Mrs Suzi Leather
Chairman H F E A
Paxton House
30 Artillery Lane
London
E1 7LS


Re Consultation on Social Sex Selection

The Medical Ethics Alliance is an umbrella organisation of Hippocratic and World Faiths medical organisations We also have individual members, not all of whom are doctors, but who work in professions related to medicine. Its purpose is to stimulate debate within medicine and society on matters of medical ethics.

The Alliance does not have one view on the moral acceptability of I V F , some holding it to be a tolerable way of enabling infertile couples who could not otherwise have children, to have a child of their own. Others take the view that the essential dignity of procreation is not compatible with fertilisation outside of the body. For those who can accept I V F , it is only acceptable when there is no other way of achieving a pregnancy.

Pre inplantaion diagnosis, to ensure it results in a healthy child may be acceptable to a few of our members, but most are not persuaded that this can be done safely or without an unacceptable loss of embryonic human life. Some of our members can accept that in cases of serious sex linked diseases, sex determination of the embryo prior to implantation may be appropriate. If there were methods of predetermining sex before embryonic life begins, by gamete selection for example, that would be preferable.

There is a consensus amongst us that discrimination between persons for reasons of gender are wrong and we will work to prevent any discrimination, either intended or unintended, arising from a change in public policy. The principle question raised by your consultation, is whether social sex selection should be supported as a matter of public policy? We are strongly opposed to such a change.

The first and most obvious reason being that this would become an instrument of discrimination against the birth of girls . The reasons for this are cultural, and linked with questions of male inheritance and the survival of the family name, held to be important in some families. We would point to practices that are prevalent in India and China, where despite proscription by law, abortion of female preborns commonly occurs.

If there is any doubt that this would occur in the United Kingdom, one need look no further than the policies currently used by those medical geneticists who carry out ante natal diagnostic tests. The finding of a healthy female preborn is not always welcomed, and it has been found that socially motivated abortions may follow. Why such abortions take place, when they are so clearly contrary to the Abortion Act, is beyond the scope of this letter. Surffice it to say that virtual abortion on demand, whether NHS or commercial, which has come about, is a warning that a facility granted and supposedly circumscribed by law, can change into something very different from what was intended.

The other main reason why we think there should be a robust opposition to social sex selection is that it will lead to an imbalance in the general population. Individuals may want to balance their families but that would disturb the overall balance that at present occurs naturally. An equal numbers of both sexes is social desirable, increases the status of females, and tends towards a just and equitable society.

All our members would be opposed to I V F becoming a routine method of conception for those with the capacity to have children normally. The impact of such a development on society is incalculable and in our view would be morally abhorrent.

Any increase in IVF for social reasons would also have huge resource implications for medical services whether provided by the N H S or on a commercial basis. There is also an increased incidence of congenital abnormalities associated with I V F , and an morbidity and mortality amongst mothers which should militate against it.

Within the cultures represented within our membership, our common ethic, and the professional experience that we share, we subscribe to the historic view of the Royal College of Midwives that, "Every child is a gift".

Yours sincerely
Dr Anthony Cole
JP FRCP FRCPCH
Chairman Medical Ethics Alliance