Philosophy

Is fetal sex selection harmful to society

Fetal sex selection entails choosing the sex of a child one would like to have. It is done through selective abortion, preimplantation genetic diagnosis or sperm sorting whichever the technique used sex selection is debatable as a section of the society views it as harmful while others view it as beneficial. This work reviews literature regarding whether fetal sex selection is harmful to the society. It is notable that sex selection is a form of sexism it promotes inequality and high sex rations. It is also viewed that sex selection is good for medical reasons and family balancing. As such, this work concludes that guidelines should be laid down on when sex selection should be done.

Introduction
Burmganer (2007) defines sex selection as application of medical techniques in choosing an offsprings sex. Among the sex selection techniques include sperm sorting, preimplantation genetic diagnosis and selective abortion (Burmganer, 2007, p 1289).  Fetal sex selection can be done either before pregnancy or during pregnancy. With development of technology and more understanding of human biology, it is now possible to select for the sex of a baby depending on an individuals preference. Preimplantation genetic diagnosis (PGD) basically involves screening the embryo for the preferred sex before the embryo is implanted. Sex selection is also done through abortion which is an older technique. In this case, the growing fetus is screened for sex using techniques such as amniocentesis or ultrasound testing. Once a couple identifies through the various testing methods that the woman is carrying a fetus of a particular sex that they may not be of preference, they may decide to abort the fetus.

There are many reasons as to why people select for certain sex. These range from health-related reasons to cultural reasons. It is for instance known that most Asian cultures prefer the male child to the girl child (Wertz  Fletcher, 1998). As far as culture is concerned, there are some cultures which prefer boys than girl child for such reasons as seeing girls as extra burden to the community. The boy child in most Asian countries gains preference over the girl child as it is viewed that boys have economic, hereditary or even cultural value than girls. Girls on the other hand are viewed as bearing great financial implications in terms of raising them. As such, girls have been selected against through either aborting the fetus or killing the infant (Liu  Rose, 1996). There are also personal reasons while selecting for any particular sex. For instance, a couple who may have several boys with no girl child may prefer sex selection in an effort to get a girl child. In case of health related reasons, there are certain sex-linked conditions such as hemophilia A and Duchenne muscular dystrophy that seem to affect a certain gender only (males in the above conditions). In an attempt to end the suffering associated with such conditions along the family line, a couple may decide to select for the sex that is not affected by the disease.

The above issues are debatable and they raise moral and ethical questions. This paper presents a review of literature on the question of whether sex selection is harmful to the society.

Literature review
There are two sides to the issue of fetal selection with one side bringing harmful outcomes in the society whereas the other one presenting beneficial outcomes. Burmganer (2007) explores the effects of sex selection in the Asian society especially in India and China and identifies that sex selection results into great disparities in sex ratios. Burmganer cites that sex ratio in India as per the 2001 census was 933 females to 1000 males. It is also worrying that the sex ratio disparity is increasing in China with 116.6 males 100 females being born in 2000 compared to a lower ratio of 113.3 males 100 females in 1990. The rising trend in sex selection in the Indian society however can be justifiable since the female child is associated with economic burdens as the culture requires that the bride pays the dowry to the bridegroom. The dowry price and the costs associated with weddings in the Indian society may be very high for some economically unstable families. It is for instance estimated that dowry costs may reach up to U.S. 35,000 which is too high for families that are earning about U.S.  3,500 annually. That being the case, women especially from the poor families in India select against the female child to avoid future agony. Burmganer (2007) indicates that dowry may result to the death of the bride more so by immolation if for instance they fail to pay in time or the amount is not as per the husbands expectations.

Viewing the issue of sex selection from a global perspective, Sharma (2007) sees sex selection through the various available technologies as a way eliminating one gender (in her case the female gender). Sharma (p 1744) argues that with assisted reproductive technology which has facilitated sex preference more than 100 million females have died on a global scale making her refer to sex selection as a mass gendercide. The greatest contributor countries to the mass gendercide are the Asian countries that have a patriarchal culture that favors males.

It is not a universal phenomenon that sex selection discriminates against females while favoring males. In fact, this preference is more restricted to the Asian countries with the western world selecting for particular sex depending on different views. In Canada for instance, sex selection does not seem to favor either sex with sex preference being mainly based on the need to balance the family. This is an example of ensuring equality along gender line as most Western families would prefer at least an equal representation of each sex among their children (Dickens, 2002). The argument that the Western families do not show sex preference is controversial if one were to go with a study carried out by Steinbacher and Gilroy (1990) on sex preference among young adults. Steinbacher and Gilroy found out that most undergraduates preferred having a boy child as their first born regardless of the race, sex or religious backgrounds of the individuals. Burmganer (2007) also notes that most American women (94) and men (81) would prefer to have their first born child being a male.

Sex selection can be very beneficial in cases where there is fear of a sex-linked disease such as hemophilia. In a sex-linked disease, the disease in question is passed down the family tree along a particular sex. In hemophilia A for instance, a hemophilic mother always transfers the hemophilia gene to her male children whereas the female child may only become a carrier of the disease at the worst instance. A hemophilic individual suffers from recurrent bleeding and severe arthritis.  Luckily, Boyle and Savulescu (2003) indicate that it is possible to detect hemophilia A during prenatal diagnosis. As such, a couple who wants to eradicate the suffering brought about by hemophilia A may select for girls (who are not carriers) only. The same argument for sex selection sets in when discussing the other sex-linked conditions. Sex selection for medical reasons is therefore a good means of ensuring that children experience a good health and can access a variety of available opportunities.

Sex selection for medical reasons has been a largely accepted view in most societies.  There is however fear that sex selection could lead a slippery slope with sex selection being misused for sexism purposes as well as cosmetic purposes. In such a case, Wertz and Fletcher, (1998) views that selecting for particular sex is likely to cause an imbalance in sex ratio. Such has been the case among the Indians and the Chinese. It is also viewed that sex selection would alter the birth order which would translate to inequality along gender. The birth order argument is however contended by Dickens (2002) who argues that a couple should always be allowed to select for the second or subsequent children as a way of addressing the potential inequality. This would in the long-term mean that a certain gender is discriminated against and is unevenly distributed in the general population.

By allowing a woman to choose the sex of their child, autonomy is greatly promoted. Puri and Nachtigall (2009) found out that many sex selection services providers regard sex selection as a means of empowering women. They observed that most physicians would offer sex selection services to couples as a means of helping them make well informed decisions regarding their family planning practices. Through sex selection, a couple would be able to create a balance in their family constitution as desired. As such, these authors argue that abortions resulting from unwanted pregnancies would be reduced whereas the possibility of having some children neglected or abused due to dislike minimized. Rhodes (2006) views that when a couple is allowed to select for a particular sex, then they are likely to give the child the best possible care which would lead to the child living a good life without being neglected. This is unlike when a couple relies on trial and error method and the resultant child may not be of preferred sex thus they may tend to neglect the child. With the current sex selection technologies however, it is feared that not only would it be possible to have a child of the desired sex but in addition it would be able to incorporate desired characteristics in the child.

The ethicality of sex selection is also brought in the question of sex selection. Sex selected is largely viewed as an ethical issue especially when the sex selection technologies are brought aboard. Neil (2007) argues that while it is a moral issue as regards whether an embryo should be destroyed, it is no less a moral issue as regards failure to begin the life of the embryo. This means that whether a couple chooses to use abortion selection or the more sophisticated preimplantation genetic diagnosis, the issue will still revolve around either terminating a life or failing to begin a life.

Sexism is associated with sex selection especially in cases where the male is the preference sex. As a result, Neil (2007) claims that the high disparity in sex distribution gives birth to violent societies. Neil specifically cites a sexist society that is predominated by males that has a higher likelihood of experiencing crime and antisocial activities since the young males in the society are unattached. For instance, Asian countries such as Pakistan and India have high sex ratios predominated by males and as such they have and still experience conflict and volatility. Neil argues that such wars are among the means of restoring the high sex ratios.

As much as couples in the western society may cite that they prefer sex selection for the purposes of ensuring family balance, there is the potential malice of simply discriminating against one gender. It is noted that most couples in the West will go for sex selection when they intend to have a single child. As such, they make preference for a certain gender depending on whatever reasons they may find comfortable to them. Neil (2007) highlights that there are some women who choose a female child based on the view that they will develop better relationship and closeness with the daughter. It is a general observation that although sex preference does not bring a major disparity in the sex ratios in the Western world, preference for the girl child is slightly higher. Neil sees the greatest danger with sex selection in the West as having the sexism mind. The argument is that the choice of sex of the child in the Western society is based on the view that that particular gender harbors specific psychological dispositions, which is itself sexism.

Critical appraisal
The above review of literature has many implications regarding sex selection. In the first place there is no doubt that the issue of sex selection is an ethical debate. In addition, sex selection is a prevalent issue which has cultural relativism at the center. Whereas one society may tolerate sex preference for a certain gender, based on arguments that are right to the society, other societies strongly oppose the practice. The sex selection debate is exacerbated by the advent of sophisticated medical technologies that are able to determine the sex of a child not only during pregnancy but also prior to. Either way, the implications of sex selection must be felt regardless of the sex selection technique applied.

Using the evidence from cultures that have practiced sex selection, one can only expect even higher sex ratios in the future unless a proper measure is taken. As much as the Chinese and the Indian societies may support their practice of boy preference, the fact is that their own communities are to suffer most. The high number of conflicts arising from a male biased society as indicated in the literature review does not only affect the general society. Such a society can rarely experience economic prosperity with instability. These findings show that sex selection has the potential to result to an unstable society. But as much as sex selection may be condemned from the perspective of the harms that it causes, there may not be any near hope that this trend will end among the Asian countries. The practice is rooted deeply in their cultures and it would only call for a change in the culture (which is obviously hard) for one to expect change in the way sex selection is viewed.

Extending preference for a particular gender is a sexism practice that only promotes inequality. Although the above literature seems to portray the Asian practice of selection against females as the main form of gender inequality, the West are camouflaging in the name of family balancing.

It is not appropriate to rule out the possibility of sex selection due to the benefits that it holds. The advancements in medicine that are able to screen for fatal genetic conditions are great contributors to the move towards sex selection. It is logical and ethically correct to allow couples decide to choose the sex of the child if the otherwise selected against child would only have ended suffering. In fact Burmganer (2007) states the Americans of South Asian heritage hold the same high preference for males just as any Asian has in their native land. Sex selection can be viewed positively as it can help in balancing the population in terms of sex composition. The same balance can also be achieved in a family. In a family or society that is predominated by males, sex selection may favor females thus bringing a balance in this composition.

Although the implications of disparities of sex ratio differences are not noted in the above literature, it is possible to foresee a situation whereby the general population would decrease as people alter the natural balance in sex distribution. For instance, a society that has a disproportionately low number of females is no doubt bound to have a reduction in the reproductive rate in the long run. In addition, it is possible to increase social ills such as women trafficking or rape as the number of the available women is disproportional to the available men.

The lack of credible instances where sex selection has spilled over to malpractices does not rule out the possibility. Sex selection has the likelihood of being used by malicious individuals to select for other discriminatory traits. It would not be a wonder to hear that a couple selected for a baby (of either sex) with certain IQ characteristics or certain skin color in the name of sex selection. At least this should be appraised with the turn of sex selection from the basis of medical risks to the now common family balancing in the west. Individuals who will not afford the more sophisticated sex selection technologies will have disadvantaged children who will face unfair competition from the better selected children.

The practice of sex selection among the Indians based on cultural practice is not justifiable. Need to avoid dowry expenses should not cause girls to be aborted and as such, sex selection in this case is a pure sexism issue. Why is it that a society where males provide the dowry does not select against the male child to avoid such expenses Why is it that in these societies, females are not selected for as a way of using them later to amass wealth through bride price Such questions should be raised against the practice of sex selection among the Indians.

It is not easy to draw a conclusion on whether sex selection should be practiced or not seeing that there are reasonable views on why it should and why it should not be done. However, every society ought to draw the limits in which sex selection should operate in order to maintain a balance of the benefits and the potential harms.

Conclusion
The debate on sex selection is a real issue in the society and has been in practice for quite a long time. The developments of medical technologies that can facilitate sex selection seem to lay the ground for the debate. Sex selection has made it possible to eradicate genetic diseases in families and this has been generally acceptable. However, some cultures like the Asian cultures have been preferring males to females and thus practicing sexism, the West has been doing sex selection in the name of family balancing. It is however still evident that there is an element of sexism in the same. It is also possible to cause great differences in sex ratios with sex selection with women being largely discriminated against. This debate does not cease to be controversial especially when a couples autonomy is brought in. it would only be wise for every society to weigh the benefits against the ills and then formulate guidelines regarding sex selection.