Sex selection by preimplantation genetic diagnosis: should it be carried out for social purposes?

Is preimplantation genetic diagnosis for ‘social sexing’ desirable in today's and tomorrow's society?

Pierre F. Ray1,4, Arnold Munnich1, Israël Nisand3, René Frydman2, Michel Vekemans1, Stéphane Viville3 and the French GET –DPI

1 Département de génétique, U393, IRNEM, Hopital Necker enfants malades, 75743 Paris Cedex 15, 2 Service de Gynécologie-Obstetrique, Hopital Antoine Béclère, 92141 Clamart, and 3 Service de Biologie de la Reproduction, Hôpitaux Universitaire de Strasbourg, 67000 Strasbourg, France

4 To whom correspondence should be addressed. e-mail: ray{at}necker.fr

Is preimplantation genetic diagnosis for ‘social sexing’ desirable in today’s and tomorrow’s society?

Dear Sir,

Although we disagree with most of the ideas expressed in Dr Seif’s letter, we will not comment each point or haggle over word definitions but we would like to express a few ideas concerning preimplantation diagnosis for social sexing (PGDSS).

One argument used to defend PGDSS is that it is preferable compared with abortion, infanticide or abandonment of the undesired sex. From a very pragmatic point of view this is probably true. But can a choice by default, almost blackmail, ever be good? In an open and bloody conflict, should the United Nations provide more accurate weapons to each side in order to spare a few innocent civilian lives and by doing so contribute actively to the continuance of the conflict or should they seek to end the war? The situation here is similar to this gross metaphor. So, yes, the use of PGD for sex selection would allow extremists to have male offspring in a more humane way but by giving in to their demand the medical and scientific community would caution PGDSS and encourage its use. If PGDSS is acceptable for some why should it not be for others who, for example already have three girls and would like to have a boy?

This brings us to the opinion—which we think is held by a number of our colleagues—that PGDSS is acceptable when the couples concerned already have children of the opposite sex i.e. strictly for family balancing purpose. The idea behind this position is that the choosing of the sex then will not be pure sexual discrimination but simply a personal decision based on individual situations. Then where should the limit be placed? Could we refuse sex selection for couples who have one child and want just one of the other sex? What about those who prefer to ‘begin’ their family with a child of a given sex? This therefore leads us to say that PGDSS is acceptable ‘so long as sexual discrimination is not an issue’. Basically we could then say that PGDSS is acceptable in Western countries where sexual equality has been achieved (has it?) whereas it is not in the East where social pressure may still favour (for the wrong reason) one sex (male) over the other. Ironically we are now in complete opposition with the first concept stating that PGDSS in perhaps appropriate in some Eastern countries to avoid worst alternatives.

So PGDSS may be acceptable altogether, but clearly if it was, there could be no objection to the selection of any character that couples might wish to have exacerbated in their offspring. The same fallacious arguments used in favour of ‘social sexing’ could then be transposed for any type of screening sought by anybody. There would be no logic whatsoever in saying that you could choose your child’s sex but not its hair colour, its height or its IQ—providing we could predict these characteristics. Do we want to encourage this trend and contribute to reinforcing the capitalistic nature of our society by allowing wealthy couples to ‘buy the perfect’ baby or do we simply want to avoid unnecessary suffering and pain while interfering with nature as little as possible?

Lastly, if the ESHRE Ethics Committee has not yet issued guidelines over PGDSS it is perhaps because they are not really necessary since European treaties already have, clearly stating 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." (Convention on Human Rights and Biomedicine, 1997). Should our European society not comply with European laws and regulations?

References

Convention on Human Rights and Biomedicine (1997) Article 14- Chapter IV titled – Non-selection of sex – in the European Convention for the Protection of Human Rights and Dignity of the Human Being with regard to the Application of Biology and Medicine: Oviedo, 4/4/1997. http://conventions.coe.int/Treaty/EN/CadreListeTraites.htm





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