Sex Selection: Some Ethical
& Policy Considerations
Eike-Henner W. Kluge
University of Victoria
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

Ethics of Sex Selection:
the standard version

Sex selection is ethically acceptable for
medical reasons
 Beneficence
 non-Malfeasance

Directed at condition,
not sex; therefore
species of medical care
Sex selection is ethically unacceptable for
all other reasons
 Sexist


values are unethical because they violate
Human dignity
Equality of persons
Objections to medically based sex
selection

Interference in human reproduction
 Donum

Instrumentalistic view of human life
 Human

beings viewed as manipulable objects
Mistaken view of parenthood
 Only

vitae
conditional acceptance of children
Negative valuation of differently-abled
persons
 Deaf
culture and the case of cochlear implants
Ethics of Sex Selection
The non-standard version
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.

Some ethically relevant facts
Preferences are logically different from
values
 Social policy that ignores material facts is

 unworkable
 unethical
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
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 preferencebased sex selection
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, 2005;83:649-58
Dahl, Beutel, Brosig and Hinsch. Preconception sex selection
for non-medical reasons: a representative survey from
Germany. Human Reproduction , 2003;18(10): 2231-2234
General position: “We want matched pairs.”
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

Ethics and Public Policy:
Some basic considerations

Not everything that is ethical should be
mandated by law.
 Truth-telling
 Charity

Not everything that is unethical should be
prohibited.
 Lying
“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)
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
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.
Important question
Is it possible to operationalize the
difference between value-based and
preference-base sex selection?
Some more ethically relevant facts
that have been ignored in the sex
selection debate
Remember: ethics that ignores facts
is not ethics but politics.
Sex Distribution at Birth
Surprise, 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.
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.
Further Facts

Survival of human species requires sexbalance
 Assumptions


Equality of persons
Rejection of polygyny
Conclusion # 4

Sex selection is pragmatically necessary
for species survival if polygyny, etc. are
not to be institutionalized.
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
Won’t this contradict the desideratum
of population reduction that underlies
the claim that responsible
reproductive behaviour limits children
to 1 per family?
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.
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
Thank you !
The full version of the preceding analysis is
forthcoming in Health Care Analysis