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A 'social compensation tax' for social sexing

11 April 2005
Appeared in BioNews 303
The recommendations of the recent report by the House of Commons Science and Technology Committee in the UK have stirred up the discussion on social sex selection. Over the years, the discussion on sex selection has been seriously hampered by the high emotional engagement of the participants. As a consequence, counter arguments are not taken seriously and possible solutions are rejected off hand. Most counter arguments can be refuted or sidestepped by creative solutions. A biased sex ratio for instance can be prevented by introducing the framework of family balancing. Another major argument by opponents is that social sexing, at least at present, implies the use of medical means for a non-medical goal. This use may be wrong for two reasons: misallocation of financial resources meant for public health and wastage of medical capacity.

The first point is easily avoided by making people who desire to use social sexing pay out of their own pockets. The fact that only people able to pay can use the technology is ethically irrelevant. Equal access is required by the principle of justice but this principle only applies to basic health care services, i.e., treatments needed for a reasonable level of well-being. The opponents of social sexing have to choose: either the desire for a child of a specific sex is reasonable and then equal access is required, or the desire is unreasonable and then no discrimination is involved when access is restricted to people who have the financial means.

However, even when no money is taken from the health care budget, there may still be inappropriate use of public funds. Not only the direct costs (who pays for the service) but also the indirect costs (who pays for the steps that make the service possible) should be taken into account. In states with a heavily subsidised educational system, each professional has a social role to fulfil. It is a loss to society if a physician whose education is largely paid for by the community invests most of his or her time, expertise and energy providing elective medical services. This loss should be compensated. The most obvious way to do this is by imposing a 'social compensation tax'. This tax should be in proportion to the time, infrastructure, personnel etc. specifically invested in social sexing. This implies that the tax should be significantly higher for sex selection by means of IVF combined with PGD (preimplantation genetic diagnosis) (IVF-PGD) than for sexing by sperm sorting (supposing of course that IVF-PGD is not needed already for medical reasons).

The tax should a) compensate society for the loss of health care capacity, b) compensate the community for the money spend on the education of physicians, and c) reduce the number of applications and as such diminish damage to the health care system. The same strategy of financial penalties is applied for other socially undesirable activities like smoking. Moreover, the amount collected by the tax could be used to support people who need PGD for medical reasons.

In this way, possible damage to the reputation of a technology, due to the application for social sexing, could at least be diminished. The wrong of inappropriately using health care capacity is transformed into a right, i.e., enabling people to use expensive techniques (especially in the case of rare genetic diseases). Although direct reciprocity should not be the rule (the money could be transferred to the general health care system), a direct link between elective applications of a technique and medical applications makes the transformation more visible. Whatever the solution, the complexity of sex selection for social reasons is not done justice by an outright prohibition.

1 September 2009 - by Sarah Pritchard 
A fertility clinic in the USA has revealed that it provides sex selection to many British couples who pay large amounts of money to travel and receive the service....
17 February 2006 - by BioNews 
A new study carried out at the University of Illinois in Chicago shows that most people would not choose the sex of their baby, if given the option. The findings, published in the journal Fertility and Sterility, are based on an online survey of 1,197 men and women aged between...
7 November 2005 - by BioNews 
A new UK study of peoples' attitudes towards social sex selection has found that 80 per cent believe that parents should not be allowed to choose their baby's sex, even for 'family balancing' reasons. The researchers, based at the Policy, Ethics and Life Sciences Unit at Newcastle University, questioned 48...
31 October 2005 - by Dr Jess Buxton 
Allowing parents to select embryos purely on the basis of their sex is one of the most controversial uses of reproductive technology, and usually one that generates plenty of press coverage every time it's mentioned. Not so last week, however, when the journal Nature reported on (and press-released) details of...
28 October 2005 - by BioNews 
A new US trial will look at the social effects of allowing parents to choose whether they have a baby girl or boy. The study, based at the Baylor College of Medicine in Houston, Texas, will follow up babies born following the use of preimplantation genetic diagnosis (PGD) to choose...
7 April 2005 - by Alan E Masterton 
As a father who has fought to use gender selection, we of course always knew that what we sought for our family was the right thing for our particular circumstances. We never tried to suggest our moral standards were right for everyone. We certainly never tried to impose our moral...
29 March 2005 - by Dr Ian Gibson MP 
When we announced that we were going to undertake a review of the Human Fertilisation and Embryology Act 1990, a lot of people said we were mad. They were absolutely right, of course, but someone had to do it. It was clear to us that the Act and the Human...
24 March 2005 - by BioNews 
The UK House of Commons Science and Technology Committee (STC) is deeply divided over its inquiry into Human Reproductive Technologies and the Law. Only half of the ten committee members put their names to the summary report, published today alongside a Special Report detailing the committee's disagreements. The dissenting MPs...
8 October 2003 - by Dr David King 
Sex selection is the exercise of sexism at the most profound level, choosing who gets born, and which types of lives are preferred. 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. In western...
5 November 2001 - by Juliet Tizzard 
Over the weekend, the UK media has run a number of stories about sex selection, which we cover in this week's BioNews. There's nothing new about sex selection: it's been possible to test embryos for sex for more than a decade, although it's never been legal to do so for...
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