The Ethics Committee of the American College of Obstetricians and Gynaecologists (ACOG) has said that helping patients to choose the sex of their offspring to avoid serious sex-linked genetic disorders is considered ethical for doctors, but gender testing simply for 'family balancing' is ethically untenable.
The opinion of the committee is in line with the views held by the United Nation's International Conference on Population and Development, and the UK's Human Fertilisation and Embryology Authority Code of Practice. The American Society for Reproductive Medicine also opposes the use of PGD for other than medical reasons, although the group issued a statement in 2001 saying that if pre-fertilisation techniques such as sperm sorting can be proven to be safe and effective, they would be ethically acceptable.
The ACOG committee fears that allowing sex selection for other than medical reasons could be seen as supporting the preference for one gender over another - usually boys - in some cultures. 'The committee opposes meeting requests for sex selection for personal and family reasons, including family balancing, because of the concern that such requests may ultimately support sexist practices', said the report.
The authors noted: 'The Committee on Ethics supports the practice of offering patients procedures for the purpose of preventing serious sex-linked genetic diseases'. Such techniques include PGD, which can be used to help parents avoid passing on sex-linked diseases such as Duchenne muscular dystrophy or haemophilia to their children.
The committee also considered post-fertilisation sex selection. 'After implantation of a fertilized egg, karyotyping of fetal cells will provide information about fetal sex', the committee members wrote. 'This presents patients with the option of terminating pregnancies for the purpose of sex selection'.
ACOG acknowledges that it will sometimes be impossible for physicians to avoid unconscious participation in sex selection because patients are entitled to obtain personal medical information: 'The ACOG's Committee on Ethics maintains that when a medical procedure is done for a purpose other than obtaining information about the sex of a fetus but will reveal the fetus's sex, this information should not be withheld from the pregnant woman who requests it', they wrote. 'This is because this information legally and ethically belongs to the patient. As a consequence, it might be difficult for health care providers to avoid the possibility of unwittingly participating in sex selection'.
The Committee pointed out that patients who are planning to abort a fetus of the undesired sex would be likely to hide their intent from physicians if they thought that their request for the procedure for sex selection might be refused.
Additionally, 'even when sex selection is requested for non-sexist reasons, the very idea of preferring a child of a particular sex may be interpreted as condoning sexist values and, hence, create a climate in which sex discrimination can more easily flourish', they added.