Sterilisation target deplored
Health workers and medical scientists in India are at the centre of a growing row over allegations that they regularly recruit illiterate people into clinical trials and sterilisation programmes without their informed consent.
The Indian Government has an annual deadline for its 'family welfare' programme, designed to stem population growth. Health workers each have their own targets for the number of people to sterilise by the end of March each year.
In rural areas, they set up temporary camps and encourage men and women to undergo the operation.
The surgery is supposed to be voluntary, but critics claim workers often target uneducated women who are not aware of the potential health risks. 'My experience has been that the women are certainly not informed when they come for the operation,' says one official at the Ministry of Health and Family Welfare.
Consent for sterilisation involves no more than leaving a thumbprint on a form. Health workers are supposed to encourage as many men as women to have the operation, yet 1,000 times as many women as men are sterilised. The government blames 'lack of male participation', but some officials claim health workers find it easier to coerce women.
Meanwhile, medical researchers are also in the spotlight for using subjects without their informed consent. The issue emerged when the British Medical Journal refused to publish a study on cervical cancer commissioned by the Indian Council of Medical Research, after discovering researchers had studied lesions without telling the women they could turn cancerous.
The scientists argue that the women were illiterate and informed consent was thus impossible.
Some Ministry of Health officials have pushed the government to tighten the consent procedure in clinical trials.