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.

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.

In a recent comment on the HFEA’s public consultation on sex selection, Soren Holm claimed that proponents of family balancing are committed to embrace a laissez faire approach. Given that arguments in support of sex selection for family balancing also support sex selection for other social reasons, advocates of family balancing, he asserts, are simply inconsistent when calling for a limit on access to sex selection. In this paper, I argue that proponents of family balancing are in no way inconsistent. Provided their advocacy of family balancing is aimed at preventing a severe distortion of the natural sex ratio, they are entirely justified in insisting on restrictions to sex selection. The real question is whether a concern for the sex ratio does indeed call for a limit on sex selection. Based on a recent survey on gender preferences and data from several Gender Clinics, I argue that a restriction on sex selection to family balancing is unwarranted. In the absence of any evidence for a pending sex ratio distortion, we are actually required to adopt a laissez faire approach to sex selection.

BACKGROUND Preconception sex selection for non-medical reasons is a controversial issue in bioethics. Little research has described preferences for preconception sex selection among Arab populations. This study describes the sex preference and interest in employing sex selection techniques among pregnant women in northern Jordan. METHODS A self-reported questionnaire was administered to 600 pregnant women in Irbid, Jordan. χ2 test and binary logistic regression were used to examine the factors associated with interest in preconception sex selection. RESULTS In general, the interest in using sex selection was low. Women who preferred boys were more likely to be interested in sex selection, if paid for by the couple [odds ratio (OR) = 4.40, 95% confidence interval (CI): 1.75–11.11] or by health insurance (OR = 3.42, 95% CI: 1.94–6.06), or, if feasible, administered through oral medication (OR = 8.84, 95% CI: 5.05–15.63). Women with lower education were more likely to be interested in sex selection, if paid by health insurance (OR = 1.96, 95% CI: 1.10–3.45) and were more likely to believe that sex selection is legal (OR = 1.79, 95% CI: 1.06–2.86). Women who had no boys were more likely to be interested in sex selection, if paid by health insurance (OR = 1.94, 95% CI: 1.10–3.42) or, if feasible, through medication (OR = 3.03, 95% CI: 1.82–5.00). CONCLUSIONS The majority of participants were not in favor of using preconception sex selection. Those with a preference to have boys, with lower education, and those with an imbalanced family were more likely to be interested in using sex selection technology.

In its recent report Human Reproductive Technologies and the Law, the House of Commons’ Select Committee on Science and Technology insisted that the United Kingdom ‘does not take a purely insular view’ on sex selection but to carefully consider the impact on other countries before allowing changes to current legislation. True, no country is an island, not even the British Isles. Still, outlawing a harmless practice in Great Britain because of its alleged harmful effects in other countries is bad public policy.

Preconception sex selection for nonmedical reasons raises important moral, legal, and social issues. The main concern is based upon the assumption that a widely available service for sex selection will lead to a socially disruptive imbalance of the sexes. For a severe sex ratio distortion to occur, however, 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 interest in employing sex selection technology. Our objective was to ascertain such demand and preferences among the United States general population.