Why is deciding to abort a baby a legitimate ethical choice but choosing to have a boy is not?

Some groups see the ethical issues in both but some only see the ethical issues in one. It shows that ethics is rife with subjective beliefs and rationalizations, so it can't be government policy. Yet there are efforts to claims such arbitrary lines are an evidence basis for decision-making.

Thomas H. Murray, President Emeritus of The Hastings Center, writes in Science that "preventing a lethal disease is one thing; choosing the traits we desire is quite another." 

Why? If genetic and genomic testing and human-assisted reproduction can provide parents with choices, who gets to make the decision on what choices are legitimate? In America, one of only two civilized countries that allows abortion on demand regardless of the trimester of the pregnancy, it will be difficult to tell mothers they have no choice about the sex or eye color of the baby, they only have choice when it comes to life or death.

One issue is recent public hearings by the United States Food and Drug Administration to consider whether to permit human testing of a new method of assisted reproduction, three person in vitro fertilization – 3-person IVF.

Say a woman has a mitochondrial DNA  mutation that will lead to disease in the baby, which happens about 4,000 times per year. In 3-person IVF, the nuclear material from the egg of a woman with inheritable mitochondrial disease inserted into a healthy egg of a donor whose own nuclear material has been discarded. The baby would carry genetic material from three people — the nuclear DNA of the mother and father, and the mitochondrial DNA of the donor.

This is not without plenty of risks, a variety of safety issues have to be addressed, but it has ethical implications also. 

Fringe religious groups who were opposed to IVF in the first place also object to this - that makes sense. But groups that oppose any restriction on virtually any other aspect of childbirth, including termination for any cause, are also opposed. The United States does not ban abortion on demand in the third trimester, which almost every other country does, but also does not ban sex selection for non-medical purposes, which dozens of other countries do. Abortion rights groups worry that any legal infringement would be a slippery slope to banning abortion. On the other side, the public has had 40 years of being told babies are a choice and see little issue with 3-person IVF, even when the FDA calls it the much scarier mitochondrial manipulation.

mitochondrial manipulation – that would prevent the transmission of certain rare diseases and perhaps address some causes of female infertility. At issue is the safety of the technology, as well as its ethical implications.

Murray writes that the FDA's discussion is the latest development that "tapped into a simmering controversy over what it means to have a child in an era of increasing convergence among genetic, genomic, and reproductive technologies" but if you tell most people what 3-person IVF is and what it is intended to do, almost no one objects to it. Only if you follow up and guide the conversation, by saying parents could manipulate births to not have girls, or some other choice the public has been trained to react negatively to, is the response one of concern.

Those technologies include preimplantation genetic diagnosis (genetic analysis of embryos before implantation via in vitro fertilization) and prenatal screening to detect health problems in the fetus, including the prospects of a blood test of a pregnant woman to screen fetal DNA in her blood. 

"Conflicts over the legal and moral status of embryos and fetuses have discouraged American legislators from proposing sensible regulations, lest they be drawn in to the abortion debate," Murray writes. And the public too. Abortion activists are going to have a hard time taking a public stand limiting choice about fetuses that 'are not people' yet, when they have campaigned since the 1960s that they are not people.

Professional societies have not waited for government to decide their ethics but they naturally have differing guidelines. Ethics is subjective and thus there are "clashing ethical frameworks for thinking about parenthood in the genomic era." 

Murray calls for a national conversation about current and emerging technologies shaping the choices that parents have, beginning with an examination by the U.S. Presidential Commission for the Study of Bioethical Issues. "It will not be easy to avoid the quicksand of the abortion debate," he writes, "but it would be a great public service to provide a sober assessment of the choices that would-be parents increasingly face, and to encourage a respectful dialogue about the meaning of parenthood and the worth of a child so that parents and children can flourish together.

Citation: Thomas H. Murray, "Stirring the Simmering “Designer Baby” Pot , Science 14 March 2014: 1208-1210. DOI:10.1126/science.1248080