CATANDUANES STATE COLLEGES

College of Health Sciences

Department of Nursing
Virac, Catanduanes

Project
in
Bioethics
Bioetical Issues
(Sex Selection)

Submitted by:

RIKKI RENZ VILLAFUERTE

BSN 2A – Group II

Submitted to:

MA. ALMA V. TABIRARA, RN, MAN

Professor
 Sheena is a thirty-year old female who has three female children. Sheena and her husband
decided to have a baby boy on his fourth pregnancy for them to carry their name. They
resorted to Preimplantation genetic diagnosis (PGD) and the procedure was successful. The
chromosomal disorder they expected the child would have was not developed. It was a great
bonus for them. This led them to a better and happy marriage and family.

Rose has already had a male child. It was his husbands will. She wanted to have a
female child so that she would have the chance to take care of a baby girl. She wants to
project her love of fashion to her own daughter. She decided to perform several procedures to
manipulate the sex of the baby expecting a favorable outcome. Unfortunately, the baby turns
out to be a boy. Out of despair and disappointment, she did not want to take care of the baby.
She did not even recognize it as her son. She also decided to put the baby to the orphanage.
Both the baby and the mother lived in an obnoxious life.

INTRODUCTION

Over the years, the gender and sex of the

baby has been the major concern of the couple. In some
aristocratic area like Europe, sex of the baby determines
the new ruler of the land. They more prefer male
descendant for it will inherit the throne that a female that
will only serve as a duchess but not a king. In the movie
the other Boleyn Girl, the twist and curls of the story lies
on the gender or sex of the baby. They believe that the rise
and fall of a czar (tyrant or tyranny) lies on the next
generation of rulers. The king marries a queen but hitched
with other women (it is considered legal but opposed by the church) and the women who had her
born the first male child recognized by the king will be the inheritor of the whole England. In
Japan, sometime before the modern time, first born male child inherits the power and honor of
their family nothing left to the next-born babies. They carries the name of the family, thus men
who are expected to be just and firm on his decisions are yearned by the family. The same is
through in the Korea. They prefer male baby than females. In the TV series, Jewel in the Palace,
the king would want to have a baby boy from his queen but the Choi family used a special
formulation of herbs to counteract the sex of the baby. In contrary, areas with high ratio of males
than females like the United Arab Emirates opt to choose female offspring than males. Some
family favors female child since it would provide them support and care during their old age.
Studies also have demonstrated that having sisters, as compared to brothers, can enhance the
quality of life of an adult. They bring colors to the family. The aforementioned reasons lead to
innovations to manipulate the sex of the baby, which counteracts the Creator and the law of
nature.
CONTEXT OF THE PAPER

Social sex selection or human sex selection is the

attempt to control the sex of the offspring to achieve a desired
sex. It is widely practiced all around the world. And since it is
many parents’ wants, that is to decide the sex of their
children, this practice grows rampantly over time. It raises
huge moral issues to the society. There are a wide variety of
social sex selections methods which have not been
demonstrated to be effective. Because even implausible and
ineffective methods have a "success" rate of 50%, many
continued to be recommended by word of mouth. Examples
of which is the prescription of Aristotle, that is, ligation (tying off) of the left testicle in men
wishing to have boy offspring.

METHODS OF SEX SELECTION

Historical Records of Sex Selection

There are several methods of sex selection. Through the years, people have been
developing the most attainable method that would ensure the sex of the baby.

Aristotle’s prescription on sex selection has been known for centuries.

Some people believe that timing conception according to astrological charts can influence
a baby's sex, though there is no evidence to support this or any other timing method. A 13th
century Chinese conception chart purports to be able to identify the sex of the baby before birth.

During the 1980s, Lawrence Livermore National Laboratories teamed with the United
States Department of Agriculture to develop the first (and only) successful and repeatable means
of separating X- (female) and Y- (male) chromosome bearing spermatozoa.. 'Sexed semen' is
offered commercially in cattle by a variety of companies including Cogent (UK) and Sexing
Technologies (USA). In humans the technique is marketed as 'MicroSort', but is unavailable
outside of the USA due to legal restrictions.

Recently, a study published in 2006 indicated that mothers with toxoplasmosis have a
significantly higher sex ratio of boys to girls. This has been discussed in connection with the
manipulation hypothesis of parasites.
 Another study found a link between sex and the diet of the mother, but this may be due to
statistical chance, and has yet to be confirmed
Other Method of Sex Selection
Pre-implantation
Two major types of pre-implantation methods can be used for social sex selection.
Sperm sorting - The separation of X Chromosome sperm from Y Chromosome sperm by
flow cytometry. The resulting sorted sperm are used in either artificial insemination or in-vitro
fertilization (IVF) procedures.

Preimplantation genetic diagnosis (PGD) - In sex selection cases, embryos resulting

from IVF procedures are genetically tested for X or Y Chromosomes. The embryos of the
desired sex are then implanted.
No "seamless" method is known to exist where couples take certain measure before
sexual intercourse normally.

Post-implantation
Prenatal diagnosis - Amniocentesis and/or ultrasound is used to determine sex of an
offspring, leading to subsequent sex-selective abortion of any offspring of the unwanted sex. The
more recent technique of fetal blood now makes it possible to test the sex of the fetus from the
sixth week of pregnancy.

Post-birth
Sex-selective infanticide - Killing children of the unwanted sex. Though illegal in most
parts of the world, it is still practiced.

Sex-selective child abandonment - Abandoning children of the unwanted sex. Though

illegal in most parts of the world, it is still practiced.

Sex-selective adoption - Placing children of the unwanted sex up for adoption. Less
commonly viewed as a method of social sex selection, adoption affords families that have a
gender preference a legal means of choosing offspring of a particular sex.

More Accepted Methods of Sex Selection

Ancient Chinese Conception Chart also known as Chinese Fertility Chart
According to the way the Ancient Chinese Conception Chart works, there are certain
months that you can conceive a boy and certain months you can conceive a girl. It all depends on
your age at conception and the month that conception occurred. Supposedly you can plan ahead
if you want a certain gender. What you do is have sexual intercourse around ovulation on the
months that says you will conceive the gender you are wishing for - and avoid on the months that
says you will conceive the opposite.

Orgasm Method
Orgasm is another sex selection method. If you want a boy, have an orgasm during
intercourse. If you want a girl, don't have an orgasm. However, there are countless women out
there who had an orgasm at conception and conceived both boys and girls.
Shettles Method
The Shettles Method is probably one of the most popular sex selection methods out there.
This method claims that female sperm swim slower and live longer than male sperm.

So if you want to conceive a girl you need to have intercourse several days before
ovulation. The slower female sperm will be waiting for the egg when it erupts from the ovary.

If you want to conceive a boy wait until the day of ovulation to have sexual intercourse.
The faster male sperm will be the first to the egg. According to Shettles, the female sperm are
more conducive in an acidic environment. He recommends douching with a weakened solution
of water and vinegar immediately before intercourse to help the female sperm to thrive. And
likewise for a boy to douche with water and baking soda to help the male sperm

LEGALITY OF SEX SELECTION

Sex selection is officially prohibited in China, but the Chinese government admits that
the practice is widespread, especially in rural areas of China and among lawless groups such as
ghettoized migrant workers in cities (despite denials by the government-sponsored studies)

Social sex selection is illegal in India. To ensure this, prenatal determination of sex
through ultrasound is also illegal in India. These laws are instituted to combat the prevalent
practice of sex-selective abortion. However, these laws have generally failed to be effective in
rural areas and, despite education efforts, sex-selective abortion continues to be widely practised
there.

Sex selection is legal in most of the world, and it's practiced particularly in Western
countries, but is more limited in Eastern countries, such as India or China. However, an
exception of this is Europe, where the practice of sex-selection is prohibited (bar the Turkish
Republic of Northern Cyprus). There is fertility tourism from the United Kingdom to the United
States for sex selection, because preimplantation genetic diagnosis (PGD, a potential expansion
of IVF), which can be used for sex selection, is prohibited in the UK, except when it is used to
screen for genetic diseases, while the laws in the US are more relaxed in this subject.

ARGUMENTS OF THE PRO-SEX SELECTION

Choice and Reproductive rights

It is often suggested that there exist ‘reproductive rights’ which includes a right for
individuals to reproduce in whatever way they wish. This is sometimes framed more negatively
as a right to non-interference by the state in supposedly private reproductive matters. Such
arguments are even used to argue against a ban on reproductive cloning. While these claims may
seem plausible, a closer inspection reveals that they cannot be sustained.

The first legitimate right is a woman’s right to choose to terminate her pregnancy. This is
based on the fact that a fetus is part of a woman’s body and that women have the right to have
control over their own bodies. This is a protection of a vital personal interest. It can also be
argued that like other technologies that increasingly subject reproduction to medical control, sex
selection will tend to decrease women’s control of their own reproduction.

The other basis for reproductive rights claims is the Universal Declaration of Human
Rights, which includes ‘the right to marry and found a family’. This article arose from the Nazi
atrocities and from eugenics laws restricting disabled people’s reproduction in other Countries.
Jurisdictions legitimately restrict whom we can marry (for example, generally prohibiting
marriage with close family members). Neither does the Declaration guarantee access to any form
of technological assistance needed to reproduce, when this is not possible in the normal way.

Generally this argument was initiated and pursued by women, and was a sign of female
empowerment that allowed couples to make well-informed family planning decisions, prevented
occurrences of unintended pregnancy and abortion, and minimized intimate partner violence
and/or child neglect.[3] In contrast, primary care physicians questioned whether women could
truly express free choice under pressure from family and community. However this could be
used differently against the moral discourse.

Prevents X-linked traits – x-linked traits can be prevented through the process of sex
selection. Since it manipulates the genes through the gametes, the chromosome characteristics
also are manipulated causing favorable change in the traits of the expected children.
 Family Balancing – sex selection can give opportunity for the family to balance their
falimy according to their needs and wants.

Free Choice – the family has been given by the jurisdiction of every land a right of free
choice. They can do whatever they want unless it does not affects negatively on other people and
the community as a whole.

ETHICAL ISSUES OF SEX SELECTION

The application of these techniques to humans creates moral and ethical concerns in the
opinion of some, while the advantages of sensible use of selected technologies are favored by
others. Here are the reasons why sex selection is wrong:

Sexism or sexual discrimination - Sex selection is the exercise of sexism at the most
profound level, choosing who gets born, and which types of lives are acceptable. In traditional
patriarchal societies, such as in India and China, the preference for boys has led to huge
imbalances in the sex ratio in the population. Worldwide, there are estimated to be 100 million
missing women as the result of sex selection. Indian communities in the US and UK are now
being targeted by clinics who have no scruples about exploiting these traditional prejudices for
profit. In Western countries, there seems to currently be a preference amongst the majority white
communities for girls, but the choices that are being made are still based on rigid, sexist, gender
roles. A society may exhibit a widespread bias towards having children of a specific gender,
either due to cultural biases or economic concerns (e.g. male children may be more employable
in the future and thus provide more financial support). When combined with frequent social sex
selection, this bias may produce a gender imbalance that has undesirable consequences. This
phenomenon has been observed in many nations in the Far East, such as India and China, where
social sex selection has produced unnaturally high male/female ratios in the population. China's
gender imbalance is further increased by the One Child Policy, although applicable only in most
urban populations. In these nations, a lack of opportunity for many men to marry is believed to
be producing increases in crime, demand for prostitution, mass emigration, and the selling of
brides. Some nations, such as India, have attempted to curtail these gender imbalances with
criminal statutes.

Eugenics – Many fear that preimplantation gentic diagnosis (PGD), in general, is a

'slippery slope' leading to a society where 'non-selected' individuals would be discriminated
against. PGD is used primarily in the U.S. for the purpose of reducing birth defects and
abnormalities, but opponents fear that there is nothing stopping persons from using PGD for
more eugenic-based purposes. If we allow sex selection it will be impossible to oppose ‘choice’
of any other characteristics, such as appearance, height, intelligence, etc. The door to ‘designer
babies’ will not have been opened a crack – it will have been thrown wide open. PGD is
currently restricted since it might in future be used for trivial conditions or normal
characteristics, such as appearance, IQ or musical talents. According to any classification, sex
selection is well down to the bottom of any such slippery slope. The same ethical concern applies
equally to sperm sorting (is a means of choosing what type of sperm cell is to fertilize the egg
cell) and the law must deal with both PGD and sperm sorting consistently. If parental preference
sex selection by sperm sorting is permitted, it will be impossible to defend the guidelines on
PGD. And once sex selection is permitted for PGD, it will be impossible to prevent its use for a
whole variety of other unacceptable eugenic purposes.

Commodification - the very act of selecting our children in this way creates a major
ethical problem. By choosing the characteristics of our children, we change the ethical
relationship between ourselves and them: choosing tends to turn them into just another human-
designed consumer commodity, or object. The relationship becomes one between designer and
object, where the latter is inevitably in a subordinate position. This degrades the normal
relationships between human beings, in which all humans are equal subjects, and undermines
human dignity.

Commodification is a bad thing in itself, but is also likely to have immediate harmful
consequences for the individuals and families involved. Once we start to pick and choose the
characteristics of our children, we damage the unconditional love between parent and child,
which depends upon accepting the child whatever their characteristics. Although parents always
influence and direct their children, parents who have chosen a girl will tend to put greater
pressure on her to conform to their hopes and expectations of her behavior, rather than allowing
her to become the person she is and wants to be. Such a child may feel that she is only wanted
when she behaves the ‘right’ way. Conversely, selecting the opposite sex to existing children
gives those children a very bad message about their parent’s feelings towards them. It gives an
idea of children being a commodity.

Psychological Implications - There may be psychological implications for both the

parents and child if the procedure does not produce a child of the desired sex. Furthermore,
problems may also arise if the gender-related expectations of the parents are not subsequently
fulfilled by the child. However, it may be the case that any child will fail to fulfill particular
parental expectations, so perhaps more emphasis should be placed on promoting acceptance and
tolerance within parents as opposed to completely banning sex selection.
 Conflict with Kantian principles – Many argue that by selecting the sex of their child,
parents are using the child as a means of fulfilling their own desires rather than respecting the
child as a person and an end in their own right.
Disputes the Natural Law and the Law of the Sole Creator – life has its destiny as it
was written guided with the natural law. It is considered immoral to break the natural process
and the edict given by His.
Post – Birth Method posits bioethical questions – one of the methods after birth is Sex-
selective infanticide wherein killing children of the unwanted sex is practiced. Whatever the
means would it is considered immoral to do such a thing. Purposive abandonment and adoption
of the child just because it does not conform to their want is undoubtly immoral.
Sex Selection is widely connected to abortion – after determining the sex of the fetus
inside the mother’s womb, if does not comply to their standards they would turn into the practice
of abortion.

CONCLUSION

The question raised for sex selection for the baby is like a question raised for some other
bioethical issues. There are always two sides of the coin; there is the head and the tail. Every side
have their different viewpoints; what is right for you could be right for others and what is wrong
for you could be right for other. For you to understand the scenario is for you dig deep within the
mean of the action not merely the end of it.
For me, the means justifies the end; however, it should be supported by a socially and
ethically justifiable reason. Every action is supported by reason that is why we are considered
human being. In our philosophy class, human actions are actions performed with the use of
wisdom and not merely with knowledge. However, I disagree to some of the methods of sex
selection like killing the fetus or the baby if the desired sex of the child is not achieved. This
violates the ultimate rule given by God, that is, thou shall not kill. We do not have the authority
to kill anybody because it is not our possession in the first place, it’s God’s.
The question is still under deliberation of experts and medical professionals but whatever
the outcomes would be, I hope that their minds will be guided by correct principles thus
generating the most appropriate decision.
REFERENCES

Books and Articles

Brown GR and Silk JB. (2002) Reconsidering the null hypothesis: is maternal rank associated
with birth sex ratios in primate groups? USA: Proc Natl Acad Sci.

Cameron EZ. (2004) Facultative adjustment of mammalian sex ratios in support of the Trivers –
Willard hypothesis: evidence for a mechanism. USA: Proc R Soc Lond B Biol Sci.

Hassold T, Quillen SD, Yamane JA. (1983) Sex ratio in spontaneous abortions. Philadelphia:
Ann Hum Genet

Hudson V and den Boer AM. (2004) Bare Branches: The Security Implications of Asia’s Surplus
Male Population.Cambridge, MA.: MIT Press.

Ridley M. (1993) The Red Queen: Sex and the Evolution of Human Nature. London: Viking
Press. pp. 122.

Shapiro VB, Shapiro JH, Paret IH. (2001) Complex Adoption and Assisted Reproductive
Technology: A Developmental Approach to Clinical Practice. New York: Guilford Press.

Internet Sources

Bailey, R.D. (2008) Sex Selection and Family Balancing. Retrieved from:fertility-docs.com.
Retrived: 26th of July, 2010.
Website: http://www.fertility-docs.com/fertility_gender.phtml

Grant, V. J. (2008) Sex predetermination and the ethics of sex selection Retrieved from:
humrep.oxfordjournals.org Retrieved: 26th of July, 2010
Website: http://humrep.oxfordjournals.org/cgi/content/full/21/7/1659

Maureen, L.V. (2009). The Gender Selection Guide. Retrieved from: in-gender.com Retrieved:
26th of July, 2010
Website: http://www.in-gender.com/

Stossel, J.C. (2008) Sex Selection; should you be allowed to pick your kid's sex? Retrieved from:
Reasons.com. Retrieved: 26th of July, 2010
Website: http://reason.com/archives/2001/10/03/sex-selection

Sex Selection. (2010) Retrieved from: Wikipedia.org. Retrieved: 26th of July, 2010
Website: http://en.wikipedia.org/wiki/Sex_selection