Today, sex selection; tomorrow, designer baby prospect looms

The trouble with opening a can of worms is that it’s mighty difficult to seal the thing up again. And when it comes to prenatal sex selection, the can of worms was opened long ago, as ultrasounds have long been able to provide obstetricians and pregnant women with information regarding the gender of their babies.

Despite that, Canadian Medical Association Journal interim editor Rajendra Kale is doing his level best to seal that particular can up again. In the current CMAJ’S editorial, Kale cites evidence that prenatal sex selection — that is, aborting female fetuses — is being practised by some South and East Asian immigrants in Canada.

Calling such a practice “discrimination against women in its most extreme form,” Kale asks how it can be stopped, and then answers his own question by advocating a ban on doctors providing a pregnant woman with information regarding the sex of her baby until about 30 weeks into the pregnancy — after which an abortion is highly unlikely.

Needless to say, Kale’s editorial has proven deeply controversial, largely because it touches on deeply controversial matters — abortion, multicultural diversity and patient autonomy. Nevertheless, he should be praised for the editorial because it does raise an important, if uncomfortable, topic.

On the other hand, Kale’s solution to the problem, which amounts to trying to seal the can of worms, is doomed to failure given that it is quite possibly illegal, and definitely impractical — or impossible.

To take the legal matter first: The Royal Commission on New Reproductive Technologies did discuss the possibility of withholding from pregnant women information about the sex of their fetus. However, the Assisted Human Reproduction Act, which came into force in 2004, does not prevent doctors from disclosing such information.

And for good reason, since the Supreme Court of Canada has held that a patient has a right to see all information in her medical record that the physician used to provide advice or treatment. One could argue that the sex of the baby is not a medical matter ( except in cases of sex- linked diseases), but given the Supreme Court’s decision, any law preventing physicians from disclosing such information would likely run afoul of the Charter.

But the legal matter is likely moot anyway, since it’s now all but impossible to stop women from learning the sex of their fetuses, and in the future, it will definitely be impossible. The reason is simple: There already exist home tests that can reveal the sex of the baby, which means preventing obstetricians from providing such info becomes meaningless.

Such tests will only become more accurate in the future, and that raises another important issue: In the not to odistant future, people will be able to buy a home test that tells them a great deal about their unborn babies. They will be able to terminate the pregnancy, not merely on the basis of the sex of the fetus, but on whether the baby has exactly the characteristics they desire.

In other words, we are about to open another can of worms, one concerning designer babies. Therefore, we need to have a serious societal discussion about where things are going, and where we want them to go. Moreover, we should thank Rajendra Kale for starting that discussion, even if he only touched the tip of the iceberg.