20 Jul 2013

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I have always aligned with the school of thought that parents should be able to consciously use conservative methods and fertility treatment to select the sex of their offspring if they so desire. In other words, they should be able to go for a preferred baby’s sex using pre-conception selection methods.

I am not unmindful that, over the years, the media has become preoccupied with expressed fear about “Frankenstein” dimension of medicine - with much tabloid disgust and broadsheet agonising over cloning, “designer babies”, and also “gender clinics” that would allow prospective parents to select the sex of their children among other moral agonising.

A quick recall relevant to the above media agonising was the story, published sometimes in 2001, of a Scottish couple, Alan and Louise Masterton, who paid £6000 to a fertility clinic in Rome for in vitro fertilisation and gender diagnosis to ensure that their next child would be a girl. They already had four boys but wanted another girl after their three-year-old daughter died in an accident in 1999.

From my experience in reproductive and sexual health diagnostics and counselling, I can assert that more and more couples are asking for related procedures to overcome the challenge to achieve the desired sex of their next offspring. Understandably, authorities in a number of countries are getting concerned and voicing some concern about this development around sex selection

For example, in the United Kingdom, it is illegal to have IVF treatment for the purpose of choosing the sex of your baby - which is why the Mastertons went to Italy - and sex selection is widely considered immoral, conjuring up images of human clones and genetically engineered monsters. In fact, in some countries in Asia, it is against the ethics to reveal the sex of the baby-to-be in ultrasound scan report, so as to discourage gender-selection related fetocide (i.e. termination of a pregnancy because it has now revealed that it is not the desired gender that is being carried in the womb).

One is however tempted to ask if there is any cogent moral objection to the practice of the aforementioned? May be one should ask: if it is morally acceptable to perform genetic tests on newly fertilised embryos to screen out those with serious genetic diseases, then why shouldn’t the process be taken further to include selection on other grounds - including sex?

Admittedly, the widespread sex selection that already goes on in many parts of the world - especially in India and China - does little to allay fears.

In some third world countries, abortion and infanticide to weed out female offspring are commonplace, partly because of the overwhelming social stigma of being “unable” to produce boys. It has been estimated that, as a result, there are about 100 million fewer living women than we should expect there to be - and the resulting imbalance of the sex ratio could mean that before long, vast numbers of males will be unable to find women with whom to have children.

Against this disturbing background, the question of whether sex selection is morally objectionable in itself might sound “academic”, in the derogatory usage of the word - an idle theoretical preoccupation of no practical consequence. But in the interests of sound reasoning and sensible policy formation, ‘academic’ questions deserve better consideration than the half-baked coverage they often get in the media. Dr Piers Benn, the renowned expert in medical ethics

For a start, we should separate questions about the safety of sex-selection procedures from the ethics of sex selection per se. Equally, we should distinguish moral worries about the methods used for sex selection - such as infanticide, abortion or pre-implantation genetic diagnosis - from moral concerns about the desired end.

Many of the familiar worries are really about the methods rather than the goal. If we object absolutely to abortion (anyway this is illegal in Nigeria but nevertheless widely practiced here), we shall obviously object to sex selective abortion. If we adopt the ‘conservative pro-life’ stance towards fertilised human ova, we shall think it wrong to destroy a fertilised human ovum for any reason whatsoever - whether to do with serious genetic handicap, sex, or any other supposed “imperfection”.

However, people who are attracted to a middle way - those who want to condemn the discarding of embryos for sex selection, but not for other reasons - face some awkward questions.

One question is whether sex selection is intrinsically wrong, whatever the method used. Is it wrong to employ existing techniques of sperm filtration, separating androgenic from gynogenic spermatozoa, and fertilising eggs with the desired type? What about adopting sex positions recommended for the purpose  These techniques do not involve creating embryos and then getting rid of the “wrong” ones, and so apparently side-step the objections of the “pro-life” people. But the idea still makes many people deeply uneasy.

So, some might object to the sexist attitudes underlying sex selection. If a couple are anxious that their child should not be a girl, doesn’t that suggest contempt for the female sex, of the sort most blatantly exemplified in cultures where girl babies are murdered or abandoned?

As a generalisation, this is surely false. Imagine a couple who try sex selection, not because they dislike one sex, but merely because they prefer the other. Or consider parents who have four girls already, and want a boy to “make up the balance”. Think of couples who have a strong preference, but never act on it. It must be common for parents to hope that their child will be of a particular sex, even if they would never dream of doing anything about it.

Injustice to the unselected sex?
Does the “sexual justice” issue arise because sex selection deprives members of the disfavoured sex of the chance to be born? This argument has its attractions. However, ingenious metaphysics aside, if these alleged victims of injustice do not yet exist, they surely cannot be wronged by not being brought into existence. Even the Roman Catholic Church’s arguments against contraception do not include saying that it takes away anybody’s right to life.

Thus, we need to ask: what sort of people would want sex selection, and for what reasons? Do they show a manipulative attitude to nature, or an inability to be content with what they are given? Do they display unpleasant sexual attitudes?

No doubt some of them do, and we should be wary of their motivations. As with many other issues in the “new genetics”, the deep and difficult moral questions come down to character and attitude, rather than rigid principle. “We should judge cases on an individual basis - and remember that tedious clichés about ‘playing God’ do little to advance understanding, but a lot to sow confusion,” Dr Piers Benn reasoned. On this I fully incline with Benn.

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