This article is from WeChat public account:Shell (Guokr42), author: Anting, editor: Li ball, title figure from: vision China
Have you heard of “marriage check”?
In the previous season’s variety “My Family”, the star couples specially conducted a pre-marital check on Zuo and Guo Biting, and publicly disclosed the whole process in the program – for example, both sides need to fill in a detailed health questionnaire, and the man needs to carry out semen. Check, the woman needs to perform a cervical smear test… Many netizens feel a little embarrassed about this process of meticulously delivering this process, but this variety show also brought “marriage check” back to the sight of many people.
In the variety show “My Family”, the star couple Xiang Zuo and Guo Biting disclosed the whole process of marriage inspection in the program. 丨 Video screenshots
After 80, I first came into contact with the word “marriage check”, and I have to go back to a TV drama “Marriage Decade” that I saw when I was young. The male and female protagonists must first receive a marriage test before they get a marriage certificate. A series of ridiculous farce. A younger generation than me may have no idea about “marriage inspection.”
The variety show and TV show are lively, but what about marriage check?
Marriage check, from mandatory to non-mandatory
Marriage inspection, as the name suggests, is a series of examinations before the registration of the two parties preparing for marriage. It includes three parts: medical history, medical examination, and knowledge popularization. Medical examination is the most important.
The marriage test is different from the general medical examination. Ordinary medical examinations are mainly reversible or controllable diseases, and these diseases are often not hereditary. The diseases screened by marriage screening are usually more serious. Once they are suffering, they are more troublesome or impossible to reverse, and may even affect the next generation. Therefore, the marriage test is a very serious matter, its purpose is simply two, to improve the quality of life after marriage and the probability of breeding healthy offspring.
According to Chinese laws and regulations, the focus of premarital medical examinations should be three major types of diseases: severe hereditary diseases (eg thalassemia), Designated infectious diseases (eg hepatitis B, AIDS, syphilis) and certain mental illnesses (eg schizophrenia, manic depressive psychosis). However, in actual implementation, other items such as the appearance of the reproductive system may be examined.
According to China’s maternal and child health law, pre-marital medical examinations should focus on three major types of diseases: severe hereditary diseases, designated infectious diseases, and certain spiritual categories. disease.
In some countries and regions, marriage screening is one of the necessary procedures for marriage registration. For example, to prevent the spread of HIV (HIV), India has passed legislation to test HIV in some areas with high HIV prevalence rates since 2002. As an essential part of the marriage test. In some places, specific diseases may be examined.In France, for example, French-aged women under the age of 50 are required to undergo Toxoplasma infection and hemolytic disease examination. The State of Montana in the United States stipulates that women who are married must undergo rubella detection. In addition, many countries and regions, such as the United Kingdom, Japan, Russia and other places, carry out voluntary marriage inspection.
In China, marriage inspections have gone through a process from mandatory to non-mandatory.
China has implemented mandatory marriage inspections since 1986. The Regulations on the Administration of Marriage Registration, which was implemented in February 1994, and the Law on Maternal and Infant Health Care of the People’s Republic of China, which was implemented in June 1995, strengthened the pre-marital inspection system in the form of legislation. At that time, both parties applying for marriage registration must carry the marriage introduction letter and the pre-marriage birth certificate issued by the work unit, and submit the pre-marital health check certificate. So the rate of marriage inspection at that time was almost 100%.
Since 2003, the marriage inspection has only started on a voluntary basis.
However, in the new version of the Marriage Registration Regulations, which was implemented in August 2003, there is no requirement to submit a pre-marital health check. Since then, the marriage test has only started on a voluntary basis. In the past 10 years of implementing mandatory marriage inspection, there have been various problems, such as the formality of the marriage inspection process and the excessive collection of marriage inspection fees… Therefore, the amendment of this regulation was welcomed at the time and was considered to be a respect for citizens. The performance of privacy and freedom of choice.
Since then, the rate of marriage inspections in China has plummeted. Taking Beijing’s data as an example, after the cancellation of compulsory marriage inspection, Beijing’s marriage inspection rate in the past ten years is only about 8%.
How much can a marriage test play?
Whether the marriage test should be mandatory or not mandatory, in fact, all kinds of opinions are available. One of the core issues is how much the marriage test can play.
As mentioned earlier, there are three main types of diseases that are involved in the marriage test – serious hereditary diseases,Designated infectious diseases and related mental illnesses. Under strict screening and accurate notification, the marriage inspection is certainly meaningful, but the reality is more complicated.
Screening for serious genetic diseases, mainly to prevent birth defects in the next generation. According to the “Report on Prevention and Control of Birth Defects in China” issued by the former Ministry of Health in 2012, in the past ten years, China has added about 900,000 birth defects every year. National birth defect monitoring data showed that the total incidence of birth defects in perinatal period showed an upward trend, from 109.79 per thousand in 2000 to 153.23 per thousand in 2011. Some studies believe that this has a certain correlation with the decline in the rate of marriage inspection.
Birth defects include:
1. Structural malformations, such as cleft lip and palate, multiple fingers (toes), neural tube defects, congenital heart disease.
2. Chromosomal abnormalities, such as Down’s syndrome.
3. Inherited metabolic diseases and dysfunction, such as phenylketonuria, congenital hypothyroidism.
In September 2018, the National Health and Health Commission issued the “National Birth Defect Comprehensive Prevention and Control Program”, which clearly pointed out that strengthening marriage inspection is one of the means to prevent birth defects, and it can be regarded as the first line of defense.
However, it must be clear that, on the one hand, screening for hereditary diseases in a marriage test cannot help prevent all types of birth defects and is only useful for some of them. On the other hand, the prevention of birth defects is far from enough by marriage examination. It is also necessary to combine pre-pregnancy examination, birth examination and newborn screening to minimize or avoid the risk of birth defects.
The National Birth Defects Integrated Prevention and Control Program proposes a specific goal: “By 2022, the awareness rate of birth defects prevention and control knowledge reaches 80%, premarital medical examination The rate reached 65%, the pre-pregnancy eugenics health check rate reached 80%, the prenatal screening rate reached 70%; the neonatal genetic metabolic disease screening rate reached 98%, the newborn hearing screening rate reached 90%, the confirmed case treatment rate AllUp to 80%.
Infectious diseases screened in marriage screening are mostly able to spread through sexual activity. The screening of this part of the disease is on the one hand to allow the sick person to find the disease as soon as possible to treat it as soon as possible, and on the other hand to protect the healthy side as much as possible. Hepatitis B, AIDS, syphilis, etc. may also affect the next generation.
The starting point is naturally good, but it may not be so ideal in practice. According to the “Chinese Sexual Health Experience Report” released in April 2012, compared with 1994, the proportion of premarital sexual behavior of Chinese people has increased by 30%, reaching 71.4%, which means that the protective significance of infectious diseases during the marriage inspection stage. May be weakened.
In addition, there may be cases of concealing medical history. In March 2015, a couple in Yongcheng, Henan Province conducted a pre-marital check at the local maternal and child health center. At that time, the woman was found to be suspected of AIDS, but she and the relevant doctor did not inform the man of the results of the examination. Shortly after the marriage, the man was also infected with HIV. The news reports on this incident have caused quite a stir, and in the trace of the incident, the Yongcheng City Center for Disease Control said that the woman knew that she was infected with HIV before the marriage test and that she had a record.
The woman was found HIV-positive. At the time, the medical opinion on the marriage report was “not recommended for marriage.” 丨 Video Screenshot
In the whole matter, the woman violated the law. According to the Law of the People’s Republic of China on the Prevention and Control of Infectious Diseases, the woman, in an informed situation, concealed her partner and did not take protective measures to cause the other party to become infected. This is a “deliberate dissemination” and is illegal. However, it is very difficult for people to blame medical institutions. According to China’s AIDS Prevention and Control Regulations, no unit or individual may disclose information about people living with HIV or AIDS without their consent.
Therefore, even if a person is found to be infected with HIV, it is not always possible to protect a healthy person. In fact, even if it is not AIDS, but other diseases are detected, according to existing laws and regulations,Medical institutions and medical personnel are also not allowed to disclose patient privacy or disclose medical records without the consent of the patient.
Article 62 of the Law of the People’s Republic of China on Liability and Tort Law 丨 Screenshot
The screening of mental illnesses is not that easy. Many times, people with mental illnesses will behave the same as healthy people, and marriage tests may not be able to accurately distinguish them. In addition, such diseases may also face a “concealed” situation. At present, screening for mental diseases in the marriage examination relies mostly on medical history, family history, and filling out some relevant questionnaires and scales. The degree means that if you want to hide it, it is possible.
In 2018, the Beijing Youth Daily reported a news that his wife concealed his history of schizophrenia before marriage. After the marriage, the two often quarreled because of trivial matters, the emotional condition of the wife continued to deteriorate, and the schizophrenia relapsed one year after marriage. After the husband knew the cause and effect, he appealed to the court for divorce, but at this time the wife had been pregnant for two months.
According to the Maternal and Infant Health Care Law of the People’s Republic of China, even if you have a mental illness, marriage is effective if you are not married during the marriage. 丨 Screenshot of the webpage
So, it is hard to say clearly how much the marriage test can play. It certainly has benefits, but at the same time it has limitations. As far as the public health level is concerned, its main role may still beOne of the means to reduce the rate of birth defects, but specific to each individual, the actual situation may be completely different.
The marriage check that looks at your own wishes now needs to understand its meaning and limitations
In 2005, Heilongjiang Province resumed the mandatory marriage inspection system, hoping to reduce birth defects by increasing the rate of marriage inspection. But this decision caused a lot of controversy at the time.
The supporting party believes that the state has cancelled the compulsory marriage inspection in the first place and feels that the marriage inspection is a manifestation of responsibility for themselves, others and future generations. The opposing party believes that marriage is not the same as giving birth. It cannot be because one or both of them have obstacles to the generation of their offspring, which hinders their right to pursue marriage. It should allow citizens to choose rather than enforce, and the rate of marriage and the rate of birth defects increase. Whether there is a definitive connection requires further argumentation. Of course, many people are also neutral.
At that time, Sina.com launched a vote on whether you agree with Heilongjiang to resume compulsory marriage inspection. The final survey results show that 46.9% of netizens agree that they can effectively promote the popularity of marriage inspection; 40.2% of netizens object, think this Violation of the privacy rights of citizens; 12.9% of netizens feel that it does not matter, whether it is mandatory or not, should be a marriage test.
Site netizen voted by 网 丨 Web page screenshot
It can be said that in the face of premarital examination, everyone has their own opinions and has their own choices. In reality, not everyone can easily and generously say “we go to the marriage check”, and some people even think that this requirement is linked to “distrust.”
The mandatory or not mandatory marriage check is a policy issue, and the removal of a mandatory marriage check does not mean that there is no marriage check. In most parts of the country, the practice is still voluntary marriage inspection, so do you want it?