William M. Briggs

Statistician to the Stars!

Sex Selection And In Vitro Fertilization

We made it through the gauntlet!

I’m always on the lookout for remunerative ways to spend my time. There yesterday on the American Statistical Association jobs site was a situation for a Medical Statistician, which is me all over. Close to home, too; only two blocks away.

My enthusiasm abated after learning that the Center For Human Reproduction is running trials on diminished ovarian reserves, frozen donor egg programs, which might be okay, but also “economical” in vitro fertilization and “gender selection” which aren’t.

IVF is dicey because only about one out of every thirty embryos make it—this is after the sperm meets the egg, folks, and therefore embryos are tiny human beings—, the other twenty-nine are “sacrificed” or die en route to the womb. I’m too squeamish to contribute to studying how to make dead people, even small ones.

The “sacrificing”, i.e. the killing, is often done for reasons of eugenics. Such as in “medical” and “elective” gender selection. The CHR uses “preimplantation genetic diagnosis”, a scientific sounding term:

On the third day after fertilization, when embryos have reached 6- to 8-cells, one of the cells is removed from the embryo, to be analyzed for its chromosomal makeup. (The removal of the cell at this stage does not negatively affect the embryo’s growth competency.) This chromosomal analysis allows us to determine whether the embryo is male or female. Then, only the embryos of the desired gender are transferred to the uterus.

In plain English it means they check whether the embryo is a girl and then kill her if she is. Or kill him if it’s a boy, if that is the parents’ preference. It’s a “war on (pre) women” in most places, though: I suppose it would be interesting to do the statistics of sex-preference of upper class Manhattanites (with an eye for ever-present racial “disparities”).

I also wonder how true that parenthetical statement is. Cutting out one-eighth to one-sixth of a person sounds rather dramatic. I’d bet they didn’t carry out a definitive experiment such as expunging cells from one group of embryos and leaving another group intact and then watching what happens. You’d have to watch for a lifetime to be sure of no deleterious effects, such as increased cancer rates.

They don’t just kill embryos because of their sex. They also whack them if they suspect “sex-linked diseases.” These

are inherited via the mother but only male offspring are affected (muscular dystrophy, hemophilia, etc.). In other cases, conditions are more severely expressed in one gender (Fragile X syndrome, autism in males, etc.) than the other.

Understand: they are not testing whether the embryo is (say) autistic, and then washing it down the sewers if it is, though there’s nothing redeeming in that practice—plus, there is no reliable way to tell—they are killing the male embryo because it’s more often boys than girls who develop autism.

That means the “disease of the week” (whatever is featured on TV talk shows) can lead nervous parents to request babies of the sex least effected. If you think not, then you weren’t paying attention to the recent vaccination-and-autism panic, which is only now waning. It’s also curious that all the maladies listed are those typically found in boys. So maybe in Manhattan, unlike the rest of the world, it’s a “war on men”.

Anyway, sex selection isn’t illegal here (they advise “patients” in countries where the practice is illegal to pay them a visit). But there are murmurings and skittishness among politicians and the public; the practice makes most uneasy. Laws might be passed. Much of the verbiage of the CHF page therefore is preemptive; they give medical- and scientific-sounding justifications to salve consciences and stave off lawmakers. Consider:

Medical reasons for gender selection can, however, also be psychological: a single female may feel better equipped having a daughter than a son; parents who lost a child may feel a strong need for a child of the same gender…

The most frequent indication for such gender selection is “family balancing,” when one gender is already represented in the family unit and the other gender is desired.

“Indication” has a nice medical ring to it. And if you can’t get the public to swallow the “might be” justification (might be autistic, might be a hemophiliac, etc.), then you can always find a shrink to claim mental distress. A “single female” who feels “better equipped” to have a daughter rather than a son probably isn’t equipped to deal properly with either. But I am not a psychologist, so I could be wrong.

I am however a bioethicist, and in that capacity I was fascinated the CHF anticipated single females. Who needs men?

35 Comments

  1. Once you start saying that 8 cells being destroyed is not only equivalent, but literally “killing”, literally “murder”, you’ve lost me completely.

    I’m not at all fond of abortion. Having said that, if you say silly things like that, don’t expect much beyond facepalms beyond your usual like-minded christian audience.

  2. “I was fascinated the CHF anticipated single females. Who needs men?”

    There is good reason for CHF to consider single females but not single males. At this point, a single female can go to CHF and have a baby using anonymous donor sperm. The reverse, a single male having a child using an anonymous donor egg is simply NOT POSSIBLE at this time.

  3. Dias, your viewpoint is obtuse. How can you ignore those cells for what they are? DNA analysis will show them to be human. A nascent human is still a human. In my mind, there is no difference between those cells and a five year old kid. This sense is not based in religion, it based in logic. Further, the whole point of the US constitution is to protect the rights of individuals. No wonder so many of us despise abortion. It is both an affront to our humanity and the very purpose of our government. 50 million dead.

  4. Dr. Briggs:

    There is about a 40% chance that a fertilized egg does not naturally implant in the uterine lining and is lost. So for all of human history, 40% of all “tiny human beings” have been “sacrificed”. Quite naturally.

    If all human life is equally important, and fertilization is always the result of an intentional action, how is this loss any different than those lost in IVF?

    If you were concerned with all “tiny human beings”, you would give at least a passing mention to those 40% lost every day through natural processes. Clearly not all “tiny human beings” matter to you.

    Perhaps you are concerned that in light of the vast preponderance of natural losses of fertilized eggs, losses through artificial selection lose significance.

    Perhaps you are concerned that awareness of the pervasive existence of natural losses of fertilized eggs provides rational precedence for any loss.

    V/r.

  5. Eric,

    So by extension it would be OK to kill off X% infants provided we don’t exceed natural infant mortality? You do understand the difference between intentional and natural, yes?

  6. Briggs

    7 February 2013 at 5:36 pm

    Eric,

    A couple of hundred thousand post-womb human beings died last year from various natural causes (old age, cancer, hit by a bus, etc.). About 13,000 were murdered. All are dead, however. Is there a difference?

  7. Eric:

    If you look at states with Feticide statutes (35), 25 of them cover the entire pre-natal development period.

    They cover the intentional killing of the fetus (excepting a legal abortion of course).

    They were created to cover the situation where a man intentionally kicked or punched a pregnant women in the belly, for the specific purpose of killing the fetus.

    There is a huge difference in the law between having specific intent to kill (i.e. murder – but not covering legal abortion by statute) and a spontaneous abortion or other natural loss of the fetus.

    So if it was possible to find out about a pregnancy at the 8 cell stage (which I doubt), and someone killed the fetus on purpose (feticide – excepting legal abortion), it would be covered and considered a crime.

  8. DAV,

    We are discussing fertilized eggs, not infants. You do understand the difference between a fertilized egg and an infant, yes?

    How many fertilized eggs have you observed never implant? You don’t even know, because you cannot naturally detect a missed implant. It is irrelevant.

    The loss of an infant you can observe. You carry that pain every day, always.

    If you cannot shed a tear over a naturally lost fertilized egg, you cannot ask me to shed one over *any* loss of a fertilized egg.

    V/r.

  9. RickA,

    There is a difference between a fetus and a fertilized egg, which is why the laws you refer to specify “fetus”.

    An nonimplanted fertilized egg is not even a “pregnancy”, since pregnancy starts at implantation.

    Should the pregnancy continue to the stage of a fetus, then the laws you mention come into effect.

    V/r.

  10. Dr. Briggs:

    I think this is the problem in your ethical analysis:

    You desire to place value on all human life. Humans have a biological life cycle, yet you desire to place “personhood” on only a subset of that life cycle.

    You have chosen point of fertilization of the egg as the origin of personhood.

    Yet in about 40% of the cases, the human body flushes out these fertilized eggs as waste material.

    Your dilemma: How can a “person”, that we value, be naturally thrown out like garbage? (This is compounded if you believe in a Creator that designed this so.)

    The source of your problem is you require a singularity where something is not-a-person, and afterward is-a-person.

    The truth of the matter is that sperm an egg are just as much part of the biological process as an nonimplanted fertilized egg, an implanted fertilized egg, a uterus, a baby, and an old man dying.

    The problem is that you are looking to the biological model for a hard delimiter to accommodate your ethical model. The biological model has no such delimiter.

    You could say, if not there, then where, because every other point is even more problematic.

    The issue lies not with the biological model, but with the constraints forced by your ethical model.

    I don’t have a solution for you, sir, except perhaps to assign personhood later in the biological process than fertilization.

    V/r.

  11. Eric,

    “The source of your problem is you require a singularity where something is not-a-person, and afterward is-a-person.

    The truth of the matter is that sperm an egg are just as much part of the biological process as an nonimplanted fertilized egg, an implanted fertilized egg, a uterus, a baby, and an old man dying.

    The problem is that you are looking to the biological model for a hard delimiter to accommodate your ethical model. The biological model has no such delimiter.”

    Actually yes the biological model has exactly such a delimiter. Conception is the point at which you have a new genetically unique (barring identical twins +) organism of species homo sapiens.

    There is no scientific or sound logical basis to draw the line anywhere else.

    You are the one with the problem. You have to either admit that where YOU draw the line is completely arbitrary and has no rational basis or you have to refuse to draw the line at all.

  12. Ye Olde Statistician

    7 February 2013 at 9:26 pm

    Eric I: The source of your problem is you require a singularity where something is not-a-person, and afterward is-a-person.

    Eric II: I don’t have a solution for you, sir, except perhaps to assign personhood later in the biological process than fertilization.

    Weirdly, the second statement sounds like something is supposed to be not-a-person before personhood is “assigned” and afterward is-a-person.

    Of course, personhood is not something assigned by a racial hygeine board or by a parliament. It is something natural.

    And the logical consequence of the lack of a “singularity” is that the identity of the person is continuous all the way back to the inception of the self-organizing, emergent system. Since time is simply a fourth dimension of a space-time manifold, the distinction between the fertilized embryo and the mature individual on axis T is no different from the distinction between the left big toe and the cranium on axis Z. Embryo, fetus, infant, baby, child, teen, adult, etc. are simply three-dimensional cross sections of the same manifold taken at different points along the T axis.

    The 40% that never implant are no less human, and their deaths are no less tragic. We mourn them less for the same reason we mourn less any human being that we have never met. Our sense of loss is proportional to our familiarity. But the prevalence of natural death is surely not a justification for manslaughter.

    We have tried that legally-applied personhood before with respect to whole classes of people, and little good came from it.

  13. This little essay has embedded within it the viewpoint that an embro is a human–which many biologists will dispute to varying points–and that killing it is a form of abortion, with which the author disagrees.

    Not to argue about values for or against abortion, where/when/how/why that might be defined & to occur…simply consider that many consider abortion to be “okay,” and, that some of these have gone so far as to endorse Partial Birth Abortion.

    But why stop there…why not go ALL-THE-WAY…to POST-BIRTH-ABORTION! Imagine where that might lead…perhaps right to:

    http://www.loweringthebar.net/2013/02/the-drone-memo.html and more about that at: http://www.guardian.co.uk/commentisfree/2013/feb/05/obama-kill-list-doj-memo

    That little digression aside, I’ve been wondering if any farmer has sued, successfully, (or if not what the laws & arguments would be) if someone did something to destroy his just-planted crop (e.g. by digging up the seeds, killing them by applying a biodegradable fertilizer or whatever that stopped them from germinating, etc.).

    Seems to me that that farmer would have a pretty good case for collecting damages from vandalism for his lost crop. Assuming that would be the case, the arguements would seem applcable to a developing embryo/fetus — if a developing seed is linked to the full-grown end-state, if it applies to a crop of corn the same reasoning ought be applicable to a brood of triplets…. Then, via legal definitions & precedent, perhaps as just outlined, we might stop the legal debate about whether an embryo/fetus is a human vs. just a mass of living cells. I’ve never heard of that approach being pursued much less if it failed or not…

  14. Sander van der Wal

    8 February 2013 at 5:30 am

    A fertilized egg is not yet a human, but it will in time become a human. Where exactly you draw the line for the law is a matter of opinion and of considering the consequences.

    If a fertilized egg is a human, and a woman’s body is ejecting him or her, the woman has to be put on trial to examine why it happened? Was she drunk, so she can be tried for negligence, things like that?

    Are you going to look for volunteers, to try and carry the children until they are born? Are you going to fund and develop machinery that can gestate these children? Are you going to fund research into drugs that will prevent a woman’s body from rejecting these children? Are you going to force women to take those drugs, ot convict them if they do not take the drugs and their bodies reject the child?

  15. You could go home for lunch. Once you knew the local rules you’d hardly need to go in at all.

    But of course it’s 97.5% likely that they’d find this blog and if so then 100% that you wouldn’t get the the job. You’d be overqualified which is code for “He can see through us as if we’re glass”.

  16. Yawrate, you use the term logic in a funny way. It’s not “logic” that will determine if the cells are human, but “definition”. Posts like this will have people debate on a definition they do not agree on from the beginning.

  17. MattS:

    A sperm and an egg are both “genetically unique organisms”, as is a fertilized egg. Your biological definition for “conception” is already in trouble, and you haven’t even left the gate. Your attempt is an excellent illustration of the problem of mapping an ethical model to a biological model.

    YOS:

    Your preference is “a self organizing emergent system”. I appreciate your worldline description, but it is unclear to me where you start the line. The sperm and the egg are both on the worldline of a person. Are these part of your emergent system? If you preclude them, what are your criteria?

    V/r.

  18. Sander van der Wal,

    A fertilized egg is a new orginism genetically distinct from both parents. If it isn’t human, what species is it?

    Your conclusions as to what will happen if we recognize basic biological truth are absurd. Humans die at all stages of life. Only a tiny fraction of those deaths are investigated by police for possible criminal activity.

    Death is a natural part of life and there is no moral basis to say we MUST go to heroic lengths to prevent every natural death. In fact the majority of such deaths are ultimately unpreventable no matter what we do.

  19. Eric:

    Once a fertilized egg starts to divide, it is no longer a fertilized egg. Once it is no longer a fertilized egg it is a fetus. Yes there are different stages of fetal development, but as soon as it is more than one cell, it is a fetus. Perhaps you do not understand the difference between a fertilized egg (one cell) and a fetus (more than one cell).

  20. Dias, your viewpoint is obtuse. How can you ignore those cells for what they are?

    I kill hundreds, nay, thousands of such cells every day. I call the event “washing myself”. Sorry if I don’t share with you the horror of the process.

  21. RickA:

    You missed a step. Check out Dr. Briggs essay.

    A fertilized egg that divides is an “embryo”. Once the cells of the embryo differentiate (the cells become recognizable structures), then it is called a “fetus”.

    Dr. Briggs essay referred to embryos, but the IVF process starts prior to fertilization, hence the discussion of fertilized eggs.

    Your original post largely focused on legislation protecting the fetus and the mother carrying the fetus.

    V/r.

  22. Sander van der Wal

    8 February 2013 at 1:02 pm

    MattS

    A dead human doesn’t become a different species either. Some of the cells of a dead human are alive, and stay alive for some time. No attempt is made to save those cells. Clearly, human cells as such get different kinds of treatments at different stages in there being a separate collection of human cells.

    A particularly interesting case is transplanting organs, collections of human cells that were part of one human and are later part of a different human. For of against?

    Regarding the heroic efforts, all ways to save people have all resulted from efforts by other people.

  23. I went and checked the feticide laws, and most of them do relate to just “fetus”. However, four states do say “embryo or fetus”.

    So thank you for the nuance – and I agree that the law does treat an embryo differently than a fetus in most states (except for four).

    I also checked the definition of fetus, based on your comment, and do see that most definitions define a human fetus as later than 8 weeks of development.

    I was not aware of that nuance.

    I guess my point has been wittled down to the fact that it is illegal in four states of the USA for a person (not the Mother via legal abortion) to intentionally kill an embryo. And it is illegal in 25 states to intentionally kill a fetus (again – not including by legal abortion).

  24. Sander van der Wal,

    “A dead human doesn’t become a different species either. Some of the cells of a dead human are alive, and stay alive for some time. No attempt is made to save those cells. Clearly, human cells as such get different kinds of treatments at different stages in there being a separate collection of human cells.”

    An embryo which is a complete organism at a very early stage of development is not in any way, shape or form comparable to a collections of cells that comprises only a portion of said organism at any stage. Your argument above is nothing more than false equivalency.

    “A particularly interesting case is transplanting organs, collections of human cells that were part of one human and are later part of a different human. For of against?”

    This is strictly based on your original false equivalency between a complete organism at an early stage of development (where the total number of cells is small) and a collection of cells from a larger version of the same type of organism at a later state of development. As such it deserves no answer.

  25. Sander van der Wal

    8 February 2013 at 5:10 pm

    @MattS

    Why does size suddently matter? Or the number of cells? A human has a number of cells with human DNA, and 10, or a hunderd time (should look this up) as many cells, bacteria, that live in his gut and digest his food. No gut bacteria, no living human. If you look at the numbers, the human cells are massively outnumbered, if you look at the size, human cells are a lot bigger so we see a human and not a pile of bacteria.

    So, a bunch of cells from a fully developed human are not a human, and therefore will never be a human. Now, image that with enough technological advancements we can clone a human from a normal cell. The cell is changed in such a way that it is identical to a fetilised egg. This couild very well be impossible,but assume for the sake of argument it is possible. You now say that this cell is not a human, and will never become a human.

    Or your position will be that the cell becomes human as soon as it is the same kind of cell as a just fertilized egg.

    And no getting out of the argument by saying this will be impossible. This particular post is discussing the ethical consequences of recent technological developments, after all.

  26. Sander van der Wal,

    Fingernail clippings have human DNA that is true. Skin cells die everyday and are replaced that is true. You can lose these and still be you. The 8 or 10 cells or even the one fertilized egg are the complete organism. Killing them is the same as killing the organism. The ethical question is not about cell death but of the propriety in killing the organism.

    As you say, size doesn’t matter.

  27. Sander van der Wal,

    Are you deliberately misunderstanding? The distinction is not size per say but having a complete organism vs only a portion of an organism.

    “So, a bunch of cells from a fully developed human are not a human, and therefore will never be a human. Now, image that with enough technological advancements we can clone a human from a normal cell. The cell is changed in such a way that it is identical to a fetilised egg. This couild very well be impossible,but assume for the sake of argument it is possible. You now say that this cell is not a human, and will never become a human.”

    I said no such thing, nor will I say such a thing in the future. Again, the distinction is not a matter of size or number of or type of cells but a complete organism vs part of an organism. Assuming such a thing becomes possible ath the moment such a cell becomes identical to a fertilized egg it becomes a complete human organism no different than the case of natural identical twins aside from the fact that technology has allowed the deliberate creation of such a twin separated in time from the original.

  28. Dr. Briggs,
    Despite all the discussion above on protoplasm, you are to be commended for turning away from this paycheck for personal moral reasons.

  29. Sander van der Wal

    10 February 2013 at 2:29 am

    Nothing wrong with examining one’s ethics in currently hypothetical situations and see how robust these particular ethics are.

    Having established that a fetus is a human, and therefore has the same rights as a human outside the womb, it is time to look at the rights of a human outside the womb. If it is not right to kill humans inside the womb, then it is not right to kill humans outside the womb and vice versa.

    But humans outside the womb can be killed, and are being killed, using ethics to say that is ok to do so. A modern example, civilians being shot at and killed by drones in the War on Terror. Some older examples, the bombings of Rotterdam and Dresden. There are in fact too many examples of people being killed legally who have done nothing to deserve that fate.

    So, why should this be different for unborn humans? You can either kill both kinds for a restricted set of reasons, or kill nobody. Not selectively killing unborn humans and killing born ones, or vice versa is hypocritical. Not killing anybody is not.

  30. Sander van der Wal,

    Your latest post is a mix of straw men, non-sequiturs.

    “Having established that a fetus is a human, and therefore has the same rights as a human outside the womb”

    Non-Sequitur: It is established legal doctrine that minors have fewer rights than adults, so it is no great leap to suppose that the un-born have fewer rights than minors.

    “But humans outside the womb can be killed, and are being killed, using ethics to say that is ok to do so. A modern example, civilians being shot at and killed by drones in the War on Terror. Some older examples, the bombings of Rotterdam and Dresden. There are in fact too many examples of people being killed legally who have done nothing to deserve that fate.”

    Straw Man: No one here has argued in favor of any of these things.

    “So, why should this be different for unborn humans? You can either kill both kinds for a restricted set of reasons, or kill nobody. Not selectively killing unborn humans and killing born ones, or vice versa is hypocritical. Not killing anybody is not.”

    This is a non-sequitur and absurd to boot. There is nothing inherently hypocritical about taking the position that killing an adult is sometimes acceptable (self-defense, capital punishment), but killing the un-born is never OK. Note: this is NOT my own position, I am just pointing out that your claim that this position is some how inherently hypocritical is absurd.

  31. Sander van der Wal

    11 February 2013 at 4:20 am

    @MattS

    But the right to live is the same for minors and adults, and here the argument is that fetuses must have that particular right as well. Legal practice is not the same as doing the right thing, i.e. having a particular ethical standpoint, and legal practice has chaged considerably over the years and centuries, because of ethical considerations. Legal practice at this moment is that killing fetuses is ok in a number of circumstances, so end-of-discussion because of that? Of course not.

    There are different opinions about capital punishment, killing innocent bystanders, killing civilians in war. And there are different opinions about killing fetuses. These different opinions are based on different ethical systems. Using a different ethical system than saying one is using is by definition hypocritical. Now, the argument that killing a fetus is wrong because he is a human being means that killing a human being is wrong. Always. Otherwise the argument makes no sense.

    So, as soon as the argument is made that killing a human being in self defence is ok, the person making both arguments is hypocritical. Note, I am not saying that anybody in particular here is shown to be hypocritical, I am establishing the circumstances undwr which the hypocracy becomes obvious.

    Change the argument to killing fetuses is wrong because they are innocent, they have done nothing wrong. Now, as soon as one argues for the killing of a terrorist leader living in a house where innocents, like children, live, and these innocents will die because of the attack on the terrorist leader, one is hypocritical again. Again, not saying this has happened here.

  32. “So, as soon as the argument is made that killing a human being in self defence is ok, the person making both arguments is hypocritical.”

    You are incorrect that a person making both arguments is necessarily being hypocritical. None of the conditions that make killing an adult morally acceptable can apply to a fetus. Additionally medical conditions that might make terminating a pregnancy acceptable, such as ectopic pregnancy, can not apply to unimplanted IVF embryos.

    “Change the argument to killing fetuses is wrong because they are innocent, they have done nothing wrong. Now, as soon as one argues for the killing of a terrorist leader living in a house where innocents, like children, live, and these innocents will die because of the attack on the terrorist leader, one is hypocritical again. Again, not saying this has happened here.”

    That last sentence is basically an admission that this entire line of argument is a straw man.

  33. Sander van der Wal

    11 February 2013 at 6:50 pm

    @MattS

    My argument is that it is not sufficient for a fetus to be a full human being, to be exempt from being killed. It is an observation that humans beings are being killed for all kinds of reasons. Fetuses are treated as any other human being. Even by the people one would expect to be against killing fetuses, the people who are against capital punishment, for example. Surelynthis is ironic.

    What’s wrong with straw men? Rhetorics has always been a part of philosophy, and our host is no stranger to a bit of rhetorics.

  34. Sander van der Wal,

    The straw man is a logical fallacy and as such is an invalid argument.

    http://www.nizkor.org/features/fallacies/straw-man.html

  35. Sander van der Wal,

    “My argument is that it is not sufficient for a fetus to be a full human being, to be exempt from being killed.”

    It’s a straw man since no one here is arguing that it is. Neither the main article nor any commenter has suggested that fetuses should be exempt from being killed under any and all circumstances.

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