Sex Selection:

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Sex Selection  Some Ethical Policy
Considerations

• Eike-Henner W. Kluge
• University of Victoria

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Plan to do four things

• Look at ethics of sex selection itself
• Look at some facts
• Look at what goes into policy considerations
• Suggest some conclusions

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Ethics of Sex Selectionthe standard version

• Sex selection is ethically acceptable for medical
  reasons
• Beneficence
• non-Malfeasance
• Sex selection is ethically unacceptable for all
  other reasons
• Sexist values are unethical because they violate
• Human dignity
• Equality of persons

Directed at condition, not sex therefore species
of medical care
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Objections to medically based sex selection

• Interference in human reproduction
• Donum vitae
• Instrumentalistic view of human life
• Human beings viewed as manipulable objects
• Mistaken view of parenthood
• Only conditional acceptance of children
• Negative valuation of differently-abled persons
• Deaf culture and the case of cochlear implants

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Ethics of Sex Selection

• The non-standard version

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Some Basic Assumptions

• Political correctness is not ethics
• Consensus is not ethics
• A consensus means that everyone agrees to say
  collectively what no one believes individually.
• attributed to Abba Eban
• Inconsistent ethics is unethical in its
  implications.
• Ethics that ignores facts is politics in another
  guise.

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Some ethically relevant facts

• Preferences are logically different from values
• Social policy that ignores material facts is
• unworkable
• unethical

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Values vs. Preferences

• Values accord worth to what one values
• Sexist values accord greater worth to the members
  of a particular sex
• Therefore
• they are discriminatory
• they violate equality and dignity of persons
• Preferences do not accord greater worth to what
  one prefers
• Preferential social associations are not
  unethical
• friendships
• clubs, etc.
• Therefore they do not violate equality and
  dignity of the person

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Conclusions 1

• Sex selection based on preference is not subject
  to the same ethical critique as sex selection
  based on sexist values
• Christine Overall 1987, 1993
• Murphy, 1990
• Society of Obstetricians and Gynaecologist of
  Canada, 1991
• CMA, 1991
• Therefore value-based reasons against sex
  selection do not apply to preference-based sex
  selection

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Data on sex preference

• Canadians do not want more children of one sex
  than of another
• Proceed With Care Final Report of the Royal
  Commission on New Reproductive Technologies
  (1993)
• Most Western Countries do not want more children
  of one sex rather than another
• Jain, Missmer, Gupta and Hornstein.
  Preimplanttion sex selection demand and
  preferences in an infertility population
  Fertility and Sterility, 200583649-58
• Dahl, Beutel, Brosig and Hinsch. Preconception
  sex selection for non-medical reasons a
  representative survey from Germany. Human
  Reproduction , 200318(10) 2231-2234
• General position We want matched pairs.

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Conclusion 2

• Data do not show that in Western society, sex
  selection would be based on sexist values
• Therefore, to be ethically defensible,
  prohibition of non-medical sex-selection in
  Western countries must have some other
  justification

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Ethics and Public PolicySome basic
considerations

• Not everything that is ethical should be mandated
  by law.
• Truth-telling
• Charity
• Not everything that is unethical should be
  prohibited.
• Lying

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There is ... a need for judicial restraint in
the development of ... law as it pertains to
sensitive and far-reaching issues of public
policy. (Supreme Court of Canada Dobson v.
Dobson, 1999)
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Ethics and public policy

• The purpose of public policy is to
• prohibit unethical acts
• encourage ethical behaviour
• encourage ethical values
• Public policy must be
• enforceable
• consistent
• Cooper v. Hobart 2001 3 S.C.R. 537
• Rights may be curtailed only to the least degree
  necessary to achieve legitimate end
• R. v. Oakes 1986 1 S.C.R. 103

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Conclusion 3

• If preferences are ethically different from
  values, then an ethically defensible public
  policy should allow sex selection on the basis of
  preference but prohibit sex selection on the
  basis of values.

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Important question

• Is it possible to operationalize the difference
  between value-based and preference-base sex
  selection?

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Some more ethically relevant facts that have been
ignored in the sex selection debate
Remember ethics that ignores facts is not ethics
but politics.
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Sex Distribution at BirthSurprise, Surprise!

• Male to female birth ration was 51.4 in favour
  of males
• Male to female birth ratio currently is 60 in
  favour of females Davis, Gottlieb and
  Stampnitzky. 1998 Møller, 1998 Mocarelli,
  Gerthoux, Ferrari, Petterson, Kieszak, Brambilla,
  Vincoli, Signorini, Tramacere, Carreri, Sampson,
  Turner and Needham, 2000 Martuzzi, Di Tanno and
  Bertollini, 2001 Ryan, Amirova and Carrier,
  2002 del Rio, Marshall, Tsai, Shao and Guo,
  2002.

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Reasons

• Long-lasting environmental pollutants
• Dioxins
• Polychlorinated biphenyls
• They are found globally
• In some locations, their effects are extreme
• In some Canadian locations, they have resulted in
  a male/female birth ratio of .35 to 1
• Mackenzie, Lockridge and Keith, 2005.

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Further Facts

• Survival of human species requires sex-balance
• Assumptions
• Equality of persons
• Rejection of polygyny

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Conclusion 4

• Sex selection is pragmatically necessary for
  species survival if polygyny, etc. are not to be
  institutionalized.

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Modest Proposal

• Allow sex selection for sex-balance
• Institute sex selection lottery
• Only for every second child
• Adjust chances relative to existing sex
  distribution of fertile members of society

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Wont this contradict the desideratum of
population reduction that underlies the claim
that responsible reproductive behaviour limits
children to 1 per family?
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Some other ignored facts

• Responsible reproductive policy cannot be
  national but must be global
• Sustainability of species requires more than one
  child
• general estimate is 2.05 and 2.1 per couple
• Espinshade, Guzman and Westoff, 2003
• Australian Academy of Science, 2006.

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Conclusion 5

• Carte blanche prohibition of sex selection is
  not ethically mandated
• Sex selection can be allowed with appropriately
  crafted public policy
• Current public policy may be politically correct,
  but
• is not based on facts
• is not based on ethics

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Thank you !

• The full version of the preceding analysis is
  forthcoming in Health Care Analysis