The Rest of the Story

Thursday, May 27, 2004

Bioethics of Gender Selection, part I

I have decided to write about the bioethics of gender selection. Gender Selection, also known as sex control or sex selection, is the practice of employing technology to influence the gender of a child, either prior to, or during the process of, conception. In this article, I will talk about the reasons for writing this, and the sources of information that I have located so far. Later, possibly tomorrow, I will write about the various ethical issues that have been discussed in the various sources. I may or may not get to my own conclusion at that time, or I might write that even later. We'll see.

How I decided to write this: Last Friday, I got to go in to work late. Well, 10AM is late. It turns out that whenever there is a little sliver of time in my schedule, if I don't keep it a secret, somebody else thinks of a way to fill it. So five weeks ago, we took out mare, April, to be bred. According to the breeding contract, we had to get an ultrasound done to verify and date the pregnancy. My wife, having her right leg in a beautiful purple cast, knew that she would not be able to help the vet. As a result, she scheduled to vet to come on Friday morning.

So here I am, Friday morning, getting my work clothes on. "Honey, is there any way you could stay and help the vet with the ultrasound?"

"Yeah, I guess." Off with the Dockers and Rockports, on with the jeans and Muck boots. The vet comes about a half hour late. We go out and I get April. She skittish because she's seen the vet's van come up the drive. Fifteen minutes of cajoling later, we're in the barn and I'm holding the horse while the vet puts this big probe up where it can see what it needs to see. On the screen, I see the little amniotic sac with what looks like a blurry comma inside.

Merely 15 minutes late, I get to the hospital. I probably smell like a pregnant mare, but everyone is too polite to say anything.

On the weekend, I run across some articles mentioning something called "gender selection." This refers to the process of trying to make sure you get a child with the set of chromosomes that you want, thereby assuring the birth of a girl, if that is what you want; or a boy, if so desired. BTW, I found out about this after reading a post on McConchie on Bioethics. His post addresses the issue of people having babies specifically for the purpose of obtaining tissue for donation to another child who has a life-threatening illness. This issue is related to the issue of gender selection, because it uses some of the same methodology, but the ethical issues are different.

Later, I read on Marcland that Marc and his wife are expecting a baby soon.

This synchronicity sparking some spontaneity, I decided to collect some information about gender selection and write about it. I read Dan McChonchie's post, then Joe Carter's (Evangelical Outpost). Then I looked for more blogger commentary; I did not find much. There is a post by Jeremy Beard on Livejournal, and one by Albert Mohler on Crosswalk. The Stanford Center for Biomedical Ethics has a mention, but it is merely a link to a newspaper article in which one of their professors is quoted.

There have been a few news articles recently. The first ones I found were these:

Newsweek: Brave New Babies
Sun-Sentinel: Family planning: More parents are selecting the gender of their children
ABC News: Congratulations! It's a (Insert Choice)!
ABC News: Tried, But Not Always True

Additional information:

For technical background on pre-implantation genetic diagnosis, see JAMA.
The President's Council on Bioethics has published a report, Reproduction and Responsibility: The Regulation of New Biotechnologies that addresses gender selection. See also the transcripts of their 17 October 2002 meeting, 16 January 2003 meeting, and their working paper: Ethical Aspects of Sex Control.
For the American Society of Reproductive Medicine's (ASRM) ethical guidelines, see their site; their paper on preconception gender selection for nonmedical purposes is in this 48KB PDF. Excerpt:

[...] After describing preconception gender selection techniques, this report will discuss the ethical arguments for and against the use of such techniques. Drawing on the Ethics Committee’s previous analysis of preimplantation genetic diagnosis for sex selection, it recognizes the serious ethical concerns that such a practice raises and counsels against its widespread use. It concludes, however, that sex selection aimed at increasing gender variety in families may not so greatly increase the risk of harm to children, women, or society that its use should be prohibited or condemned as unethical in all cases. [...]

For the American College of Obstetrics and Gynecology position on gender selection, see this 25KB PDF. Excerpt:

The committee rejects the position that sex selection should be performed on demand...because this position may reflect and encourage sex discrimination.

Some background points gleaned from these sources:

There are two methods of gender selection that have been validated: pre-implantation genetic diagnosis, and flow cytometry.
Both methods raise ethical concerns, but the concerns are different for each method.
There are various unvalidated schemes on the market and in folklore (1 2 3).
Several clinics in the USA are offering gender selection services.
At one such clinic, the most common reason cited is "for family balancing."
The two main professional societies that may be involved in gender selection have taken opposite views on the subject.