Sex Selection

SEX SELECTION
 

Explanation
of Terms and Procedures

Sex selection “refers to means whereby the sex of an offspring can be chosen.” (l)
This includes the use of  reproductive
technologies which attempt to achieve the conception of a child of a particular
sex (sex
preselection) and the abortion of a child of an unwanted sex.

 
Policy

Sex selection
is not permissible.


Sources
of Policy
A
negative judgment on sex preselection is rendered in the
Instruction on Respect for Human Life in Its Origin and on the Dignity of
Procreation (Donum Vitae) from the Vatican
Congregation for the Doctrine of the Faith (1987):

Certain
attempts to influence chromosomic or genetic inheritance are not therapeutic but
are aimed at producing human beings selected according to sex or other
predetermined qualities. These manipulations are contrary to the personal
dignity of the  human being and his
or her integrity and identity. Therefore  in
no way can they be justified on the grounds of possible beneficial consequences
for future humanity. Every person must be respected for himself: in this
consists the dignity and right of every human being from his or her beginning.
(2)

Sex
selection through abortion falls under the general prohibition against abortion
clearly articulated in the Ethical and
Religious Directives for Catholic Health Care Servicesfrom the National
Conference of Catholic Bishops: 

  Abortion (that is, the directly
intended termination of  pregnancy
before viability or the directly intended destruction of a viable fetus) is
never permitted. Every procedure whose sole immediate effect is the termination
of pregnancy before  viability is an
abortion, which, in its moral context, includes the interval between conception
and implantation of the embryo. (No. 45)  (3)

The Declaration
on Abortion  of the Vatican
Congregation for  the Doctrine of
the Faith (1974) explicitly affirms the right
to life as independent of considerations of sex:

The
first right of the human person is his life. He has other goods and some are
more precious, but this one is fundamental–the condition of all the others.
Hence, it must  be protected above
all others. It does not belong to society,
nor does it belong to public authority in any form to recognize
this right for some and not for others: all discrimination is evil,
whether it be founded on race, sex, color or religion. (4)




1. Gale Largey, “Reproductive Technologies: Sex Selection,” Encyclopedia
of Bioethics (1978).

 2.
Congregation for the Doctrine of the Faith, Instruction
on Respect for Human Life in Its Origin and on the Dignity of Procreation (Washington,
DC: United States Catholic Conference, 1987): I.6, pp. 19-20.

3.
National Conference of Catholic Bishops, Ethical
and Religious Directives for Catholic Health Care Services (1994)
(Washington, DC: United States Catholic Conference, 1995).

 4.
Congregation for the Doctrine of the Faith, Declaration
on Abortion III.ll  in Catholic
Mind (April 1975): 54-64 at 58. 

 

COMMENTARY SEX SELECTION


Methods
of Sex Selection

Over
the centuries folklore has contained various prescriptions for having a child of
a particular sex. For  example,
“The Hebrew Talmud suggested that placing the marriage
bed in a north-south direction favored the conception of boys.”
(l) In Germany a father was advised to take an ax to bed with
him if he wanted to conceive a boy. (2) Yet other prescriptions
for influencing the sex of the child conceived included having
intercourse in dry weather or when there is a north wind; having
the man wear boots to bed or hanging his pants on the right
bedpost; or having the woman lie on her right side during
intercourse or wear male clothing to bed on her wedding night. (3)

On
a more scientific level, methods which have been examined for conceiving a child
of a particular sex (i.e., “sex  preselection”)
include the timing of intercourse during the
woman’s menstrual cycle (4), the time of artificial insemination
(5), the provision of acidic
(or alkaline) environments for  sperm
(6), the degree of penetration (7), a woman’s diet (8), and low or high sperm
count within the female tract. (9) Another
method of trying to conceive a child of a particular sex is
to inject the woman with antibodies against androgenic (i.e.,
male-determining, Y-bearing) sperm or gynogenic (i.e., female-determining,
X-bearing) sperm. (10) There has also  been
speculation “about the eventual development of a
sex-selection pill which might, for instance, alter the ratio
of androgenic and gynogenic sperm produced by the man, or
induce the woman’s immune system to selectively attack and
destroy sperm of one or the other sort.” (11) Development
of a diaphragm which would allow
only one type of sperm to pass  through
has also been suggested. (12)

Currently
the most promising methods of sex preselection
are those involving the separation of androgenic and gynogenic
spermatozoa followed by artificial insemination of a woman or
in vitro fertilization with sperm of predominantly one type. (13)
Such methods increase  the probability
of conceiving a child of a particular sex. (14)

 Sex
selection after conception is also being practiced. Postfertilization procedures
involve determining the sex of the child conceived through some form of prenatal
diagnosis, such as amniocentesis or ultrasound, and then aborting a child of an
unwanted sex. (15)  Yet other
methods which may be used for determining sex include removing chorionic
placental tissue via the cervix and identifying Y-specific DNA, measuring the
level of testosterone (a hormone  produced
more in male than in female fetuses) in maternal blood  or saliva, determining fetal hormone levels in amniotic
fluid, and assessing fetal blood cells in maternal blood. (16)

 In
vitro fertilization (IVF) with preimplantation diagnosis also offers an
opportunity  for sex selection: the
developing cells can be tested for sex, and only those embryos implanted which
are of the desired sex. (17) It is likewise speculated that the experimental
procedures of parthenogenesis and the fusion of ova could be
used as sex selection technologies. (18)  (See the entries on In
Vitro Fertilization, Preimplantation Diagnosis,and
Proposed Reproductive Technologies).

 Reasons Advanced for Sex Selection

Some
reasons given for sex selection are matters of parental
self-fulfillment, e.g., the pleasures associated with one or
the other sex, replacing oneself biologically, carrying on
the family name. (19) In some cultures, such as India, sons  (rather than daughters) are important economically and in
providing support for aging parents. (20) In some cultures
sons are also important for religious reasons. For example,
males carry on the line of ancestors in China, and in Judaism
it is a son who says the Kaddish for a dead father. (21)

“Quality
of life” arguments have also been advanced for
sex selection, namely, that “sex choice would enhance quality
of life more for a child of the ‘wanted’ sex than a child of
the ‘unwanted’ sex,” that it “would provide better quality  of life for the family that has the ‘balance’ it
desires,”  and that it would
provide “a better quality of life for the
mother, because she will undergo fewer births to have the desired
number of children of each sex.” (22) Further, sex selection
is viewed by some simply as a more sophisticated form of family  planning. (23)

An
alleged societal benefit of sex selection is that it
will help to limit the population. (24) In the United States,  some parents “keep trying” until they have a child
of a specific  sex. (25) It is
speculated that, “in other cultures, assurance of having male
children–highly valued for economic, religious
and cultural reasons–could have a considerable impact on
population size.” (26)

The
aforementioned reasons for sex selection are non-medical  in
nature. However, some genetic diseases are sex-linked,
and couples might be motivated to select the sex of their child
in order to ensure the health of the child. (27)

Ecclesiastical Rationale for Opposition to Sex Preselection

The
Vatican Instruction‘s rejection of sex
preselection  (i.e., attempts to
achieve the conception of a child of a  particular
sex) is based on the dignity, integrity, and identity
of the human person:

These
manipulations are contrary to the personal dignity of the
human being and his or her integrity and identity. …Every person
must be respected for himself: in this consists the dignity and
right of every human being from his or her beginning. (28)

The
importance of respecting each individual for himself or herself is a
consideration which has appeared in other  discussions
of choosing the sex of children. In this vein,
Catholic ethicists Benedict Ashley and Kevin O’Rourke have  made the following comments about sex preselection:

…Christian
teaching shows that it is highly significant to
children that they be accepted by their parents as a divine gift
to be loved for what they uniquely are and not merely because
they conform to the parents’ hopes or expectations. At present,
society is becoming more aware of the immense injustice and harm
done to women by cultural patterns and structures that constantly
say to a girl, “You should have been a boy.” Sex selection by
the parents either will reinforce this male preference pattern
or, if parents can be reeducated to equal preference, will still
say to the individual child, “You are loved because you conform
to your parents’ preferences.” This seems an injustice to the  child and further reinforces the cultural message that
children  exist primarily to fulfill
the needs of the parents rather than
for their own sake. This implication is already built into many
cultural structures, and people have an ethical responsibility  to fight against it. (29)

The concern that sex selection fails to respect each
individual  for himself or herself
has also been expressed  by
the President’s Commission  for
the  Study
of  Ethical
Problems in  Medicine
and Biomedical and Behavioral
Research, although in the context  of
postfertilization selection. (30) The Commission points out that choosing the
sex of children “seems incompatible with the attitude of virtually
unconditional acceptance that developmental psychologists have found to be
essential to  successful
parenting.” (31) Hence, “for the good of all
children, society’s efforts should go into promoting the acceptance of
each individual–with his or her particular strengths and weaknesses–rather
than reinforcing the negative  attitudes
that lead to rejection.” (32) Indeed, the Commission  remarks that sex selection involves an attitude which,
“taken  to an extreme,…treats
a child as an artifact and the  reproductive
process as a chance to design and produce human
beings according to parental standards of excellence…”. (33)

The
Vatican Instruction  also states that procedures such
as sex preselection cannot be justified on grounds of “possible
beneficial consequences for future humanity.” (34) It has
been claimed, for example, that sex selection procedures would
have the good consequence of alleviating population pressures,
especially in Third World countries. (35) Yet the very accuracy  of this prediction has been called into question. (36)
Indeed,  it has been argued in the
nonecclesiastical literature that  sex
selection may have many harmful consequences (see below
“Nonecclesiastical Arguments Against Sex Selection”).


Sex Preselection for Sex-Linked Diseases Specifically

Some
genetic diseases, such as hemophilia, Hunter’s syndrome,
Cooley’s anemia, and Duchenne’s muscular dystrophy are
sex-linked, and couples might be motivated to preselect the
sex of their child in order to ensure the health of the child. (37) It
might be suggested that distinctions should be made
ethically among various motives for and methods of sex selection,
with this case being a morally permissible use of sex
preselection. (38)

In
dealing with sex preselection, the Vatican Instruction
speaks of “certain attempts to influence chromosomic or genetic
inheritance [which] are not therapeutic but are aimed at
producing human beings selected according to sex…” [italics added;
39]. It might be said that sex selection to prevent passing on a sex-linked
disease belongs to a different category. Does the Vatican Instruction  leave open the use of sex
preselection in such cases?

For
one thing, the nature of the particular procedure used
for sex preselection would have to be evaluated. As a general  rule, only those reproductive methods and technologies are
permissible which facilitate the natural act of sexual intercourse or
assist it to achieve the objective of conception but do not replace it (see the
entryGeneral
Policy on Assisted Reproductive Technologies (ART)). Two current  methods
of sex preselection involve a technological separation of
androgenic (i.e., male-determining, Y-bearing) and gynogenic
(i.e., female-determining, X-bearing) spermatozoa followed by artificial
insemination with sperm of predominantly one type; one method is also used with
in vitro fertilization. (40)  In
vitro fertilization is not considered a morally permissible procedure according
to the aforementioned principle (see the entry In
Vitro Fertilization (IVF)).  Further,
even when the husband’s sperm is used for artificial insemination, question
could be raised about the method of sperm collection utilized. (41)

 Suppose, however, that a technique for sex preselection
could be developed which operated within the context of a
substantially complete act of intercourse. Would sex
preselection in the case of sex-linked diseases then be morally  permissible?

To
answer this question, further clarification would have
to be sought from the magisterium. At the present time, the  most that can be said is that the Vatican Instruction  does
not explicitly make an exception for sex preselection in the
case of sex-linked diseases.


Sex Selection, Prenatal Diagnosis, and Abortion

One
method of sex selection currently being practiced
consists in determining the sex of the child conceived through some form
of prenatal diagnosis and then aborting a child of
an unwanted sex. While it is recognized that abortion is morally
impermissible, a further moral question is whether prenatal
diagnosis should ever be undertaken specifically to determine the sex of
the child.

In
1986 the Catholic Health Association of the United States
convened a Research Group on Ethical Issues in Early Human Development
and Genetics. (42) This research group explicitly recommended that:
   
Institutions and professionals should refuse to
participate in prenatal diagnosis performed solely
for the        purpose of sex selection.
(43)

The research group maintained that such use of
prenatal diagnostic techniques “undermines the reason for which genetic
testing  and counseling are done:
namely, to prevent serious genetic  disease.”
(44) Further, the group points out that “providing prenatal diagnosis for
sex selection runs the risk of setting  precedents
for selecting nondisease-related characteristics,
and ultimately of eroding public support for prenatal diagnosis.”  (45)

 Outside
of the Church, opposition has also been expressed to the use of prenatal
diagnosis simply to determine the sex of the child on the grounds that such use
of medical technologies represents an inappropriate use of scarce resources.
(46)



Nonecclesiastical Arguments Against Sex Selection

The
reasons advanced for sex selection have not been
universally accepted. The claim that the practice of sex
selection would help control population has been called into
question (47), as have the claims that sex selection would
improve the quality of family life and the quality of life
for women (48) and enhance parental self-fulfillment. (49)
In addition, various arguments have been put forward directly
against sex selection.

 The
charge has frequently been made that sex selection
is an instance of “sexism,” that is, of making a distinction
between sexes that is not rationally justified. (50)
Concomitantly, it has been suggested that the practice of sex
selection “would probably reinforce sexist attitudes both in
those who practice it and in others.” (51)
As has been noted by the President’s Commission for the Study of Ethical
Problems in Medicine and Biomedical and Behavioral Research:

 In
some cases, the prospective parents’ desire to undertake the
procedures is an expression of sex prejudice. Such attitudes
are an affront to the notion of human equality and are especially
inappropriate in a society struggling to rid itself of a heritage
of such prejudices. (52)

It
has also been contended that sex selection could have
harmful consequences, especially for women. For one thing,  “evidence exists that most people who want a child of
each  sex prefer to have a male
first, and that first-born children  are
apt to achieve more than later-born children.” (53) Thus,
if couples used sex selection to have a male child first, the
advantages of being first-born could go predominantly to
men and, in turn, men on the whole might be better social
achievers than females. (54)  In
addition, given the evidence of preference for male children (55), there is
concern that  sex selection might
upset the male-female ratio in the population
in the direction of a male-dominated society. (56)
A numerical  predominance of
males in society could,

 in turn, result in
more violent crime, more commercial sex, and more homosexuality. (57)
Finally, sex selection might have a negative psychological
impact on children themselves. Children who are sex-selected “could
feel subtly harmed, controlled, or invidiously different
from other children not so conceived.” (58) If a daughter
knows that she was “planned-to-be-second,” she may “suffer
a loss of confidence or self-esteem.” (59) And even if a daughter is
first-born, she “may be damaged if she learns that whereas she was not
sex-selected, her younger brother was.”
(60) Moreover, there is the possibility that a given method of sex
selection may fail, with the child of the unwanted sex
experiencing parental rejection or developing feelings of inadequacy.
(61)

It
is likewise feared that the use of procedures to select
the sex of children will set a precedent for selecting other  characteristics in children, characteristics which may have
nothing to do with a medical condition. (62) Indeed, question
has been raised about the whole concept of using medical
technology “for nonmedical purposes, simply to facilitate the
wishes of the consumer.” (63)



Nonecclesiastical Documents on Sex Selection


On the issue of sex preselection, the Council on Ethical and Judicial
Affairs of the American Medical Association has taken the position that
“sex selection of sperm for the purposes of avoiding a sex-linked
inheritable disease is appropriate.” (64)
At the same time, the Council  maintains
that “physicians should not participate in sex selection for reasons of
gender preference” but “should encourage a prospective parent or
parents to consider the value of both sexes.” (65)

With
respect to postfertilization procedures (viz., prenatal diagnosis
followed by abortion of a child of an unwanted sex), the
President’s Commission for the Study of Ethical Problems in  Medicine and Biomedical and Behavioral Research reached the
conclusion that “public policy should discourage the use of
amniocentesis for sex selection.” (66) However, the Commission  did not go so far as to recommend legal prohibition of the
practice. (67) The same position of recommending discouragement
of the practice but not legal prohibition was taken by a genetic research
group at the Hastings Center. (68)  A
consensus development conference of the National Institutes of Health likewise
advised agianst the use of prenatal diagnosis for sex selection. (69)

 1.
Gale Largey, “Reproductive Technologies: Sex Selection,” Encyclopedia of Bioethics (1978),

1440.

 2.
Ibid.

3.
Letty Cottin Pogrebin, Growing Up Free:
Raising Your Child in the 80’s  (New
York: Bantam Books, 1981), p. 82; quoted in Mary Anne Warren, Gendercide:
The Implications of Sex Selection
(Totowa, NJ: Rowman & Allanheld, 1985), p. 6.

4.
“One theory is that the timing of intercourse and conception can alter  the odds of producing a male or female child. Because
androgenic spermatozoa  tend to be
more numerous, and because they have been thought to be
shorter-lived and faster-moving than gynogenic spermatozoa, it has been
hypothesized that intercourse close to the time of ovulation is more apt
to produce male conception, while intercourse several days prior to
ovulation  is more apt to produce
females. In a popular book on sex selection published
in 1970, David Rorvik and Landrum Shettles recommended that couples
wanting  boys should have
intercourse close to the time of ovulation, while those
wanting girls should have intercourse several days prior to that time.
However, Elizabeth Whelan, in a competing book, argued that this schedule
actually lowers the probability
of getting a child of the desired sex. Studies have been done which tend to
support each of these contradictory  theories.”
Warren, Gendercide,  pp.
8-9. See David Rorvik and Landrum B. Shettles, Your Baby’s Sex: Now You Can Choose (Toronto: Dodd, Mead & Co.,
1970); and Elizabeth Whelan, Boy or Girl? (Indianapolis:
Bobbs-Merrill, 1977).

 5.
“To confuse matters even further, some researchers have claimed that  the appropriate schedules are reversed in the case of
artificial insemination. Guerrero has reported that natural inseminations early
and late in the fertile period produce more males than those nearer to the time of ovulation, while
the opposite effect occurs with conceptions resulting from artificial
insemination. It is entirely possible that the time of conception does
sometimes affect the sex of the offspring; but at present the evidence is
so inconsistent that no method of sex selection involving timing appears
particularly promising.” Warren, Gendercide,
p. 9. See R. Guerrero, “Sex  Ratio:
A Statistical Association with the Type and Time of Insemination  in the Menstrual Cycle,” International
Journal of Fertility  (1970):
221-5. For a summary of research on the influence
of the timing of conception,  see
William H. James, “Timing of Fertilization and the Sex Ratio of
Offspring,” in Neil G. Bennett (ed.) Sex
Selection of Children (New York:  Academic
Press, 1983), pp. 73-99.

 6.
“A second theory is that acidic environments are more favorable to
gynosperm, while alkaline environments favor androsperm. Rorvik and
Shettles  recommend the use of acid
douches to increase the odds of conceiving a girl,  and alkaline douches to increase the odds of a boy. …These
methods…have  not been proven to
be reliable.” Warren, Gendercide,
p. 9. See David Rorvik  and Landrum
B. Shettles, Your Baby’s Sex: Now You Can
Choose (Toronto: Dodd, Mead & Co., 1970).

 7.
“On the same theory, couples wishing to conceive a boy have been advised  to use deep penetration, since the secretions of the cervix
are thought  to be less acidic than
those of the vagina. These methods…have not been
proven to be reliable.” Warren, Gendercide,
p. 9.

 8.
“A third theory is that fetal sex can be influenced by the mother’s  diet in the weeks prior to conception. Stolkowski and
Choukroun advise  that a woman who
wants to conceive a boy should eat foods high in sodium
and potassium; for a girl, she should eat foods high in calcium and
magnesium. The assumption is that a woman’s internal mineral balance may affect
the  consistency of her cervical
mucus, or some other environmental condition
within her reproductive tract, making it more hospitable to sperm of one
or the other sort. Several other researchers have recommended particular
diets for the production of boys or girls. So far, however, there has
been  no experimental confirmation
of such claims, and most fertility researchers
regard the odds of selecting sex through diet as close to nill.”
Warren,  Gendercide,
pp. 9-10. See J. Stolkowski and J. Choukroun, “Preconception
Selection of Sex in Man,” Israel
Journal of Medical Science 17
(1981): 1061-7; Sally Langendoen and William Proctor, The
Preconception Gender Diet (New
York: Evans & Co., 1982); J. Lorrain & R. Gagnon, “Selection  Preconceptionelle du Sexe,” L’Union Medicale Du Canada 104 (1975): 800-3.

9.
“A fourth theory is that high sperm counts are conducive to the conception
of males. On this theory, men who want sons should be healthy and well
nourished, wear loose clothing around their testicles, and avoid
ejaculating  for several days prior
to the attempted conception. Repeated intercourse
on the same day apparently also increases the sperm count within the
female tract. (The Talmud advises men who want sons to have intercourse with
their wives twice in succession.) Experimental confirmation of this theory is
also scant, although it enjoys wide popular acceptance.” Warren, Gendercide,  p. 10.

10.
Michael D. Bayles, Reproductive Ethics
(Englewood Cliffs, NJ: Prentice-Hall, 1984), p. 34; Richard T. Hull, Ethical Issues in the New Reproductive Technologies
(Belmont, CA: Wadsworth, 1990), p. 205.

 11.
Warren, Gendercide, p. 10.

12.
Ibid.

13.
Warren, Gendercide,  p. 11; see also Joyce Bermel, “Selecting a Sex Before
Conception: More Men and Hens?”, Hastings
Center Report 15/3 (June 1985): 2.

“Sperm
separation is the technique that has received the most attention. Sperm contain,
among 22 chromosomes, one X or one Y chromosome, which will  determine at fertilization the sex of the offspring. Swimming
a sample  in a layered density
gradient of protein solution can concentrate Y-bearing
sperm up to 70 percent purity. This technique has been widely publicized
by Ronald Ericsson, and is used in the U.S. laboratories offering
selection toward male children. Another technique separates sperm by pouring a
sample  through an ionized column of
resins. In this case, X-sperm can be isolated a fraction up to 90 percent
“pure”…But we have found only one clinical
report…of the use of this technique to select for female
offspring!” Betty B. Hoskins & Helen Bequaert Holmes, “When Not to
Choose: A Case Study,”  Journal
of Medical Humanities and Bioethics 6/1 (Spring/Summer 1985): 28-37 at 30. See Ronald J. Ericsson,
“Isolation and Storage of Progressively
Motile Human Sperm,” Andrologia
9/1 (1977): 111-14; Ronald J. Ericsson and
Robert H. Glass, “Functional Differences between sperm bearing the
X- or Y-chromosome,” in Rupert P. Amann & George E. Seidel (eds.), Prospects
for Sexing Mammalian Sperm(Boulder, CO: Colorado Associated University
Press, 1982), pp. 201-11; O. Steeno, A. Adimeolja, & J. Steeno, “Separation
of  X- and Y-bearing Spermatozoa
With the Sephadex Gel-filtration Method,”
Andrologia
7 (1975): 95-7; A. Adimeolja, R. Hariadi, I.G.B. Amitaba, P. Adisetya,
& Soeharna, “The Separation of X- and Y-spermatozoa with regard
to the Possible Clinical Application by means of Artificial Insemination,
Andrologia
9/3 (1977): 289-92; S.L. Carson, F.R. Batzer, & S. Schlaff,
“Preconception Female Gender Selection,” Fertility and Sterility  40/3
(1983): 384-5.

  A more recent technique is MicroSort developed at the Genetics
& IVF Institute in Fairfax, Virginia in 1998.  It is based on the fact that X chromosomes have about 2.8%
more DNA than Y chromosomes.  By
staining sperm with a flourescent dye that latches onto DNA and measuring the
glow of the sperm cells under laser light, how much genetic material each one
carries can be gauged.  Once the
sperm has been distinguished in this way, an automated sorting machine separates
the Xs from the Ys.  The separation
is then followed by artificial insemination or in vitro fertilization.  Currently, MicroSort is the only validated method for
the preferential conception of daughters.  Genetics
& IVF Institute, “Microsort” at http://www.givf.com; Frederic
Golden, “Boy? Girl? Up to You,” Time
152/12 (Sept. 21, 1998) available at http://www.givf.com; E.F. Fugger, S.H.
Black, K. Keyvanfar, J.D. Schulman, “Births of normal daughters after
MicroSort sperm separation and intrauterine insemination, in-vitro
fertilization, or intracytoplasmic sperm injection,” Human
Reproduction (Sept. 1998) available at http://www.givf.com.

14.
For example, in 1982 Ericsson reported a success rate of about 75 percent  for the conception of boys by his technique. F.J. Beernick
& R.J. Ericsson,  “Male Sex
Preselection Through Sperm Isolation,” Fertility
and Sterility  38/4 (1982):
493-5.  Current MicroSort technology
offers couples an 85% chance of conceiving a girl, and preliminary results
suggest that selection for male children will work 65% of the time.
Frederic Golden, “Boy? Girl? Up to You,” Time
152/12 (Sept. 21, 1998) available at http://www.givf.com.

 15.
In the procedure of amniocentesis, a needle is inserted through the abdominal
wall of  the mother into the
amniotic sac which surrounds the fetus, and a small amount
of the amniotic fluid is withdrawn. This fluid contains cells that have
flaked off the body of the fetus. These cells are grown in culture for
examination of chromosomes and biochemicals. Amniocentesis cannot be performed
until 14-16 weeks into the pregnancy because, until that time, there is not an
adequate amount of amniotic fluid. Ronald Munson (ed.) Intervention and Reflection, 3rd ed. (Belmont, CA: Wadsworth
Publishing, 1988), p. 348;  Orville
N. Griese, Catholic Identity in Health
Care: Principles and Practice (Braintree,
MA:  Pope John Center, 1987), p.
106; Patricia L. Monteleone,  “Development
of the Embryo and Prenatal Diagnosis” in Donald G. McCarthy
(ed.) Reproductive Technologies, Marriage and the Church (Braintree, MA:
Pope John Center, 1988), p. 35;  Ricki
Lewis, Human Genetics Concepts and Applications, 2nd ed. (Dubuque, IA: Wm.
C. Brown, 1997), p. 64.

  In an ultrasound exam, “sound
waves are bounced off the embryo or fetus, and the pattern of deflected sound
waves is converted into an image” on a screeen, providing a picture
of the embryo or fetus. Lewis, Human
Genetics, p. 205.

 16.
Hoskins & Holmes, “When Not to Choose: A Case Study,” p. 31. See
also  Helen B. Holmes & Betty B.
Hoskins, “Prenatal and preconception sex choice
technologies: a path to femicide?” in Gena Corea et al., Man-Made
Woman: How New Reproductive Technologies Affect Woman (Bloomington, IN:
Indiana  University Press, 1987),
pp. 18-20.

 17.
Warren, Gendercide, pp. 10-11; Holmes
& Hoskins, “Prenatal and  preconception
sex choice technologies: a path to femicide?”, pp. 18-19.

 18.
“Still another means of sex selection might arise from the future  discovery of ways of inducing parthenogenesis. In
parthenogenetic  reproduction, the
ovum begins dividing without fertilization by a
spermatozoon. Many invertebrate species (e.g. aphids, flatworms, and
certain arthropods) routinely reproduce asexually through parthenogenesis, as do
several species of fish and lizards. It is possible that parthenogenesis
may occasionally occur spontaneously in humans, though no proof of this
speculation is available. Because the human ovum has only an
X-chromosome,  the resulting embryo
could only be female… parthenogenetic reproduction  has been induced in amphibians through a number of different
methods, such  as pricking the eggs
with a needle or treating them with antibiotics or
ions. A strain of turkeys has been developed in which many unfertilized
eggs begin to develop, and a few grow to maturity.

 It
may also eventually prove possible to induce two human ova to fuse and begin
cell division, thereby producing a daughter with two mothers and
no father. Pierre Soupart has reported success in inducing ovular merging
in mice. If this report is correct, then the prospect of success with our
own species may be better than has generally been assumed.” Warren,
Gendercide, p. 12.

 19.
Peter Steinfels, “Choosing the Sex of Our Children,” Hastings Center Report 4/1 (Feb. 1974): 3-4 at 3; Dorothy C. Wertz
and John C. Fletcher,  “Fatal
Knowledge? Prenatal Diagnosis and Sex Selection,” Hastings Center Report 19/3 (May/June 1989): 21-7 at 23; Warren, Gendercide,
pp. 172-3.

 20.
Wertz & Fletcher, “Fatal Knowledge? Prenatal Diagnosis and Sex
Selection,”  p. 25; Bernard M.
Dickens, “Prenatal Diagnosis and Female Abortion: A Case
Study in Medical Law and Ethics,” Journal of Medical Ethics 12/3 (Sept. 1986): 143-4 & 150 at 144.

 21.
Steinfels, “Choosing the Sex of Our Children,” p. 3.

 22.
Wertz & Fletcher, “Fatal Knowledge? Prenatal Diagnosis and Sex
Selection,”  p. 22.

 23.
Video Boy or Girl? Should the Choice Be
Ours?  Hard Choices series
produced by KCTS/ Seattle (1980).

24.
Wertz & Fletcher, “Fatal Knowledge? Prenatal Diagnosis and Sex
Selection,”  p. 22; Warren, Gendercide, pp. 163-66.

 25.
Steinfels, “Choosing the Sex of Our Children,” p. 3.

 26.
Ibid., Tabitha M. Powledge, “Toward a Moral Policy for Sex
Choice,”  in Bennett (ed.),
Sex Selection of Children, pp. 203-4.

 27.
“The ability to separate X- and Y-bearing sperm cells provides new
opportunities for women who are carriers of X-linked disorders.
There are over 350 X-linked diseases in humans including hemophilia,
Duchenne muscular dystrophy, and X-linked hydrocephalus.
In most cases, the X-linked diseases are only expressed in the male
offspring of carrier mothers.  The
use of MicroSort for the enrichment of the X-chromosome bearing sperm cells can
now allow for the preferential conception of unaffected female offspring.”  E.F. Fugger, S.H. Black, K. Keyvanfar, J.D. Schulman,
“Births of normal daughters after MicroSort sperm separation and
intrauterine insemination, in-vitro fertilization, or intracytoplasmic sperm
injection,” Human Reproduction
(Sept. 1998), available at http://www.givf.com. See also John C. Fletcher,
“Ethics and Amniocentesis for Fetal Sex Identification,”
Hastings Center Report 10/1
(Feb. 1980): 15-7 at 15. 

 28.
Congregation for the Doctrine of the Faith, Instruction
on Respect for Human Life in Its Origin and on the Dignity of Procreation (Washington,
DC: United States Catholic Conference 1987), I.6, p. 20.

 29.
Benedict M. Ashley, OP and Kevin D. O’Rourke, OP, Healthcare
Ethics: A Theological Analysis, 3rd ed. (St. Louis: Catholic Health
Association  of the United States,
1989), p. 317  


30.
President’s Commission for the Study of Ethical Problems in Medicine
and Biomedical and Behavioral Research, Screening and Counseling for Genetic Conditions  (Washington,
DC: U.S. Government Printing Office, 1983), pp. 56-9.

 31. Ibid., p. 57.

 32. Ibid.

 33.
Ibid., p. 58.

 34.
Congregation for the Doctrine of the Faith, Instruction
on Respect for Human Life in Its Origin and on the Dignity of Procreation,
I.6, p. 20.

 35.
“It is the argument made by the biologist John Postgate in a 1973 article,
an argument more recently taken up by Clare Booth Luce (1978). They argue
that the rate of population increase in the Third World could be slowed
more rapidly and effectively if people could be guaranteed not just the
number but also the sexes of their children. In some less-developed
countries, nurturing a certain number of sons to adulthood is a couple’s
best chance for a secure old age. In places where infant mortality is
high  and female children are
perceived as a drain on family resources, Postgate
asserted, the drive to overproduce sons, partly for status and partly to
assure that some will be around to provide care a generation hence,
contends  powerfully and often
successfully with any natural (and other economic)
inclination to limit family size. A
Man Child Pill–his name for a cheap,  safe,
convenient (and, of course, so far unavailable) technology for getting  sons–would, he believed, solve this problem in both direct
and secondary  ways: first by its
immediate effects on family size, and then by the greatly  reduced number of women in subsequent generations–the
rate-limiting factor  in population
growth being the number of available uteruses…

  Without referring to Postgate, Luce made exactly
the same argument…she  argued…that
‘if the world birth rate were only one female baby per two women, world population, instead of doubling, as it is now
doing every 34  years, would undouble
every 35 years.'” Tabitha M. Powledge, “Toward a
Moral Policy for Sex Choice” in Bennett (ed.), Sex
Selection of Children, pp. 203-4. See also Warren, Gendercide, pp. 163-66.



36.
“Another argument to justify sex selection is that it would help to  limit the population. Families would not have six girls to
have their desired  son, for
example. But there is no evidence that population trends result  from a desire to have sons. Rather, most families try to have
the number  of children that seems
most economically advantageous. If they could select  sex, and if one sex presented an economic advantage over the
other, some  families might actually
have more children than they would have had in the  absence of sex selection.” Wertz & Fletcher,
“Fatal Knowledge? Prenatal  Diagnosis
and Sex Selection,” p. 22.

 Mary
Anne Warren argues that “the long-term effects of sex selection
upon birth rates are unpredictable, and the scenario painted by Postgate
and Luce might prove to be highly unrealistic.” Gendercide,
p. 169. For her discussion of the population control argument, see  Gendercide, pp 163-72.
Warren also points out that “it is morally objectionable for citizens
of wealthy nations to suggest that Third World nations ought to fight
overpopulation through massive reductions in the number of women.” Gendercide,
 p. 169.

 37. Hoskins & Holmes, “When Not to Choose: A Case Study,”
p. 31; Paul R. Gastonguay, “Fetal Sex Determination,” America
135/6 (Sept. 11 1976): 123-4 at 124; Warren, Gendercide, pp. 160-3.
See also note 27 above.

 38. “It becomes obvious that there are two issues here: l)
detecting the  sex of a fetus
already conceived and 2) controlling the sex of a fetus to be. It is conceivable
that segments of the population might approve one
while disapproving the other. It may be that the Catholic Church could
approve sperm ejaculation in order to isolate the types of sperm desired,
thereby preventing the conception of a severely afflicted child. This
would  reduce significantly the
numbers of abortions for ‘therapeutic’ reasons. I would like to see this shift.
But the detection of fetal sex with intent
to abort is another matter.” Gastonguay, “Fetal Sex
Determination,” p. 124.

 39. Congregation for the Doctrine of the Faith, Instruction on Respect for Human Life in Its Origin and on the Dignity
of Procreation, I.6, p. 20.

 40.
See note 13 above.

 41.
For example, masturbation would not be a morally permissible way to obtain the
husband’s sperm.  If sperm were
collected during an act of sexual intercourse using a perforated condom (which
would be a morally permissible means), some sperm would escape into the woman’s
genital tract which could possibly result in a conception.  This would defeat the goal of trying to conceive a child of a
particular sex, making it unlikely that sperm would be collected in this way for
the procedure.  See also the entry Impermissible
Cases of Artificial Insemination by Husband.

42. Research Group on Ethical Issues in Early Human Development and
Genetics,  Human Genetics: Ethical Issues in Genetic Testing, Counseling, and
Therapy  (St. Louis: Catholic
Health Association of the United States, 1990), p. v.

 43. Ibid., p. 39.

 44.
Ibid., p. 34.

 45.
Ibid., p. 35.

 46.
Mentioned in Fletcher, “Ethics and Amniocentesis for Fetal Sex
Identification” p. 15; Wertz & Fletcher, “Fatal Knowledge?
Prenatal Diagnosis and Sex Selection,” p. 23; Gastonguay, “Fetal Sex
Determination,” p. 124;  President’s
Commission for the Study of Ethical Problems in Medicine and
Biomedical and Behavioral Research,
Screening and Counseling for Genetic
Conditions, p. 56.

 47. See note 36 above.

 48. “Warren claims, moreover, that there is no evidence that sex
selection  would result in a better
quality of family life; in fact, there are several  ways in which it could worsen it. Sex selection could
encourage favored  treatment of a
child whose sex was deliberately selected by parents and
result in neglect of existing children whose sex was determined by
nature. Sex selection also may occasion conflict about family composition, and,
in societies where women possess little power, foreclose their only
chance  to have a girl. In addition,
improved quality of life for women by sex choice is an illusion. Warren argues
on consequentialist grounds that (assuming persons would act on their
preferences, if they could) in most  societies,
sex selection would tend to be used against women. Even in the
U.S., where most couples desire to have one child of each sex, there are
preferences for boys. …We agree with Warren’s conclusion that there
appear  to be no valid arguments for sex selection on the basis of
‘quality of life,'”  Wertz
& Fletcher, “Fatal Knowledge? Prenatal Diagnosis and Sex
Selection,”  p. 22.

 49.
“The sex of the child does not make her or him any more “my”
child than  one of the other sex;
genetically, parents contribute equally to each child. Women can carry on the
family name. They do so increasingly in the United
States by retaining their maiden names, hyphenating their last names, or
using the husband’s family name only in society’s private sector. In
almost  all nations, males and
females are now more equal in the capacity to inherit
the estates of parents or others. Any normal pleasure that can be enjoyed
with a child of one sex such as sports, vacation, hobbies, games, art,
and  literature can be enjoyed with
a child of the other sex. …Our analysis  does
not diminish the power of biologically or culturally based sex
preferences, but the desire itself cannot directly be acted upon,
especially  in deliberate choices
about sex selection, without a prior admission that
it is irrational to do so.” Wertz & Fletcher, “Fatal
Knowledge? Prenatal  Diagnosis and
Sex Selection,” p. 23.

 50.
“Also, desire for a boy or girl contains within it preconceptions on sex
roles. Powledge, therefore, called sex preselection ‘the original sexist sin.’
Markle (1981 on the PBS show “Hard Choices”) called it ‘the ultimate  form of sex discrimination’ and further argued that peoples’
reasons for  wanting firstborn sons
reflect machismo values and sexual prejudice such  as carrying on a family name.” Hoskins & Holmes,
“When Not to Choose: A Case Study,” p. 29.

 “Considerable
evidence exists that many men and women…desire male
children. Indeed, many prefer to have a male child first, and then a
female. But is it rational to desire a child of a particular sex? A preference
for one sex over the other, for its own sake, is simply sexism. It
implies  that one sex is
intrinsically more valuable than another, but good reasons
can be and have been given against this view by many authors, so such a
desire is irrational.”  Bayles,
Reproductive Ethics,
p. 14.

 “…the
only reason people want a child of a particular sex in the first  place is because of beliefs they have about qualities such a
child will  possess. Whether biology
dictates any sex role characteristics
continues  to be a matter for
debate. But it is simply no longer debatable that many
attributes of sex roles quite recently thought innate are actually
learned, imposed by the culture.” Powledge, “Toward a Moral Policy for
Sex Choice” in Bennett (ed.), Sex
Selection of Children, pp. 205-6.

 51.
Bayles, Reproductive Ethics, p. 36.

 52.
President’s Commission for the Study of Ethical Problems in Medicine
and Biomedical and Behavioral Research, Screening and Counseling for Genetic Conditions, p. 57.

 53.
Bayles, Reproductive Ethics, p. 36.

 54. Ibid. See also Hoskins & Holmes, “When Not to Choose: A
Case Study,”  p. 33; and Joyce
Bermel, “Selecting a Sex Before Conception: More Men and
Hens?”, Hastings Center Report 15/3 (Jan. 1985): 2. For a critical
assessment  of this line of
argument, see Warren, Gendercide, pp.
138-42.

 55.
Warren, Gendercide, pp. 12-13;
President’s Commission for the Study  of
Ethical Problems in Medicine and Biomedical and Behavioral Research,
Screening and Counseling for
Genetic Conditions,p. 57.

 56.
Steinfels, “Choosing the Sex of Our Children”, pp. 3-4; Ashley &
O’Rourke,  Healthcare Ethics, p. 317; Warren, Gendercide, pp. 16-7.

 57.
Video Boy or Girl: Should the Choice Be
Ours?  Hard Choices Series,
KCTS/Seattle (1980); Hoskins & Holmes, “When Not to Choose: A
Case Study,”  pp. 32-3. See
also A Etizioni, “Sex Control, Science, and Society,”
Science 161 (1968): 1107-12.  This
issue is critically discussed at some length
in Warren, Gendercide, pp.
108-31 (chap. 5, “More Males/More Violence?”)
and pp. 151-2.

 58.
John C. Fletcher, “Ethics and Public Policy: Should Sex Choice Be  Discouraged?” in Bennett (ed.), p. 248.

 59.
Warren, Gendercide, p. 142, reporting
Roberta Steinbacher, “Futuristic  Implications
of Sex Preselection,” in Helen B. Holmes, Betty B. Hoskins,
and Michael Gross (eds.), The
Custom-made Child? Women-Centered Perspectives
(Clifton, NJ: Humana Press, 1981), p. 187.

 60.
Warren, Gendercide, p. 142, reporting
John Fletcher, “Is Sex Selection  Ethical?”,
Research Ethics 128 (1983), p. 343.

61.
Warren, Gendercide, pp. 173-5.

 62.
“Another argument against sex selection–one that anticipates completion
of the human genome map–is that by selecting for sex we set precedents
for attempts to select other characteristics that have nothing to do with
disease, for instance, height, eye
and hair color, thinness, skin color,  and
straight teeth. Many parents already include some of these
characteristics in visualizing their perfect children. If sex selection
is permitted, will it not be a precedent for other requests from anxious
parents in the next century? Why
stop at gender selection? What else will  geneticists
be asked to do if and when they can understand and determine
the expression of several genes? Parents could argue that having a child
with ‘undesirable’ characteristics–shortness, nearsightedness,
color-blindness, or just an average IQ would make them miserable, and lower
the quality of their family life (especially if they already had several
such children)–many of the same arguments given for sex selection.”
Wertz & Fletcher, “Fatal Knowledge? Prenatal Diagnosis and Sex
Selection,” p. 24. For a critical assessment of this line of argument, see
Warren,  Gendercide,
pp. 155-8.

 63.
Hull, Ethical Issues in the New
Reproductive Technologies, p. 207.

 64.
Council on Ethical and Judicial Affairs of the American Medical Association, Current Opinions E-2.04; see also E-2.05. http://www.ama-assn.org/apps/pf_online/pf_online?f_n=browse&doc=
policyfi…E-2.01HTM.

 65.
Ibid.

 66.
President’s Commission for the Study of Ethical Problems in Medicine and
Biomedical and Behavioral Research, Screening
and Counseling for Genetic Conditions, p. 58.

 67. Ibid.

 68.
Tabitha M. Powledge and John C. Fletcher, “Guidelines for the Ethical,  Social, and Legal Issues in Prenatal Diagnosis,”
New England Journal of Medicine  300/4
(1979): 168-72 at 172.

 69.
U.S. Department of Health, Education, and Welfare, National Institutes  of Health, Antenatal
Diagnosis (Bethesda, MD: U.S. Government Printing  Office/NIH, 1979), 1-77.