This article discusses the ethics of the use of preimplantation genetic diagnosis to prevent the birth of children with intersex conditions/disorders of sex development , such as congenital adrenal hyperplasia and androgen insensitivity syndrome . While pediatric surgeries performed on children with ambiguous genitalia have been the topic of intense bioethical controversy, there has been almost no discussion to date of the ethics of the use of PGD to reduce the prevalence of these conditions. I suggest that PGD for those (...) conditions that involve serious medical risks for those born with them is morally permissible and that PGD for other “cosmetic” variations in sexual anatomy is more defensible than might first appear. However, importantly, the arguments that establish the latter claim have radical and disturbing implications for our attitude toward diversity more generally. (shrink)

What's wrong with designer children, bionic athletes, and genetic engineering.

This paper analyses the British Human Fertilisation and Embryology Authority's 2002 public consultation on sex selection, a consultation that was mainly concerned with sex selection for non-medical reasons. Based on a close reading of the consultation document and questionnaire it is argued that the consultation is biased towards certain outcomes and can most plausibly be construed as an attempt not to investigate but to influence public opinion.

Prohibition on sex selection may well be unnecessary and oppressive as well as posing risks to women’s lives The urge to select children’s sex is not new. The Babylonian Talmud, a Jewish text completed towards the end of the fifth century of the Christian era, advises couples on means to favour the birth of either a male or a female child.1 The development of amniocentesis alerted the public in the mid-1970s to the scientific potential for prenatal determination of fetal sex,2 (...) and progressive decriminalisation of abortion afforded choice about continuation of pregnancy. The more recent emergence of preimplantation genetic diagnosis (PGD) obviates resort to abortion, and improved techniques of sperm sorting and diagnosis permit creation of zygotes that will ensure the sex of a future child. Growth of biomedical means to select the sex of future children has been accompanied by fear that such means will be employed to favour births of sons, and so perpetuate devaluation of girl children and women’s inferior family and social status. A reaction to this fear has been the demand for legal and medical professional prohibition of sex selection techniques. For instance, the Council of Europe’s Convention on Human Rights and Biomedicine3 provides in article 14 that: The use of techniques of medically assisted procreation shall not be allowed for the purpose of choosing a future child’s sex, except where serious hereditary sex-related disease is to be avoided. Legislation has been enacted in a number of countries, and proposed in others, to prohibit sex selection on non-medical grounds, such as the Prenatal Diagnostic Techniques (Regulation and Prevention of Misuse) Act, 1994 in India. In Canada, for instance, government draft legislation introduced in May 2002 proposes to make it a crime for any person, for the purpose of creating a human …. (shrink)

Sex selection technologies have become increasingly prevalent and accessible. We can find them advertised widely across the Internet and discussed in the popular media—an entry for “sex selection services” on Google generated 859,000 sites in April 2004. The available services fall into three main types: preconception sperm sorting followed either by intrauterine insemination of selected sperm or by in vitro fertilization ; preimplantation genetic diagnosis, by which embryos created by IVF are tested and only those of the desired sex are (...) transferred to the woman's uterus; and prenatal testing of fetuses through ultrasound or chromosomal analysis, followed by selective abortion of fetuses detected to be of the undesired sex. (shrink)

Theorists analyzing the concepts of race and gender disagree over whether the terms refer to natural kinds, social kinds, or nothing at all. The question arises: what do we mean by the terms? It is usually assumed that ordinary intuitions of native speakers are definitive. However, I argue that contemporary semantic externalism can usefully combine with insights from Foucauldian genealogy to challenge mainstream methods of analysis and lend credibility to social constructionist projects.

One of the most talked-about scholarly works of the past fifty years, Judith Butler’s _Gender Trouble_ is as celebrated as it is controversial. Arguing that traditional feminism is wrong to look to a natural, 'essential' notion of the female, or indeed of sex or gender, Butler starts by questioning the category 'woman' and continues in this vein with examinations of 'the masculine' and 'the feminine'. Best known however, but also most often misinterpreted, is Butler's concept of gender as a reiterated (...) social _performance _rather than the expression of a prior reality. Thrilling and provocative, few other academic works have roused passions to the same extent. (shrink)

The spaces provided by biotechnologies of sex selection are rich with epistemological, ontological, and ethical considerations that speak to broadly held social values and epistemic frameworks. In much of the discourse about sex selection that is not medically indicated, the figure of the “naturally” conceived child is treated as a problem for parents who want to select the sex of their child. As unknown, that child is ambiguous in terms of sex—“it” is both and neither, and might be the “wrong” (...) sex. Drawing on Beauvoirean thinking about ambiguity and desire, I cast part of the desire to select the sex of a child as bound to an ethic and epistemology of disambiguation, and urge that the space of being-unknown is one to which each person is entitled. (shrink)

There is a popular and widely accepted version of the precautionary principle which may be expressed thus: “If you are in a hole—stop digging!”. Tom Baldwin, as Deputy Chair of the Human Fertilisation and Embryology Authority , may be excused for rushing to the defence of the indefensible,1 the HFEA’s sex selection report,2 but not surely for recklessly abandoning so prudent a principle. Baldwin has many complaints about my misrepresenting the HFEA and about my supposed elitist contempt for public opinion; (...) readers of this exchange will decide for themselves.REDRAFTING THE REPORTBaldwin begins with a piece of wishful thinking:"Harris objects that in this recommendation “an absurdly high standard of caution is employed”, since a theoretical risk is associated with almost all medical procedures. This objection is misplaced: as paragraph 142 of the report indicates, the phrase “theoretical risk” is to be understood here in the light of the earlier discussion of the risks arising from the fact that flow cytometry exposes sperm to laser energy, a procedure which is known to be liable to damage DNA."Paragraph 142 does not make that clear. It does indeed refer back to a set of earlier paragraphs but these give, if anything, an upbeat assessment of the safety of flow cytometry. Paragraph 121 states: “However whilst potentially less intrusive, and with potentially lower risk to the health of patients, flow cytometry …” .2 But even if the overall burden of the report does indicate unresolved fears, the standard is still absurdly high. However, so far from endorsing the report’s judgement that flow cytometry has “potentially lower risk to the health of patients”, Baldwin now regards the risk of flow cytometry as “serious”1:"Since the application of flow cytometry to humans is a new procedure, the risk of … ". (shrink)

The Human Fertilisation and Embryology Authority’s recent restrictive recommendations on sex selection have highlighted the need for consideration of the plausibility of ethical arguments against sex selection. In this paper, the author suggests a parental virtues approach to some questions of reproductive ethics as a superior alternative to an exclusively harm focused approach such as the procreative liberty framework. The author formulates a virtue ethics argument against sex selection based on the idea that acceptance is a character trait of the (...) good parent. It is concluded that, because the argument presented posits a wrong in the sex selecting agent’s action that is not a harm, the argument could not function as a justification of the HFEA’s restrictive position in light of their explicit commitment to procreative liberty; it does, however, suggest that ethical approaches focused exclusively on harm fail to capture all the relevant moral considerations and thus that we should look beyond such approaches. (shrink)

BACKGROUND: -/- Preconception sex selection for non-medical reasons raises serious moral, legal and social issues. The main concern is based on the assumption that a freely available service for sex selection will distort the natural sex ratio and lead to a severe gender imbalance. However, for a severe gender imbalance to happen, at least two conditions have to be met. First, there must be a significant preference for children of a particular sex, and second, there must be a considerable demand (...) for preconception sex selection. To ascertain whether or not these two conditions are met, we have conducted a survey in Germany. METHODS: -/- As a representative sample of the German population, 1094 men and women aged 18-45 years were asked about their gender preferences and whether or not they could imagine selecting the sex of their children through flow cytometric separation of X- and Y-bearing sperm followed by intrauterine insemination. RESULTS: -/- 58% of respondents stated that they do not care about the sex of their offspring. 30% wish to have a family with an equal number of boys and girls. 4% would like to have more boys than girls, 3% more girls than boys, 1% only boys and 1% only girls. For first-borns, however, there is still a preference for boys over girls. While 75.6% claimed to have no gender preference, 14.2% would like their first child to be a boy and 10.1% would like their first child to be a girl. Whereas 6% could imagine taking advantage of preconception sex selection, 92% found this to be out of the question. Even in the hypothetical case that a medication for sex selection were ever to become available, 90% stated that they would not want to use it. CONCLUSION: -/- Given that a majority does not seem to care about the sex of their offspring and only a minority seem to be willing to select the sex of their children, a freely available service for preconception sex selection for non-medical reasons is rather unlikely to cause a severe gender imbalance in Germany. (shrink)

Jesudason and Weitz's article examines two public policy debates in California, where both sides of the debate used similar language that had the potential to be detrimental to women. Specifically, they show how anti-abortion crusaders in California used similar language to describe why women's rights should be curtailed as pro-choice advocates use when fighting for more choice and privacy for women's reproductive decisions. This commentary builds upon their article by demonstrating the harm that such co-opting causes to women's rights using (...) the example of sex selective abortion. By examining the legislative history of state and national bills to ban sex-selective abortion, this commentary demonstrates how the anti-abortion lobby has adopted the language of pro-choice advocates quite effectively. Although the framing of this issue as being “woman-protective” is strategic and insincere, such political framing is powerful, as Jesudason and Weitz have noted. Anti-abortion activists have convinced lawmakers in many states that sex-selective abortion is a dire issue in their state and that they must restrict it in order to protect women. In fact, there is no evidence that sex selective abortion is a problem in the United States, yet these frames have been very effective in weakening women's privacy rights. Whenever woman-protective framings are invoked for self-serving purposes, women's rights advocates must work hard to uncover the truth behind these discourses to prevent successful legislative efforts that curtail women's reproductive freedom. (shrink)

In a recent comment on the HFEA’s public consultation on sex selection, Soren Holm claimed that proponents of family balancing are committed to embrace a laissez faire approach. Given that arguments in support of sex selection for family balancing also support sex selection for other social reasons, advocates of family balancing, he asserts, are simply inconsistent when calling for a limit on access to sex selection. In this paper, I argue that proponents of family balancing are in no way inconsistent. (...) Provided their advocacy of family balancing is aimed at preventing a severe distortion of the natural sex ratio, they are entirely justified in insisting on restrictions to sex selection. The real question is whether a concern for the sex ratio does indeed call for a limit on sex selection. Based on a recent survey on gender preferences and data from several Gender Clinics, I argue that a restriction on sex selection to family balancing is unwarranted. In the absence of any evidence for a pending sex ratio distortion, we are actually required to adopt a laissez faire approach to sex selection. (shrink)

Despite tremendous advances in neuroscience, the topic “brain, sex and gender” remains a matter of misleading interpretations, that go well beyond the bounds of science. In the 19th century, the difference in brain sizes was a major argument to explain the hierarchy between men and women, and was supposed to reflect innate differences in mental capacity. Nowadays, our understanding of the human brain has progressed dramatically with the demonstration of cerebral plasticity. The new brain imaging techniques have revealed the role (...) of the environment in continually re-shaping our brain all along our lifetimes as it goes through new experiences and acquires new knowledge. However, the idea that biology is a major determining factor for cognition and behavioral gender differentiation, is still very much alive. The media are far from being the only guilty party. Some scientific circles actively promote the idea of an innate origin of a gender difference in mental capacities. Experimental data from brain imaging, cognitive tests or genetics are often distorted to serve deterministic ideas. Such abuse of “scientific discourses” have to be counteracted by effective communication of clear and unbiased information to the citizens. This paper presents a critical analysis of selected examples which emphasize sex differences in three fields e.g. skills in language and mathematics, testosterone and financial risk-taking behavior, moral cognition. To shed light on the data and the methods used in some papers, we can now—with today’s knowledge on cerebral plasticity—challenge even more strongly, many false interpretations. Our goal here is double: we want to provide evidence against archaic beliefs about the biological determinism of sex differences but also promote a positive image of scientific research. (shrink)

Since the 19th century, and despite tremendous progress in science, the topic of 'brain and sex' remains a matter of misleading interpretations, far beyond the field of science. The media are not solely responsible for this situation. Some scientific circles still actively promote the ideology of biological determinism in their attempt to explain differences in behaviour and cognitive abilities between men and women. Experimental data from brain imaging studies, cognitive tests or the discovery of new genes are often distorted to (...) serve deterministic ideas. As biotechnologies and genetic engeneering represent today a new economic and lucrative challenge, the question of what is innate and what is acquired is becoming more and more significant, requiring vigilant scrutiny from us all. (shrink)

Safe and effective methods of preconception gender selection through flow cytometric separation of X- and Y-bearing sperm could greatly increase the use of gender selection by couples contemplating reproduction. Such a development raises ethical, legal, and social issues about the impact of such practices on offspring, on sex ratio imbalances, and on sexism and the status of women. This paper analyzes the competing interests in preconception gender selection, and concludes that its use to increase gender variety in a family, and (...) possibly for selecting the gender of firstborn, might in many instances be ethically acceptable. (shrink)

ABSTRACT Although a preference for sons is reportedly a universal phenomenon, in some Asian societies daughters are considered financial and cultural liabilities. Increasing availability of ultrasonography and amniocentesis has led to widespread gender screening and selective abortion of normal female foetuses in many countries, including India. Feminists have taken widely divergent positions on the morality of this practice. Feminists from India have strongly opposed it, considering it as a further disenfranchisement of females in their patriarchal society, and have agitated successfully (...) for legislative prohibitions. Libertarian feminists on the other hand, primarily from the United States, have argued that any prohibition of the use of this technology is a curtailment of a woman's reproductive choices and a violation of her right to make autonomous decisions regarding procreation. Using India as an illustrative case, this paper argues that in the context of what prevails in some societies, an ethical argument that hinges on the principle of autonomy as understood in the West can be problematic. Furthermore, a liberal theoretical assumption that it is always better to have more rather than fewer choices may not hold up well against the realities of life for such women. Although feminists have little disagreement concerning substantive matters, it is in the area of strategy that differences of opinion have arisen, their moral reasoning and responses shaped by the culture, ethnicity, class and race to which they belong. A view that a single ‘orthodox’ feminism of any variety can embody the aspiration of all women reverts to the problematic issues in the evolution of the rationalistic, individualistic, ‘male’ ethics against which women have consistently raised objections. (shrink)

Bioethics and feminist scholarship has explored various justice implications of nonmedical sex selection and family balancing. However, prospective users’ viewpoints have been absent from the debate over the socially acceptable bounds of nonmedical sex selection. This qualitative study provides a set of empirically grounded perspectives on the moral values that underpin prospective users’ conceptualizations of justice in the context of a family balancing program in the United States. The results indicate that couples pursuing family balancing understand justice primarily in individualist (...) and familial terms rather than in terms of social justice for women and girls or for children resulting from sex selection. Study participants indicated that an individual’s desire for gender balance in their family is ethically complex and may not be inherently sexist, immoral, or socially consequential, particularly given the social context in which they live. Our findings suggest that the social conditions that contribute to prospective users’ desires for gender balance in their families may direct them away from recognizing or engaging broader social justice concerns relating to sexism and stratified reproduction. (shrink)

Although deeply committed to the model of nondirective counseling, most genetic counselors enter the profession with certain assumptions about health and disability—for example, that it is preferable to be a hearing person than a deaf person. Thus, most genetic counselors are deeply troubled when parents with certain disabilities ask for assistance in having a child who shares their disability. This ethical challenge benefits little from viewing it as a conflict between beneficence and autonomy. The challenge is better recast as a (...) conflict between parental autonomy and the child's future autonomy. (shrink)

The aim of this paper is to demonstrate that there are significant ethical problems with nonmedical sex selection, and that prohibitive legislation is justified. The central argument put forward is that nonmedical sex selection is a sexist practice which promotes socially restrictive conceptions of sex, gender and family. Several steps are taken to justify this position: background information on technology and legislation is provided, the neoliberal position that is supportive of nonmedical sex selection is described, and preliminary reasons for rejecting (...) this approach are given. A detailed description of how a harm/benefit based analysis contributes to the argument against nonmedical sex selection, and how it successfully counters most criticism, is provided. The paper concludes by suggesting that virtue ethics further strengthens the moral argument against nonmedical sex selection. (shrink)

Although sex selection calls for careful thought, it seems in many cases to be neither intrinsically objectionable nor likely to have bad consequences.

Non-medical sex selection is premised on the notion that the sexes are not interchangeable. Studies of individuals who undergo sex selection for non-medical reasons, or who have a preference for a son or daughter, show that they assume their child will conform to the stereotypical roles and norms associated with their sex. However, the evidence currently available has not succeeded in showing that the gender traits and inclinations sought are caused by a “male brain” or a “female brain”. Therefore, as (...) far as we know, there is no biological reason why parents cannot have the kind of parenting experience they seek with a child of any sex. Yet gender essentialism, a set of unfounded assumptions about the sexes which pervade society and underpin sexism, prevents parents from realising this freedom. In other words, unfounded assumptions about gender constrain not only a child’s autonomy, but also the parent’s. To date, reproductive autonomy in relation to sex selection has predominantly been regarded merely as the freedom to choose the sex of one’s child. This paper points to at least two interpretations of reproductive autonomy and argues that sex selection, by being premised on gender essentialism and/or the social pressure on parents to ensure their children conform to gender norms, undermines reproductive autonomy on both accounts. (shrink)

Although surprising to some proponents of sex selection for non-medical reasons (Dahl 2005), a considerable amount of critical debate has been raised by this practice (Blyth, Frith, and Crawshaw 2008; Dawson and Trounson 1996; Dickens 2002; Harris 2005; Heyd 2003; Holm 2004; Macklin 2010; Malpani 2002; McDougall 2005; Purdy 2007; Seavilleklein and Sherwin 2007; Steinbock 2002; Strange and Chadwick 2010; Wilkinson 2008). While abortion or infanticide has long been used as means of sex selection, a new technology—preimplantation genetic diagnosis (PGD)—has (...) become a highly efficient, and arguably less controversial, way of ensuring the birth of a child of a particular sex. PGD, used in combination with in vitro .. (shrink)

The British have taken a comprehensive approach to regulating reproductive medicine. A loophole in the current law leaves some cases of sex selection uncovered; if that loophole were closed, however, the law is robust enough to address the concerns about sex selection while permitting it in many cases.