Last Wednesday, the director general of the Health Ministry published Protocol 21/05, which entitles parents to determine the sex of their fetus for nonmedical as well as medical reasons. The new protocol attempts to strike a balance between the public's interest in access to new technology, and a series of ethical considerations. However, the protocol in its current format appears to be lacking on a number of fronts.
The minimal conditions set out in the protocol include stringent demands that permit access to sex selection technology for nonmedical reasons only in extreme cases: Candidates must be parents to four children of the same sex, and they must prove that if their fifth child is not of the opposite sex, the resulting emotional damage to them or their newborn child will be severe enough to cancel any other ethical considerations. As far as most potential Israeli parents are concerned, these conditions make the existence of sex selection technology purely theoretical. They will never have access to this technology, given these standards.
This raises the question: Why adopt such exacting minimal conditions? The protocol attempts to address this question in its declaration, "A man's basic right to liberty and to determine his own destiny is tempered by other vital interests necessary to the existence of a just and moral society. These interests support medical and ethical claims that oppose the implementation of a medical procedure, with its inherent risk, to promote a nonmedical goal, claims pertaining to the status of the fetuses not chosen for implantation, and the need to prevent gender-based discrimination in order to preserve the demographic balance."
Every day, Israeli citizens make decisions to undergo medical procedures that are not medically necessary. (Plastic surgery is a blatant example.) Despite the fact that these procedures bear considerable risk, it never occurs to anyone to interfere in these decisions. How does the Health Ministry justify its interference in the decision of these potential parents to expose themselves to the risks of in-vitro fertilization, when thousands of Israeli women undergo this treatment every year?
Arguments pertaining to the status of the fetus that was not chosen, and measures taken to prevent discrimination and preserve "demographic balance," hint that the protocol strives to prevent discrimination that favors male fetuses. But that is exactly what the protocol does, in its current format.
The minimal conditions set forth in the protocol make sex selection the sole domain of sectors of the Israeli public that tend to have more than four children. It is safe to assume these sectors tend to also prefer male babies. There is the risk that the current protocol will become a tool in the hands of parents who would suffer real emotional damage from the birth of another daughter.
In addition, the arguments detailed in the protocol to justify these conditions fail to address other questions adequately: Why must sex selection, or the selection of any other fetal trait, be regulated by the authorities? Why not allow access to this technology to the parents of one son, who want their second child to be a girl (even if it is only to fulfill their desire to experience being parents to both genders)? What horrible tragedy does the protocol seek to prevent? Does anyone truly believe that there might be a significant glut of men in the next generation in Israel, as there is in India, or China?
Moreover, it is relatively easy for Israeli women to have abortions. Thus, in the final analysis, the new protocol cannot prevent a determined mother from selecting the sex of her fetus.
In Israel, as in many nations in the world, there is apparently an archaic fear of "interfering with Creation" or with "nature." However, a look at reality reveals that man has been "interfering" in determining his destiny since he climbed down from the trees, and there is no reason for him to stop now that technology offers him more efficient tools with which to shape his future.
In summation, the new protocol prevents Israeli citizens from access to new, efficient and harmless technology for no real reason, and on the other hand, promotes certain ethical considerations and cultural preferences. It is highly doubtful that Israel, as a democratic nation, should extend a hand to ethical considerations and cultural preferences of this type.
The writer is a doctoral student of law at Columbia University, specializing in bioethics.
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