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SUBMISSION from the CHRISTIAN MEDICAL FELLOWSHIP to the HUMAN FERTILISATION AND EMBRYOLOGY AUTHORITY on SEX SELECTION

Article Reference: CMF Submissions, May 1993; Author: Christian Medical Fellowship

Introduction

Christian Medical Fellowship is interdenominational and has as members well over 4,000 British doctors who are Christians and who desire their professional and personal lives to be governed by the Christian faith as revealed in the Bible. We have members in all branches of the profession, and regularly make submissions on ethical matters to Governmental and other bodies. We are grateful for this opportunity to comment on this difficult topic.

In Relation to Human Life

To maintain the deepest respect for individual human life from its beginning to its end, including the unborn, the helpless, the handicapped...

With these perspectives we will now turn to address the key issues in the Consultation Document on Sex Selection, occasionally referring to Paragraph numbers in the document.

1. The Ethics of Primary Sex Selection as a Technique.

The vast majority of our members do not see that it is necessarily wrong to interfere with 'God's hand in procreation', and therefore accept in principle that some medical involvement is legitimate. (For example, some applications of some methods of contraception are 'good stewardship'.)

Consequently we would see pre-fertilisation, primary sex selection in itself as an advance in that it did not raise issues of discarding embryos, which many of us would find unacceptable, or of abortion. We would therefore support research and development of the technique.

2. Medical Indications for Sex Selection.

We would accept primary sex selection as an ethical means of preventing the creation of male embryos who might carry serious sex-linked diseases such as haemophilia and Duchenne muscular dystrophy. Our concern would be that the diseases in question were severe ones. Recognising the difficulties of producing an appropriate list (Paragraph 32), we would still recommend the just application of an agreed list.

3. Social Indications for Sex Selection.

a. Deontological Considerations.

We are somewhat divided here. We would all see children as being 'a gift from God' (Genesis 33:5, 48:9; Psalm 127:3ff) and many of us would therefore endorse Paragraph 22. Whilst appreciating the wonder of God's gifts, others would see this concept as one of a number of relevant concepts, and for them the use of primary sex selection for social reasons is not intrinsically unethical. This issue is new and we regret that so far there has been insufficient discussion of this aspect.

b. Consideration of Consequences.

Here we are more agreed that there could be unacceptable consequences if sex selection for social reasons were allowed. For example, at the level of society there might end up an imbalance of one sex against the other, most probably of boys against girls. God sees males and females as of equal value (Galatians 3:28) and we would reject any discrimination against females.

In other words we endorse here the arguments 'against' of Paragraphs 20, 36 and 37, and further feel that the different arguments 'against' of Paragraphs 38 and 39 have weight. The potential problems arising would be likely to outweigh any possible advantages.

c. Conclusion.

Overall we come down against sex selection for social reasons and suspect that most Christian couples after reflection and prayer would not want to take advantage of this technique if it were available.

However, we do not feel that the issue is so unequivocal that we should seek to proscribe it for all, should a pluralistic society democratically decide upon it. If primary sex selection for social reasons is to be permitted, then we would want to see the safeguards listed in Section 4.

We would all hold that secondary sex selection by pre-implantation diagnosis should never be permitted for social reasons. For many of us this would be on the grounds of the disposal of embryos of the 'wrong' sex; for all of us it would represent an inappropriate use of scarce IVF technology.

4. Safeguards in the Event of Society Deciding Upon Primary Sex Selection for Social Reasons.

a. The HFEA should regulate all uses of the technique.

Procedures should take place on licensed premises only, to ensure, amongst other things, adequate counselling (including assessment of the couple's willingness and ability to accept a child of the 'wrong' sex) and proper data collection. We endorse the concern expressed by the British Medical Association and others about the ethics of promotion of services, that claims made should be validated by proper scientific assessment.

b. Social sex selection should be available for second and subsequent children only.

To guard against any preference for the first-born child to be male (Paragraph 37) we advocate that social sex selection should only be allowed for the second or subsequent children.

c. Abortion should not be allowed for the 'wrong' sex.

It is unlawful to perform abortion on the grounds of sex alone. This should be rigidly enforced in cases where, owing to the failure rate of the technique, the parents conceived a child of the 'wrong' sex.

Summary

We will summarise our position in short answers to the two key questions of Paragraph 44:

Can primary sex selection techniques such as sperm sorting be considered necessary or desirable in any circumstances for either medical or social reasons?

We support the use of primary sex selection techniques for medical reasons of serious X-linked diseases. We come down against their use for social reasons but should society decide democratically upon them, we advocate certain safeguards.

Can secondary sex selection by pre-implantation diagnosis be considered necessary or desirable in any circumstances for any social reasons?

We reject this technique for social reasons on the grounds of disposal of embryos of the 'wrong' sex and of the inappropriate use of scarce IVF resources.

SUBMISSION from the CHRISTIAN MEDICAL FELLOWSHIP to the HUMAN FERTILISATION AND EMBRYOLOGY AUTHORITY on SEX SELECTION