How to treat gender selection from the perspective of medical ethics

In the early days of human history, due to some social or cultural factors, people have a special preference for a certain gender. There is a proverb in ancient India: the daughter of eighteen fairies is not as good as a hunchbacked son, which clearly expresses people's preference for male sex. There are three kinds of unfilial, unfilial. In China, people have raised the preference for sons to the moral level, which has become one of the most legitimate reasons for husbands to punish their wives or file for divorce. Preference for a certain sex is followed by the emergence of human sex selection behavior. In order to achieve the goal of sex selection, various nationalities or cultures have accumulated some experience and knowledge on how to have boys and girls. For example, in ancient Greece, it was believed that a boy would be born at night when the north wind blew and a girl would be born at night when the south wind blew. In China, people think that if a mother likes sour food during pregnancy, she will give birth to a boy, and if her mother likes spicy food, she will give birth to a girl. Although similar knowledge and common sense are not common in all nations or cultures, they do not only exist in individual nations or cultures. On the one hand, this understanding reflects the desire of human beings to understand their own fertility phenomenon, and at the same time, it also shows that people at that time really had the actual demand for sex selection. But on the whole, most of these knowledge and experiences are untrue and lack enough scientific nature. For human beings at that time, sex selection was basically a natural reproductive behavior regulated by invisible hands. According to the understanding of religious culture, the birth of boys and girls is controlled by God or other inhuman supernatural forces. Ancient people prayed for boys or girls, which led to many fertility superstitions. Therefore, it can be said that in an era when human beings are very poor in knowledge about their own fertility problems, although there is a demand for gender preference, in fact, human beings basically have no choice in gender selection. Human's complete freedom of sex choice is realized only after the development of medical technology to a certain extent.

B-ultrasound is one of the medical techniques of sex selection in developing countries. B-ultrasound, invented in the 1940s, is a physical examination method that closely combines the physical characteristics of ultrasound with the acoustic characteristics of human tissue structure. Because B-ultrasound can display the image of the fetus on the monitor screen for dynamic observation through sound waves, doctors all over the world now use ultrasonic instruments to evaluate the development of the fetus, but for parents with gender preference, they prefer to use it to know the sex of the fetus as soon as possible during pregnancy. Therefore, the B-ultrasound technology and fetal sex identification are especially welcomed by China, Indian and other countries that prefer boys to girls, followed by amniocentesis technology and villus sampling technology. However, this phenomenon has led to a serious imbalance between men and women in these countries. In 2005, the ratio of male to female babies born in China was 1 18: 100, far exceeding the ratio of normal biological systems 106: 100, while in Punjab, the ratio of male to female was1000:. However, many Indian families, especially those in poor areas, use medical technology such as B-ultrasound for sex selection, and the direct consequence is that once the fetus is detected to be a girl, they try to abort. In China, it is estimated by the health department that at least 30,000 fetuses are aborted every year because they are girls. Although the gender preference of all ethnic groups has been continuous since ancient times, it is obvious that modern medical technology has undoubtedly expanded this preference, so that some fetuses are selected or abandoned just because of their gender. In India, China and other countries, the use of B-ultrasound and other technologies to detect fetal sex has caused a serious gender imbalance in society. The serious gender imbalance will inevitably lead to the social problem of marriage for young people of school age. According to some media, by 2020, there will be 30 million to 40 million more men of marriageable age in China than women, which means that 1 in every five men can't find a spouse. In view of this possible negative impact, both China and India have enacted laws to prohibit the abuse of sex selection technology. However, the reality is that the prohibition by law has not fundamentally changed people's practice of using sex selection technology. It has been suggested that the key to solving the problem is not to control new technologies, because the development of new technologies far exceeds the speed of control. Compared with the ancient custom of female infanticide, it seems that the selective abortion of female fetus by using new medical technology can reduce the harm to the sacred concept of human life to a certain extent, and the psychological harm to pregnant women may be less. But on the whole, as stated by the Ethics Committee of Human Reproduction and Women's Health of the International Federation of Obstetrics and Gynecology in its statement on sex selection 1994, the Committee deplores the deep-rooted gender discrimination that still exists in many societies, and the recent selective abortion of female fetuses has become another manifestation of social injustice. [1] In Indian, China and other East Asian countries, people's preference for sex selection is related to the traditional preference for boys over girls, people's concept and understanding of life, and the dominant position of male citizens in social life. Moreover, in comparison, the latter two are more likely to be the main motives that influence people's sex choice in modern society. Therefore, fundamentally speaking, only by changing the reality of social inequality and people's attitude towards life can we substantially curb people's abuse of sex selection technology and truly realize the ideal of an author who cares about sex selection. I hope our daughter will not slaughter again.

In a sense, it is generally believed that the use of medical technology for sex selection is a unique phenomenon in developing countries. In fact, in developed countries, there are also cases of using medical high technology for sex selection to varying degrees. The difference is that the main purpose of sex selection in developed countries is to balance the gender of family members. Because the religion or culture of most western countries prohibits abortion for non-medical reasons, in these countries, people hope to achieve the purpose of sex selection through other medical assisted reproductive means. This technique is called preimplantation genetic diagnosis. The original research and application of this technology is to avoid hereditary diseases. Because there are obvious gender differences when some human diseases are passed on to future generations, for example, the incidence of hemophilia in men is 50%, while women may only carry the disease-causing genes without getting sick. So we can determine the sex of the child in the early stage of fetal development through preimplantation genetic diagnosis, and then get pregnant by embryo implantation technology. For parents with genetic diseases, healthy children can be obtained through preimplantation genetic diagnosis technology. Just like the fate of ultrasound and other medicine before, fetal technology is not necessary. Because of people's needs, genetic diagnosis technology before embryo implantation has also begun to be used for fetal sex selection for non-medical purposes. Because many countries think that sex selection is a violation of human dignity, they refuse to design babies and prohibit sex selection technology for non-medical purposes, but in some countries, such as the United States, sex selection is legal, so in order to avoid the domestic laws prohibiting sex selection, wealthy foreign couples come to the United States to get the boy or girl they want through medical means. The doctor who provided this technology took the egg out of the client's body, fertilized it with her husband's sperm, and then observed it until each fertilized egg divided into 8 cells. Then the laboratory technicians will take a cell from each embryo for genetic analysis, and if it meets the gender requirements, implant it into the client's uterus to obtain the required baby gender. The customer will decide whether to freeze the remaining embryos, donate them to research institutions or destroy them immediately. Although preimplantation genetic diagnosis technology has avoided many problems caused by induced abortion, for those who believe that human life begins with fertilized eggs, the use of this technology has led to some surplus embryos, and how people deal with these embryos involves some important ethical issues.

It is a great progress in the development of human reproductive technology and self-knowledge, and also a challenge to human reproductive moral responsibility. Although in modern society, people's sex selection behavior is not for the same reason, or to avoid genetic diseases or pure male sex preference, or to balance the gender imbalance in the family. But all the facts of sex selection behavior show that people try to control their reproductive behavior. Especially in the real society, there is still a serious gender concept of son preference, so giving birth is by no means a matter of personal choice.