfare of the society, especially of the women and the children. The   Act   was   enacted   with   a   purpose   to   ban   the   use   of   sex selection   techniques   before   or   after   conception;   prevent   the misuse   of   pre­natal   diagnostic   techniques   for   sex   selection abortions and to regulate such techniques.   It is mandatory to maintain proper record in respect of use of ultrasound machines under   the   Act.     For   effective   implementation   of   the   Act,   a hierarchy of Appropriate Authority at State, District and Sub­ District level is created. 8 13. It is   contended   that  ultrasonography   test  on   a  pregnant woman   is   considered   to   be   an   important   part   of   a   pre­natal diagnostic   test   and   the   person   conducting   such   test   has   to maintain a complete record thereof in the manner prescribed in the rules and a deficiency or inaccuracy in maintaining such records would amount to an offence.   Chapter VII of the Act prescribes offences and penalties and there is no gradation of offences under the Act as it does not classify offences.  Equating the clerical errors on same footing with the actual offence of sex determination is in compliance with the provisions of the Act and rules   thereunder.     The   Act   does   not   differentiate   among   the violations committed by doctors and provides for punishment for all violations under the Act.   The Act prescribes punishment in furtherance   of   its   object   and   purposes   which   is   to   prevent detection of female foetus which is in the larger public interest, hence Section 23 of the Act does not violate Articles 14 and 21. It is further averred that right to practice a profession under Article 19(1)(g) of the Constitution is not an absolute right. 14. It is contended that petitioner­Society in the garb of social cause is trying to mislead this Court and a criminal act cannot be 9 protected under the umbrella of the Article 19.   The offences under  the   Act   are   per  se   criminal   and   no   exemption   can   be sought for criminal violations in the guise of public interest or right to freedom. 15. It   is   contended   that   the   Appropriate   Authority   conducts inspection pursuant to the directions issued by this Court in Centre for Enquiry into Health & Allied Themes (CEHAT) v. Union of India,  (2003) 8 SCC 398, wherein it was directed to constitute National   Inspection   and   Monitoring   Committee   for   conducting inspections.  As the sex determination is hatched in secrecy and committed in privacy and as both the parties are hand in glove with   each   other,   therefore   it   becomes   difficult   to   detect   the commission of the offence, hence traps are usually laid or raids are conducted by the inspecting authorities and sometimes non­ maintenance   of   records   or   incomplete   records   may   provide substantial evidence towards the commission of offence.   It is further submitted that the Act specifically provides for the record keeping   under   Rule   9   of   the   Pre­conception   and   Pre­natal Diagnostic Techniques (Prohibition of Sex Selection) Rules, 1996 (hereinafter   referred   to   as   ‘the   Rules’)   and   any   deficiency   or 10 inaccuracy in record keeping amounts to violation of Sections 5 and 6 of the Act.    16. The respondents contend that record keeping is important for proper implementation of the Act and the stringent provisions with   regard   to   maintenance   of   records   and   punishment   for non­compliance cannot be equated or considered as infirmity of the Act.  If it is exempted from the mandatory requirement, the probably involvement in sex determination and sex selection in the   guise   of   use   of   diagnostic   techniques   would   continue unabated. 17. It   is   also   contended   that   the   purpose   of   Form   ‘F’   is   to maintain personal and medical record of the patient visiting the Pre­Natal Diagnostic Clinic to avail the services and confirmation regarding   the   consent   of   the   patient/pregnant   woman   with regard to the prohibition of communication of the sex of foetus so as to avoid abuse of the technology.   Section 4(3) of the Act requires every Genetic Counselling Centre/Genetic Clinic to fill Form ‘F’.  The filling of Form ‘F’ is commensurate with the objects of the Act which is to regulate the technology and to avoid the abuse of the technology for the purpose of sex determination.  It 11 gives the insight into the reasons for conducting ultrasonography and incomplete Form ‘F’ raises presumption of doubt against the medical   practitioner   and   in   the   absence   of   Form   ‘F’,   the Appropriate Authority will have no means to supervise the usage of the ultrasonography machine and shall not be able to regulate the use of the technique. The non­maintenance of records is not merely   a   technical   or   procedural   lapse   in   the   context   of   sex determination,   it   is   the   most   significant   piece   of   evidence   for identifying   the   accused.   It   is   further   contended   that   clerical errors   in   Form   ‘F’   fall   under   Section   4   of   the   Act   and   any deficiency   or   inaccuracy   found   therein   shall   amount   to contravention of the provisions of Section 5 or 6 of the Act unless contrary   is   proved   by   the   person   conducting   such ultrasonography. 18. It is contended that every aggrieved person, who suffered from   any   procedural   irregularity,   can   avail   legal   remedy   as provided under Section 21 of the Act and Rule 19 of the Rules. 19. The respondents have placed reliance on decision rendered by High Court of Gujarat in  Suo Motu v. State of Gujarat, (2009) 1 GLR 64 , which dealt with the issue of proper maintenance of 12 records and to the decision rendered by High Court of Rajasthan in   S.K. Gupta v. Union of India,   wherein it was observed that female infants have also right to live.  There is right of still born child to be looked after properly during pregnancy.  Once a child is conceived, it has to be treated with dignity.  Such right cannot be denied and practice of female foeticide/infanticide is prevailing at large which is illegal and unconstitutional. 20. The   respondents   have   also   drawn   our   attention   to   the provisions   of   Regulation   1.3   of   the   Indian   Medical   Council (Professional Conduct, Etiquette and Ethics) Regulations, 2002; Regulation   6.2   of   Pharmacy   Practice   Regulation,   2015;   and Transplantation of Human Organs and Tissues Act, 1994, which contains the provisions with respect to maintenance of proper records.    21. It   is   submitted   that   Section   23   and   Section   25   are complimentary to each other, not contradictory as contended by the petitioner­Society.   It is lastly contended that no case for striking down the proviso to Section 4(3) is made out. 22. Shri Soli J. Sorabjee and Shri Shyam Divan, learned senior counsel urged that present is the classic example of unequals 13 being treated as equals.   Due to inherent infirmity in the Act, whereunder   members   of   the   petitioner­Society   are   treated unequally   as   mere   clerical   errors   has   resulted   in   breach   of personal liberties.  The Act fails to classify offence of actual sex determination   vis­à­vis   clerical error in maintenance of record. There is no gradation of offence.   23. The   presumption   of   innocence   ought   not   to   be   disposed away with under the Act.   The same is part of human rights. Presumption   of   innocence   continues   until   conviction.     The provisions of suspension under Section 23(2) is draconian.  Any deficiency or inaccuracy in maintenance of records ought not to amount to contravention under Section 5 or Section 6 and the proviso to Section 4(3) accordingly be diluted.  It may be clarified that contravention of proviso to Section 4(3), Section 29 and Rule 9 or technical lapses attracting minor penalty should not attract Section 27 of the Act.   The provision of Section 23(2) be read down so that suspension should not fall under Section 23(2) in the   case   of   clerical   mistakes   or   inadvertent   technical errors/lapses.     Issuance   of   notice   be   made   mandatory   under Section 20.   No action be taken on technical grounds such as writing   short   forms,   writing   ‘NA’   instead   of   “not   applicable”, 14 writing initials of the doctors etc. while filing up Form ‘F’.  The competent authority should consider each case on merits with the   aid   of   legal   advisor.     Denial   of   renewal   of   registration   of Centre of a running unit on the ground of pendency of criminal trial is illegal and harsh.   There should not be seizure of any equipment etc. as ultrasound machine are necessary for human use.   It is not appropriate to keep such utilitarian instruments sealed. 24. Ms. Pinki Anand, Additional Solicitor General appearing on behalf of respondents countering the submission raised on behalf of petitioner­Society contended that there is alarming decline in the child sex ratio in India and in several districts it is worse as the ratio per thousand is below 800.  She has also relied upon the   purpose   and   legislative   history   of   enactment   of   the   Act including amendments made thereunder and the Rules.   It has been made mandatory to maintain proper records in respect of use of ultrasound machines.  The Act provides for prohibition of sex   selection/determination   as   well   as   regulation   of   pre­natal diagnostic techniques.  The rate of conviction is extremely poor, despite 24 years of the existence of the Act, it is only 586 out of 4202 cases registered, resulting into action against 138 medical 15 licenses.     Emphasis   has   been   laid   by   this   Court   in   several decisions on proper maintenance of records.   Section 23 is the central provision in the  scheme of  the  Act.   Form ‘F’  is  very important as it gives the details and the reasons for conducting ultrasonography and incomplete Form ‘F’ raises the presumption of doubt against the medical practitioner.  Section 23 and Form ‘F’ are inter­linked, thus, the provisions cannot be diluted.  She further contended that the non­maintenance of records is not merely procedural lapse, it is key evidence given the collusive nature   of   the   crime.     There   exist   effective   and   efficacious remedies to the instances cited by the petitioner­Society.   She also   relied   upon   a   case   study   on   record   keeping   as   an implementation tool of Prabhakar Hospital in Panipat.   The Act enjoys a presumption of constitutionality and no case of violation of   fundamental   rights   has   been   made   out   by   the   petitioner­ Society.  The Act is regulatory and is for the wholesome purpose same advances the intendment of other provisions applicable to medical   fraternity,   which   requires   rigorous   maintenance   of records.     Considering   the   wide   prevalence   of   violence   against women   and   children   in   different   forms,   the   Legislature   has enacted several Acts in order to ensure gender justice and to take 16 care of cry of female foetus.  No case for striking down, dilution or issuance of any guidelines is made out by the petitioner­Society. 25. It was urged on behalf of intervenor that Section 28 of the Act makes it clear  that no court  shall take  cognizance  of an offence unless on a complaint made by Appropriate Authority. The   composition   of   Appropriate   Authority   is   provided   under Section 17(3)(a), which is a High­Powered Body.  The Supervisory Board shall review the activities of the Appropriate Authorities as provided under Section 16A(1)(ii).   The Supervisory Committee consists of large body.   Thus, there are adequate safeguards to maintain check and balance provided within the Act. 26. Before   we   dilate   upon   various   aspects,   we   take   note   of provisions of the Act.  The Act was introduced by Parliament with the following Statement of Objects and Reasons: “STATEMENT OF OBJECTS AND REASONS It is proposed to prohibit pre­natal diagnostic techniques for determination of sex of the foetus leading to female foeticide. Such abuse of techniques is discriminatory against the female sex and affects the dignity and status of women.  A legislation is required to regulate the use of such techniques and to provide deterrent punishment to stop such inhuman act. The Bill,  inter alia , provides for:— (i) prohibition   of   the   misuse   of   pre­natal   diagnostic techniques for determination of sex of foetus, leading to female foeticide; (ii) prohibition of advertisement of pre­natal diagnostic techniques for detection or determination of sex; 17 (iii)permission   and   regulation   of   the   use   of   pre­natal diagnostic techniques for the purpose of detection of specific genetic abnormalities or disorders; (iv) permitting  the  use  of such  techniques  only  under certain conditions by the registered institutions; and (v) punishment   for   violation   of   the   provisions   of   the proposed legislation. 2. The Bills seeks to achieve the above objectives.” The concern of the Legislature was that the female child is not welcomed with open arms in most of Indian families and the diagnostic technique is being used to commit female foeticide. 27. The female foeticide is not only the concern of India, but of various countries.   The United Nations General Assembly had adopted Resolution No.52/106 on 11.2.1998 expressing concern about   pre­natal   sex   selection,   female   infanticide   and   female genital mutilation.  The said Resolution also urged all States to enact and enforce legislation protecting girls from all forms of violence, including female infanticide and prenatal sex selection. The   United   Nations   Fourth   World   Conference   on   Women   in September, 1995 adopted the Beijing Declaration and Platform for Action.                 Beijing Declaration and Platform for Action identified “violence against women” to “include forced sterilization and forced abortion, coercive/forced use of contraceptives, female infanticide   and   pre­natal   sex   selection”.     It   further   urged Governments   to   “enact   and   enforce   legislation   against   the 18 perpetrators  of   practices  and  acts   of  violence   against  women, such as female genital mutilation, female infanticide, prenatal sex   selection   and   dowry­related   violence”.     Further   urged Governments to “Eliminate all forms of discrimination against the girl child and the root causes of son preference, which result in harmful and unethical practices such as pre­natal sex selection and   female   infanticide;   this   is   often   compounded   by   the increasing use of technologies to determine foetal sex, resulting in abortion of female foetuses”.                              28. Beijing Declaration and Platform for Action was adopted at th the   16   Plenary   Meeting   of   the   Fourth   World   Conference   on Women   held   on   15.9.1995   at   Beijing.     The   relevant   extract relating to violence against women and actions to be taken is reproduced hereunder: “115.   Acts   of   violence   against   women   also   include   forced sterilization   and   forced   abortion,   coercive/forced   use   of contraceptives, female infanticide and prenatal sex selection. Strategic objective L.2. Eliminate negative cultural attitudes and practices against girls Actions to be taken 276. By Governments: (a)   Encourage   and   support,   as   appropriate,   non­governmental organizations and community­based organizations in their efforts to promote changes in negative attitudes and practices towards girls; (b) (c) 19 (d) Take steps so that tradition and religion and their expressions are not a basis for discrimination against girls. 277.   By   Governments   and,   as   appropriate,   international   and non­governmental organizations: (a) (b) (c) Eliminate all forms of discrimination against the girl child and the root causes of son preference, which result in harmful and unethical practices such as prenatal sex selection and female infanticide; this is often compounded by the increasing use of technologies   to   determine   foetal   sex,   resulting   in   abortion   of female foetuses” 29. The   1994   Programme   of   Action   of   the   International Conference on Population and Development (ICPD) resolved to eliminate all forms of discrimination against the girl child and the root   causes   of   son   preference,   which   result   in   harmful   and unethical practices regarding female infanticide and prenatal sex selection, and also to increase public awareness of the value of the girl child.   Further urged Governments to take necessary measures   to   prevent   infanticide,   prenatal   sex   selection, trafficking of girl children and forcing of girls in prostitution and pornography.   The International Conference on Population and Development   adopted   the   Programme   of   Action   of   the International   Conference   on   Population   and   Development   and th passed   the   resolution   at   the   14   Plenary   meeting   held   on 13.9.1994.   The relevant portion of the aforesaid resolution is extracted hereunder: 20 “4.15. Since in all societies discrimination on the basis of sex often starts at the earliest stages of life, greater equality for the girl child is a necessary first step in ensuring that women realize their full potential and become equal partners in development. In a number of countries, the practice of prenatal sex selection, higher rates of mortality among very young girls, and lower rates of school enrolment for girls as compared with boys, suggest that "son preference" is curtailing the access of girl children to food, education   and   health   care.   This   is   often   compounded   by  the increasing use of technologies to determine foetal sex, resulting in   abortion   of   female   foetuses.   Investments   made   in   the   girl child's   health,   nutrition   and   education,   from   infancy   through adolescence, are critical. Objectives 4.16. The objectives are: (a) To eliminate all forms of discrimination against the girl child and the root causes of son preference, which results in harmful and unethical practices regarding female infanticide and prenatal sex selection; (b) To increase public awareness of the value of the girl child, and concurrently, to strengthen the girl child's self­image, self­esteem and status; (c) To improve the welfare of the girl child, especially in regard to health, nutrition and education. 4.23. Governments are urged to take the necessary measures to prevent   infanticide,   prenatal   sex   selection,   trafficking   in   girl children and use of girls in prostitution and pornography.”  30. The   Resolution   56/139   adopted   by   the   U.N.   General Assembly,   on   26.2.2002   expressed   deep   concern   about discrimination against the girl child, including practices such as female infanticide, incest, early marriage, prenatal sex selection etc.     The   Resolution   also   urged   States   to   enact   and   enforce legislation to protect girls from all forms of violence, including female   infanticide   and   prenatal   sex   selection,   female   genital mutilation, rape, domestic violence, incest, sexual abuse, sexual exploitation,   child   prostitution   and   child   pornography,   and   to 21 develop age­appropriate safe and confidential programmes and medical, social and psychological support services to assist girls who are subjected to violence.  The General Assembly of United Nations   adopted   the   following   resolution   no.56/139   on 26.2.2002: “Deeply concerned about discrimination against the girl child and the violation of the rights of the girl child, which often result in less  access  for  girls  to  education,  nutrition and physical  and mental   health   care   and   in   girls   enjoying   fewer   of   the   rights, opportunities  and  benefits  of childhood  and  adolescence  than boys   and   often   being   subjected   to   various   forms   of   cultural, social,   sexual   and   economic   exploitation   and   to   violence   and harmful   practices,   such   as   female   infanticide,   incest,   early marriage, prenatal sex selection and female genital mutilation. 10.  Also   urges  all   States   to   enact   and   enforce   legislation   to protect   girls   from   all   forms   of   violence,   including   female infanticide and prenatal sex selection, female genital mutilation, rape, domestic violence, incest, sexual abuse, sexual exploitation, child prostitution and child pornography, and to develop age­ appropriate   safe   and   confidential   programmes   and   medical, social and psychological support services to assist girls who are subjected to violence.” 31. Resolution 70/138, adopted by the U.N. General Assembly on   17.12.2015,   also   expressed   its   concern   at   discrimination against girl child including pre­natal sex selection, and urged states “to enact and enforce legislation to protect girls from all forms   of   violence,   discrimination,   exploitation   and   harmful practices in all settings, including female infanticide and prenatal sex selection”. 22 th 32. The General Assembly of United Nations in the 80  Plenary Meeting   adopted   resolution   no.70/138   dated   17.12.2015 concerning   the   girl   child,   the   relevant   portion   of   the   said resolution reads thus: “… Deeply concerned also  about discrimination against the girl child and the violation of the rights of the girl child, including girls with disabilities, which often result in less access for girls to education,   and   to  quality   education,   nutrition,   including   food allocation, and physical and mental health­care services, in girls enjoying   fewer   of   the   rights,   opportunities   and   benefits   of childhood and adolescence than boys, and in leaving them more vulnerable than boys to the consequences of unprotected and premature sexual relations and often being subjected to various forms of cultural, social, sexual and economic exploitation and violence, abuse, rape, incest, honour­related crimes and harmful practices,   such   as   female   infanticide,   child,   early   and   forced marriage, prenatal sex selection and female genital mutilation. 20.Urges all States to enact and enforce legislation to protect girls from   all   forms   of   violence,   discrimination,   exploitation   and harmful practices in all settings, including female infanticide and prenatal sex selection, female genital mutilation, rape, domestic violence,   incest,   sexual   abuse,   sexual   exploitation,   child prostitution   and   child   pornography,   trafficking   and   forced migration, forced labour and child, early and forced marriage, and to develop age­appropriate, safe, confidential and disability­ accessible   programmes   and   medical,   social   and   psychological support services to assist girls who are subjected to violence and discrimination. 29.Calls upon  Governments, civil society, including the media, and non­governmental organizations to promote human rights education and full respect for and the enjoyment of the human rights   of   the   girl   child,   inter   alia,   through   the   translation, production   and   dissemination   of   age­appropriate   and   gender­ sensitive information material on those rights to all sectors of society, in particular to children. 30.Requests  the   Secretary­General,   as   Chair   of   the   United Nations   System   Chief   Executives   Board   for   Coordination,   to ensure that all organizations and bodies of the United Nations system,   individually   and   collectively,   in   particular   the   United Nations   Children’s   Fund,   the   United   Nations   Educational, Scientific and Cultural Organization, the World Food Programme, the United Nations Population Fund, the United Nations Entity for   Gender   Equality   and   the   Empowerment   of   Women   (UN­ Women), the World Health Organization, the Joint United Nations Programme   on   HIV/AIDS,   the   United   Nations   Development 23 Programme, the Office of the United Nations High Commissioner for Refugees and the International Labour Organization, take into account the rights and the particular needs of the girl child in country programmes of cooperation in accordance with national priorities,   including   through   the   United   Nations   Development Assistance Framework.” 33. The   General   Assembly   of   United   Nations   adopted   the following resolution no.52/106 on 12.12.1997 keeping in view the   discrimination   against   the   girl   child   and   violation   of   her rights: “Deeply concerned about discrimination against the girl child and the violation of the rights of the girl child, which often result in less access for girls to education, nutrition, physical and mental health care and in girls enjoying fewer of the rights, opportunities and benefits of childhood and adolescence than boys and often being subjected to various forms of cultural, social, sexual and economic exploitation and to violence and harmful practices such as   incest,   early   marriage,   female   infanticide,   prenatal   sex selection and female genital mutilation. 3. Also urges all States to enact and enforce legislation protecting girls from all forms of violence, including female infanticide and prenatal sex selection, female genital mutilation, incest, sexual abuse,   sexual   exploitation,   child   prostitution   and   child pornography,   and   to   develop   age­appropriate   safe   and confidential programmes and medical, social and psychological support services to assist girls who are subjected to violence.” 34. The concern world over as to female foeticide and infanticide is writ large from aforesaid resolution.  It is worthwhile to quote the statistics of World Factbook, 2016 of the Central Intelligence Agency   of   the   United   States   of   America   on   female foeticide/infanticide across the world, which is to the following effect: 
RankName of the countrySex ratio at birth
24
1.Liechtenstein126 males/100 females
2.China115 males/100 female
3.Armenia113 males/100 females
4.India112 males/100 females
5.Azerbaijan111 males/100 females
5.Viet Nam111 males/100 females
6.Albania110 males/100 females
7.Georgia108 males/100 females
8.South Korea107 males/100 females
8.Tunisia107 males/100 females
9.Nigeria106 males/100 females
10.Pakistan105 males/100 females
11.Nepal104 males/100 females
35. There is sharp decline in the sex ratio in India.  In the year 1901 where 972 females as against 1000 males were recorded. In 1961, it was recorded as 941; in 1971 it was 930; in 1981 it was reported 934; in 1991 it was 927; in 2001 it was 933 and in 2011   it   was   943.     On   behalf   of   respondent­Union   of   India following State wise data has been furnished: “Sex Ratio (Female per 1000 Male) at Birth by residence, India and bigger States, SRS 2012­14 to 2014­16
S.N.India and2012­2013­Change2013­2014­Change
India906900­6900898­2
1.Andhra<br>Pradesh919918­1918913­5
2.Assam918900­18900896­4
3.Bihar9079169916908­8
4.Chhattisgarh973961­129619632
5.Delhi876869­7869857­12
6.Gujarat907854­53854848­6
7.Haryana866831­358318321
8.Himachal938924­14924917­7
9.Jammu &<br>Kashmir89989908999067
10.Jharkhand910902­890291816
25
11.Karnataka950939­11939935­4
12.Kerala974967­7967959­8
13.Madhya<br>Pradesh927919­89199223
14.Maharashtra896878­18878876­2
15.Orissa953950­3950948­2
16.Punjab870889198898934
17.Rajasthan893861­32861857­4
18.Tamil Nadu921911­109119154
19.TelanganaN.A.N.A.N.A.N.A.901N.A.
20.Uttar<br>Pradesh869879108798823
21.Uttarakhand871844­278448506
22.West Bengal952951­1951937­14
The   aforesaid   table   indicates   decline   in   18   States   and maximum decline of 53 points was recorded in Gujarat followed by Haryana by 35 points and Rajasthan by 32 points.  Sex ratio of the States in 2014­2016 indicates decline in 13 States.   The maximum   decline   of   14   points   was   recorded   in   West   Bengal followed  by  Delhi recorded  at  12  points.   In a publication of United Nations (UNFPA), it was published that 0.46 million girls were missing at birth on an average annually during the period 2001­2012 as a result of sex­selective abortions.  The fall in sex ratios does not only have an impact on the demography of the nation,   but   it   also   gives   rise   to   violent   practices   such   as trafficking of women and bride buying.   The Act was conceived out of the urgency for the prohibition of sex selection practices and prohibition of the advertisement of the pre­natal diagnostic techniques for detection/determination of sex.  It came into force 26 in the year 1996.  It was amended in 2003 following a PIL which was filed in 2000 to improve regulation of technology capable of sex selection.  By way of amendment in the Act, the name of the Act   has   been   changed   to   Pre­Conception   and   Pre­natal Diagnostic Techniques (Prohibition of Sex Selection) Act, 1994. The main purpose of the Act is to ban the use of sex selection and misuse of pre­natal diagnostic technique for sex selective abortions and to regulate such techniques.   The amendments have brought techniques of pre­conception sex selection within the ambit of the Act and have also brought use of ultrasound machines   under   its   umbrella.     It   has   further   provided   for constitution of Central and State Level Supervisory Board.  More stringent   punishments   have   been   provided.     The   Appropriate Authorities   have   been   given   powers   of   civil   court   for   search, seizure and sealing.  The maintenance of record has been made mandatory in respect of use of ultrasound machines.  It has also regulated the sale of ultrasound machines only to the registered bodies.     The   Act   provides   for   prohibition   of   sex selection/determination   and   regulate   pre­natal   diagnostic technology.  Several important amendments were notified in the Rules.     Rule   11(2)   was   amended   in   2011   to   provide   for 27 confiscation   of   the   unregistered   machines   and   Section   23(1) prescribes imprisonment upto three years and with fine upto ten thousand rupees against the unregistered clinic/facilities and on any subsequent conviction, the imprisonment may extend to five years and with fine which may extend to fifty thousand rupees and Section 23(3) prescribes imprisonment upto three years of imprisonment and with fine upto fifty thousand rupees against the unregistered clinic/facilities for the first offence and for any subsequent offence, the imprisonment may extend to five years and with fine which may extend to one lakh rupees.  Rule 3A(3) has been inserted in 2012 to restrict the registration of medical practitioners qualified under the Act to conduct ultrasonography in maximum of two ultrasound facilities within a district only. Number   of   hours   during   which   the   Registered   Medical Practitioner would be present in each clinic would be specified clearly to the Appropriate Authority.   The amendment made to Rule   13   in   2012   requires   every   Genetic   Counselling   Centres, Genetic   Laboratory,   Genetic   Clinic,   Ultrasound   Clinic   and Imaging   Centre   to   intimate   every   change   of   employee,   place, address and equipment installed to the Appropriate Authority 30 days in advance of the expected date of such change and seeks 28 issuance of a new certificate with the changes duly incorporated. Rules   for   six   months’   training   in   ultrasound   for   the   MBBS doctors have been notified vide GSR 14(E) dated 10.1.2014.  The Rules include the training curriculum, criteria for accreditation of institutions   which   will   impart   training   and   procedure   for Competency   Based   Evaluation   Test   for   such   trained   medical practitioners.  Revised Form ‘F’ has been notified vide GSR 77 (E) date   4.2.2014.     The   revised   format   is   more   simplified   as   the details of invasive and non­invasive diagnostic procedures have been separated and made more simplified. 36. There are only 586 convictions out of 4202 cases registered even after 24 years of existence.  It reflects the challenges being faced by the Appropriate Authority in implementing this social legislation.     Below   is   the   chart   showing   State   wise   status   of implementation of the Act as on September 2018 submitted on behalf of respondents:
State wise status of implementation of the PC&PNDT Act as on<br>SEPTEMBER, 2018
S.No.States/UTsNo. of<br>registered<br>bodiesNo. of<br>ongoing<br>Court/<br>Police<br>casesNo. of<br>Machines<br>seized/<br>sealedConvictions*Medical<br>licenses<br>cancelled/<br>suspendedNumber<br>of cases<br>decided/<br>closed
1.Andhra<br>Pradesh31192018008
2.Arunachal<br>Pradesh970­00­
3.Assam930114104
4.Bihar2761132386032
29
5.Chhattisgar<br>h700140007
6.Goa1741100
7.Gujarat5994235218799
8.Haryana21443135628521157
9.Himachal<br>Pradesh46404103
10.Jammu &<br>Kashmir49331310­
11.Jharkhand76132020­
12.Karnataka4711495838041
13.Kerala17370­00­
14.Madhya<br>Pradesh17235017439
15.Maharashtra86725874629979358
16.Manipur1300­00­
17.Meghalaya500­00­
18.Mizoram610­00­
19.Nagaland490000­
20.Odisha100166­504
21.Punjab16031473831193
22.Rajasthan303970150614921368
23.Sikkim270000­
24.Tamil Nadu6717123­109283
25.Telangana3547241083025
26.Tripura481­00­
27.Uttarakhand64747124016
28.Uttar<br>Pradesh60311393920110
29.West Bengal32382429001
30.A & N Island170­00­
31.Chandigarh1831­002
32.D & N Haveli160000­
33.Daman &<br>Diu100000­
34.Delhi158410417010357
35.Lakshadeep90­00­
36.Puducherry1091­00­
TOTAL62596282520815861381377
Note: *Convictions and Medical licenses data up to June 2018
37. In the light of aforesaid, we examine the submission raised on behalf of petitioner based upon clerical errors.  It was urged that the license of members of noble charitable profession are being suspended on account of clerical errors/mistakes in paper work under the Act and the Rules made thereunder.  On account 30 of   clerical   errors   in   filling   up   of   the   forms,   it   would   not   be appropriate to inflict the punishment.  In case of actual offence of sex determination, the provisions of the Act may govern the field. As   submission   appears   to   be   attractive   and   it   requires   deep scrutiny whether it is a clerical error in filling up of the forms or is foundation of substantial breach of the provisions of the Act and Rules framed thereunder.   It was urged that Section 23 of the Act treats unequals as equals and there is infirmity in the Act as the clerical error in filling up of the Form ‘F’ cannot be treated at par with actual offence of sex determination.   There is no gradation of the offence under the Act.  Learned senior counsel has placed reliance on  Uttar Pradesh Power Corporation Ltd. vs. Ayodhya Prasad Mishra,  (2008) 10 SCC 139 ,  wherein this Court held   that   unequals   cannot   be   treated   equally.   Treating   of unequals as equals would as well offend the doctrine of equality enshrined in Articles 14 and 16 of the Constitution.  The same is extracted hereunder: “40.  It is well settled that equals cannot be treated unequally. But it is equally well settled that unequals cannot be treated equally. Treating of unequals as equals would as well offend the doctrine   of   equality   enshrined   in   Articles   14   and   16   of   the Constitution. The High Court was, therefore, right in holding that Executive Engineers placed in Category I must get priority and preference for promotion to the post of Superintendent Engineer over Executive Engineers found in Category II.”   31 38. It is contended that merely clerical error cannot be equated with offences as mentioned in Sections 5 and 6 of the Act.  The main purpose and the object of the Act is being misused and more   than   60   per   cent   cases   registered   under   the   Act,   are pertaining to non­maintenance of record. 39. In   order   to   appreciate   whether   it   is   clerical   omission   or otherwise, we have to delve on the provisions of the Act what is mandated   thereunder.     Section   3   provides   for   regulation   of Genetic Counselling Centres, Genetic Laboratories and Genetic Clinics, Section 3A deals with prohibition of sex­selection and Section 3B deals with prohibition on sale of ultrasound machine, etc. to persons, laboratories, clinics, etc. not registered under the Act.  The same are extracted hereunder:   “ 3.   Regulation   of   Genetic   Counselling   Centres,   Genetic Laboratories   and   Genetic   Clinics. —   On   and   from   the commencement of this Act, — (1) no Genetic Counselling Centre, Genetic Laboratory or Genetic Clinic unless registered under this Act, shall conduct or associate with,   or   help   in,   conducting   activities   relating   to   pre­natal diagnostic techniques; (2)   no   Genetic   Counselling   Centre   or   Genetic   Laboratory   or Genetic  Clinic   shall  employ  or  cause   to  be   employed   or  take services of any person whether on honorary basis or on payment who does not possess the qualifications as may be prescribed; (3) no medical geneticist, gynaecologist, paediatrician, registered medical practitioner or any other person shall conduct or cause to be conducted or aid in conducting by himself or through any other   person,   any   pre­natal   diagnostic   techniques   at   a   place other than a place registered under this Act. 32
derived from either or bothof them.
3B. Prohibition on sale of ultrasound machine, etc., to
persons, laboratories, clinics, etc., not registered under the
Act .No person shall sell any ultrasound machine or imaging
machine or scanner or any other equipment capable of detecting
sex of foetus to any Genetic Counselling Centre, Genetic
Laboratory, Genetic Clinic or any other person not registered
under the Act.”(emphasis supplied)
40. Section   4   deals   with   regulation   of   pre­natal   diagnostic techniques, which is extracted hereunder: “ 4. Regulation of pre­natal diagnostic techniques.  — On and from the commencement of this Act,— (1) no place including a registered Genetic Counselling Centre or Genetic Laboratory or Genetic Clinic shall be used or caused to be   used   by   any   person   for   conducting   pre­natal   diagnostic techniques except for the purposes specified in clause (2) and after satisfying any of the conditions specified in clause (3); (2) no pre­natal diagnostic techniques shall be conducted except for   the   purposes   of   detection   of   any   of   the   following abnormalities, namely: — (i) chromosomal abnormalities; (ii) genetic metabolic diseases; (iii) haemoglobinopathies; (iv) sex­linked genetic diseases; (v) congenital anomalies; (vi) any other abnormalities or diseases as may be specified  by the Central Supervisory Board; (3) no pre­natal diagnostic techniques shall be used or conducted unless the person qualified to do so is satisfied for reasons to be recorded   in   writing   that   any   of   the   following   conditions   are fulfilled, namely:— (i) age of the pregnant woman is above thirty­five years; (ii)   the   pregnant   woman   has   undergone   of   two   or   more spontaneous abortions or foetal loss; (iii) the pregnant woman had been exposed to potentially teratogenic   agents  such  as   drugs,   radiation,   infection  or chemicals; 33 (iv) the pregnant woman or her spouse has a family history of   mental   retardation   or   physical   deformities   such   as, spasticity or any other genetic disease; (v) any other condition as may be specified by the Board; Provided that the person conducting ultrasonography on a pregnant woman shall keep complete record thereof in clinic in such   manner,   as   may   be   prescribed,   and   any   deficiency   or inaccuracy found therein shall amount to contravention of the provisions of section 5 or section 6 unless contrary is proved by the person conducting such ultrasonography; (4) no person including a relative or husband of the pregnant woman shall seek  or encourage the conduct  of any pre­natal diagnostic techniques on her except for the purposes specified in clause (2). (5)  no person including a relative or husband of a woman shall seek or encourage the conduct of any sex­selection technique on her or him or both.” (emphasis supplied) There is prohibition created under Section 4(1) to use any registered Genetic Counselling Centre or Genetic Laboratory or Genetic   Clinic   for   conducting   pre­natal   diagnostic   techniques except for the purposes specified in sub­section (2) of Section 4. Wrong expression has been used as clause (2) in the Act, where it should   be   sub­section   (2).     Be   that   as   it   may.     Section   4(2) provides for conducting of pre­natal diagnostic techniques for the purpose of detection of abnormalities. Section   4(3)   provides   that   no   pre­natal   diagnostic techniques shall be used unless the person qualified to do so is satisfied for the reasons to be recorded in writing that prescribed conditions are fulfilled such as age of the pregnant women is above thirty­five years; the pregnant woman has undergone two 34 or   more   spontaneous   abortions   or   foetal   loss;   she   had   been exposed   to   potentially   teratogenic   agents   such   as   drugs, radiation,   infection  or   chemicals;   the   pregnant  woman  or   her spouse has a family history of mental retardation or physical deformities as prescribed therein; or any other condition as may be specified by the Board. In   the   absence   of   aforesaid   fulfilment   of   the   aforesaid conditions   provided   in   Section   4(3)   and   in   the   absence   of abnormality as provided in Section 4(2), no such test can be performed.     Proviso   to   Section   4(3)   makes   it   mandatory   that person conducting ultrasonography on a pregnant woman shall keep complete record as may be prescribed and any deficiency or inaccuracy found therein shall amount to contravention of the provisions of Section 5 or Section 6 unless contrary is proved by the person conducting such ultrasonography.  Section 5 provides for   written   consent   of   pregnant   woman   and   prohibition   of communicating the sex of foetus, whereas Section 6 provides that determination   of   sex   is   prohibited.     Sections   5   and   6   are extracted below: “5. Written consent of pregnant woman and prohibition of communicating the sex of foetus .— (1) No person referred to in clause (2) of section 3 shall conduct the pre­natal diagnostic procedures unless— 35 (a) he has explained all known side and after effects of such procedures to the pregnant woman concerned; (b)   he   has   obtained   in   the  prescribed   form  her   written consent to undergo such procedures in the language which she understands; and (c) a copy of her written consent obtained under clause (b) is given to the pregnant woman. (2)  No  person   including   the   person   conducting   pre­natal diagnostic procedures shall communicate to the pregnant woman concerned or her relatives or any other person the  sex of the foetus by words, signs, or in any other manner. 6.   Determination   of   sex   prohibited. —   On   and   from   the commencement of this Act, —  (a)  no  Genetic   Counselling   Centre   or   Genetic   Laboratory   or Genetic  Clinic   shall  conduct  or  cause   to   be   conducted   in  its Centre,   Laboratory   or   Clinic,   pre­natal   diagnostic   techniques including  ultrasonography, for the purpose of determining the sex of a foetus; (b) no person shall conduct or cause to be conducted any pre­ natal   diagnostic   techniques   including   ultrasonography   for   the purpose of determining the sex of a foetus. (c) no person shall, by whatever means, cause or allow to be caused selection of sex before or after conception.” (emphasis supplied) 41. Independently, specific provisions have been made barring use   of   technology   i.e.,   pre­natal   diagnostic   techniques   for determination of sex of foetus under Section 6 of the Act.   The use of technology can only be for the purposes as provided in Section 4(2) and with the pre­conditions as provided in Section 4(3). 42. As  a  safeguard   to  arbitrary   use   of   powers   by  concerned authorities   the   constitution   of   State   Supervisory   Board   and 36 Union Territory Supervisory Board is provided in Section 16A, which is a large body consisting of various representatives.   It has   to   create   public   awareness,   review   the   activities   of   the Appropriate Authorities and to monitor the implementation of the provisions of the Act and to send the periodical report.  Relevant portion of Section 16A of the Act reads thus:   “ 16A. Constitution of State Supervisory Board and Union territory Supervisory Board .— (1)   Each   State   and   Union   territory   having   Legislature   shall constitute a Board to be known as the State Supervisory Board or the Union territory Supervisory Board, as the case may be, which shall have the following functions:— (i) to create public awareness against the practice of pre­ conception sex selection and pre­natal determination of sex of foetus leading to female foeticide in the State; (ii) to review the activities of the Appropriate Authorities functioning in the State and recommend appropriate action against them; (iii) to monitor the implementation of provisions of the Act and the rules and make suitable recommendations relating thereto, to the Board;  (iv) to send such consolidated reports as may be prescribed in respect of the various activities undertaken in the State under the Act to the Board and the Central Government; and  (v) any other functions as may be prescribed under the Act. (2) The State Board shall consist of,— (a) the Minister in charge of Health and Family Welfare in the State, who shall be the Chairperson,  ex­officio ; (b) Secretary in charge of the Department of Health and Family   Welfare   who   shall   be   the   Vice­Chairperson,   ex­ officio ;  (c) Secretaries or Commissioners in charge of Departments of Women and Child Development, Social Welfare, Law and Indian System of Medicines and Homoeopathy,  ex­officio , or their representatives; (d) Director of Health and Family Welfare or Indian System of Medicines and Homoeopathy of the State Government, ex­officio ; (e)   three   women   members   of   Legislative   Assembly   or Legislative Council; 37 (f) ten members to be appointed by the State Government out of which two each shall be from the following categories: — (i) eminent social scientists and legal experts; (ii) eminent women activists from non­governmental organizations or otherwise; (iii)   eminent   gynaecologists   and   obstetricians   or experts of  stri­roga  or  prasuti­tantra ; (iv) eminent paediatricians or medical geneticists; (v) eminent radiologists or sonologists; (g) an officer not below the rank of Joint Director in charge of   Family   Welfare,   who   shall   be   the   Member   Secretary, ex­officio . (3) The State Board shall meet at least once in four months.” 43. The   constitution   of   Appropriate   Authority   and   Advisory Committee is provided in Section 17.  It consists of an officer of or above the rank of the Joint Director of Health and Family Welfare   as   Chairperson,   an   eminent   woman   representing women’s organization and an officer of Law Department of the State or the Union Territory as members as the case may be.  The functions of the Appropriate Authority are prescribed in Section 17(4).  It empowers the Appropriate Authority to grant, suspend or   cancel   the   registration,   enforce   standards,   investigate complaints   and   to   do   other   acts   as   provided   therein. Constitution   of   Advisory   Committee   is   also   provided   under Section   17(6),   to   aid   and   advise   the   Appropriate   Authority, consisting of three medical experts from amongst gynaecologists, obstetricians, paediatricians and medical geneticists, one legal expert,   an   officer   as   provided   thereunder,   and   three   eminent 38 social workers.  No person who has been associated with the use or promotion of pre­natal diagnostic techniques for determination of sex or sex selection can be member of the Advisory Committee. Section 17 is extracted hereunder:  “ 17. Appropriate Authority and Advisory Committee .— (1) The Central Government shall appoint, by notification in the Official Gazette, one or more Appropriate Authorities for each of the Union territories for the purposes of this Act. (2) The State Government shall appoint, by notification in the Official   Gazette,   one   or   more   Appropriate   Authorities   for   the whole or part of the State for the purposes of this Act having regard   to   the   intensity   of   the   problem   of   pre­natal   sex determination leading to female foeticide.  (3) The officers appointed as Appropriate Authorities under sub­ section (1) or sub­section (2) shall be,—  (a) when appointed for the whole of the State or the Union territory, consisting of the following three members:— (i) an officer of or above the rank of the Joint Director of Health and Family Welfare—Chairperson; (ii)   an   eminent   woman   representing   women’s organization; and (iii) an officer of Law Department of the State or the Union territory concerned:  Provided that it shall be the duty of the State or the Union territory   concerned   to   constitute   multi­member   State   or Union   territory   level   Appropriate   Authority   within   three months of the coming into force of the Pre­natal Diagnostic Techniques   (Regulation   and   Prevention   of   Misuse) Amendment Act, 2002: Provided further that any vacancy occurring therein shall be filled within three months of the occurrence. (b) when appointed for any part of the State or the Union territory, of such other rank as the State Government or the Central Government, as the case may be, may deem fit. (4) The Appropriate Authority shall have the following functions, namely:— (a) to grant, suspend or cancel registration of a Genetic Counselling Centre, Genetic Laboratory or Genetic Clinic; (b)   to   enforce   standards   prescribed   for   the   Genetic Counselling Centre, Genetic Laboratory and Genetic Clinic; 39 (c) to investigate complaints of breach of the provisions of this Act or the rules made thereunder and take immediate action; (d)   to   seek   and   consider   the   advice   of   the   Advisory Committee,   constituted   under   sub­section   (5),   on application   for   registration   and   on   complaints   for suspension or cancellation of registration; (e) to take appropriate legal action against the use of any sex selection technique by any person at any place,   suo motu   or   brought   to   its   notice   and   also   to   initiate independent investigations in such matter;  (f) to create public awareness against the practice of sex selection or pre­natal determination of sex;  (g) to supervise the implementation of the provisions of the Act and rules; (h)   to   recommend   to   the   Board   and   State   Boards modifications   required   in   the   rules   in   accordance   with changes in technology or social conditions; (i) to take action on the recommendations of the Advisory Committee   made   after   investigation   of   complaint   for suspension or cancellation of registration. (5) The Central Government or the State Government, as the case may   be,   shall   constitute   an   Advisory   Committee   for   each Appropriate   Authority   to   aid   and   advise   the   Appropriate Authority in the discharge of its functions, and shall appoint one of the members of the Advisory Committee to be its Chairman. (6) The Advisory Committee shall consist of— (a)   three   medical   experts   from   amongst   gynaecologists, obstericians, paediatricians and medical geneticists;  (b) one legal expert; (c)   one   officer   to   represent   the   department   dealing   with information and publicity of the State Government or the Union territory, as the case may be; (d) three eminent social workers of whom not less than one shall   be   from   amongst   representatives   of   women’s organisations. (7) No person who has been associated with the use or promotion of pre­natal diagnostic techniques for determination of sex or sex selection   shall   be   appointed   as   a   member   of   the   Advisory Committee.  (8) The Advisory Committee may meet as and when it thinks fit or on the request of the Appropriate Authority for consideration of any application for registration or any complaint for suspension or cancellation of registration and to give advice thereon:   Provided   that   the   period   intervening   between   any   two meetings shall not exceed the prescribed period. (9) The terms and conditions subject to which a person may be appointed to the Advisory Committee and the procedure to be 40 followed  by such  Committee  in the  discharge  of  its  functions shall be such as may be prescribed.” 44. Section 17A empowers Appropriate Authority to summon any person who is in possession of any information relating to violation   of   the   provisions   of   the   Act   and   production   of documents, issue search warrant etc.  It is mandatory that such Genetic Counselling Centres, Laboratories or Clinics should be registered under Section 18 of the Act. 45. Section   20   deals   with   cancellation   or   suspension   of registration.  An action can be taken as provided under Section 20(2) after giving reasonable opportunity of being heard.  In case there is breach of provisions of the Act or the Rules, and the same is without prejudice to any criminal action that it may take against   such   Centres,   Laboratory   or   Clinic,   the   Appropriate Authority in public interest for reasons to be recorded in writing, can suspend the registration of any Genetic Counselling Centres, Laboratories or Clinics under Section 20(3) of the Act without issuing any notice referred to in sub­section (1) of Section 20. The   provisions   of   appeal   against   the   order   of   suspension   or cancellation of registration passed by Appropriate Authority has 41 been provided in Section 21.  Sections 20 and 21 are extracted hereunder:   “ 20. Cancellation or suspension of registration. —   (1). The Appropriate Authority may     suo moto   , or on complaint, issue a notice to the Genetic Counselling Centre, Genetic Laboratory or Genetic Clinic to show cause why its registration should not be suspended or cancelled for the reasons mentioned in the notice. (2)  If, after giving a reasonable opportunity of being heard to the Genetic Counselling Centre, Genetic Laboratory or Genetic Clinic and having regard to the advice of the Advisory Committee, the Appropriate Authority is satisfied that there has been a breach of the provisions of this Act or the rules, it may, without prejudice to any criminal action that it may take against such Centre, Laboratory or Clinic, suspend its registration for such period as it may think fit or cancel its registration, as the case may be. (3) Notwithstanding anything contained in sub­sections (1) and (2),   if   the   Appropriate   Authority   is   of   the   opinion   that  it   is necessary or expedient so to do in the public interest, it may, for reasons to be recorded in writing, suspend the registration of any Genetic Counselling Centre, Genetic Laboratory or Genetic Clinic without issuing any such notice referred to in sub­section (1). 21.   Appeal .—   The   Genetic   Counselling   Centre,   Genetic Laboratory or Genetic Clinic may, within thirty days from the date   of   receipt   of   the   order   of   suspension   or   cancellation   of registration passed by the Appropriate Authority under section 20, prefer an appeal against such order to— (i) the Central Government, where the appeal is against the order of the Central Appropriate Authority; and (ii) the State Government, where the appeal is against the order of the State Appropriate Authority,  in the prescribed manner.” (emphasis supplied) 46. Section 22 deals with prohibition of advertisement relating to   pre­conception   and   pre­natal   determination   of   sex   and punishment for contravention. 42 47. Section 23 deals with offences and penalties.  Section 23(1) provides for contravention of any provisions of the Act or Rules made   thereunder,   punishment   with   imprisonment   for   a   term which may extend to three years and with fine which may extend to ten thousand rupees.   Section 23(2) contains provision with respect to reporting of name of the registered medical practitioner by   the   Appropriate   Authority   to   the   State   Medical   Council concerned for passing appropriate order including suspension of the registration, if the charges are framed by the Court and till the case is disposed of and on conviction for removal of his name from the register of the Council for a period of five years for the first offence and permanently for the subsequent offence.   Any person   who   seek   aid   of   any   Genetic   Counselling   Centre, Laboratory, Clinic or ultrasound clinic or imaging clinic etc. for sex selection, shall be punishable with imprisonment which may extend to three years and with fine which may extend to fifty thousand rupees for the first offence and for any subsequent offence with imprisonment which may extend to five years and with fine which may extend to one lakh rupees.  If a woman is compelled by her husband or any other relative to undergo pre­ natal diagnostic technique for the purpose of Section 4(2), such 43 person shall be liable for abetment of offence under Section 23(3). Sections 23 and 24 are extracted hereunder:   “ 23.   Offences   and   penalties .—   (1)   Any   medical   geneticist, gynaecologist, registered medical practitioner or any person who owns a Genetic Counselling Centre, a Genetic Laboratory or a Genetic Clinic or is employed in such a Centre, Laboratory or Clinic and renders his professional or technical services to or at such a Centre, Laboratory or Clinic, whether on an honorary basis or otherwise, and who contravenes any of the provisions of this   Act   or   rules  made   thereunder   shall   be   punishable   with imprisonment for a term which may extend to three years and with fine which may extend to ten thousand rupees and on any subsequent conviction, with imprisonment which may extend to five   years   and   with   fine   which   may   extend   to   fifty   thousand rupees. (2)   The   name   of   the   registered   medical   practitioner   shall   be reported   by   the   Appropriate   Authority   to   the   State   Medical Council   concerned   for   taking  necessary   action   including suspension of the registration if the charges are framed by the court  and   till   the   case   is   disposed   of   and   on   conviction   for removal of his name from the register of the Council for a period of   five   years   for   the   first   offence   and   permanently   for   the subsequent offence. (3)  Any person who seeks the aid  of any Genetic Counselling Centre, Genetic Laboratory, Genetic Clinic or ultrasound clinic or imaging clinic or of a medical geneticist, gynaecologist, sonologist or imaging specialist or registered medical practitioner or any other   person   for   sex   selection   or   for   conducting   pre­natal diagnostic techniques on any pregnant women for the purposes other than those specified in sub­section (2) of section 4, he shall be punishable with imprisonment for a term which may extend to three years and with fine which may extend to fifty thousand rupees for the first offence and for any subsequent offence with imprisonment which may extend to five years and with fine which may extend to one lakh rupees. (4) For the removal of doubts, it is hereby provided, that the provisions of sub­section (3) shall not apply to the woman who was compelled to undergo such diagnostic techniques or such selection. 24.   Presumption   in   the   case   of   conduct   of   pre­natal .—Notwithstanding anything contained in   diagnostic techniques   the   Indian   Evidence   Act,   1872   (1   of   1872),   the   court   shall presume unless the contrary is proved that the pregnant woman was compelled by her husband or any other relative, as the case may   be,   to   undergo   pre­natal   diagnostic   technique   for   the purposes other than those specified in sub­section (2) of section 4 44 and such person shall be liable for abetment of offence under sub­section (3) of section 23 and shall be punishable for the offence specified under that section.” (emphasis supplied) 48. Section   25   of   the   Act   deals   with   the   penalty   for contravention of the provisions of the Act or rules for which no specific punishment is provided.   Any contravention under this Section shall be punishable with imprisonment for a term which may extend to three months or with fine which may extend to one thousand rupees or both and in case of continuing contravention with an additional fine which may extend to five hundred rupees for every day. 49. Section 27 makes offence to be cognizable, non­bailable and non­compoundable.  Section 27 is extracted hereunder:   “ 27.   Offence   to   be   cognizable,   non­bailable   and   non­ compoundable .­Every offence under this Act shall be cognizable, non­bailable and non­compoundable.” 50. The   mode   of   taking   cognizance   of   offence   is   provided   in Section 28 on a complaint made by the Appropriate Authority or any officer authorised in this behalf; or by a person who has given   notice   of   not   less   than   fifteen   days   to   the   Appropriate Authority of the alleged offence and of his intention to make a complaint to the court.  The Metropolitan Magistrate or a Judicial Magistrate is competent to try any offence punishable under this 45 Act.  Maintenance of records is provided in Section 29 and that has to be preserved for two years.  In case any criminal or other proceedings   are   instituted   against   any   Genetic   Counselling Centre, Laboratory or Clinic, the records shall be preserved till the final disposal of such proceedings.   Section 30 empowers Appropriate Authority to search and seize records etc.  Section 31 provides for protection of action taken in good faith. 51. Section 32 empowers the Central Government to make rules for carrying out the provisions of the Act.  Section 33 gives power to the Board to make regulations with the previous sanction of the Central Government.  Rules and regulations are required to be laid before the Parliament as provided in Section 34. 52. Rule   9   of   the   Rules   provides   for   maintenance   and preservation of records.  The same is extracted hereunder: 9. Maintenance and preservation of records .— (1)  Every  Genetic   Counselling  Centre,   Genetic   Laboratory  and Genetic   Clinic   including   a   mobile   Genetic   Clinic,   Ultrasound Clinic and Imaging Centre shall maintain a register showing, in serial order, the names and addresses of the men or women given genetic counselling, subjected to pre­natal diagnostic procedures or pre­natal diagnostic tests, the names of their spouse or father and the date on which they first reported for such counselling, procedure or test. (2) The record to be maintained by every Genetic Counselling Centre, in respect of each woman counselled shall be as specified in Form D. 46 (3) The record to be maintained by every Genetic Laboratory, in respect   of   each   man   or   woman   subjected   to   any   pre­natal diagnostic   procedure/technique/test,   shall   be   as   specified   in Form E.  (4) The record to be maintained by every Genetic Clinic including a   mobile   Genetic   Clinic,   in   respect   of   each   man   or   woman subjected to any pre­natal diagnostic procedure/technique/test, shall be as specified in Form F. (5) The Appropriate Authority shall maintain a permanent record of applications for grant or renewal of certificate of registration as specified   in   Form  H.   Letters   of   intimation  of  every  change   of employee, place, address and equipment installed shall also be preserved as permanent records. (6) All case related­records, forms of consent, laboratory results, microscopic   pictures,   sonographic   plates   or   slides, recommendations and letters shall be preserved by the Genetic Counselling   Centre,   Genetic   Laboratory   or   Genetic   Clinic, Ultrasound Clinic or Imaging Centre for a period of two years from the date of completion of counselling, pre­natal diagnostic procedure or pre­natal diagnostic test, as the case may be. In the event of any legal proceedings, the records shall be preserved till the final disposal of legal proceedings, or till the expiry of the said period of two years, whichever is later. (7) In case the Genetic Counselling Centre or Genetic Laboratory or   Genetic   Clinic   or   Ultrasound   Clinic   or   Imaging   Centre maintains records on computer or other electronic equipment, a printed copy of the record shall be taken and preserved after authentication by a person responsible for such record. (8)     Every   Genetic   Counselling   Centre,   Genetic   Laboratory, Genetic Clinic, Ultrasound Clinic and Imaging Centre shall send a complete report in respect of all pre­conception or pregnancy related   procedures/techniques/tests   conducted   by   them   in th respect of each month by 5   day of the following month to the concerned Appropriate Authority.” Rule 9 makes it mandatory to maintain a register showing in serial order the names and addresses of the men or women given   genetic   counselling,   subjected   to   pre­natal   diagnostic procedures   or   pre­natal   diagnostic   tests,   the   name   of   their spouse or father and the date on which they first reported for 47 such counselling.  Rule 9(2) states that record to be maintained uniformly.   Rule 9(4) provides that record to be maintained by every Genetic Clinic in respect of each man or woman subjected to any pre­natal diagnostic procedure/technique/test, shall be specified   in   Form   ‘F’.     Rule   10   deals   with   conditions   for conducting   pre­natal   diagnostic   procedures.     Rule   10(1A) provides   that   it   is   mandatory   for   every   person   conducting ultrasonography to declare that he/she has neither detected nor disclosed the sex of foetus of the pregnant woman to anybody. The pregnant woman shall declare before undergoing the test that she does not want to know the sex of her foetus.  Rule 19 provides   for   an   appeal   against   the   decision   of   Appropriate Authority.     Form   ‘F’,   which   is   the   bone   of   contention   of   the learned counsel for the parties, is extracted hereunder:                                         “FORM F FORM FOR MAINTENANCE OF RECORD IN RESPECT OF PREGNANT WOMAN BY GENETIC CLINIC/ULTRASOUND CLINIC/IMAGING CENTRE
1.Name and address of the Genetic Clinic/Ultrasound<br>Clinic/Imaging Centre.
2.Registration No.
3.Patient’s name and her age
4.Number of children with sex of each child
5.Husband’s/Father’s name
6.Full address with Tel. No., if any
7.Referred by (full name and address of Doctor(s) /<br>Genetic Counselling Centre (referral note to be<br>preserved carefully with case papers)/self referral
8.Last menstrual period/weeks of pregnancy
9.History of genetic/medical disease in the family<br>(specify)
48
Basis of diagnosis:<br>(a) Clinical<br>(b) Bio­chemical<br>(c) Cytogenetic<br>(d) Other (e.g. radiological, ultrasonography etc.<br>specify)
10.Indication for pre­natal diagnosis<br>A. Previous child/children with:<br>(i) Chromosomal disorders<br>(ii) Metabolic disorders<br>(iii) Congenital anomaly<br>(iv) Mental retardation<br>(v) Haemoglobinopathy<br>(vi) Sex linked disorders<br>(vii) Single gene disorder<br>(viii) Any other (specify)<br>B. Advanced maternal age (35 years)<br>C. Mother/father/sibling has genetic disease (specify)<br>D. Other (specify)
11.Procedures carried out (with name and registration No.<br>of Gynaecologist/ Radiologist/ Registered Medical<br>Practitioner) who performed it.<br>Non­Invasive<br>(i) Ultrasound (specify purpose for which<br>ultrasound is to done during pregnancy)<br>[List of indications for ultrasonography of pregnant<br>women are given in the note below]<br>Invasive<br>(ii) Amniocentesis<br>(iii) Chorionic Villi aspiration<br>(iv) Foetal biopsy<br>(v) Cordocentesis<br>(vi) Any other (specify)
12.Any complication of procedure – please specify
13.Laboratory tests recommended<br>(i) Chromosomal studies<br>(ii) Biochemical studies<br>(iii) Molecular studies<br>(iv) Preimplantation genetic diagnosis
14.Result of<br>(a) pre­natal diagnostic procedure (give details)<br>(b) Ultrasonography Normal/Abnormal (specify<br>abnormality detected, if any).
15.Date(s) on which procedures carried out.
16.Date on which consent obtained. (In case of invasive)
17.The result of pre­natal diagnostic procedure were<br>conveyed to ……….on ……………
18.18. Was MTP advised/conducted?
19.Date on which MTP carried out
Date ……………..     Name, Signature and Registration number  Place……………..       of the Gynaecologist/Radiologist/Director of                                  the Clinic 49 DECLARATION OF PREGNANT WOMAN I, Ms…………………..(name of the pregnant woman) declare that by undergoing ultrasonography /image scanning etc. I do not want to know the sex of my foetus. Signature/Thump impression of pregnant woman  DECLARATON OF DOCTOR/PERSON CONDUCTING ULTRASONOGRAPHY/IMAGE SCANNING I,……………………(name   of   the   person   conducting ultrasonography/image scanning) declare that while conducting ultrasonography/image scanning on Ms…………………..(name of the pregnant woman), I have neither detected nor disclosed the sex of her foetus to any body in any manner. Name and signature of the person conducting ultrasonography/image scanning/Director or owner of genetic clinic/ultrasound clinic/imaging centre. Important Notes:— (i) Ultrasound   is   not   indicated/advised/performed   to determine the sex of foetus except for diagnosis of sex­linked diseases such as Duchenne Muscular Dystrophy, Haemophilia A & B, etc. (ii) During   pregnancy   Ultrasonography   should   only   be performed when indicated. The following is the representative list of indications for ultrasound during pregnancy. (1) To diagnose intra­uterine and/or ectopic pregnancy and confirm viability. (2) Estimation of gestational age (dating). (3) Detection of number of foetuses and their chorionicity. (4)  Suspected  pregnancy with IUCD in­situ or suspected pregnancy following contraceptive failure/MTP failure. (5) Vaginal bleeding / leaking. (6) Follow­up of cases of abortion. (7) Assessment of cervical canal and diameter of internal os. (8)   Discrepancy   between   uterine   size   and   period   of amenorrhoea. (9)   Any   suspected   adenexal   or   uterine   pathology   / abnormality. (10)   Detection   of   chromosomal   abnormalities,   foetal structural defects and other abnormalities and their follow­ up. (11) To evaluate foetal presentation and position. (12) Assessment of liquor amnii. (13)   Preterm   labour   /   preterm   premature   rupture   of membranes. (14) Evaluation of placental position, thickness, grading and abnormalities   (placenta   praevia,   retroplacental haemorrhage, abnormal adherence etc.). (15) Evaluation of umbilical cord – presentation, insertion, nuchal  encirclement, number  of  vessels  and  presence  of true knot. 50 (16) Evaluation of previous Caesarean Section scars. (17) Evaluation of foetal growth parameters, foetal weight and foetal well being. (18) Colour flow mapping and duplex Doppler studies. (19)   Ultrasound   guided   procedures   such   as   medical termination of pregnancy, external cephalic version etc. and their follow­up. (20)   Adjunct   to   diagnostic   and   therapeutic   invasive interventions   such   as   chorionic   villus   sampling   (CVS), amniocenteses, foetal blood sampling,  foetal  skin  biopsy, amnioinfusion, intrauterine infusion, placement of shunts etc. (21) Observation of intra­partum events. (22) Medical/surgical conditions complicating pregnancy. (23) Research/scientific studies in recognised institutions.  Person conducting ultrasonography on a pregnant woman shall keep complete record thereof in the clinic/centre in Form   F   and   any   deficiency   or   inaccuracy   found   therein shall amount to contravention of provisions of section 5 or section 6 of the Act, unless contrary is proved by the person conducting such ultrasonography.” 53. The Act and Rules are not the only regulatory framework which requires the medical fraternity to keep proper record.  The medical profession has highly specialised nature and considering the nature of services rendered by medical professional, proper maintenance of records is an integral part of the medical services. It is contended on behalf of Medical Council of India that the Medical Council of India (MCI) under Section 33 of the Indian Medical Council Act, 1956 has framed the Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations, 2002, which also placed a burden on physicians to observe the law of the country.  By the said Regulations, it is mandatory for every doctor to maintain the records of the patients treated by him/her 51 and non­maintaining of records is a misconduct.  MCI Regulation 1.3 deals with maintenance of medical records, which reads thus:  “ 1.3 Maintenance of medical records : 1.3.1  Every   physician   shall   maintain   the   medical   records pertaining to his / her indoor patients for a period of 3 years from the   date   of   commencement   of   the   treatment   in   a   standard proforma laid down by the Medical Council of India and attached as Appendix 3. 1.3.2. If any request is made for medical records either by the patients / authorised attendant or legal authorities involved, the same may be duly acknowledged and documents shall be issued within the period of 72 hours. 1.3.3 A Registered medical practitioner shall maintain a Register of Medical Certificates giving full details of certificates issued. When issuing a medical certificate he / she shall always enter the identification   marks   of   the   patient   and   keep   a   copy   of   the certificate. He / She shall not omit to record the signature and/or thumb mark, address and at least one identification mark of the patient   on   the   medical   certificates   or   report.  The   medical certificate shall be prepared as in Appendix 2. 1.3.4 Efforts shall be made to computerize medical records for quick retrieval.” (emphasis supplied) 54. Regulation   7.1   under   Chapter   7   deals   with   misconduct committed   by   a   doctor   by   violating   any   provisions   of   the Regulations, whereas Regulation 7.2 provides that the failure to maintain the medical records of indoor patient for a period of three years and refusal to provide the medical record to a patient on request within 72 hours is a misconduct.   Regulation 7.6 deals   with   misconduct   relating   to   sex   determination   and 52 termination of pregnancy.  The relevant portion of Regulation 7 is reproduced hereunder: “ 7. MISCONDUCT The following acts of commission or omission on the part of a physician shall constitute professional misconduct rendering him/her liable for disciplinary action. 7.1   Violation   of   the   Regulations :   If   he/she   commits   any violation of these Regulations. 7.2 If he/she does not maintain the medical records of his/her indoor patients for a period of three years as per regulation 1.3 and   refuses   to   provide   the   same   within   72   hours   when   the patient or his/her authorised representative makes a request for it as per the regulation 1.3.2. * 7.6 Sex Determination Tests : On no account sex determination test shall be undertaken with the intent to terminate the life of a female foetus developing in her mother’s womb, unless there are other   absolute   indications   for   termination   of   pregnancy   as specified in the Medical Termination of Pregnancy Act, 1971. Any act   of   termination   of   pregnancy   of   normal   female   foetus amounting to female foeticide shall be regarded as professional misconduct on the part of the physician leading to penal erasure besides rendering him liable to criminal proceedings as per the provisions of this Act.” 55. Regulation 8 of the MCI Regulation deals with punishment and disciplinary action for misconduct committed by a doctor. The relevant portion of Regulation 8 reads thus: “ 8. PUNISHMENT AND DISCIPLINARY ACTION 8.1 It must be clearly understood that the instances of offences and of Professional misconduct which are given above do not constitute and are not intended to constitute a complete list of the infamous acts which calls for disciplinary action, and that by issuing  this notice the Medical Council  of India  and or  State Medical Councils are in no way precluded from considering and dealing with any other form of professional misconduct on the part of a registered practitioner. Circumstances may and do arise from time to time in relation to which there may occur questions of   professional   misconduct   which   do   not   come   within   any   of these categories. Every care should be taken that the code is not violated in letter or spirit. In such instances as in all others, the 53 Medical Council of India and/or State Medical Councils have to consider and decide upon the facts brought before the Medical Council of India and/or State Medical Councils. 8.2   It   is   made   clear   that   any   complaint   with   regard   to professional misconduct can be brought before the appropriate Medical   Council   for   Disciplinary   action.   Upon   receipt   of   any complaint of professional misconduct, the appropriate Medical Council   would   hold   an   enquiry   and   give   opportunity   to   the registered   medical   practitioner   to   be   heard   in   person   or   by pleader.   If   the   medical   practitioner   is   found   to   be   guilty   of committing   professional   misconduct,   the   appropriate   Medical Council may award such punishment as deemed necessary or may direct the removal altogether or for a specified period, from the register of the name of the delinquent registered practitioner. Deletion   from   the   Register  shall   be   widely  publicized   in   local press   as   well   as   in   the   publications   of   different   Medical Associations/ Societies/Bodies.”  56. It is further pointed out that Pharmacy Practice Regulations, 2015 also require pharmacists to maintain records.  The relevant portion of the Regulations is extracted hereunder: “ 6.2 Maintenance of patient records .— (a)   Every   registered   pharmacist   shall   maintain   the   medical/ prescription records pertaining to his / her patients for a period of 5 years from the date of commencement of the treatment as laid down by the Pharmacy Council of India in Appendix II. (b)   If   any   request   is   made   for   medical   records   either   by   the patients/authorised attendant or legal authorities involved, the same may be duly acknowledged and documents shall be issued within the period of 72 hours. (c)   Efforts   shall   be   made   to   computerize   medical/prescription records for quick retrieval.” 57. Reference   has   also   been   made   to   the   provisions   of   the Transplantation of Human Organs and Tissues Act, 1994 and Rules,   which   contain   provisions   that   are   similar   to   the   Act. Section 20 of the Transplantation of Human Organs and Tissues Act, 1994, reads thus: 54 “ 20.  Punishment for contravention of any other provision of this Act.—  Whoever contravenes any provision of this Act or any rule   made,   or   any   condition   of   the   registration   granted, thereunder for which no punishment is separately provided in this Act, shall be punishable with imprisonment for a term which may extend to five years or with fine which may extend to twenty lakh rupees.” 58. Reference has also been made to the Medical Termination of Pregnancy Act, 1971, which also places an obligation on medical professional to maintain proper records.   59. When we scrutinise the Form ‘F’ with the provisions of the Act/Rules and there cannot be any dispute with respect to serial Nos.1 and 2 wherein name and address of Genetic Laboratory and its registration number is required to be mentioned in the Form as it is necessary to have a registration under Section 18 of the Act.  It cannot be said to be a clerical requirement.  Patient name and her age at serial No.3 is also absolutely necessary so as to identify a person who is undergoing the test and before the age   of   35   years,   it   cannot   be   conducted   as   provided   under Section 4(3)(i).  The same is as per the mandatory requirement of Section 4.  Husband’s/father’s name is also necessary as per the statutory mandate for the purpose of identification of patient. Full address is also mandatory so as to ascertain the identity who is  undergoing   such   test.     In   case   these   information   are   kept 55 vague, the violation of the Act would be blatant and unchecked and offence can never be detected.  Information at serial No.8 of the Form ‘F’ requires last menstrual period/weeks of pregnancy to be mentioned, same is also necessary to be mentioned as it has co­relation with the investigations and provisions of the Act and the rules framed thereunder.  The column in Form at serial No.9 requires history of genetic/medical disease in the family to be specified which is as per the mandate of Section 4(3)(iv) of the Act.   Form ‘F’ at serial No.10 requires indication for pre­natal diagnosis which is mandatory as per the provisions contained in Section 4(2) as except for the purposes as mentioned in Sections 4(2) and 4(3) no such tests/procedures can be performed.  Thus, what   is   mandated   by   the   Sections   and   in   Rule   9   has   been mentioned in the Form ‘F’.  Procedure carried whether invasive or non­invasive   has   to   be   obviously   mentioned   and   in   case   any laboratory tests have been recommended that is to be mentioned along with the result.  The note attached to Form ‘F’ also contains the   representative   list   of   indications   when   ultrasound   during pregnancy can be performed.  Thus, though the submission that Form   ‘F’   is   clerical   requirement   urged   by   learned   counsel appearing for the petitioner­Society appears at the first blush to 56 be worthy examination, but on close scrutiny it is found that in case any information in the Form is avoided, it will result in the blatant violation of the provisions of Section 4 and may lead to result which is prohibited under               Section 6.  It cannot be said to be a case of clerical error as doctor has to fulfil pre­ requisites for undertaking the procedure in case the conditions precedent   for   undertaking   pre­natal   diagnostic   test   is   not specifically   mentioned,   it   would   be   violative   of   provisions contained in Section 4.   The Form ‘F’ has to be prepared and signed by either Gynaecologist/Medical Geneticist / Radiologist / Paediatrician / Director of the Clinic/Centre/Laboratory.  In case the indications and the information are not furnished as provided in   the   Form   ‘F’   it   would   amount   that   condition   precedent   to undertake   the   test/procedure   is   absent.     There   is   no   other barometer   except   Form   ‘F’   to   find   out   why   the   diagnostic test/procedure   was   performed.     In   case   such   an   important information   beside   others   is   kept   vague   or   missing   from   the Form,   it   would   defeat   the   very   purpose   of   the   Act   and   the safeguards provided thereunder and it would become impossible to check violation of provisions of the Act.  It is not the clerical job  to   fill  the   form,   it  is   condition   precedent   for   undertaking 57 test/procedure.  With all due regards to the submission advanced on behalf of petitioner­Society that it is a clerical job, is wholly without substance but it is a responsible job of the person who is undertaking   such   a   test   i.e.,   the   Gynaecologist/   Medical Geneticist/   Radiologist   /   Paediatrician   /   Director   of   the Clinic/Centre/Laboratory   to   fill   the   requisite   information.     In case he keeps it vague, he knows fully well that he is violating the provisions of the Act and undertaking the test without existence of   the   conditions   precedent   which   are   mandatory   to   exist   he cannot undertake test/procedure without filling such information in   the   form.   There   is   no   other   way   to   ensure   that   test   is undertaken on fulfilment of the prescribed conditions.  There is nothing else but the record which required to be maintained and on the basis of which counter­check can be made.  There is no other   barometer   or   criteria   to   find   out   the   violation   of   the provisions of the Act.  Rule 9(4) also requires that every Genetic Clinic to fill Form ‘F’ wherein information with regard to details of the patient, referral notes with indication and case papers of the patient are required to be filled and preserved.   Form ‘F’ lays down the indicative list for conducting ultrasonography during pregnancy.  Form ‘F’ being technical in nature gives the insight 58 into the reasons for conducting ultrasonography and incomplete Form ‘F’ raises the presumption of doubt against the medical practitioner.  In the absence of Form ‘F’, Appropriate Authorities will have no tool to supervise the usage of ultrasound machine and shall not be able to regulate the use of the technique which is the object of the Act. 60. It is rightly contended on behalf of respondents that there are different forms for record keeping prescribed under the Act and the  Rules  they are important  and interlinked,  operate  in tandem with one another.  These records have to be maintained only when the  procedure  or  tests  are  conducted  on pregnant woman   or   when   patient   may   have   been   advised   to   use   pre­ conception diagnostic tools to conceive a child.  It is required for Genetic Counselling Centre advising the procedure/test with a potential of detecting or determining the sex of the foetus and referring   a   person   to   a   Genetic   Clinic/Imaging Centre/Ultrasound Clinic to record the details of Genetic Clinic to which patient is referred at point 15 of the Form ‘D’ along with the details of the diagnosis and relevant medical details of the person.  Accordingly, Genetic Clinic/Imaging Centre/Ultrasound Clinic conducting the aforesaid referred procedure has to record 59 the name and address of Genetic Counselling Centre with the referral slip along with the relevant medical record of the person on whom procedure/test/technique is conducted.  The aforesaid record   keeping   procedure   shall   be   followed   by   Genetic Laboratories also.  The scheme of the Act makes it evident that record keeping is meant to track/monitor and regulate the use of technology   that   has   potential   of   sex   selection   and   sex determination.  Section 23 is not stand­alone Section.  It is rather used   in   the   enforcement   of   other   provisions   of   the   Act   and violations of Section 23 are often accompanied by violations of provisions of Sections 4, 5, 6 and 18 of the Act.  It is submitted that   non­maintenance   of   record   in   the   context   of   sex determination is not merely a technical or procedural lapse.  It is most significant piece of evidence for identifying offence and the accused.     The   inspection   of   records   is   crucial   to   identify wrong­doers as the crime of sex determination being a collusive crime given  the   nexus   between  the   patients   and   the   doctors. Accordingly,   punishment   is   provided   in   Section   23   for   not maintaining the records. 61. Ms. Pinki Anand, learned Additional Solicitor General has relied upon a case study on record keeping as an implementation 60 tool of Prabhakar Hospital in Panipat.  In this case Hospital had not sent the report of IVF done at its Centre to the Appropriate Authority despite meeting held on 10.10.2013 and subsequent reminders.  After thirteenth reminder dated 27.11.2014, a show cause   notice   was   issued   to   the   Hospital   on   2.2.2015.     The aforesaid case study reads thus: “In the case of this Hospital the report of IVF done at the centre was not sent to the Appropriate Authority despite meetings held on   10.10.2013   and   reminders   sent   on   6.3.2014,   14.3.2014, 20.3.2014,   21.3.2014,   25.3.2014,   28.3.2014,   31.3.2014   and finally with a thirteenth reminder on 27.11.2014. During inspection following discrepancies were found­ a. In form no.9338, In­vitro Fertilization (IVF) was done on patient  with  2  female   children  with   repeated   history  of 4 abortions. b. In form no.9700, woman with 8 female children received IVF. c. In form no.10385, patient Santosh with 7 female children received   IVF   but   did   not   fill   the  section   C   in   F­Form. Section C in form F pertains to the records of the invasive procedures   which   requires   records   of   all   diagnostic procedures done on men and women which has potential of sex determination/selection to be recorded. d. Form no.10389, woman with 3 female children received IVF, form F Section C not filled in. e. Form   no.9338,   woman   had   2   female   children   and   6 abortions, and received IVF. f. Form no.9700, a woman with 8 female children received IVF. The hospital was asked why patients who had female children underwent IVF as evident from the records.   In several of the cases it is inexplicable why the samples were sent to Delhi and Bombay.   In many F forms many female patients with wrong phone   numbers   were   mentioned.    Similarly  in   other   Form   F, patients with wrong identity proofs, address proof and no identity proofs were found.  In another set of form F wrong Obstetric and Abortion history was mentioned as confirmed from the patients. Difference   history   on   referral   slip   and   Form   F   was   observed. Signature of patient was found to be missing in the consent form in many forms.  The Signature of the witness Doctor/Counsellor was missing in all consent forms of IVF patients.  Accordingly a complaint has been filed in the court.” 61 (emphasis supplied) 62. It is submitted that the record keeping provide information on individual patients who could have potentially undergone sex selection/determination techniques, which is an offence under this  Act.     If  record  keeping   is   diluted   or   exempted   from   the mandatory requirement of the Act, the probable involvement in sex   determination   and   sex   selection   in   the   guise   of   use   of diagnostic techniques would continue unbated. 63. The way in which the non­maintenance of record can be used for violating the provisions of the Act, is apparent from the aforesaid example.  The aforesaid facts have been mentioned in the show cause notice that had been issued.  In many Form ‘F’ female patients with wrong phone numbers were mentioned.  In other Form ‘F’ patients with wrong identity, proof of address and no identity proof were found.   In another set of Form ‘F’ wrong obstetric   and   abortion   history   was   mentioned.     Signature   of patient was also found missing in the consent forms.  Thus, the non­filling of information cannot be termed to be clerical error, but in case it is kept vague that itself facilitates an offence.   It would   definitely   a   blatant   and   intentional   violation   of   the provisions of the Act in order to prevent the mischief which is 62 intended to by maintenance of record, filling up details of the forms is mandated by Sections 4 and 5.  The wholesome social legislation would be defeated in case Form is not filled which is sine qua non   toto   undertake tests/procedures if such condition does not exist, no such procedure can be performed and diluting the provisions would be against the gender justice.  It is in order to create the equality that the provisions have been enacted not that unequals are being treated equally.  The non­maintenance of form/not   reflecting   correct   medical   condition   is   offence,   not mentioning it would also be an offence or keeping it vague. 64. It   was   pointed   on   behalf   of   petitioner­Society   by   filing certain affidavits of the medical practitioners raising grievances with   regard   to   the   criminal   cases   filed   against   them   by   the Appropriate Authority on certain grounds.   Acquittals have also been recorded, but they are not attributable to the deficiency in the Act.  The provision of the law cannot be struck down on the ground   of   allegation   of   such   exercise   of   power   in   arbitrary manner,   especially   when   0.46   million   girls   were   stated   to   be missing at birth as a result of sex selective abortions. 63 65. In  Voluntary Health Association of Punjab v. Union of India , (2016) 10 SCC 265, this Court observed as under: “46. Now, we shall advert to the prayers in Writ Petition (Civil) No.   575   of   2014.   The   writ   petition   has   been   filed   by   Indian Medical Association (IMA). It is contended that Sections 3­A, 4, 5, 6, 7, 16, 17, 20, 23, 25, 27 and 30 of the Act and Rules 9(4), 10 & Form "F" (including foot­note), which being the subject matter of concern in the instant writ petition, are being misused and wrongly interpreted by the authorities concerned thereby causing undue   harassment   to   the   medical   professionals   all   over   the country under the guise of the 'so­called implementation'. It is also urged that, implementation of steps and scrutiny of records was   started   at   large   scale   all   over   the   country   and   lot   of anomalies   were   found   in   records   maintained   by   doctors throughout the country. It is however pertinent to mention here that the majority of the defaults were of technical nature as they were merely minor and clerical errors committed occasionally and inadvertently in the filing of Form "F". It is also put forth that the Act does not classify the offences and owing to the liberal and vague terminology used in the Act, it is thrown open for misuse by the implementing authorities concerned and has resulted into taking of cognizance of non­bailable (punishable by three years) offences against doctors even in the cases of clerical errors, for instance non­mentioning of N.A. (Not Applicable) or leaving of any column   in   the   Form   "F"   concerned   as   blank.   It   is   further submitted   that   the   said   unfettered   powers   in   the   hands   of implementing authority have resulted into turning of this welfare legislation into a draconian novel way of encouraging demands for bribery as well as there is no prior independent investigation as mandated Under Section 17 of the Act by these Authorities. It is also set forth that the Act states merely that any contravention with   any   of   the   provisions   of   the   Act   would   be   an   offence punishable Under Section 23(1) of the said Act and further all offences under the Act have been made non­bailable and non­ compoundable and the misuse of the same can only be taken care of by ensuring that the Appropriate Authority applies its mind to the fact of each case/complaint and only on satisfaction of a prima facie case, a complaint be filed rather than launching prosecution mechanically in each case. With these averments, it has   been   prayed   for   framing   appropriate   guidelines   and safeguard parameters, providing for classification of offences as well, so as to prohibit the misuse of the PCPNDT Act during implementation and to read down this Sections 6, 23, 27 of the PCPNDT   Act.   That   apart,   it   has   been   prayed   to   add   certain provisos/exceptions   to   Sections   7,   17,   23   and   Rule   9   of   the Rules. 64 47. In our considered opinion, whenever there is an abuse of the process   of   the   law,   the   individual   can   always   avail   the   legal remedy. As we find, neither the validity of the Act nor the Rules has been specifically assailed in the writ petition. What has been prayed   is   to   read   out   certain   provisions   and   to   add   certain exceptions. We are of the convinced view that the averments of the present nature with such prayers cannot be entertained and, accordingly, we decline to interfere.” (emphasis supplied) 66. The emphasis of this Court is on the proper maintenance of records.   In   Centre for Enquiry into Health and Allied Themes (CEHAT) v. Union of India,  (2001) 5 SCC 577, this Court observed thus:   “3. It is apparent that to a large extent, the PNDT Act is not implemented   by   the   Central   Government   or   by   the   State Governments. Hence, the petitioners are required to approach this Court under Article 32 of the Constitution of India……Prima facie   it   appears   that   despite   the   PNDT   Act   being   enacted   by Parliament five years back, neither the State Governments nor the   Central   Government   has   taken   appropriate   action   for   its implementation.   Hence,   after   considering   the   respective submissions   made   at   the   time   of   hearing   of   this   matter,   as suggested by the learned Attorney­General for India, Mr Soli J. Sorabjee,   the   following   directions   are   issued   on   the   basis   of various provisions for the proper implementation of the PNDT Act: II. Directions to the Central Supervisory Board (CSB) 1. * 2. * 3.   CSB   shall   issue   directions   to   all   State/UT   appropriate authorities to furnish quarterly returns to CSB giving a report on the implementation and working of the Act. These returns should inter alia contain specific information about: (i) survey of bodies specified in Section 3 of the Act; (ii) registration of bodies specified in Section 3 of the Act; (iii)   action   taken   against   non­registered   bodies   operating   in violation of Section 3 of the Act, inclusive of search and seizure of records; 65 (iv) complaints received by the appropriate authorities under the Act and action taken pursuant thereto; (v) number and nature of awareness campaigns conducted and results flowing therefrom.….” 67. In  Voluntary Health Association of Punjab v. Union of India, (2013) 4 SCC 1, the Court dealt with the issue of maintenance of record and issued the following directions: “9.4.   The   authorities   should   ensure   also   that   all   genetic counselling   centres,   genetic   laboratories   and   genetic   clinics, infertility clinics, scan centres etc. using preconception and pre­ natal diagnostic techniques and procedures should maintain all records and all forms, required to be maintained under the Act and the Rules and the duplicate copies of the same be sent to the district authorities concerned, in accordance with Rule 9(8) of the Rules. 9.6. There will be a direction to all genetic counselling centres, genetic laboratories, clinics etc. to maintain Forms A, E, H and other   statutory   forms   provided   under   the   Rules   and   if   these forms are not properly maintained, appropriate action should be taken by the authorities concerned.” 68. The High Court of Gujarat in  Suo Motu v. State of Gujarat, (2009) 1 Gujarat Law Reporter 64, dealt at length with the issue of proper maintenance of record and observed as under: “5.    A  conjoint  reading  of   the  above  provisions  would  clearly indicate a well­knit legislative scheme for ensuring a strict and vigilant enforcement of the provisions of the Act directed against female foeticide and misuse of pre­natal diagnostic techniques….  * 7.     As   seen   earlier,   the   Act   and   the   Rules   made   thereunder provide for an elaborate scheme to ensure proper implementation of   the   relevant   legal   provisions   and   the   possible   loopholes   in strict and full compliance are sought to be plugged by detailed provisions for maintenance and preservation of records. In order to fully operationalise the restrictions and injunctions contained in the Act in general and in Secs. 4, 5 and 6 in particular, to regulate the use of pre­natal diagnostic technique, to make the pregnant   woman   and   the   person   conducting   the   pre­natal diagnostic   tests   and  procedures   aware   of  the  legal   and   other 66 consequences and to prohibit determination of sex, the Rules prescribe   the   detailed   forms   in   which   records   have   to   be maintained. Thus, the Rules are made and forms are prescribed in aid of the Act and they are so important for implementation of the Act and for prosecution of the offenders, that any improper maintenance of such record is itself made equivalent to violation of the provisions of Secs. 5 and 6, by virtue of the proviso to sub­ sec. (3) of Sec. 4 of the Act. It must, however, be noted that the proviso would apply only in cases of ultra­sonography conducted on a pregnant woman. And any deficiency or inaccuracy in the prescribed   record   would   amount   to   contravention   of   the provisions of Secs. 5 and 6 unless and until contrary is proved by the   person   conducting   such   ultra­sonography.   The   deeming provision   is   restricted   to   the   cases   of   ultra­sonography   on pregnant women and the person conducting ultra­sonography is, during the course of trial or other proceeding, entitled to prove that the provisions of Secs. 5 and 6 were, in fact, not violated. 8. It needs to be noted that improper maintenance of the record has   also   consequences   other   than   prosecution   for   deemed violation   of   Secs.   5   or   6.   Section   20   of   the   Act   provides   for cancellation or suspension of registration of Genetic Counselling Centre, Genetic Laboratory or Genetic Clinic in case of breach of the provisions of the Act or the Rules. Therefore, inaccuracy or deficiency in maintaining the prescribed record shall also amount to   violation   of  the   prohibition  imposed   by  Sec.   6  against   the Genetic Counselling Centre, Genetic Laboratory or Genetic Clinic and expose such clinic to proceedings under Sec. 20 of the Act. Where, by virtue of the deeming provisions of the proviso to sub­ sec. (3) of Sec. 4, contravention of the provisions of Secs. 5 or 6 is legally presumed and actions are proposed to be taken under Sec. 20, the person conducting ultra­sonography on a pregnant woman shall also have to be given an opportunity to prove that the   provisions   of   Secs.   5   or   6   were   not   violated   by   him   in conducting  the   procedure.   Thus,   the   burden   shifts   on   to   the person accused of not maintaining the prescribed record, after any   inaccuracy   or   deficiency   is   established,   and   he   gets   the opportunity to prove that the provisions of Secs. 5 and 6 were not contravened in any respect. Although it is apparently a heavy burden, it is legal, proper and justified in view of the importance of the Rules regarding maintenance of record in the prescribed forms   and   the   likely   failure   of   the   Act   and   its   purpose   if procedural requirements were flouted. The proviso to sub­sec. (3) of Sec. 4 is crystal clear about the maintenance of the record in prescribed manner being an independent offence amounting to violation of Secs. 5 or 6 and, therefore, the complaint need not necessarily also allege violation of the provisions of Secs. 5 or 6 of the Act. A rebuttable presumption of violation of the provisions of Secs. 5 or 6 will arise on proof of deficiency or inaccuracy in maintaining the record in the prescribed manner and equivalence with those provisions would arise for punishment as well as for disproving their violation by the accused person. That being the scheme of these provisions, it would be wholly inappropriate to quash   the   complaint   leging   inaccuracy   or   deficiency   in 67 maintenance of the prescribed record only on the ground that violation of Secs. 5 or 6 of the Act was not alleged or made out in the complaint. It would also be improper and premature to expect or   allow   the   person   accused   of   inaccuracy   or   deficiency   in maintenance   of   the   relevant   record   to   show   or   prove   that provisions of Secs. 5 or 6 were not violated by him, before the deficiency   or   inaccuracy   were   established   in   Court   by   the prosecuting agency or before the authority concerned in other proceedings.” 69. The Act enjoys a presumption of constitutionality.  We find no   violation   of   the   constitutional   principles.     The   problem   of female   foeticide   is   worldwide   and   the   matters   of   common knowledge, reports and history are the basis of the legislation, provisions of which cannot be termed to be illegal or arbitrary in any manner.   In   Namit Sharma v. Union of India,  (2013) 1 SCC 745, this Court has laid down as under:   “18.  The principles for adjudicating the constitutionality of a provision   have   been   stated   by   this   Court   in   its   various judgments. Referring to these judgments and more particularly to Ram Krishna Dalmia v. Justice S.R. Tendolkar, AIR 1958 SC 538 and Budhan Choudhry v. State of Bihar, AIR 1955 SC 191, the author Jagdish Swarup in his book  Constitution of India  (2nd Edn., 2006) stated the principles to be borne in mind by the courts and detailed them as follows: (Ram Krishna Dalmia case, AIR pp. 547­48, para 11) “( a ) ( b )   that   there   is   always   a   presumption   in   favour   of   the constitutionality of an enactment and the burden is upon him who attacks it to show that there has been a clear transgression of the constitutional principles; ( c ) that it must be presumed that the legislature understands and correctly appreciates the need of its own people, that its laws are directed to problems made manifest by experience and that its discriminations are based on adequate grounds; ( d ) ( e ) that in order to sustain the presumption of constitutionality the   court   may   take   into   consideration   matters   of   common knowledge, matters of common report, the history of the times and may assume every state of facts which can be conceived existing at the time of legislation; and 68 ( f )” 70. The   petitioner   has   not   shown   which   of   the   entry   is   not mandatory in the form.  As the entries are mandatory and  sine qua   non   for   undertaking   a   test/procedure,   the   assertion   that their   fundamental   rights   are   being   violated   by   not   providing requisite information is not germane and is without substance. 71. The Act intends to prevent mischief of female foeticide and the declining sex ratio in India.  When such is the objective of the Act   and   the   Rules   and   mischief   which   it   seeks   to   prevent, violation of the rights under Part III of the Constitution is not found.  This Court in  Hamdard Dawakhana v. The Union of India, AIR 1960 SC 554, has laid down the following principles: “8.   Therefore,   when   the   constitutionality   of   an   enactment   is challenged on the ground of violation of any of the articles in Part III of the Constitution, the ascertainment of its true nature and character becomes necessary i.e. its subject matter, the area in which it is intended to operate, its purport and intent have to be determined.   In   order   to   do   so   it   is   legitimate   to   take   into consideration all the factors such as history of the legislation, the purpose thereof, the surrounding circumstances and conditions, the mischief which it intended to suppress, the remedy for the disease which the legislature resolved to cure and the true reason for the remedy; Bengal Immunity co. Ltd. v. State of Bihar, 1955­ 2 SCR 603 at pp. 632, 633 ( (S) AIR 1955 SC 661 at p.674); R.M.D. Chamarbaughwala v. Union of India, 1957 SCR 930 at p. 936: ( (S) AIR 1957 SC 628 at p.631); Mahant Moti Das v. S.P. Sahi, AIR 1959 SC 942 at p. 948. 9. Another principle which has to borne in mind in examining the constitutionality of a statute is that it must be assumed that the legislature understands and appreciates the need of the people and the laws it enacts are directed to problems which are made 69 manifest   by   experience   and   that   the   elected   representatives assembled in a legislature enact laws which they consider to be reasonable   for   the   purpose   for   which   they   are   enacted. Presumption is, therefore, in favour of the constitutionality of an enactment. Charanjit Lal v. Union of India, 1950 SCR 869: (AIR 1951 SC 41); State of Bombay v. F.N. Bulsara, 1951 SCR 682 at p. 708: (AIR 1951 SC 318 at p. 326); AIR 1959 SC 942.” 72. The mischief sought to be remedied is grave and the effort is being made to meet the challenge to prevent the birth of the girl child.  Whether Society should give preference to male child is a matter of grave concern.  The same is violative of Article 39A and ignores  the   mandate   of   Article   51A(e)  which   casts   a   duty   on citizens to renounce practices derogatory to the dignity of women. When sex selection is prohibited by virtue of provisions of Section 6, the other interwoven provisions in the Acts to prevent the mischief obviously their constitutionality is to be upheld.  73. The provisions of MTP Act came up for consideration before the High Court of Delhi in  Raj Bokaria v. Medical Council of India (W.P. (C) No.795 of 2010), it observed:  “11. On a reading of Section 5 of the MTP Act, it appears to this Court that the opinion formed by the medical practitioner to go for   either   MTP   or   pre­term   inducement   of   labour   when   the pregnancy is beyond 20 weeks, has necessarily to be in writing and in the prescribed format. There was no question of there not being any record whatsoever of the forming of such opinion of the medical   practitioner.  The  argument  advanced  by  Ms.   Acharya that in a case of emergency there may be no time for recording such opinion cannot explain the failure to record an opinion in the  present case.  The facts  narrated  by the  Petitioner  herself show that a very conscious decision was taken of going for a pre­ term inducement of labour sometime around 6th October 2003 when the deceased was admitted to Respondent No. 3 hospital. 70 Even at that time the opinion of the Petitioner should have been recorded.   The   pre­term   induced   delivery   took   place   on   8th October   2003.   There   was   sufficient   time,   therefore,   for   the Petitioner to record her opinion, mandatorily required by Section 5(1).  In   terms   of   Rule   3(1)   of   the   Medical   Termination   of Pregnancy   Regulations,   2003   the   medical   practitioner   has   to record her opinion in Form I. The non­maintenance of records to show the basis on which an opinion was formed to going in for a pre­term inducement in a case where the pregnancy is beyond the 20th week is indeed a very serious lapse.  There can be no excuse whatsoever for a medical practitioner seeking to defend herself with reference to Section 5 of the MTP Act not maintaining any record of the formation of the opinion in terms of Section 5(1) read with the Regulations of 2003. In the considered view of this Court, the above factor alone is enough to demonstrate the gross negligence on the part of the Petitioner.” (emphasis supplied) 74. On   behalf  of   petitioner­Society,   reliance   has  been  placed regarding  mens rea  on  Arun Bhandari v. State of Uttar Pradesh, (2013) 2 SCC 801, wherein the Court observed as under: “22. In G.V. Rao v. L.H.V. Prasad,(2000) 3 SCC 693, this Court has held thus: (SCC pp. 696­97, para 7) “7. As mentioned above, Section 415 has two parts. While in   the   first   part,   the   person   must   ‘dishonestly’   or ‘fraudulently’   induce   the   complainant   to   deliver   any property;   in   the   second   part,   the   person   should intentionally induce the complainant to do or omit to do a thing. That is to say, in the first part, inducement must be   dishonest   or   fraudulent.   In   the   second   part,   the inducement should be intentional. As observed by this Court in Jaswantrai Manilal Akhaney v. State of Bombay, AIR   1956   SC   575,   a   guilty   intention   is   an   essential ingredient of the offence of cheating. In order, therefore, to   secure   conviction   of   a   person   for   the   offence   of cheating, ‘mens rea’ on the part of that person, must be established. It was also observed in Mahadeo Prasad v. State   of   W.B.,   AIR   1954   SC   724,   that   in   order   to constitute the offence of cheating, the intention to deceive should be in existence at the time when the inducement was offered.” No sustenance can be drawn from the aforesaid decision as keeping the information blank is definitely a violation of the Act 71 and very basic fundamental requisite for undertaking the test. Thus, when form has not been filled up, obviously the act is dishonest, fraudulent and can be termed intentional also.  Such case cannot be classified into clerical error.   75. Reliance has also been placed on the decision of this Court in   Dr.   Subhash   Kashinath   Mahajan   v.   State   of   Maharashtra , (2018) 6 SCC 454, in which this Court observed that the Court has to balance the right of liberty of the accused guaranteed under Article 21, which could be taken away only by just, fair and reasonable procedure and to check abuse of power by police and injustice to a citizen.  Thus, some filters were required to be incorporated to meet the mandate of Articles 14 and 21.   The substantive as well as procedural laws must conform to Articles 14 and 21.  The expression procedure established by law under Article 21 implies just, fair and reasonable procedure.  The court to make purposive interpretation and consider the doctrine of proportionality.  This Court has observed thus:  “12. The learned Amicus submitted that under the scheme of the Atrocities   Act,   several   offences   may   solely   depend   upon   the version of the complainant which may not be found to be true. There may not be any other tangible material. One sided version, before trial, cannot displace the presumption of innocence. Such version may at times be self­serving and for extraneous reason. Jeopardising liberty of a person on an untried unilateral version, without   any   verification   or   tangible   material,   is   against   the fundamental rights guaranteed under the Constitution. Before 72 liberty of a person is taken away, there has to be fair, reasonable and just  procedure. Referring  to Section 41(1)( b ) CrPC it  was submitted   that   arrest   could   be   effected   only   if   there   was “credible” information and only if the police officer had “reason to believe”   that   the   offence   had   been   committed   and   that   such arrest   was   necessary.   Thus,   the   power   of   arrest   should   be exercised   only   after   complying   with   the   safeguards   intended under Sections 41 and 41­A CrPC. It was submitted that the expression “reason to believe” in Section 41 CrPC had to be read in the light of Section 26 IPC and judgments interpreting the said expression. The said expression was not on a par with suspicion. Reference has been made in this regard to Joti Parshad v. State of Haryana, 1993 Supp (2) SCC 497,  Badan Singh  v.  State of U.P., 2001 SCC OnLine All 973,  Adri Dharan Das  v.  State of W.B.,   (2005)   4   SCC   303,  Tata   Chemicals   Ltd.  v.  Commr.   of Customs, (2015) 11 SCC 628 and Ganga Saran & Sons (P) Ltd. v. CIT, (1981) 3 SCC 143.  In the present context, to balance the right of liberty of the accused guaranteed under Article 21, which could be taken away only by just, fair and reasonable procedure and to check abuse of power by police and injustice to a citizen, exercise of right of arrest was required to be suitably regulated by way of guidelines by this Court under Article 32 read with Article 141   of   the   Constitution.   Some   filters   were   required   to   be incorporated   to   meet   the   mandate   of   Articles   14   and   21   to strengthen the rule of law. * 31. We may, at the outset, observe that jurisdiction of this Court to   issue   appropriate   orders   or   directions   for   enforcement   of fundamental rights is a basic feature of the Constitution. This Court,  as the  ultimate  interpreter  of the  Constitution,  has  to uphold the constitutional rights and values. Articles 14, 19 and 21 represent the foundational values which form the basis of the rule of law. Contents of the said rights have to be interpreted in a manner which enables the citizens to enjoy the said rights. Right to equality and life and liberty have to be protected against any unreasonable procedure, even if it is enacted by the legislature. The   substantive   as   well   as   procedural   laws   must   conform   to Articles 14 and 21. Any abrogation of the said rights has to be nullified by this Court by appropriate orders or directions. Power of   the   legislature   has   to   be   exercised   consistent   with   the fundamental rights. Enforcement of a legislation has also to be consistent with the fundamental rights. Undoubtedly, this Court has   jurisdiction  to  enforce  the  fundamental  rights  of  life   and liberty against any executive or legislative action. The expression “procedure established by law” under Article 21 implies just, fair and reasonable procedure. * 53. It is well settled that a statute is to be read in the context of the background and its object. Instead of literal interpretation, the   court   may,   in   the   present   context,   prefer   purposive interpretation   to   achieve   the   object   of   law.   Doctrine   of proportionality is well known for advancing the object of Articles 14   and   21.   A   procedural   penal   provision   affecting   liberty   of 73 citizen must be read consistent with the concept of fairness and reasonableness.” (emphasis supplied) No sustenance can be drawn from aforesaid decision as the procedure   under   the   Act   is   due   procedure   of   law   with   the safeguards of not only of appeals under Section 21 and Rule 19, but there is a State Supervisory Board in Section 16A.   The constitution of multi­member Appropriate Authority is provided in Section 17(3)(a) and the Advisory Committee as provided in Section 17(6) which is again also a multi­member Committee. The Advisory Committee has to aid and advise the Appropriate Authority   in   discharge   of   its   functions.     Thus,   internal safeguards are provided in the Act and the Rules which conform to Articles 14 and 21. 76. Reliance has also been placed on   Gian Kaur v. State of Punjab , (1996) 2 SCC 648, wherein this Court dealt with the provisions of right to die within the ambit of Article 21.  While discussing the aforesaid, this Court has observed thus:  “43. This caution even in cases of physician­assisted suicide is sufficient to indicate that assisted suicides outside that category have  no rational basis  to claim exclusion of the fundamental principles of sanctity of life. The reasons assigned for attacking a provision which penalises attempted suicide are not available to the abettor of suicide or attempted suicide. Abetment of suicide or attempted suicide is a distinct offence which is found enacted even in the law of the countries where attempted suicide is not made   punishable.   Section   306   IPC   enacts   a   distinct   offence 74 which can survive independent of Section 309 in the IPC. The learned  Attorney  General  as  well as  both  the  learned  amicus curiae rightly supported the constitutional validity of Section 306 IPC.” (emphasis supplied) 77. In   Subramanian Swamy v. Union of India,   (2016) 7 SCC 221,   it   was   observed   that   restriction   that   goes   beyond   the requirement   of   public   interest   cannot   be   considered   as   a reasonable   restriction   and   would   be   arbitrary.       The   same reasonableness is not a static concept.  Articles 14 and 19 are part of Article 21.   Misuse of a provision or its possibility of abuse   is   no   ground   to   declare   Section   499   IPC   as unconstitutional.  If a provision of law is misused or abused, it is for the Legislature  to  amend,  modify  or  repeal  it. This Court has observed thus:  “9.3. Section 499 IPC  ex facie  infringes free speech and it is a serious inhibition on the fundamental right conferred by Article 19(1)( a )   and   hence,   cannot   be   regarded   as   a   reasonable restriction   in   a   democratic   republic.  A   restriction   that   goes beyond the requirement of public interest cannot be considered as a reasonable restriction and would be arbitrary. Additionally, when the provision even goes to the extent of speaking of truth as an   offence   punishable   with   imprisonment,   it   deserves   to   be declared unconstitutional, for it defeats the cherished value as enshrined   under   Article   51­A( b )   which   is   associated   with   the national   struggle   for   freedom.   The   added   requirement   of   the accused having to prove that the statement made by him was for the public good is unwarranted and travels beyond the limits of reasonableness because the words “public good” are quite vague as   they   do   not   provide   any   objective   standard   or   norm   or guidance as a consequence the provisions do not meet the test of reasonable restriction and eventually they have the chilling effect on the freedom of speech. 75 9.4.  “Reasonableness” is not a static concept, and it may vary from time to time. What is considered reasonable at one point of time may become arbitrary and unreasonable at a subsequent point of time.  The colonial law has become unreasonable and arbitrary in independent India which is a sovereign, democratic republic and it is a well­known concept that provisions once held to be reasonable, become unreasonable with the passage of time. * 10.3.  Reasonable   restriction   is   founded   on   the   principle   of reasonableness which is an essential facet of constitutional law and one of the structural principles of the Constitution is that if the restriction invades and infringes the fundamental right in an excessive manner, such a restriction cannot be treated to have passed   the  test   of  reasonableness.   The  language   employed  in Sections   499   and   500   IPC   is   clearly   demonstrative   of infringement   in   excess   and   hence,   the   provisions   cannot   be granted   the   protection   of   Article   19(2)   of   the   Constitution. Freedom   of   expression   is   quintessential   to   the   sustenance   of democracy   which   requires   debate,   transparency   and   criticism and dissemination of information and the prosecution in criminal law   pertaining   to   defamation   strikes   at   the   very   root   of democracy, for it disallows the people to have their intelligent judgment.  The intent of the criminal law relating to defamation cannot be the lone test to adjudge the constitutionality of the provisions   and   it   is  absolutely  imperative  to  apply  the  “effect doctrine” for the purpose of understanding its impact on the right of freedom of speech and expression, and if it, in the ultimate   eventuality, affects the sacrosanct right of freedom, it is     ultra . The basic concept of “effect doctrine” would not come in the   vires   category of exercise of power, that is, use or abuse of power but in the compartment of direct effect and inevitable result of law that abridges the fundamental right. * 17.2.  Articles 14 and 19 have now been read to be a part of Article 21 and, therefore, any interpretation of freedom of speech   under Article 19(1)(   a   ) which defeats the right to reputation under Article 21 is untenable.  The freedom of speech and expression under   Article   19(1)( a )   is   not   absolute   but   is   subject   to constrictions under Article 19(2). Restrictions under Article 19(2) have been imposed in the larger interests of the community to strike a proper balance between the liberty guaranteed and the social interests specified under Article 19(2). One’s right must be exercised so as not to come in direct conflict with the right of another citizen. The argument of the petitioners that the criminal law of defamation cannot be justified by the right to reputation under   Article   21   because   one   fundamental   right   cannot   be abrogated to advance another, is not sustainable. It is because ( i ) the right to reputation is not just embodied in Article 21 but also built in as a restriction placed in Article 19(2) on the freedom of speech in Article 19(1)( a ); and ( ii ) the right to reputation is no less important a right than the right to freedom of speech. * 76 18.2.  Misuse   of   a   provision   or   its   possibility   of   abuse   is   no ground   to   declare   Section   499   IPC   as   unconstitutional.   If   a provision of law is misused or abused, it is for the legislature to amend, modify or repeal it, if deemed necessary. Mere possibility of   abuse   of   a   provision   cannot   be   a   ground   for   declaring   a provision procedurally or substantively unreasonable. * 76.  The submission is that Sections 499 and 500 IPC are not confined to defamation of the State or its components but include defamation   of   any   private   person   by   another   private   person totally unconnected with the State. In essence, the proponement is that the defamation of an individual by another individual can be a civil wrong but it cannot be made a crime in the name of fundamental   right   as   protection   of   private   rights   qua   private individuals cannot be conferred the status of fundamental rights. If, argued the learned counsel, such a pedestal is given, it would be outside the purview of Part III of the Constitution and run counter to Articles 14, 19 and 21 of the Constitution. It is urged that   defamation   of   a   private   person   by   another   person   is unconnected   with   the   fundamental   right   conferred   in   public interest   by   Article   19(1)( a );   and   a   fundamental   right   is enforceable against the State but cannot be invoked to serve a private interest of an individual. Elucidating the same, it has been propounded that defamation of a private person by another person cannot be regarded as a “crime” under the constitutional framework and hence, what is permissible is the civil wrong and the remedy under the civil law. Section 499 IPC, which stipulates defamation of a private person by another individual, has no nexus with the fundamental right conferred under Article 19(1)( a ) of   the   Constitution,   for   Article   19(2)   is   meant   to   include   the public interest and not that of an individual and, therefore, the said constitutional provision cannot be the source of criminal defamation. This argument is built up on two grounds: ( i ) the common thread that runs through the various grounds engrafted under Article 19(2) is relatable to the protection of the interest of the State and the public in general and the word “defamation” has to be understood in the said context, and ( ii ) the principle of noscitur   a   sociis ,   when   applied,   “defamation”   remotely   cannot assume the character of public interest or interest of the crime inasmuch a crime remotely has nothing to do with the same. * 90.  In     R. Sai Bharathi       v.     J. Jayalalitha , (2004) 2 SCC 9, while opining about crime, it has been observed as under: (SCC pp. 54­ 55, para 56) “ 56 .  Crime is applied to those acts, which are against social   order   and   are   worthy   of   serious   condemnation.   Garafalo,   an   eminent   criminologist,   defined   “   ”   in   crime   terms of immoral and anti­social acts. He says that: ‘ crime is an immoral and harmful act that is regarded as criminal by public opinion because it is an injury to so much of the moral sense as is possessed by a community 77 — a measure which is indispensable for the adaptation of   the individual to society  ’. The authors of the Indian Penal Code stated that: ‘… We cannot admit that a Penal Code is by any means to be considered as a body of ethics, that the legislature ought   to   punish   acts   merely   because   those   acts   are immoral, or that, because an act is not punished at all, it follows   that   the   legislature   considers   that   act   as innocent.   Many   things   which   are   not   punishable   are morally worse than many things which are punishable. The man who treats a generous benefactor with gross ingratitude   and   insolence   deserves   more   severe reprehension than the man who aims a blow in passion, or breaks a window in a frolic; yet we have punishment for assault and mischief, and none for ingratitude.  The rich man who refuses a mouthful of rice to save a fellow creature from death may be a far worse man than the starving wretch who snatches and devours the rice; yet we punish the latter for theft, and we do not punish the former for hard­heartedness.’” * 96.  We   have   referred   to   this   facet   only   to   show   that   the submission so astutely canvassed by the learned counsel for the petitioners that treating defamation as a criminal offence can have no public interest and thereby it does not serve any social interest or collective value is sans substratum. We may hasten to clarify   that   creation   of   an   offence   may   be   for   some   different reason declared unconstitutional but it cannot be stated that the legislature cannot have a law to constitute an act or omission done by a person against the other as a crime. It depends on the legislative wisdom. Needless to say, such wisdom has to be in accord   with   constitutional   wisdom   and   pass   the   test   of constitutional challenge. If the law enacted is inconsistent with the constitutional provisions, it is the duty of the Court to test the law on the touchstone of the Constitution. * 122. In  State of Madras  v.  V.G. Row , AIR 1952 SC 196, the Court has ruled that the test of reasonableness, wherever prescribed, should be applied to each individual statute impugned and no abstract standard, or general pattern of reasonableness can be laid  down  as  applicable   to  all  cases.  The  nature   of   the  right alleged to have been infringed, the underlying purpose of the restrictions imposed, the extent and urgency of the evil sought to be   remedied   thereby,   the   disproportion  of   the   imposition,   the prevailing conditions at the time, should all enter into the judicial verdict. * 127. In  Sahara India Real Estate Corpn. Ltd. v. SEBI , (2012) 10 SCC 603, this Court reiterated the principle of social interest in the context of Article 19(2) as a facet of reasonable restriction. In Dwarka Prasad Laxmi Narain  v.  State of U.P. , AIR 1954 SC 224, while deliberating upon “reasonable restriction” observed that it 78 connotes that the limitation imposed upon a person in enjoyment of   a   right   should   not   be   arbitrary   or   of   an   excessive   nature beyond what is required in the interest of the public. It was also observed   that   to   achieve   quality   of   reasonableness   a   proper   balance between the freedom guaranteed under Article 19(1)(   g   ) and the social control permitted by clause (6) of Article 19 has to be struck.” (emphasis supplied) When we consider the aforesaid dictum and apply to the Act, nothing can be more sinister, immoral and anti­social act allowing female foeticide.   In   R. Sai Bharathi v. J. Jayalalitha (supra) it has been observed that crime is against social order, immoral and harmful act.   It has also been observed by this Court that legislature can have a law to constitute an act or omission   done   by   a   person   against   the   other   as   a   crime. Considering the evils sought to be remedied it cannot be said that the imposition in the Act in question is disproportionate. The restrictions and the provisions of punishment have close nexus with the object sought to be achieved.  It is not possible to term action as merely clerical one as that is pre­requisite for the test/procedure and that is what is intended by the Act, if it is given a go­bye under the guise of clerical error, the Act would be rendered otiose.  Restriction cannot be said to be excessive and beyond what is required in the public interest, they cater to the 79 felt need of the society and the complex issues facing people which the legislature intends to solve. 78. In   Shreya Singhal v. Union of India,   (2015) 5 SCC 1, the Court   dealt   with   provisions   of   Section   66­A   of   Information Technology Act, 2000.  This Court has observed thus: 55.  The US Supreme  Court has repeatedly held in a series of judgments that where no reasonable standards are laid down to define guilt in a section which creates an offence, and where no clear   guidance   is   given   to   either   law   abiding   citizens   or   to authorities and courts, a section which creates an offence and which   is   vague   must   be   struck   down   as   being   arbitrary   and   unreasonable.   Thus,   in    Musser      v.      Utah    ,   92   L   Ed   562   a   Utah statute which outlawed conspiracy to commit acts injurious to public morals was struck down. * 59. It was further held that a penal law is void for vagueness if it fails   to   define   the   criminal   offence   with   sufficient   definiteness. Ordinary people should be able to understand what conduct is prohibited and what is permitted. Also, those who administer the law must know what offence has been committed so that arbitrary and discriminatory enforcement of the law does not take place. * 66.  In  Federal   Communications   Commission  v.  Fox   Television Stations Inc., 132 S Ct 2307 it was held: (S Ct p. 2317) “A fundamental principle in our legal system is that laws which regulate persons or entities must give fair notice of conduct that is forbidden or required. See   Connally   v. General   Construction   Co. ,   269   US   385,   US   391   (“[A] statute which either forbids or requires the doing of an act in terms so vague that men of common intelligence must necessarily guess at its meaning and differ as to its application, violates the first essential of due process of law”);  Papachristou  v.  Jacksonville , 405 US 156, US 162 {“Living under a rule of law entails various suppositions, one   of   which   is   that   ‘[all   persons]   are   entitled   to   be informed   as   to   what   the   State   commands   or  forbids’” [quoting   Lanzetta   v.   New Jersey , 306 US 451, US 453 (alteration   in   original)]}.  This   requirement   of   clarity   in regulation is essential to the protections provided by the Due Process Clause of the Fifth Amendment. See  United States  v.  Williams , 553 US 285, US 304.  It requires the invalidation   of   laws   that   are   impermissibly   vague.  A conviction   or   punishment   fails   to   comply   with   due 80 process   if   the   statute   or  regulation   under  which   it   is obtained “fails to provide a person of ordinary intelligence fair notice of what is prohibited, or is so standardless that it authorizes or encourages seriously discriminatory   enforcement.”       Ibid   .   As   this   Court   has   explained,   a regulation   is   not   vague   because   it   may   at   times   be difficult to prove an incriminating fact but rather because   it is unclear as to what fact must be proved. See        id. , at 306. Even when speech is not at issue, the void for vagueness doctrine addresses at least two connected but discrete due process concerns: first, that regulated parties should know   what   is   required   of   them   so   they   may   act accordingly;   second,   precision   and   guidance   are necessary so that those enforcing the law do not act in an arbitrary or discriminatory way. See  Grayned  v.  Rockford , 33 L Ed 2d 222, US 108­109. When speech is involved, rigorous adherence to those requirements is necessary to ensure that ambiguity does not chill protected speech.”” (emphasis supplied) It   is   apparent   from   the   aforesaid   discussion   in   Shreya Singhal  (supra) in a case where no reasonable standards are laid down to define guilt in a section which creates an offence, it would be arbitrary and unconstitutional.   It is absolutely clear that the provisions in the Act in question cannot be termed as arbitrary   or   illegal   or   unreasonable.     The   provisions   are   not vague.     A   responsible   doctor   is   supposed   to   know   before undertaking   such   pre­natal   diagnostic   test   etc.   what   is   he undertaking   and   what   his   responsibilities   are.     If   he   cannot understand the form he is required to fill and the impact of medical findings   and its consequences which is virtually the pre­ requisite for undertaking a test, he is not fit to be a member of a 81 noble   medical   profession.     Such   culpable   negligence   is   not warranted from a doctor.  It is crystal clear from the provisions of   the   Act   which   can   be   gathered   by   a   person   of   ordinary intelligence and they can have fair notice of what is prohibited and   what   omission   they   should   not   make.     The   principles deliberated upon in  Shreya Singhal  (supra)   rather supports the constitutionality of the Act and the Rules framed thereunder. 79. The   reliance   has   also   been   placed   by   the   petitioner   in Nikesh Tarachand Shah v. Union of India,   (2018)  11 SCC 1, in which Court observed thus: “10.  On the other hand, the learned Attorney General Shri K.K. Venugopal   impressed   upon   us   the   fact   that   the   Parliamentary legislation qua money laundering is an attempt by Parliament to get back   money   which   has   been   siphoned   off   from   the   economy. According to the learned Attorney General, scheduled offences and offences under Sections 3 and 4 of the 2002 Act have to be read together and the said Act, therefore, forms a complete code which must   be   looked   at   by   itself.   According   to   the   learned   Attorney General, it is well settled that classification which is punishment centric has been upheld by a catena of judgments and so have the twin   conditions   been   upheld   by   various   decisions   which   were referred to by him. According to him, the expression “any offence” in Section 45(1)( ii ) would mean offence of a like nature and not any offence, which would include a traffic offence as well. According to the learned Attorney General, Section 45 can easily be read down to make it constitutional in two ways. First, the expression “there are reasonable   grounds   for   believing   that   he   is   not   guilty   of   such offence” must be read as the making of a prima facie assessment by the court of reasonable guilt.  Secondly, according to the learned Attorney General, in any case the conditions contained in Section 45(1)(ii) are there in a different form when bail is granted ordinarily insofar as offences generally are concerned and he referred to State of U.P.  v.  Amarmani Tripathi, (2005) 8 SCC 21  for this purpose. According   to   the   learned   Attorney   General,   if   harmoniously construed with the rest of the Act, Section 45 is unassailable. He relied upon Section 24 of the Act, which inverts the burden of proof, 82 and   strongly   relied   upon  Gautam   Kundu  v.  Directorate   of Enforcement, (2015) 16 SCC 1 and Rohit Tandon v. Directorate of Enforcement,   (2018)   11   SCC   46.   In   answer   to   Shri   Rohatgi’s argument on the object of the 2012 Amendment Act, according to the   learned   Attorney   General,   it   is   well   settled   that   where   the language of the Act is plain, no recourse can be taken to the object of the Act and he cited a number of judgments for this proposition. He referred us to Section 106 of the Evidence Act, 1872 and argued that when read with Section 24 of the 2002 Act, it would be clear that   the   twin   conditions   contained   in   Section   45   are   only   in furtherance of the object of unearthing black money and that we should, therefore, be very slow to set at liberty persons who are alleged  offenders of the cancer  of  money laundering. Ultimately, according to the learned Attorney General, Section 45 being part of a complete code must be upheld in order that the 2002 Act work, so that money that is laundered comes back into the economy and persons responsible for the same are brought to book. * 46. We must not forget that Section 45 is a drastic provision which turns   on   its   head   the   presumption   of   innocence   which   is fundamental to a person accused of any offence. Before application of a section which makes drastic inroads into the fundamental right of personal liberty guaranteed by Article 21 of the Constitution of India,   we   must   be   doubly   sure   that   such   provision   furthers   a compelling  State   interest   for  tackling   serious   crime.   Absent   any such compelling State interest, the indiscriminate application of the provisions   of   Section   45   will   certainly   violate   Article   21   of   the Constitution. Provisions akin to Section 45 have only been upheld on the ground that there is a compelling State interest in tackling crimes of an extremely heinous nature. * 49. The learned Attorney General relied heavily on Section 24 of the 2002   Act   to   show   that   the   burden   of   proof   in   any   proceeding relating to proceeds of crime is upon the person charged with the offence of money laundering, and in the case of any other person i.e. a person not charged with such offence, the court may presume that such proceeds are involved in money laundering. Section 45 of the   Act   only   speaks   of   the   scheduled   offence   in   Part   A   of   the Schedule,   whereas   Section   24   speaks   of   the   offence   of   money laundering,   and   raises   a   presumption   against   the   person prosecuted for the crime of money laundering. This presumption has no application to the scheduled offence mentioned in Section 45, and cannot, therefore, advance the case of the Union of India.” (emphasis supplied) Considering   the   compelling   general   public   interest   and gender justice and declining sex ratio, we have no hesitation in 83 upholding the validity of the provisions of Section 23(1) of the Act. 80. Reliance has also been placed in   P. Rathinam v. Union of India,  (1994) 3 SCC 394, this Court observed thus: 48.  The   aforesaid   show   that   law   has   many   promises   to   keep including granting of so much of liberty as would not jeopardise the interest of another or would affect him adversely, i.e., allowing of stretching of arm up to that point where the other fellow’s nose does not begin. For this purpose, law may have “miles to go”. Then, law cannot be cruel, which it would be because of what is being stated later, if persons attempting suicide are treated as criminals and are prosecuted   to   get   them   punished,   whereas   what   they   need   is psychiatric treatment, because suicide basically is a “call for help”, as stated by Dr (Mrs) Dastoor, a Bombay Psychiatrist, who heads an organisation called “Suicide Prevent”. May it be reminded that a law which is cruel violates Article 21 of the Constitution,  a la,  Deena v. Union of India, (1983) 4 SCC 645. * 51. A crime presents these characteristics: (1) it is a harm, brought about by human conduct which the sovereign power in the State desires to prevent; (2) among the measures of prevention selected is the threat of punishment; and (3) legal proceedings of a special kind are  employed   to  decide  whether  the   person  accused   did  in  fact cause   the   harm,   and   is,   according   to   law,   to   be   held   legally punishable for doing so. (See  pp. 1 to 5 of Kenny’s  Outlines of Criminal Law, 19th Edn., for the above propositions.) (emphasis supplied) 81. We   find   that   Act   intends   not   to   jeopardise   the   female foetus.   As such curtailment of the liberty in cause of such a violation cannot be said to be disproportionate. 82 Reliance has also been placed on .  State of Uttar Pradesh v. Wasif Haider,  (2019) 2 SCC 303, in which it has been laid down 84 that an offence has to be proved beyond reasonable doubt.  The relevant portion of the decision is extracted hereunder:   “22. In the instant appeals before us, the prosecution has failed to link the chain of circumstances so as to dispel the cloud of doubt about the culpability of the respondent­accused. It is a well­settled principle that a suspicion, however grave it may be cannot take place of proof i.e. there is a long distance between "may be" and "must be", which must be traversed by the prosecution to prove its case beyond reasonable doubt [See Narendra Singh v. State of M.P., (2004) 10 SCC 699].” There is no dispute with the aforesaid proposition, but that is not the question before us.  When trial takes place obviously the   commission   of   the   offence   has   to   be   proved   as   required under the relevant applicable law. 83. There can be a legislative provision for imposing burden of proof in reverse order relating to gender justice.   In the light of prevalent violence against women and children, the Legislature has   enacted   various   Acts,   and   amended   existing   statutes, reversing   the   traditional   burden   of   proof.   Some   examples   of reversed burden of proof in statutes include Sections 29 and 30 of the Protection of Children from Sexual Offences (POCSO) Act in   which   there   is   presumption   regarding   commission   and abetment of certain offences under the Act, and presumption of mental state of the accused respectively. In Sections 113­A and 113­B of the Indian Evidence Act there is presumption regarding 85 abetment of suicide and dowry death, and in Section 114­A of the   Indian   Evidence   Act   there   is   presumption   of   absence   of consent of prosecutrix in offence of rape. 84. These provisions are a clear indication of the seriousness with   which   crimes   against   women   and   children   have   been viewed   by   the   Legislature.     It   is   also   evident   from   these provisions that due to the pervasive nature of these crimes, the Legislature has deemed it fit to employ a reversed burden of proof in these cases. The presumption in the proviso to Section 4(3) of the Act has to be viewed in this light. 85. The Act is a social welfare legislation, which was conceived in   light   of   the   skewed   sex­ratio   of   India   and   to   avoid   the consequences of the same. A skewed sex­ratio is likely to lead to greater incidences of violence against women and increase in practices   of   trafficking,   ‘bride­buying’   etc.     The   rigorous implementation of the Act is an edifice on which rests the task of saving the girl child. 86. In view of the aforesaid discussion and in our opinion, no case  is   made   out   to   hold   that   deficiency   in   maintaining   the record mandated by Sections 5, 6 and the proviso to Section 4(3) 86 cannot   be   diluted   as   the   aforesaid   provisions   have   been incorporated in various columns of the Form ‘F’ and as already held that it would not be a case clerical mistake but absence of sine qua non   for undertaking a diagnostic test/procedure.   It cannot be said to be a case of clerical or technical lapse.  Section 23(1)   need   not   have   provided   for   gradation   of   offence   once offence   is   of   non­maintenance   of   the   record,   maintenance   of which itself intend to prevent female foeticide.  It need not have graded offence any further difference is so blur it would not be possible   to   prevent   crime.     There   need   not   have   been   any gradation of offence on the basis of actual determination of sex and non­maintenance of record as undertaking the test without the pre­requisites is totally prohibited under the Act.  The non­ maintenance of record is very foundation of offence. For first and second   offences,   gradation   has   been   made   which   is   quite reasonable. 87. Provisions of Section 23(2) has also been attacked on the ground that suspension on framing the charges should not be on the basis of clerical mistake, inadvertent clerical lapses.  As we found it is not what is suggested to be clerical or technical lapse nor it can be said to be inadvertent mistakes as existence 87 of the particular medical condition is mandated by Sections 4 and 5 including the age etc.   Thus, suspension on framing of charges cannot be said to be unwarranted.  The same intends to prevent mischief. We are not going into the minutes what can be treated as a simple clerical mistake that has to be seen case wise and no categorization can be made of such mistakes, if any, but with respect to what is mandatory to be provided in the Form as per provisions of various sections has to be clearly mentioned, it cannot be kept vague, obscure or blank as it is necessary for undertaking   requisite   tests,   investigations   and   procedures. There are internal safeguards in the Act under the provisions relating   to   appeal,   the   Supervisory   Board   as   well   as   the Appropriate Authority, its Advisory Committee and we find that the provisions cannot be said to be suffering from any vice as framing of the charges would mean   prima facie   case has been found by the Court and in that case, suspension cannot be said to be unwarranted.  88. It   was   also   prayed   that   action   should   be   taken   under Section 20 after show cause notice and reasonable opportunity of being heard.  There is already a provision in Section 20(1) to issue a show cause and in Section 20(2) contains the provision 88 as to reasonable opportunity of being heard.  Thus, we find no infirmity in the aforesaid provision. 89. There also the Appropriate Authority to consider each case on merits with the help of Advisory Body which has legal expert. The Advisory Committee consists of one legal expert which has to   aid   and   advise   the   Appropriate   Authority   as   provided   in Sections 16 and 17(5)(6).  Thus, the submission that legal advice should be taken before prosecution, in view of the provisions, has no legs to stand. 90. It   was   also   contended   that   action   of   seizure   of ultrasonography machine and sealing the premises cannot be said to be appropriate.  The submission is too tenuous and liable to be rejected.   Section 30 of the Act enumerates the power of search and seizure and Rules 11 and 12 of the Rules provide for the   power   of   the   Appropriate   Authority   to   seal   equipment, inspect   premises   and   conduct   search   and   seizure.     It   was pointed out by the respondents that a “Standard Operational Procedure”, detailing the procedure for search and seizure has been developed by the Ministry of Health and Family Welfare. Further,   regular   training   of   Appropriate   Authorities   is   being carried out at both the National and State level.  All the States 89 have also been directed to develop online MIS for monitoring the implementation of the Act. It is settled proposition that when offence   is   found   to   be   committed,   there   can   be   seizure   and sealing of the premises and equipment during trial as no license can be given to go on committing the offence.  Such provisions of seizure/sealing,   pending   trial   are   to   be   found   invariably   in various penal legislations.   The impugned provisions contained in  the Act  constitute   reasonable   restrictions   to  carry   on   any profession   which   cannot   be   said   to   be   violative   of   Right   to Equality   enshrined   under   Article   14   or   right   to   practise   any profession under Article 19(1)(g).  Considering the Fundamental Duties under Article 51A(e) and considering that female foeticide is most inhumane act and results in reduction in sex ratio, such provisions   cannot   be   said   to   be   illegal   and   arbitrary   in   any manner besides there are various safeguards provided in the Act to prevent arbitrary actions as discussed above.   91. In light of the nature of offences which necessitated the enactment of the Act and the grave consequences that would ensue otherwise, suspension of registration under Section 23(2) of the Act serves as a deterrent. The individual cases cited by the petitioner­Society   cannot   be   a   ground   for   passing   blanket 90 directions,   and   the   individuals   have   remedies   under   the   law which they can avail. Moreover, the concept of double jeopardy would have no application here, as it provides that a person shall   not   be   convicted   of   the   same   offence   twice,   which   is demonstrably not the case here. Suspension is a step­in­aid to further the intendment of act.   It cannot be said to be double punishment.  In case an employee is convicted for an offence, he cannot continue in service which can be termed to be double jeopardy. 92. Non maintenance of record is spring board for commission of   offence   of   foeticide,   not   just   a   clerical   error.  In   order   to effectively   implement   the   various   provisions   of   the   Act,   the detailed forms in which records have to be maintained have been provided for by the Rules. These Rules are necessary for the implementation of the Act and improper maintenance of such record amounts to violation of provisions of Sections 5 and 6 of the   Act,   by   virtue   of   proviso   to   Section   4(3)   of   the   Act.   In addition, any breach of the provisions of the Act or its Rules would   attract   cancellation   or   suspension   of   registration   of Genetic   Counselling   Centre,   Genetic   Laboratory   or   Genetic 91 Clinic, by the Appropriate Authority as provided under Section 20 of the Act. 93. There is no substance in the submission that provision of Section 4(3) be read down. By virtue of the proviso to Section 4(3),   a   person   conducting   ultrasonography   on   a   pregnant woman, is required to keep complete record of the same in the prescribed manner and any deficiency or inaccuracy in the same amounts to contravention of Section 5 or Section 6 of the Act, unless the contrary is proved by the person conducting the said ultrasonography.   The aforementioned proviso to Section 4(3) reflects the importance of records in such cases, as they are often the only source to ensure that an establishment is not engaged in sex­determination. 94. Section   23   of   the   Act,   which   provides   for   penalties   of offences, acts in aid of the other Sections of the Act is quite reasonable.   It   provides   for   punishment   for   any   medical geneticist,   gynecologist,   registered   medical   practitioner   or   a person who owns a Genetic Counselling Centre, a Genetic Clinic or   a   Genetic   Laboratory,   and   renders   his   professional   or technical services to or at said place, whether on honorarium 92 basis or otherwise and contravenes any provisions of the Act, or the Rules under it. 95. Therefore, dilution of the provisions of the Act or the Rules would   only   defeat   the   purpose   of   the   Act   to   prevent   female foeticide, and relegate the right to life of the girl child under Article 21 of the Constitution, to a mere formality.    96. In view of the above, no case is made out for striking down the proviso to Section 4(3), provisions of Sections 23(1), 23(2) or to read down Section 20 or 30 of the Act.  Complete contents of Form ‘F’ are held to be mandatory.   Thus, the writ petition is dismissed. No costs. .……......................J. (Arun Mishra)    .……......................J. (Vineet Saran)    New Delhi; May 03, 2019