Is Prenatal Sex Selection Ethical?
Part I
Parents have always been curious of the gender of their children during pregnancy and some have even wanted to be able to choose the gender of their child. In the past, choosing a child's gender with certainty was impossible, and the methods of choosing the gender were restricted mostly to folk wisdom passed down from generation to generation (Folk). But now that biogenetical-engineering technology has been created and refined, prenatal sex selection is possible and occurs in our world today.
Prenatal sex selection is when the parents of the child choose what gender the child is before the child is born (Gender Selection). Before delving into how prenatal sex selection happens and the technology involved, it is necessary to explain why since, though the technology is new, the reasoning behind why prenatal sex selection occurs has existed much longer before and has helped create this new growth of technology. There are many reasons why sex selection happens, but the reasons have been divided into two categories, called medical and elective (Gender Selection).
Medical prenatal sex selection is fairly straightforward, meaning parents choose the gender of their child to avoid certain sex-linked genetic or chromosomal disorders that, without sex selection, would likely occur (ACOG). For instance, there are some certain chromosomal disorders that can affect one gender but not the other, such as hemophilia, where boys are more likely to carry hemophilia than girls. In cases such as that, a doctor may advise the parents to use prenatal sex selection.
Elective prenatal sex selection, on the other hand, means the parents choose the sex of the child because they wish for the child to be that gender. The category for elective can be further broken down into two subcategories, which are personal and cultural motives. Though these subcategories may appear to be very similar at first, on closer examination they are very different. A personal motive is when the parents want a particular gender regardless of what culture they are raised up in. For instance, there are many parents who want another child of the opposite gender from the rest of their family in a move called "family balancing" where the genders of the children are more equally distributed (Family Balancing). A cultural motive might be a Chinese family, who is only allowed one child per family, and would rather have a male since males continue the lineage and are supposed to take care of the parents in their old age (Baculinao).
Though there will always be motives for prenatal sex selection and choosing one gender over another, what has caused this growth of prenatal sex selection is the technology involved and the relative ease to access it. There are three different major treatments available that are used for prenatal sex selection, which are preimplantation gender diagnosis (PGD), MicroSort, and ultrasound screenings (Methods). PGD works through in-vitro fertilization, which is a technique that takes different sex cells and combines them together to form several embryos. After the embryos are examined, a healthy embryo of the "correct" gender is then planted into the female's uterus. This is a very expensive process and though it is very likely to work, many people are barred from this technology, either by lack of sufficient monies or government regulations. Another technique is MicroSort, where the proportion of X-chromosomes and Y-chromosomes are changed so that it is more likely to have the desired sex (MicroSort). This is less expensive than PGD, but it is still experimental and not as accurate as IVF. These two treatments are usually used for those who have a substantial income and want children of a particular gender, but due to some reason, cannot create it on their own.
The third major technique, ultrasound, is, at first glance, not a technique or an aid to prenatal sex selection, but actually it is one of the most commonly used technologies for sex selection available since it is relatively cheap and widespread (Jones). Since ultrasound technology was invented, it has brought forth a better understanding of how fetuses progress and throughout the years, this technology has been used to determine, not only what gender the child will be, but also whether the child will have genetic defects or diseases. Many parents who want to have children of a certain gender will use this ultrasound technology once the female is pregnant, and then, if the fetus is not the correct gender, the fetus is aborted (Westley). This technique is especially used in third world countries.
Though the biogenetical-engineering technology has progressed this far and will continue to progress, many ethicists are questioning prenatal sex selection and the motives behind it. Many people can understand the use of prenatal sex selection to a certain extent for those who want to avoid having children with genetic diseases, but for those who use this technology for elective motives, there is definite controversy. Is this technology being used to further society in a productive manner, or this being used as a way to satisfy individuals temporarily and will end up hurting our future populations? As this technology is only continuing to improve, it is necessary to look at the motives and outcomes and determine how far and to what extent we should use this technology in order to progress.
In order to look at the issue, I have decided to take an altruistic outlook to this subject. This is because, of an issue this important to society, society and government should be looking for a healthy medium that ends up being good for the whole and not just for individual parts, though ideally the individual parts will benefit as well.
It is hard to pinpoint a place in the world to focus this subject, especially since individuals who are denied these technologies and have enough money often travel to other countries where prenatal sex selection is acceptable, but I would like to focus on three countries and research how prenatal sex selection affects these countries. These countries, which have been chosen because of their different perspectives of this topic and their general representation of all countries, are the United States, which has a relatively liberal viewpoint of this topic, China, which is undergoing a huge population shift due to sex selection, and the United Kingdom, which has remained relatively conservative on sex selection throughout all technological advances.
In this issue of prenatal sex selection, couples in society who want to choose their child's sex and government are pitted against each other. My use of the word "couples" is intentional; many of these operations are either too expensive for one income to handle and require a very strong desire to have a child of this gender. Many single parents do not have the money to pay for these operations and, if they abort the child, the first motive would not likely be prenatal sex selection (Lino). Government would be defined as any body that governs over a country and, in this case, any organization a part of the government who helps determine the policies of genetic operations.
Except for the US, whose government does not control prenatal sex selection rigidly, both the UK and China have strict guidelines on prenatal selection. In the UK, The Human Fertilisation and Embryology Authority (HFEA) controls prenatal sex selection (HFEA). Since medical procedures are regulated by the government to ensure the safety of its people, many medical treatments that are uncertain or need further research, such as IVF and MicroSort, are only given to those who absolutely need the treatment or those who could hire a private doctor and get past the government regulations, usually by traveling out of the country to another country such as the US, which have less stringent laws concerning embryos (Duckworth). Others who cannot afford to travel actively try to petition the government, with mixed results. For China, the circumstances are different. As mentioned before, Chinese couples want male children and, with the one child limit China's government has imposed, many families are using prenatal sex selection is largely via ultrasound and abortions, usually in rural areas. Because of this, the ratio between males and females is skewed for males (Westley). The Chinese government is trying to stop this by using incentives for families to keep female children (Xiaoyi). In the middle between governments and couples are the biogenetical engineers who are continuously researching and developing new ways to apply genetics and doctors who want to help the couples who come in and ask for a treatment.
I have always been intrigued by the notion of "designer babies" and the ethics behind them. As a writer, I have written a novel (as of yet, unpublished) about eugenics, and I have tried to keep updated with all the embryonic research that has been happening. This interest of mine has developed into my majoring in bioengineering so I can be a witness to the technology that comes out and position myself to be in a good position to debate ethics, knowing both the science involved and the social considerations that go along with it. This topic is perfect for me since I am able to narrow down my research to a single subject and still be able to discuss topics that I have always been interested in.
My initial reaction of prenatal sex selection was disgust, since I could not understand why parents would not accept their children as they were born to them. This is mainly because, as being a fraternal female twin of a brother, many people told my mother that she had all the children she needed since she had both female and male children. If my mother believed this rhetoric, I would not have my sister. Because of this, I find myself unfazed by arguments of family balancing, though I can understand the reasoning. As far as addressing China and its growing male population, as a Roman Catholic who believes abortion is unacceptable, I do not agree with the use of ultrasound to abort fetuses, just because the fetuses are female.
With that said, I am very excited about writing and researching this report and providing facts in an unbiased manner to answer this question:
Is prenatal sex selection ethical?
Works Cited
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Baculinao, Eric. "China Grapples with Legacy of Its 'Missing Girls': Disturbing
Demographic Imbalance Spurs Drive to Change Age-Old Practices." NBC News.
14 September 2004.
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Lino, Mark. "Income and Spending Patterns of Single Mother Families." May 1994.
http://www.bls.gov/opub/mlr/1994/05/art5full.pdf
Human Fertilisation and Embryology Authority. Home page.
http://www.hfea.gov.uk/cps/rde/xchg/hfea
Duckworth, Lorna. "IVF Couple Give Away "Wrong Sex" Embryo." The London
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Westley, Sidney. "Evidence Mounts for Sex-Selective Abortion in Asia." East-West
Center. May 1995.
http://www.eastwestcenter.org/stored/pdfs/p&p034.pdf
Xiaoyi, Shao. "Zhejiang Tackles Gender Selection." China Daily. 13 August 2004.
http://www.chinadaily.com.cn/english/doc/2004-08/13/content_364904.htm