Human rights activists who oppose selective reduction cite selective reduction as discrimination against unborn children on the basis of sex, disability, or birth order. Although this occurs in western nations such as the United States and the United Kingdom, it is particularly prevalent in India, China, or other societies in which girl children are not necessarily favored. Second, third, and/or fourth children (or more) can be expensive in time, attention, and resources – particularly monetary. Such is particularly true with female children.[1] This is a failure of justice. As such, those who support selective reduction question the wisdom of birthing children who will be subjected to abuse and/or societal exclusion.
Sleep and His Half-Brother Death. 1874. John William Waterhouse.
These unwanted children – and their families – can ultimately be susceptible to socioeconomic suffering. In fact, many second children born in China in the era of the “one-child” policy were subjected to a state of non-existence and/or persecution – unable to obtain government IDs, residence permits, employment, healthcare, or services.[2] [3] Most of all, many of these children were robbed of the emotional, psychological, spiritual benefits of being wanted. As genetic technology continues to advance, concerns abound regarding further discrimination against the unborn by selecting for intelligence, or physical characteristics (eye color, hair color).[4]
Utilitarian, rights/autonomy, and justice arguments often justify the use of selective reduction for the physical, psychological, and/or emotional welfare of the mother and unborn child(ren). However, no clear resolution for the morality of selective reduction is evident. As the exact point of origin on life is in dispute, the law is unclear on selective reduction, as well. Acknowledgement of these truths fails to give selective reduction opponents an advantage in their attempt to justify voting against IVF because of the mere possibility that selective reduction may occur subsequent to the procedure. Multi-fetal pregnancy can be a hazardous predicament regardless of steps taken or not taken by physicians to prevent selective reduction.
Dorkina Myrick, MD, PhD, MPP, is a physician-scientist and pathologist trained at the National Institutes of Health. Dr. Myrick also previously served as a Senior Health Policy Advisor on the United States Senate. She obtained her Master of Public Policy degree at the University of Oxford in Oxford, England. Dr. Myrick is currently a JD candidate at the Boston University School of Law.
References:
[1] “Selective abortion.” BBC Ethics Guide. 2014. Online: http://www.bbc.co.uk/ethics/abortion/medical/selective_1.shtml.
[2] “Fighting for identity.” The Economist. Online: http://www.economist.com/news/china/21602257-people-born-outside-family-planning-regulations-are-fighting-obtain-legal-documents-prove. 17 May 2014.
[3] Hui, Ning. “I Was an Illegal Second Child in China.” The Atlantic. http://www.theatlantic.com/china/archive/2013/11/i-was-an-illegal-second-child-in-china/281873/. 26 November 2013.
[4] Rorty, Mary and Pinkerton, Joanne. Elective Fetal Reduction. Journal of Contemporary Health and Policy. Volume 13. Issue 1. Article 7. 1996. https://pdfs.semanticscholar.org/99c4/906a71ada9898fa06f0bc95c2201c9d3b277.pdf.
Reflections and Analysis in Law, Policy and Medicine 