The Ethics Of Selecting Child's Sex
BOSTON — You could call it the ultimate consumer choice: Having a baby? What kind would you like - boy or girl?
The recent announcement that doctors have found a form of technology that helps couples choose the sex of their child-to-be wasn't stated in such crassly commercial terms. News reports focused on parents being able to "balance" their families or avoid passing on what scientists regard as sex-linked diseases such as hemophilia, which is associated with boys.
But beyond the headlines that inevitably accompany medical breakthroughs in reproduction, thinkers in theology, ethics, sociology, and gender studies say these discoveries raise troubling questions about the march of science and technology into the very human arenas of birth and life.
The accessibility of sex selection, they say, may force a deeper dialogue on gender and what it means to be a parent.
"We are redefining scientifically what a family is, and that's troubling," says Richard Louv, author of several books on family issues, including "The Web of Life."
"It turns children into consumer items, which we're already doing in so many ways," he says. Sex-selection technology "may have unintended consequences in terms of who is valued and who is not. The trap here is the idea of a super race, the idea that there is such a thing as a perfect child."
Many experts who criticize an unquestioning embrace of new technology say they understand the appeal of a method like sex selection in individual cases where parents may be concerned about the health of a child. But they argue that society as a whole needs to engage in a much broader discussion about the implications of technology.
"There is no capacity in our basic health technologies to do any social critique of these technologies and their worth," says the Rev. Dennis Brodeur, who teaches at the Center for Health Care Ethics at St. Louis University's School of Medicine.
"There's an unquestioned assumption that all new technology is necessarily better, and that may not be true," Mr. Brodeur says. "Every year there are new genetic or new conception possibilities, and we're not having a conversation about who are our children, what do children need, and what is their role in the family,"
Other medical ethicists argue, however, that dialogue on new technology has changed in the past 25 years. Arthur Caplan, director of the Center for Bioethics at the University of Pennsylvania in Philadelphia, says the first successful heart transplant in 1967 sparked almost no debate about ethical implications.
Since that time, says Dr. Caplan, health-care professionals have widely discussed such issues - prompted in large part by a growing interest in medical ethics. Caplan also notes an increase in public interest, as measured by visits to his center's Web site, which includes areas on assisted suicide, cloning, and reproductive technologies. Two years ago, he says, the site had 500 visitors a month; today it gets about 240,000.
"There's been some positive change in getting these issues before us," he says. "But the question is, can we take the next step? Can we institutionalize these changes? Can we have more congressional hearings? Can we have more forums in secondary schools, in Sunday schools? Can we get the media on to reporting more than today's crisis?"
Caplan argues that sex selection and cloning will turn out to be minor, short-term issues because "most people won't want to reproduce that way."
But other critics disagree. These technologies raise questions of class and social structure, they say, because they will most likely be available only to those who can independently afford them. Even more important, they say, are questions about the role of gender and the nature of parenting.
"What people are doing with this is not trying to determine the genitalia of their child, but the shape of their parenting experience," says Barbara Katz Rothman, who explores the confrontation between science and social values in a book to be published next month, "Genetic Maps and Human Imaginations: The Limits of Science in Understanding Who We Are."
"Parenting was always supposed to allow a certain amount of openness in that you don't know who you'll be parenting," she says. "Morally, historically, the commitment is supposed to be unconditional. This introduction of some kind of conditionality kind of scares me."
Ms. Rothman says it may be easy to empathize with situations where a woman with two sons may desperately want a daughter so she can take part in mother-daughter experiences, including things such as choosing a prom dress. But, she adds, "then you've got to think this kind of woman probably isn't ready for a six-foot-tall, 300-pound girl who wears nothing but jeans and boots. Or let's say that the boy you long for asks for ballet lessons. OK, now what do you do?"
Sex selection, in particular, raises questions about gender in a society that is still struggling with a social revolution in the roles of men and women. Experts say the issues become even more socially charged when considered in the light of studies that have repeatedly shown a preference among parents for boys over girls, and for having a son first, followed by a daughter.
ACCORDING to The New York Times report announcing the relative successes of the sex-selection technique developed by a private, for-profit fertility center in Virginia, one couple who wanted a boy and went to the clinic aborted the female fetus they conceived. The Times also reported that a group of Chicago doctors working with a different sex-selection technique in the early 1990s ended their project after learning that some couples were aborting fetuses that were not the desired sex.
"People don't want to ask themselves ... whether [we're behaving as though] being male or female is a disease," says Stephen Lammers, a professor at Lafayette College in Easton, Pa., who has studied medical ethics.
Mr. Lammers and other scholars and theologians say religious thinkers need to take a more vocal role in stirring public debate. Religion, they say, has become a countercultural voice in society and should be offering a distinctly different point of view.
"The church has always said that children are gifts," says William Willimon, chaplain at Duke University in Durham, N.C. "But technology is making children into products or achievements or commodities.
"And it makes us gods unto ourselves," he says. "People of faith ought to be worried about that."