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Sex Selection: Ethical Issues
A paper to be used as background for discussion
K. Cloonan, C. Crumley, and S. Kiymaz
Edited by S. F. Gilbert and E. Zackin
Discussions of cloning and stem cell research involve whether we should set limits on technologies that do not yet exist. However, the debate on whether sex selection is an ethical practice involves technology that is already perfected. It is possible, through prenatal genetic screening, to determine which four-to-eight-cell human embryos are male and female and to implant into the uterus only those of the desired sex.
This technology was developed for the implantation of female embryos into the uteri of women carrying X-linked lethal or debilitating diseases. For instance, a woman who is a carrier for X-linked hemophilia or Tay-Sachs disease may want to have a child and not undergo the tentative pregnancy associated with amniocentesis or chorionic villi sampling. Therefore, she could have fertilization with her partner done in vitro, and have only the XX embryos implanted. Since these diseases are recessive, the girls should not have the disease (although they will have a 50% chance of being carriers themselves).
However, if a couple have a son and want a daughter, should they not be allowed to have sex selection to get one? If a couple has daughters and the husband wants a son to "carry on his name," should they be allowed to use this technology? Once the technology has been developed, though, there are no laws (in the United States) making it illegal to have sex selection for any reason. In some countries, sex selection is not legal: see http://www.bionetonline.org/English/Content/db_leg2.htm#sex.
The professional organizations concerned with sex selection in vitro have been ambivalent about this issue. There are two groups that occupy the primary places of the preconception sex selection debate, one is the American Society for Reproductive Medicine (ASRM) in the United States and the other is the Human Fertilisation and Embryology Authority (HFEA) in Britain. Britain's HFEA, unlike the ASRM, is a government body and can determine whether or not clinics are legally able to perform sex selection technologies. The ASRM is an organization composed of doctors, nurses, and scientists who have a hand in making their views on reproductive medicine known at the state and federal levels (1) The HFEA banned sex selection for social reasons in 1993 after the majority of respondents to a consultation exercise felt that sex selection should not be available for "family balancing." (2) Their decision did, however, allow its use for medical reasons to persist. This remains the opinion and current regulation in Britain as dictated by...