China: The Maternal and Infant Health Care Law

Sun‐Wei Guo, Fudan University, Shanghai, China

Published online: April 2012

DOI: 10.1002/9780470015902.a0005201.pub2

Abstract

The Law of the People's Republic of China on the Maternal and Infant Health Care (MIHCL), enacted in 1995, sparked widespread concerns, criticisms and in some cases fierce outcries in the Western scientific community. This article describes the background in drafting the law, chronicles reactions to its release and its subsequent development, attempts to provide a balanced presentation on perspectives of the West and of Chinese side, draws up a list of questions surrounding this controversy and its subsequent development, and, finally, argues that the entire process holds several lessons to future legislature in China when drafting health‐related laws.

Key Concepts:

  • The Law of the People's Republic of China on the Maternal and Infant Health Care (MIHCL) was enacted in 1995.

  • The law was drafted apparently in response to enormous population pressure, the heavy burden of people with disability, and questionable local practices that restrict reproductive freedom on people with mental and putative hereditary diseases.

  • The law sparked widespread concerns, criticisms, and in some cases fierce outcries in the Western scientific community, yet experts in China defended the law.

  • The most contentious articles in the law include ones that propel physicians to provide medical advice on long‐term contraception or sterilisation to couples who have been diagnosed with unspecified genetic disease of a serious nature after a mandatory pre‐marital medical examination (PMME).

  • In 2001, the Implementation Methods of MIHCL went effective, in which articles in the MIHCL that aroused controversies were written in a manner that is more ‘politically correct’ by Western standards.

  • In 2003, the Ministry of Civil Affairs issued The Marriage Registration Code, which effectively abolished the mandatory requirement for PMME as a prerequisite for marriage registration.

  • This dramatic change, viewed by many as inconsistent with the MIHCL, received warm welcome from the public, many of them unhappy with the mandatory requirement for PMME, but it also raised concern that the abolishment may have resulted in increased incidence of birth defects.

  • In 2005, a special Task Force reached conclusions that there is no credible evidence that suggests that the rising incidence of birth defects in some areas can be attributable to the abolishment of compulsive PMME and that the PMME has limited value in preventing birth defects.

  • The enactment of MIHCL and the subsequent, somewhat dramatic reverse in course beg for many questions regarding the scientific basis, if any, for the legislature.

  • The controversy surrounding the MIHCL and its subsequent development hold several lessons for people who attempt to solve complex health‐related problems through judiciary means.

Keywords: China; eugenics; infant; law; maternal

References

Anonymous editorial (1994) China's misconception of eugenics. Nature 367: 1–2.

Anonymous editorial (1995a) Western eyes on China's eugenics law. Lancet 346: 131.

Anonymous editorial (1995b) When is prenatal diagnosis ‘eugenics’? Nature 378: 549.

Anonymous editorial (1996) Speak, don't hold your peace. New Scientist 152: 3.

Anonymous editorial (1998) China's ‘eugenics’ law still disturbing despite relabelling. Nature 394: 707.

Beardlsey T (1997) China syndrome. China's eugenics law makes trouble for science and business. Scientific American 276: 33–34.

Berry RJ, Li Z, Erickson JD et al. (1999) Prevention of neural‐tube defects with folic acid in China. China–U.S. collaborative project for neural tube defect prevention. New England Journal of Medicine 341(20): 1485–1490.

Board of Directors of the American Society of Human Genetics (1999) ASHG statement: eugenics and the misuse of genetic information to restrict reproductive freedom. American Journal of Human Genetics 64: 335–338.

Bobrow M (1995) Redrafted Chinese law remains eugenic. Journal of Medical Genetics 32: 409.

Breyer S (1998) The interdependence of science and law. Science 280: 537–538.

Brown LR (1995) Who Will Feed China? Wake Up Call for a Small Planet. New York: Norton.

Canadian College of Medical Geneticisits (1997) China's eugenics law: position statement of the Canadian college of medical geneticists. Journal of Medical Genetics 34: 960.

Chen JH and Simeonsson RJ (1993) Prevention of childhood disability in the People's Republic of China. Child Care, Health, and Development 19: 71–88.

Coghlan A (1998) Perfect People's Republic. New Scientist 160: 18.

Dickson D (1994) Concern grows over China's plans to reduce number of ‘inferior births’ [News]. Nature 367: 3.

Dickson D (1998a) Congress grabs eugenics common ground [News]. Nature 394: 711.

Dickson D (1998b) Geneticists told to debate with politicians. Nature 394: 610.

Feng X, Tang S, Bloom G, Segall M and Gu Y (1995) Cooperative medical schemes in contemporary rural China. Social Science & Medicine 41: 1111–1118.

Grogan CM (1995) Urban economic reform and access to health care coverage in the People's Republic of China. Social Science & Medicine 41: 1073–1084.

Guo M and Meng JX (1993) Demography of people with disabilities in China. International Journal of Rehabilitative Research 16: 299–301.

Guo SW, Zheng CJ and Li CC (1998) Dilemma over genetics and population in China. Nature 394: 313–314.

Guo SW (1999) Cultural difference and the eugenics law. American Journal of Human Genetics 64: 1197–1199.

Harper PS (1995) Eugenics in China. [Letter to Editor]. Lancet 346: 508.

Harper PS and Harris R (1986) Medical genetics in China: a western view. Journal of Medical Genetics 23: 385–388.

Hawkes N (1995) Scientists attack China over selective breeding. The Times, June 5.

Hesketh T (2003) Getting married in China: pass the medical first. British Medical Journal 326: 277–279.

Hesketh T and Zhu WX (1997) Maternal and child health in China. British Medical Journal 314: 1898–1900.

Hsiao WC (1995) The Chinese health care system: lessons for other nations. Social Science & Medicine 41(8): 1047–1055.

Hsiao WC and Maynard A (2009) Health economics in China. Foreword. Health Economics 18(suppl. 2): S1–S2.

Knoppers BM and Kirby M (1997) Report on the law of the People's Republic of China on maternal and infant health‐care. Genome Digest. April issue, 6–8.

Li CC (1955) First course in population genetics. Reprinted with corrections, 1978. Pacific Grove, CA: Boxwood Press.

Li CC (2000) Progressing from eugenics to human genetics. celebrating the 70th birthday of professor Newton E. Morton. Human Heredity 50: 22–33.

Liu Y and Hsiao WC (1995) The cost escalation of social health insurance plans in China: its implication for public policy. Social Science & Medicine 41: 1095–1101.

Liu Y, Hsiao WC, Li Q, Liu X and Ren M (1995) Transformation of China's rural health care financing. Social Science & Medicine 41: 1085–1093.

Lu M, Zhang J, Ma J, Li B and Quan H (2008) Child health insurance coverage: a survey among temporary and permanent residents in Shanghai. BMC Health Services Research 17; 8: 238.

Mao X (1997a) Chinese eugenic legislation. Lancet 349: 139.

Mao X (1997b) Ethics and genetics in China: an inside story. Nature Genetics 17: 20.

Mao X (1998) Chinese geneticists’ views of ethical issues in genetic testing and screening: evidence for eugenics in China. American Journal of Human Genetics 63: 688–695.

Morton NE (1998) Hippocratic or hypocritic: birth pangs of an ethical code. Nature Genetics 18: 18.

Neel JV (1997) Looking ahead: some genetic issues of the future. Perspectives in Biology and Medicine 40: 328–347.

Normile D (1998) Geneticists debate eugenics and China’ infant health law. Science 281: 1118–1119.

O'Brien C (1996) China urged to delay ‘eugenics’ law. Nature 383: 204.

Pearson V (1995) Population policy and eugenics in China. British Journal of Psychiatry 167: 1–4.

Reichman JM, Brezis M and Steinberg A (1996) China's eugenics law on maternal and infant health care. Annals of Internal Medicine 125: 425–426.

Rosenthal E (1998) Scientists debate China's law on sterilizing the carriers of genetic defects. New York Times. Aug 16:14.

Sleeboom‐Faulkner M (2010) Eugenic birth and fetal education: the friction between lineage enhancement and premarital testing among rural households in mainland China. China Journal 64: 121–141.

Tyler PE (1993) China weighs using sterilization and abortions to stop ‘abnormal’ births. New York Times. 1993 Dec 22; A9.

Uzych L (1995) Eugenics. British Journal of Psychiatry 167: 697–698.

Wang Y (1999) A call for a new definition of eugenics. Eubios Journal of Asian and International Bioethics 9: 73–74.

Xue Ninglan (2007) [Premarital physical examination: should it be compulsive or voluntary?] www.civillaw.com.cn/article/default.asp?id=33299, accessed on 5 December 2011.

Yip W and Hsiao WC (2008) The Chinese health system at a crossroads. Health Affairs (Millwood) 27(2): 460–468.

Zou QH, Lei ZW and Zhang ZX (1994) An epidemiological study on etiology of mental retardation. Zhonghua Yi Xue Za Zhi 74: 134–137 (in Chinese).

Further Reading

Garver KL and Garver B (1991) Eugenics: past, present, and the future. American Journal Human Genetics 49: 1109–1118.

Neel JV (2000) Some ethical issues at the population level raised by ‘soft’ eugenics, euphenics, and isogenics. Human Heredity 50: 14–21.

Related Sub-Topics:

Bioethics | General Genetics and Disease | Health Care | Science and Society - General
Contact Editor close
Submit a note to the editor about this article by filling in the form below.

* Required Field

Article Title: China: The Maternal and Infant Health Care Law
 
How to Cite close
Guo, Sun‐Wei(Apr 2012) China: The Maternal and Infant Health Care Law. In: eLS. John Wiley & Sons Ltd, Chichester. http://www.els.net [doi: 10.1002/9780470015902.a0005201.pub2]