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Analysis

The consequences of son preference and sex-selective abortion in China and other Asian countries

Therese Hesketh, Li Lu and Zhu Wei Xing
CMAJ September 06, 2011 183 (12) 1374-1377; DOI: https://doi.org/10.1503/cmaj.101368
Therese Hesketh
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  • For correspondence: t.hesketh@ich.ucl.ac.uk
Li Lu
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Zhu Wei Xing
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  • "Rethinking the entire question"
    jonathan s. ponesse
    Posted on: 19 October 2011
  • Let's reconsider...
    John Loge
    Posted on: 20 September 2011
  • Gender issues and population dynamics: it is time to act now
    Sergei V. Jargin
    Posted on: 01 April 2011
  • Posted on: (19 October 2011)
    Page navigation anchor for "Rethinking the entire question"
    "Rethinking the entire question"
    • jonathan s. ponesse, developmental pediatric neurologist

    I would like to thank the authors for highlighting the insidious problem of sex-selective abortion, what many would rightly consider the ultimate form of discrimination against women. I am cognizant of the fact that this report was descriptive of the current state of affairs and policy rather than proscriptive in nature; nonetheless, it is a case-study in contemporary relativistic and consequentialist bioethics. The major...

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    I would like to thank the authors for highlighting the insidious problem of sex-selective abortion, what many would rightly consider the ultimate form of discrimination against women. I am cognizant of the fact that this report was descriptive of the current state of affairs and policy rather than proscriptive in nature; nonetheless, it is a case-study in contemporary relativistic and consequentialist bioethics. The majority of this paper deals with describing the motive for sex-selection and the ensuing policy response to change that motive. Claiming that there is a need to differentiate a "proper" family-planning intent from the undesired sex-selection intent is impractical and virtually impossible to achieve, as acknowledged by the authors. However, it also raises the question of whether there is any good reason for targeting any unborn child, whether female or male, of a particular race or health status, etc. As the authors note, tackling the cultural mores surrounding male baby preference is likely more successful. It should also not be surprising to the authors that government-imposed bans or obstetrical society recommendations against the use of ultrasounds for sex-selection purposes will accomplish little. Inexpensive, direct-to-consumer home use genetic tests will proliferate. Many of them will have their accuracy called into question, perhaps lawsuits will result, but that will not likely quell the demand for them.

    Next,the consequences are highlighted and speculated as dire for a society (ie. sex-trafficking, increased violence perpetrated by frustrated young men) or possibly having "positive aspects". This description of the upside of this phenomenon, albeit a minor portion of the paper, conveys a confusing and ironic thread; namely, that once upon a time the right to abortion empowered women but now it does not seem to empower them, yet if we look at it another way it will ultimately end up empowering them (ie. fewer females in the population will lead to enhanced social standing).

    Given what I see as a befuddled attempts to address motive and make sense of consequence, it leads one to wonder why the action of this ethical framework does not receive its due treatment. The action itself, abortion, is barely mentioned as a locus for control or policy change. When we fail to look at the act itself, but only at the intended consequence, however well-intended, there are always unintended consequences. The problem is, as seen in this paper and Maria Hvistendahl's book "Unnatural Selection", is that the underlying pretext for abortion, the individual's right to choose, is sacrosanct. There is little universal outrage at present because of this fact. Society is now, in its unmitigated attachment to abortion on demand, reaping what it has sown. The impact of abortion is being displaced beyond the life ended in the womb and that of the potential mother to a nation's demographic balance sheet. Addressing the morality of abortion in its totality is the only way to save girls.

    * Reference: "The consequences of son preference and sex-selective abortion in China and other Asian countries" (Hesketh et al. CMAJ 183 (12))

    Conflict of Interest:

    None declared

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    Competing Interests: None declared.
  • Posted on: (20 September 2011)
    Page navigation anchor for Let's reconsider...
    Let's reconsider...
    • John Loge, physician

    The article in the September 6/11 CMAJ about Sex-selective abortion in China (and elsewhere) was read with interest. Western societies have long promoted abortion on demand and have insisted that the discussion of reproductive health be kept between a doctor and the patient. We screen for "defects" such as down's syndrome and spina bifida, and taxpayer funds cover the termination of unwanted pregnancies of all sorts. T...

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    The article in the September 6/11 CMAJ about Sex-selective abortion in China (and elsewhere) was read with interest. Western societies have long promoted abortion on demand and have insisted that the discussion of reproductive health be kept between a doctor and the patient. We screen for "defects" such as down's syndrome and spina bifida, and taxpayer funds cover the termination of unwanted pregnancies of all sorts. This philosophy has been extended to the use of medications such as Plan B that are available in pharmacies without a prescription. A mother here in Canada can find out the gender of her unborn child and decide at less than 20 weeks to have an abortion. Western culture has gone to great lengths to make abortion on demand part of medical "rights" around the world. So when a Chinese (or any other nationality) person decides to have an abortion on demand for sex selection, are they not accepting our own culture's philosophy? That is abortion on demand. This sounds like we are reaping what we have sown, and that this is not a Chinese problem, but a world-wide problem. This writer would encourage a reconsideration of the policy of abortion on demand in the first place. Sincerely, John Loge, Bonnyville, Alberta

    Conflict of Interest:

    None declared

    Show Less
    Competing Interests: None declared.
  • Posted on: (1 April 2011)
    Page navigation anchor for Gender issues and population dynamics: it is time to act now
    Gender issues and population dynamics: it is time to act now
    • Sergei V. Jargin, Moscow, Russia

    The distinction between men and women has been one of the key dimensions of population dynamics (Lutz and Samir 2010). In this regard, it has been reported that in China, the population's sex ratio has considerably skewed towards men, partly as a result of illegal sex- selective abortions. A similar phenomenon was reported from India and other countries (Heskethet al., 2011; Torjesen 2010), including the immigrant milieu...

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    The distinction between men and women has been one of the key dimensions of population dynamics (Lutz and Samir 2010). In this regard, it has been reported that in China, the population's sex ratio has considerably skewed towards men, partly as a result of illegal sex- selective abortions. A similar phenomenon was reported from India and other countries (Heskethet al., 2011; Torjesen 2010), including the immigrant milieu (Singh 2010). Note that official census data for China (Lutz and Samir 2010), India and other countries probably underestimate the population size and growth, as it was obviously the case in Russia, where many people even don’t know that the census of 2010 has taken place. Overabundance of men is clearly visible also in the countries receiving many immigrants. Therefore, effective measures should be taken against sex -selective abortions in China and in other countries, because regional overproduction of men has a global repercussion, making it necessary to rethink the role of sexes and of traditional patterns of sexual behaviour. Regrettably, it appears improbable that such measures would be efficient. There were many campaigns in China since the 1940s, which ended with nothing; and the ‘one child policy’ is probably one of them (Lancet 2011). In future, it will be only worse, considering advancing prenatal sex- testing technologies, persistent discrimination against the girl child and son preference in China and other countries (Heskethet al., 2011). Therefore, measures within China must be taken by a powerful international executive. It is time to act now, or it will be too late.

    Grandiose projects could be accomplished by a globalised mankind: construction of irrigation facilities for drought-stricken lands; nuclear, solar, tidal and other power plants to reduce the consumption of fossil fuels (Jargin 2011), which would create work for many people. Not much is required for that: a globalised administration and English as the first or second language for everyone. However, such globalization can be applied only if existing national borders remain barriers to international migrations. Only by concentrating of authority within a powerful international executive, based in the most civilized part of the world, can globalised leadership break the vicious circus of international competition and conflicts and create priorities for addressing overpopulation.

    References

    Hesketh T, Lu L, Xing ZW (2011) The consequences of son preference and sex-selective abortion in China and other Asian countries. CMAJ. Mar 14.

    Jargin SV (2009) Overpopulation and modern ethics. South African Medical Journal, 99, 572–573.

    Jargin SV. (2010) Ethical challenges in an age of overpopulation. South African Medical Journal, 100, 694. Jargin SV. (2011) Chernobyl consequences: obfuscated truth for the common good. Sustainable Energy Resource, 30 March 2011 http://www.energy- resource.co.za/content/energy-resource/ejournal/news-a-articles/press- releases/item/1046-chernobyl-consequences-obfuscated-truth-for-the-common- good.html

    Lancet (2011) The end of the one-child policy in China? Lancet, 377(9770), 968.

    Lutz W, Samir KC (2010) Dimensions of global population projections: what do we know about future population trends and structures? Philosophical Transactions of the Royal Society of London. Series B, Biological Sciences, 365, 2779–2791.

    Singh N, Pripp AH, Brekke T, Stray-Pedersen B (2010) Different sex ratios of children born to Indian and Pakistani immigrants in Norway. BMC Pregnancy Childbirth, 10, 40. Torjesen I (2010) Chinese would resist having larger families if one child policy was relaxed. BMJ, 3;340:c1212 (doi: 10.1136/bmj.c1212).

    Conflict of Interest:

    None declared

    Show Less
    Competing Interests: None declared.
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Canadian Medical Association Journal: 183 (12)
CMAJ
Vol. 183, Issue 12
6 Sep 2011
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The consequences of son preference and sex-selective abortion in China and other Asian countries
Therese Hesketh, Li Lu, Zhu Wei Xing
CMAJ Sep 2011, 183 (12) 1374-1377; DOI: 10.1503/cmaj.101368

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The consequences of son preference and sex-selective abortion in China and other Asian countries
Therese Hesketh, Li Lu, Zhu Wei Xing
CMAJ Sep 2011, 183 (12) 1374-1377; DOI: 10.1503/cmaj.101368
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  • Prevalence and correlates of sex-selective abortions and missing girls in Nepal: evidence from the 2011 Population Census and 2016 Demographic and Health Survey
  • Gender-related differences in care-seeking behaviour for newborns: a systematic review of the evidence in South Asia
  • Determinants of imbalanced sex ratio at birth in Nepal: evidence from secondary analysis of a large hospital-based study and nationally-representative survey data
  • Sex ratios at birth after induced abortion
  • Socially repugnant or the standard of care: Is there a distinction between sex-selective and ability-selective abortion?
  • Socialement repugnant ou norme de soins: Y a-t-il une distinction entre l'avortement selectif en fonction du sexe ou de la capacite?
  • A proposed new international convention supporting the rights of pregnant women and girls and their newborn infants
  • Let us reconsider
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