![]() This strategy is called preconception sex selection, primary sex selection or sex pre-selection – before conception/fertilization, where one can make a selection at the level of the sperm using sperm sorting. ![]() Sex selection can be performed at three stages: A second distinction concerns the timing of sex selection. Some further distinctions and specifications are important. The focus of this paper is on medical methods for sex selection - not on the ‘do it yourself’ methods. Some countries (in Europe: Austria and Switzerland) go even further and prohibit sex selection for any reason.Īlthough it may seem that the sheer weight of this prohibitive consensus between jurisdictions, at least in Europe, has brought the debate about allowing sex selection for non-medical reasons to a closure, and although it is clear (as again confirmed in the consultation held in the UK) that among the public there are strong moral feelings against more liberal policies, we will argue that there are still good reasons for questioning the arguments behind this international consensus. In the same vein, article 14 of the European Convention on Human Rights and Biomedicine (Oviedo Convention) of 1997 states that ‘techniques of medically assisted reproduction 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’. A recent overview (Darnovsky, 2009) shows that a similar restrictive stance is adopted in all 36 countries with laws and policies on sex selection, including China, India, Turkey, Australia, Canada, and 25 European countries (among which are also Belgium and the Netherlands). This is now also given a further legal underpinning in the amended British Human Fertilisation and Embryology (HFE) Act of 2008. The latest round in this debate was fuelled by the public consultation held in the United Kingdom on the initiative of the Human Fertilisation and Embryology Authority (HFEA) in 2002, and the HFEA’s subsequent decision to continue to limit the use of sex selection techniques in licensed centres to cases ‘in which there is a clear and overriding medical benefit’ (HFEA, 2002 HFEA, 2003). However, sex selection for non-medical reasons has been the subject of recurrent ethical and public policy debate in many countries. This is widely (though not universally) seen as a welcome development insofar as sex selection for medical reasons is concerned. Modern science provides people with new, more effective, methods for sex selection. Apparently, every folk culture has its own strategies. Other people have assumed that special diets, the timing of intercourse in relation to ovulation, binding up one of the testicles during intercourse, or the position during intercourse, might facilitate sex selection. Aristotle, for example, advised those wanting a boy to have intercourse when the wind is in the north. Since ancient times, prospective parents have tried to influence the sex of their future children. Finally, a difficult set of questions is raised by concerns about the reliability and unproven (long-term) safety of the only technology (flow cytometry) proven to work. Measures to this effect may include limiting the practice to couples who already have at least one child of the sex opposite to that which they now want to select (‘family balancing’). The authors conclude that the ban should be reconsidered, but also that existing societal concerns about possible harmful effects should be taken seriously. The article further provides a critical review of the arguments for the prohibition of sex selection for non-medical reasons and finds that none of these are conclusive. Focusing on preconception sex selection, the authors first observe that it is unclear what should count as a ‘medical reason’ in this context and argue for the existence of ‘intermediate reasons’ that do not fit well within the rigid distinction between ‘medical’and ‘non-medical’. Sex selection for non-medical reasons is forbidden in many countries.
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