“Family Balancing”
Doctors and patients confront decisions of whether to perform “positive selection”—to choose embryos for various socially desired characteristics—most commonly sex but also deafness and dwarfism. Physicians routinely screen embryos for sex not only to prevent the transmission of serious sex-associated diseases (e.g., autism) but also for “family balancing”—though differing widely in how they define this concept. University-affiliated clinics tend to consult formal external ethics committees about these issues, while free-standing private clinics do not. While many countries explicitly prohibit social sex selection, US providers regularly perform it, raising concerns about a possible “slippery slope” toward eugenics. In the near future, screening for genes associated with other non-medical “desired traits” such as blond hair and blue eyes will probably also be developed and requested. Providers and patients wrestle with whether certain types of embryo selection might restrict a child’s “open future” and ability to make key choices for him- or herself, as well as how to uphold the child’s best interests.