Edgar Dahl

In her paper, The case for physician assisted suicide: not proven, Bonnie Steinbock argues that the experience with Oregon’s Death with Dignity Act fails to demonstrate that the benefits of legalising physician assisted suicide outweigh its risks. Given that her verdict is based on a small number of highly controversial cases that will most likely occur under any regime of legally implemented safeguards, she renders it virtually impossible to prove the case for physician assisted suicide. In this brief paper, we suggest some ways that may enable us to weigh the risks and benefits of legalisation more fairly and, hopefully, allow us to close the case for physician assisted suicide.

One staple of living in our information society is having access to the web. Web-connected devices interpret our queries and retrieve information from the web in response. Today’s web devices even purport to answer our queries directly without requiring us to comb through search results in order to find the information we want. How do we know whether a web device is trustworthy? One way to know is to learn why the device is trustworthy by inspecting its inner workings, 156–170 1995; Humphreys 2004, Episteme, 6, 221–229 2009). But ordinary users of web devices cannot inspect their inner workings because of their scale, complexity, and the corporate secrecy which enshrouds both the procedures by which the devices operate and the companies that make them. Further piling on this predicament, authors have criticized web technology on the grounds that the invisibility of the web devices’ inner workings prevents users from critically assessing the procedures that produce a given output, in some cases, barring users from fulfilling their epistemic responsibilities, 343–355 2010; Miller and Record Episteme, 10, 117–134 2013). I consider four broad kinds of reasons which we can acquire without inspecting the inner workings of black-boxed technology: individual understanding, expert testimony, testing through experience, and social vetting; and show how each is a viable method of appraising black-boxed technology. By deploying these methods, we can remain responsible inquirers while nonetheless benefitting from today’s epistemic resources on the web.

BACKGROUND: Preconception sex selection for non-medical reasons raises serious moral, legal and social issues. The main concern is based on the assumption that a freely available service for sex selection will distort the natural sex ratio and lead to a severe gender imbalance. However, for a severe gender imbalance to happen, at least two conditions have to be met. First, there must be a significant preference for children of a particular sex, and second, there must be a considerable demand for preconception sex selection. To ascertain whether or not these two conditions are met, we have conducted a survey in Germany. METHODS: As a representative sample of the German population, 1094 men and women aged 18-45 years were asked about their gender preferences and whether or not they could imagine selecting the sex of their children through flow cytometric separation of X- and Y-bearing sperm followed by intrauterine insemination. RESULTS: 58% of respondents stated that they do not care about the sex of their offspring. 30% wish to have a family with an equal number of boys and girls. 4% would like to have more boys than girls, 3% more girls than boys, 1% only boys and 1% only girls. For first-borns, however, there is still a preference for boys over girls. While 75.6% claimed to have no gender preference, 14.2% would like their first child to be a boy and 10.1% would like their first child to be a girl. Whereas 6% could imagine taking advantage of preconception sex selection, 92% found this to be out of the question. Even in the hypothetical case that a medication for sex selection were ever to become available, 90% stated that they would not want to use it. CONCLUSION: Given that a majority does not seem to care about the sex of their offspring and only a minority seem to be willing to select the sex of their children, a freely available service for preconception sex selection for non-medical reasons is rather unlikely to cause a severe gender imbalance in Germany.

Within the next parliamentary term, the German government is expected to replace the current Embryo Protection Act with a new Human Reproductive Technology Act. Before introducing new legislation, policy makers may want to survey public attitudes towards novel applications of reproductive technology. In order to assess opinions and concerns about preconception sex selection for non-medical reasons, a social survey has been conducted in Germany. As a representative sample of the German population, 1005 men and women 18 years and older were asked whether or not preconception sex selection should be made available. Of the respondents, 32% held that sex selection should be strictly prohibited, be it for medical or non-medical reasons, and 54% accepted the use of preconception sex selection for medical purposes. Only a minority of 11% approved of the use of preconception sex selection for non-medical reasons. The widespread opposition to a freely available service for non-medical sex selection is based on several claims: 87% of respondents hold that 'children are a gift and deserve to be loved regardless of any characteristics such as beauty, intelligence or sex'; 79% argue that choosing the sex of children is 'playing God'; 76% are opposed because it is seen as 'unnatural'; 49% are afraid that it is 'skewing the natural sex ratio'; and 40% consider it to be 'sexist'.

In its recent statement 'Sex Selection and Preimplantation Genetic Diagnosis', the Ethics Committee of the American Society of Reproductive Medicine concluded that preimplantation genetic diagnosis for sex selection for non-medical reasons should be discouraged because it poses a risk of unwarranted gender bias, social harm, and results in the diversion of medical resources from genuine medical need. We critically examine the arguments presented against sex selection using preimplantation genetic diagnosis. We argue that sex selection should be available, at least within privately funded health care.

Preconception sex selection for non-medical reasons raises serious moral, legal and social issues. The main concerns include the threat of a sex ratio distortion due to a common preference for boys over girls, the charge of sexism, the danger of reinforcing gender stereotypical behaviour in sex selected children, and the fear of a slippery slope towards creating designer babies. This paper endeavours to show that none of the objections to preconception sex selection is conclusive and that there is no justification for denying parents the right to choose the sex of their prospective children.

Preconception sex selection is one of the most controversial issues in bioethics today. There is a widespread fear that a technology that allows parents to choose the sex of their children will have disastrous social effects. In its article “Gendercide: The Worldwide War on Baby Girls,” The Economist claimed that the advent of preconception sex selection will lead to a socially disruptive imbalance of the sexes in Asian and Arab countries. While it is true that prenatal diagnosis and selective abortions have led to a distorted sex ratio in countries such as India and China, it is unjustified to blame science for Asia’s social problems. It is religion not science that is responsible for the problems arising from new reproductive technologies, such as preimplantation genetic diagnosis or preconception sex selection

Many people look to religion to help resolve the serious moral and legal issues associated with assisted reproductive technologies. Doing so presupposes that religion is the cornerstone of ethics, but this assumption is not well founded. While various faiths are entitled to articulate their views on matters of human reproduction, the contradictions involved in doing so make it unwise to rely on religion in the formulation of law and policy. These contradictions – such as the indeterminacy about what revealed truths means – make moral secular philosophy a better guide for the protection of human welfare.

Much has been written about the ethics of sex selection. This article thoroughly explores the ethical arguments put forth in the literature both for and against non-medical sex selection using sperm sorting. While most of these arguments come from philosophers, feminist scholars, social scientists and members of the healthcare community, they are often echoed in empirical studies that have explored community values. This review is timely because the first efficacious method for sex selection via sperm sorting, MicroSort, is currently in clinical trials and moving closer to FDA approval for marketing in the USA. While the clinical trials are currently focused on the use of MicroSort to avoid X-linked genetic diseases, MicroSort can also be used to satisfy parental preferences.

In its recent statement 'Sex Selection and Preimplantation Genetic Diagnosis', the Ethics Committee of the American Society of Reproductive Medicine concluded that preimplantation genetic diagnosis for sex selection for non-medical reasons should be discouraged because it poses a risk of unwarranted gender bias, social harm, and results in the diversion of medical resources from genuine medical need. We critically examine the arguments presented against sex selection using preimplantation genetic diagnosis. We argue that sex selection should be available, at least within privately funded health care.