Medical ethics- sex selection

Running head: SEX SELECTION: MEDICAL ETHICS 1
Sex Selection: Medical Ethics
Nishita Patolia
West Coast University

Sex Selection: Medical Ethics 2
Sex Selection: Medical Ethics
Sex selection is a popular fertility method used nowadays to choose a preferred or
specific gender for a child. Fertility specialists, with the success of technology, have been able to
create embryos of male and female sexes. Only one technology has been approved for sex-
selective insemination. Microsort flow cytometry methods is where the sperm is stained with a
fluorescent dye and sent past a laser team where “the difference in DNA content between X- and
Y-bearing sperm gives a measureable difference in fluorescence” (Dondorp, DeWert, Pennings,
Shenfield, Devroey, Tariatzis, et al., 2013).
There has been much controversy regarding sex selection in multiple countries. In the
United Kingdom, it is illegal to have a sex selection unless there is a medical risk to the baby.
For this, one must have a pre-implantation genetic diagnosis (PGD) before being approved for
sex selection (The Science Behind Sex Selection, n.d.). A reason why sex selection is preferred
for medical diagnoses is because it prevents future harm to the baby or the development of
diseases. Autism, for example, is a male dominant disorder but there is no early diagnosis before
the baby is born(Willingham, 2013). For one to be applicable for sex selection (in the UK), high
risks families would have multiple boys with “severe autism” (Willingham, 2013). In this case, a
male embryo would not be chosen to prevent autism in that child, which does not guarantee a
child without autism (Willingham, 2013).
“A couple of which the male partner is a hemophilia patient will not have affected
children themselves, but becau0se any daughter will be (healthy) carriers, their grandchildren are
potentially at risk. In such cases, sex selection aimed at the birth of the boy would serve the
double aim of protecting one’s children from difficult reproductive decision-making and
avoiding the transmission of the mutation to a possible third generation” (Dondorp et al., 2013).

Sex selection to be justified measures the percentage of benefit to the amount of risk reduction of
a disease in using this procedure. Over 36 countries, including 25 European countries, have laws
or policies regarding sex selection and is prohibited unless for a medical reason.
Sex selection in many countries has been a controversial issue that brings up matters
about discrimination in third world countries. It is an issue is many South Asian, East Asian and
Central Asian countries where “more than 100 million girls are ‘missing’. Skewed sex ratios in
those countries will have long-lasting social and demographic impact” (Latest Publications, n.d.).
In China, Azerbaijan, and Armenia the male to female ratio is 115 to 100 female births. In most
of Asian countries, men are particularly preferred compared to females (Stop Sex Selection,
n.d.). “Son preference reflects socio-economic influences and deep-rooted traditions where sons
alone inherit property, care for ageing parents, conduct funeral rites and carry on the family
name, while the daughters may require dowries and leave their families once they’re married”
(Stop Sex Selection, n.d.). Women face much discrimination and fear violence in many
countries in the east. “Since the early 1980s, the availability of ultrasound and other diagnostic
technologies which can detect the sex of a fetus has in some parts of the world led to an
accelerated increase in sex-ratio imbalances at birth” (Preventing Gender-biased, n.d.). It’s in
these countries where sex selection is used for reasons other than medical risks. Using this
procedure for this purpose can cause an imbalance in societies across the world (Stop Sex
Selection, n.d.). Some debate that the root cause is not the availability of this technology but the
cultures that prefer male offspring over female (Dondorp et al., 2013).
Sex selection is also opposed due to safety risks related to the fluorescent dye put on the
embryos and the use of the laser. “With regard to human use, the latest publication from the
Microsort trial reports normal pregnancy outcomes and malformation rates in760 children.”

(Dondorp et al., 2013). It is also said to be a step towards creating a “designer child” (Dondorp et
al., 2013). It opens doors to options that allow parents to choose characteristics of a child that are
not medically necessary (Dondorp et al., 2013).
One limitation is the evidence used to support the proficiency of sex selection. There is a
chance of failure or a different gender than selected. “If sperm sorting were to be used for non-
medical reasons, a specific concern is that a failure may have adverse consequences for the
welfare of children born to parents who have gone to great lengths to have a child of other sex.”
(Dondorp et al., 2013). In other words, in case of a failure, it is unknown how parents will react
to the failure.
Debates have also shown that sex selection followed abortion due to a fetus of the
“wrong sex” is also morally wrong. It has led to “adverse effects of making safe medical
abortion less easily available for women who need such procedures for whatever reason.”
(Dondorp et al., 2013). With the use of technology called Non-Invasive Prenatal Test, parents are
able to identify the gender of the fetus at an early stage of pregnancy, allowing them to have a
sex- selection abortion earlier and at a “safer time” (Dondorp et al., 2013). One method
suggested to avoid sex-selection abortion is to withhold test results of the fetus gender, however
this would be holding information from the parent who has full rights to this information
(Dondorp et al., 2013).
All in all, there are positive and negative outcomes for using sex-selection. It is said to be
morally wrong if used for non-medical reasons. Strict rules apply when used for medical reasons,
such as proof of diagnosis of future fetuses. Many countries in Eastern Europe have banned sex-
selection due to medical risks applied to the baby. Asian countries need to have policies for sex-

selection in regards to social imbalances related to a male fetus preference. There are still some
limitations in this new technology due to lack of evidence-based research.
This subject is a controversial topic that has its pros and cons. It’s necessary that
prospective research be done to further examine whether this new technology is safe and fully
beneficial since there is still a chance that one does not get the preferred fetus. Personally, sex-
selection should only be used for parents who have severe mental or health related diseases
within the family. Using it for social benefits is morally wrong and is “playing with God’s
creations.” Sex selection is disturbing Mother Nature when the process of pregnancy should
naturally run its course unless used for medical reasons. Through personal experience, India is a
male-dominant culture where men are “necessary” to keep the country going. Having a
procedure like sex selecting available to the public will only cause problems socially and most
definitely will increase the unbalancing ratio of male to females. European countries are doing
the right thing by putting strict laws and regulations on sex-selection. It is only legal if performed
for severe diseases with proof. All countries, if allowing its citizens the right to use this
technique, should only allow sex-selection if used for medical purposes. Both sides had great
points, but the cons side has more evidence and showed more positive outcomes than the pros
side. Sex-selection should be avoided unless used for severe medical purposes and only when
used for good intentions for the baby, not the parents.

References
Dondorp, W., DeWert, G., Pennings, G., Shenfield, F., Devroey, P., Tarlatzis, B., et al.
(2013). ESHRE Task Force on Ethics and Law 20. Medscape, 28(6), 1448-1454.
Latest Publications. (n.d.). Son Preference and Pre-Natal Sex Selection. Retrieved
December 11, 2013, from http://www.unfpa.org/gender/selection.html
Preventing Gender-biased Sex Selection. (n.d.). World Health Organization . Retrieved
December 11, 2013, from http://whqlibdoc.who.int/publications/2011/
STOP SEX SELECTION: A Threat to Women’s Lives, Human Rights. (n.d.). UNFPA.
Retrieved December 11, 2013, from http://www.unfpa.org/gender/docs/factsheet_
The Science Behind Sex Selection. (n.d.). Baby Centre. Retrieved December 11, 2013,
from http://www.babycentre.co.uk/a1014303/the-science-behind-sex-selection
Willingham, E. (2013, October 21). Embryo Sex Selection To Select Against Autism?.
Forbes. Retrieved December 11, 2013, from
http://www.forbes.com/sites/emilywillingham/2013/10/21/embryo-sex-selection-to-select-
against-autism/

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