India

Abstract

The fundamental ethical principles that govern the practice of genetic medicine are patient autonomy, beneficence, non-maleficence, and justice. In India and other developing countries the application of these principles is influenced by poverty and numerous social factors. Table 1 compares the demographic indicators in India with those in Thailand, Japan, US, and UK (UNICEF, 1998). It emphasizes the huge population in India, high birth rate, and an infant mortality rate 9–18 times more than that of the US or Japan. Most striking is the per capita income, which is 79 times less than that in the US, and 116 times less than that in Japan. Adult literacy is also almost 1/2 of that observed in US/Japan. It is thus easy to see that the majority of the people are struggling for survival, and have limited resources for their basic needs like food, housing, education, and health. For them “survival is more important than ethics” (Siva Subramanian, 1986). This position is not well appreciated in the West. For example, child labor in India has been the cause of much hue and cry in the West (Flor Cruz et al., 1996). The fact remains that these children have to engage in labor in order to survive. For them “no labor” means no or little food, malnutrition, misery, and slow deatH. Therefore attempts in western countries to boycott the products of those industries which employ children are ill-founded (Table 1).

Table 1. Demographic Indic ators in Different Countries