Thursday, January 16, 2003
Session 4: Beyond Therapy:
Controlling Sex of Children
Discussion of Staff Working Paper, "Ethical
Aspects of Sex Control"
CHAIRMAN KASS: While the last let's
see we've got I think Janet and Charles. Well, let me just
remind people this will take a moment. You have your
information about dinner, which is at 6:00, at 1201 F Street,
which is a couple of blocks south and west of here, but walking
distance for sure.
Again, I remind you, these additional materials are for tomorrow.
Professor Merrill's outline for his talk, along with his advance
paper, and then these materials which will help us get started
in the discussion of neuropsychopharmacology and the questions
of social control in the discussion we'll have for ourselves
before the public session.
In this session, we move from sort of general questions of
Beyond Therapy to a particular case of it. The staff, as I
indicated to you, has been working up several of the cases
on which we had expert presentations in the months from
well, actually starting in July, but mostly September, October
The paper that was sent to you, a working paper prepared,
in fact, by Adam Wolfson, primarily, with a little help from
others. Adam, I should say, has been made the full editor
of The Public Interest, and as a result of that assignment
has had to give up his one day a week with us, but let the
record show how much we've appreciated his work for us, and
we hope we can bring him back here simply to sit in and join
But this is a working paper of interest in its own right,
but also of interest as a kind of model for what we might
be doing with some of the others. This one falls somewhat
short by design on the technological side.
We will beef that up in a subsequent draft, but this at least
gives us something to go on and something to talk about. In
the constructive part, part two of the paper, we have a section
on terminology and an argument made as to why we should call
this "sex" rather than "gender", and "control" rather than
We have some discussion about why this might be an instance
where the principle of liberty might run into some limits,
namely that because children are involved and it is their
identity which is at stake, this is not purely a self-regarding
free activity, and also owing to the possible changes in the
sex ratio that there are social effects that might be socially
There are two arguments having to do with the human context,
one following from the fact that this is control of sex, and
the other that is the fact of some choice or control or foreordaining
of a certain important feature of human children, that we
have two discussions in parts three and four of the human
context having to do with the meaning of sexuality as an essential
aspect of identity, and then returning to the questions of
choosing a particular child and how this feeds into matters
of manipulation and parental control, and then finally a section
which is not written, but depends, in fact, upon what the
Council is interested in saying for itself, where the question
of policy is at least raised as to whether or not there's
something on this topic that we'd at least like to flag, whether
as recommendations or more likely as alternatives.
Nothing specified there. It seemed to me that it would be
useful to go around to see what kind of general reactions
one has to this analysis. I think one should know that at
least there are certain winds of change in the assisted reproduction
community, moving in the direction, I think, of favoring the
use of some of these techniques and I was told since the last
meeting that there are quite a number of clinics, especially
out in California, in which they are, in fact, doing this,
using PGD for this purpose already.
The fact that there are already changes in the sex ratio
at birth in this country among certain sub-populations means
that the practice is going on, I suspect, probably more with
sonography and selective abortion than with preimplantation
genetic diagnosis, of which there have been, I think, only
about one thousand births, so that's hardly enough to produce
the kind of skewing that we have seen.
But I think what we should do is try to get some reaction
to a form of presentation and moral analysis, and then see
where Council members are as to whether this is a worrisome
enough matter in which we want to do more than just present
So let me just declare the floor open for substantive comment
first and then policy.
PROF. GEORGE: Yes, Leon, on the subject
of sex selection abortion. Of course, the country has had
a running debate over abortion itself for 35 years or more
now, but my sense is that there's a fairly wide consensus
that sex selection is not a good reason for abortion, and
I believe that there are jurisdictions, I don't know if these
laws are enforced, but there are jurisdictions that at least
prohibit sex selection in cases of late-term abortion.
I might not be right about that. I'm sorry Mary Ann's not
here because she would know right off the top of her head,
but if in fact sonography leading to sex selection abortions
is a significant part of the change in the ratio, then I wonder
if the morality of sex selection abortion really ought to
be front and center in a public debate.
CHAIRMAN KASS: Give me another sentence?
I mean, just elaborate how you'd want to formulate?
PROF. GEORGE: Well, if it's true that there
is a consensus in the country that sex selection whatever
people's views about abortion are that sex selection
is not a legitimate reason for abortion and ought not to be
abortion ought not to be permitted for purposes of sex
selection, then at least the public opinion basis for public
policy in the area, and what that would be, whether at the
national level or at the state level, and exactly how such
laws could be drafted and whether they could be enforced and
so forth would all have to be discussed, but in any event,
the public opinion basis for legislation in the area would
seem to be there.
CHAIRMAN KASS: Does anyone, Rebecca, do
you know is there law on this?
PROF. DRESSER: I know that at least Pennsylvania
has that in their statute, but that wasn't part of the case
that challenged that law because it's not enforced.
The problem, or one problem with these things is that people
can go and say, "I just want this pregnancy ended," or, in
these other situations, "I want PGD for some other reason."
Now it would be more difficult to come up with something
because that's a newer technology, but you don't know what
the true reason is, so it's an enforcement problem.
In the context of diagnosis, I mean, there have been discussions
of prohibiting physicians and genetic counselors from telling
the sex, and that would be a place where you could try to
enforce it and just not pass on the information, but people
have said that's pretty difficult and have had a lot of objections
PROF. GEORGE: Could the medical people
say at what stage in gestation it's possible to give a pretty
clear answer as to whether you've got a boy or a girl?
CHAIRMAN KASS: Sixteen to eighteen weeks,
DR. ROWLEY: It's got to be very much earlier
DR. FOSTER: I think it's much earlier than
that, about 16 to 18 days after
CHAIRMAN KASS: When the tests are done?
DR. ROWLEY: Well, yes, but you can get
fetal cells and do FSH analysis with X and Y probes until
I mean, they're doing chorionic villus at, what, 12
weeks or earlier, so that it's
DR. FOSTER: Yes, I misinterpreted the question.
We know phenotypically about the 16th or 18th day what's going
to happen. You remember that if the gonads are removed, that
the phenotypic development is female.
So what makes a male is when the testes develops and injects
testosterone, and then there is the Mullerian ducts in the
female apparatus then is atrophied, and the male duct system
goes on, the testes have to move down to the inguinal region,
all that sort of stuff.
But remember that what you get if you have no gonads is a
phenotypic female with a short, blind-ending vagina. There's
no reproductive capacity there. If it's an XY, you know, if
you know that it genetically, as Janet was saying, is a male,
it's an XY, we know that, let's say, from a biopsy or whatever,
but if you remove the testes, then both the male and the female
develop in the same way phenotypically, and that's known,
if I'm not mistaken, at about the I think the testes
kicks in about 16 to 18 days, something like that.
So what you get, it's a good argument for that the universe
really wanted only women, but then it got frustrated from
there. So you know the genetics immediately, whether it's
an XX or an XY if you tested for it, but you don't know phenotypically,
even if you're an XY, something can happen, and that may be
because you don't make any testosterone or the testosterone
The classic example is what's called testicular feminization,
that you go ahead and get the testes, but the receptor for
the testosterone is totally resistant to the action, and so
what you get is generally voluptuous females, they have heavy
breast development and they have short, blind-ending vaginas.
They characteristically, in the full-blown state, have no
sexual hair at all. There's no axillary hair or pubic hair
and so forth. It's a very, you know, the wife of the Shah
of Iran was a testicular feminization.
Kim Novak was a well-known testicular feminization. Males
who appear we had the head of a convent who, it was
discovered, was XY and it was a huge problem for her to have
to deal with, she says, you know, I mean I'm a woman, but
I mean, genetically I'm a man.
So that's the way the problem works.
PROF. GEORGE: What I was wondering is is
the procedure that Janet described routine, and how invasive
would it be? My understanding is that sonography is now routine
and it's minimally invasive, but I take it that you can determine
sex by sonography only much later than by the technique that
DR. ROWLEY: That's my impression.
CHAIRMAN KASS: Bill Hurlbut.
DR. HURLBUT: What you're asking is when
can you see it on a sonogram. There are more invasive methods
like amniocentesis and chorionic villus sampling, where you
have to look at the cells, but you're saying when's it real
easy to see, cheap and quick.
Well, with a sonogram there's a time at which you just can't
resolve close enough, and I think that a figure for when you
can detect sex is around 12 weeks.
DR. ROWLEY: On sonography?
DR. HURLBUT: On sonography. It's later
PROF. GEORGE: Well, the reason I think
it would be good to know is that if we can agree that sex
selection, whatever people think about abortion generally,
that sex selection abortion late in term is not ethical and
ought not to be well, at least ought to be discouraged
at a minimum, it seems to me that then you might be able to
think about public policies that would, minimally at least,
discourage that ground for feticide.
DR. ROWLEY: Well, let me just follow up
on this. It seems to me that for couples who intend to have
only, say, male children, they certainly would use one of
the more invasive techniques that can determine this very
much earlier, and there's talk of trying to get fetal cells
from the uterus much earlier where you then could determine
There are also techniques that are being used by some clinics
looking at the shedding of fetal cells in the maternal circulation,
and looking for XY cells just in the blood of the mother.
There are certain problems with that, and to my understanding
this is an area I'm pretty much not well-informed on,
but there are if a mother has been pregnant before with
a male child, there can be residual cells from that male child
still circulating some time after the child has been delivered,
so that can be a confounding factor.
At least that's my impression, but the most reliable way
would be to actually go in and do some kind of a biopsy and
as Dr. Opitz, who I guess isn't here, could probably give
us a far more informed statement than I'm going to make.
As he indicated, some cells in the placenta are of fetal
origin, so that you would be able to, with biopsies properly
done, to get fetal tissue without actually doing anything
deleterious to the fetus.
CHAIRMAN KASS: Rebecca, please.
PROF. DRESSER: This is not on this direct
point. Is that all right?
CHAIRMAN KASS: Please.
PROF. DRESSER: Okay. I think this paper
is definitely something to work with. I had two broad points
I guess. I would like to see something in here which, in fact,
ties into the previous discussion on enhancement, whatever
it is, which is talking about this as a practice of medicine
and whether it fits professional integrity ideas about this,
what's appropriate for medicine to do.
I think if we want to say anything about public policy, professional
standards and what insurance should cover and all those kinds
of things would be tied into that theme, and that also might
be something that some people would find more persuasive than
some other things.
So I would like to see more of that. The other thing is I
do not like it that people want to do this, but at the end
of the day, as I finish reading this paper, and I don't know
that this will ever exist, but say there were a completely
safe system of sperm sorting, and reasonably accurate, so
that we would say, if the FDA were regulating it, if it's
effective enough, and people wanted it for non-discriminatory
Now we could talk about what qualifies there, but you know,
they have a girl and now they want a boy, whatever. It's hard
for me to say those parents are immoral in what they want
It's easier for me to say it's wrong for physicians to offer
it or physicians to use their skills and talents and the resources
that they have and what we've invested in their training and
so forth to perform this, but I still find it difficult to
say, you know, I can say I don't think it's ethical, I don't
approve of it, I don't like it, I wish you didn't want to
I think it's misguided, but to say it's immoral, I'd like
to hear some views on that.
CHAIRMAN KASS: Actually, could I try you
on the other half? Maybe it would help us if you could say
why you don't think they should do it or why they're misguided.
That might be sufficient unto the day.
PROF. DRESSER: Yes. Well, I find it
I think that most people when they say they want a boy or
a girl, and let's say outside of a certain cultural tradition
or religious belief, they're saying that because they think,
well, there's a certain relationship I want to have with my
child, or certain hopes, aspirations I have for my child,
and I'll only be able to have those if it's this particular
I think that's sad. I think it's confining for the child.
I think it's confining for the parent. I think it would not
necessarily promote a good relationship, and I guess that's
this common sense, my basic problem with it.
CHAIRMAN KASS: Would someone join Rebecca
before we move away and let's just pursue this question. Alfonso,
DR. GÓMEZ-LOBO: Yes, on the moral
point, of course any moral judgment needs a broader story,
a broader context I think. So let me provide a little bit
On the one hand, there's this consideration that was brought
forth by Frank, that a singular act or an act of a particular
person may have ramifications for the community, for the whole,
and that's very worrisome in this case.
So that would be a consideration that we should in our choices
consider how we're going to affect the common good when we
choose. Now, when we come to the particular level, the level
of the personal choices, I don't think we can do away totally
in this case with the prejudice against women.
I think that it's fairly clear that in those places where
sex control is practiced, it's clearly anti-feminist biased.
Now, but the broader context I think is this.
I think one can argue that not all desires ought to be fulfilled.
In other words, we have desires for things good, and they're
legitimate, and sometimes we have desires for things that
are bad, and those are the ones that if we heed to, we would
consider the act immoral.
My basic intuition here, for whatever it's worth, is that
there's nothing wrong with having a family, as I do, with
more daughters than sons, for instance.
There's no human good imperiled by having more children of
one sex or the of the other sex. The human good of the family
does not depend on that, so I'm inclined to say that any motivation
to make this choice, whether by immoral means such as abortion,
or by perhaps permissible means like sperm selection
sorting, sperm sorting.
Still, there is something about a human desire to aim at
a good, which really is apparent, because a family with girls
will be fine. Now, there is the cultural problem, of course,
namely those societies which are strongly biased against girls.
But of course, as a moral philosopher I would have to say,
well, so much worse for the culture. I mean, there has to
be something of a hopefully a realization that there's
something deeply wrong in what they're doing, particularly
if they end up having these skewed ratios.
There surely has to be some reflection about the morality
of the actions that lead them to this quandary.
CHAIRMAN KASS: Could I just ask Alfonso
a question? The social argument and the sexist argument are
clear, but I thought the other argument was incomplete.
If you said there's nothing wrong with having a family that's
mixed, the question is would there be something wrong with
determining to have a family, assuming for the moment that,
let's say, one chose to have a family of all girls, and that
it didn't contribute to some in other words, the fact
that this is not necessary to achieve a human good doesn't
necessarily mean that the attempt to use it is worse than
neutral, let met say.
So, do you think this is worse than neutral?
DR. GÓMEZ-LOBO: I see the problem.
As I was explaining it, I suddenly saw the objection in my
mind. I think Let me think about it for a day or two,
because I think there must be a problem with that.
Otherwise, well, I would have to fall back on the impact
on the social good, and say, well, maybe it is legitimate
for me personally to do this, but on balance, you see, the
community may suffer if there is generalized sex selection
PROF. SANDEL: But falling back on the social
good isn't going to help you in this case, because in the
United States so far, both in the use of this micro sort sperm
sorting and in surveys, people actually go more for girls
than for boys.
So that won't necessarily give you grounds for opposing this
if you want to oppose it. You're going to need an affirmative
CHAIRMAN KASS: And by the way, for what
it's worth, the working paper has a couple such arguments.
I mean, in sections three and four, which perhaps they might
maybe they didn't strike you as
DR. GÓMEZ-LOBO: May I make a different
sort of cultural remark. There is this footnote on page 22
which I found interesting, which talks about the advantage
that can arise for women from the skewed ratio.
I've heard that it's already happening in India, that they're
switching from dowries to bride money. Namely that now, instead
of the family of the bride having to pay the groom, families
of boys go out there and pay families.
Culturally, this is just a particular thing of mine, it's
interesting because in the ancient Mediterranean in the second
millennium B.C. in archaic pre-history there's a switch from
bride money to dowries, and it's unaccounted for.
There isn't an adequate explanation, and maybe this provides
CHAIRMAN KASS: Small thing on this?
DR. HURLBUT: Yes, it's important to recognize
that that isn't necessarily a salutary transition, because
it has been noted that when women are scarce they become chattel,
a kind of chattel, and well, you get it.
Just one little comment to this too. It would be natural
if it's a balancing act, if you were trying to balance your
family to have a higher skewing of choice for girls, because
there's a natural higher birth rate among males.
Do you see what I mean? 105 to 100, I don't think it's quite
that high, but that's yes, in the paper it says 105,
but I think that's
CHAIRMAN KASS: Up to 105 I think is regarded
DR. HURLBUT: But you get my point?
CHAIRMAN KASS: I think we're going to have
a small bit of piggybacking here. There are two people waiting
here, but Frank this is something on this last comment? Please,
PROF. FUKUYAMA: Well, I just think all
the evidence shows that actually a sex ratio skewed against
women is good for women, and it promotes actually a lot of
social values that people like when you put women in the driver's
seat in marriage markets.
CHAIRMAN KASS: Like large gangs of unmarried
PROF. FUKUYAMA: No, that's not, but in
terms of stability of family life and a lot of other things.
CHAIRMAN KASS: I have Janet and then Gil.
DR. ROWLEY: Well, I sort of echo Rebecca's
sense of caution here, because I think similar to the discussions
that we had earlier about your paper, that it very much has
to be looked at in the context of the particular situation,
and I can see why a family where, say, there are already two
children of one sex might strongly consider trying to increase
the likelihood of having a child of the opposite sex, so that
you really get mixing within the family of boys and girls,
and they learn to grow up together.
So I think that, as I say, we do have to look at the context.
CHAIRMAN KASS: Janet let me ask you this.
I mean, it's also conceivable to me that some family with,
let's say, three boys or four thought for its own good or
bad reasons that if you had five you would have a basketball
team, and that the choice might not be for its own personal
reasons for one of the opposite, but for another like.
The question is are we in a position, if we sort of relativize
this to people's circumstances, to sit in judgment and say
balancing, that's okay. More of the same, that's suspect.
Or do you want to say, well, look, who are we to judge the
parents and their own circumstances. They probably have their
own good reasons for liking what they like.
Are we going to be able to or is each case absolutely
going to be different and there are no going to be general
principles? I mean
DR. ROWLEY: Well, I'm the mother of four
boys and I have to say that the lack of a daughter hasn't
been a great tragedy for me because my sons are marvelous,
but at the same time, I certainly would have liked to have
had a girl.
I think this is an area we should leave alone.
CHAIRMAN KASS: Leave alone meaning leave
DR. ROWLEY: Leave it unregulated.
CHAIRMAN KASS: Gil.
PROF. MEILAENDER: Brother of five sisters.
PROF. MEILAENDER: It can be tough at times.
I want to come back to Rebecca's point also, because I think
she has articulated a kind of concern that many people have
here, and I want to make just a very simple point with respect
to it, and that is that whatever we think the complex relation
between law and morality is, it may be useful when we're thinking
about these matters to keep them a little separate and to
start by thinking about morality.
In other words, I wonder, Rebecca, and I certainly don't
wish to put words into your mouth, or thoughts into your mind,
but the kinds of hesitations that you expressed I think we
feel most strongly if what we're thinking we mean when we
say, "It's wrong," is and maybe we should publicly prohibit
you from doing it, or something like that.
We get very cautious at that point. If you think of a good
friend talking to you and asking you, `Do you think I should
do this?' it has a different flavor.
Now even there, I might distinguish between saying to a friend,
`Oh, I don't know if I think that's wise,' and saying, `I
think it's wrong,' but there certainly are many occasions,
and this might well be one of them, in which I could conceive
of myself saying to a friend, `No, I think it would be wrong
of you to do that,' without necessarily making a judgment
about what I'd want to say if somebody wanted to transpose
that into law.
So it just seems to me that it may be useful for us if we
want to make any progress to think first of all about just
what do we think about this as a moral practice without thinking
that that rushes any conclusion about what a policy might
I mean, I like the fact that the policy section was blank
there, and the kind of what I take to be the principle argument,
well the negative externality argument's one, but the other
principle argument put forward, which has to do with the issue
of control, and the way that has an effect on the relation
between parents and children may be best thought about first
as a moral argument, whatever one does or does not then conclude
about possible policy options.
CHAIRMAN KASS: Having the floor and having,
I think, wisely encouraged us, and by the way I second this
completely. There's talk about prohibition, and getting in
the way of this is not on the docket here, but having sort
of steered us in this direction, would you offer a moral judgment
on this, either responding to Rebecca or to Alfonso and to
see if we can move the ball forward.
PROF. MEILAENDER: You want me to say something
stronger than just, "It's not wise." You want me to offer
CHAIRMAN KASS: Or just
PROF. MEILAENDER: Well, I'd be happy to,
and I think, in fact, that one of the interesting things about
there are several interesting things about the argument
presented in the draft.
One is that it takes seriously the importance of sexuality,
over against those discussions of it being a non-essential
characteristic and so forth.
The other is that what I take the argument developed most
fully in it, actually brings us back to some things that we
talked about and, in fact, wrote about in the cloning document,
namely the sense in which too strong an attempt to control
the characteristics of the next generation distorts the relation
between those two generations; sort of undercuts some of the
chief parental virtues and I think that that's morally very
problematic, and I can conceive of myself in many circumstances
being willing to use the "wrong" word.
CHAIRMAN KASS: What if one were to say,
Gil, granted that sexuality is an important aspect of one's
identity. I'm not sure it's the most important, but it's certainly
But after all, they're really basically, leaving aside some
minor variations, you're either X or Y, and it's not quite
like entering into the control of all kinds of other things.
What's the big deal really in terms of the kind of control?
I mean, it is an element of control, I grant that, but couldn't
one say that simply sort of controlling something that's going
to be there anyhow one way or the other, it's not all that
I mean, what would you say?
PROF. MEILAENDER: You don't think it matters
that you're male rather than female to the you that you are?
CHAIRMAN KASS: No, I think it does. Sure.
PROF. MEILAENDER: I mean, every cell of
your body is marked by that. It's impossible to conceive of
your being the person you are were it not for that, so I guess
I don't I mean, unless I'm missing something, I don't
understand why you would suggest that it's a trivial matter.
I mean, all the other sorts of things that people have the
ability to get worried about. You're going to have an IQ too,
you know, and some people think it would be nice to have it
be 140 rather than 120.
So I guess I don't see the nature of the argument. Yes,
presumably you're going to have a sex, but that doesn't make
it an unimportant matter. It still may be something that marks
and constitutes the person that you are.
CHAIRMAN KASS: Let me think about it some
more. Robby? Bill May?
DR. MAY: I think the word that you used,
Rebecca, earlier was "immoral." Hardly, however hard Gil would
argue, would not seem to be immoral in the way that pedophilia
would be viewed as immoral, and so forth.
I, unfortunately, picked this up very late, and so I have
only skimmed it, and maybe it does deal with this problem,
but an interesting issue if it can be done for this reason,
to what degree it presents interesting problems, not simply
in one's understanding of parenting, but the relationship
of the man and woman to one another as one.
As things stand now, you tend to we've decided to have
a child, and a kind of openness to the unelected element in
that, and if it can be subjected to control, that control
spills over in a problem not simply in the relationship with
the parent to the child, but maybe some elements of forcing
in the relationship of the mates to one another, not that
the dominant mate would necessarily win out.
But it does create an interesting problem in the conjugal
relationship that is not quite there in a setting where this
is not viewed as an acceptable reason for eliminating of the
gender, the sex, you don't want.
PROF. GEORGE: Yes, I certainly think that
is a very good point, and something really to be considered.
I'd like to make two separate points. The first is the subject
matter of public policy isn't always prohibition or permission.
Often it has to do with other matters. For example, quite
apart from the question of whether any particular technology
for sex control is to be prohibited or permitted, there's
the question of whether insurance coverage for it will have
to be provided by employers, whether employers who are morally
opposed to it would have an exemption from any mandatory coverage.
Recent history suggests in a lot of cases where you have
a controversial question, an argument for permitting the practice
might begin as an argument for liberty, saying well we have
disagreements in this culture about the controversial practice
Let's just leave it up to individuals and not impose any
societal judgment. Then, a few years go along, and what was
considered an evil that has to be tolerated seems to be transformed
culturally into something that's accepted as a good, and something,
then, that has to be paid for with public funds, and perhaps
imposed on dissenters who, as a matter of moral judgment,
don't wish to pay for it or pay for insurance coverage for
it, but who are now considered to be behaving wrongfully in
resisting, implicating themselves in the practice.
So I don't think we can escape, even if we lay aside the
question of prohibition, I don't think that we can escape
public policy questions on an issue like this.
Public policy questions which will have to be grounded, ineluctably
I would say, in a moral judgment one way or another. Then
the second point is this.
It seems to me the heart of the argument here is the control
argument as it's put forth in the paper, sketched at least
in the paper, page 25, section D, the point about sex control
challenging the fundamental understanding of procreation and
I think that's right. Leon, in his devil's advocate role,
raises the question about, well what's the big deal about
this element. I think the use of the term "element" there
Looked at simply in abstraction from the rest of what's going
on in procreation and child-bearing as it's practiced in the
culture, looked at in abstraction, yes, it doesn't seem like
such a big deal, but as an element of a larger pattern, really
a movement of procreation in the direction of being treated
as a kind of manufacture, the child being the product at the
end of the manufacturing process, I think it's a ground for
a very serious concern.
Here again, to harken back to a point that I made in an earlier
discussion, here I think we have an example of something that
simply cannot, at the end of the day, be left to individual
choice, because the character of that fundamental understanding
of procreation and parenthood that's going to affect everybody
in the culture, the character of that is going to be shaped
by a lot of individual decisions adding up to a large cultural
understanding which then in turn affects the decisions that
people make, and even the options that they have as they're
constrained by informal matters and by formal constraints
such as law and public policy.
Now, what that understanding is going to be, then, really
is a social decision. It doesn't mean that public policy is
the only way to address that cultural understanding, and to
try to shape and affect it for what one considers to be good,
but it does mean that we can't simply satisfy ourselves to
think that, well, look, this is a matter of individual decision
and people can simply be left alone to make decisions as they
There will be social consequences of it, not simply in a
kind of concrete, material sense, but perhaps even more importantly
social consequences affecting the large cultural understanding
of what procreation is and whether there's, in fact, a difference
between conceiving of a child as a gift and conceiving of
a child as a product.
It could be that the capacity of future generations to grasp,
to understand children as gifts and not products will be profoundly
affected by decisions that we make today and in the next few
years about what the shape of that cultural understanding
is going to be.
CHAIRMAN KASS: Someone want to respond to
Robby? I mean, Paul is waiting, but do you want to join this
DR. MCHUGH: My comments are a little bit
along that line. On the other hand, I have a lot of sympathy
with what Janet has said. Let me put it this way.
I was my major concerns at first were exactly along
Robby's lines. That is, we're going to affect children
do not just belong to us, they belong to the world, they eventually
become part of the world.
Not only that, even in the family, before they are outside
of the family they affect the community, and I know that and
I've spoken to you before about it, about how recruiting people
to my department, I've discovered I was recruiting families
and the families' children interacted in the community in
most wonderful ways, athletically, academically, and the like.
So, it is really important, and we could change our whole
view, perhaps, of the world if this technology became so dominant.
However, my other concerns and objections to this related
to cultures that were prejudiced against one or the other
sex, and that they expressed this both in relationship to
feticide, but also in infanticide.
We're seeing that right now in China. They are fundamentally
killing girls left and right, and our friends go there and
rescue these little girls out of the mouth of the dragon,
really, and they come here, and that's wonderful.
On the other hand, if we are in a culture in which we appreciate
women and men equally, recognizing their wonderful diversities
and similarities, if we say killing is a behavior that we
won't produce no matter what, in any form we won't kill anybody
to do this, then it seems to me that the argument that Janet
produces is very powerful, that if you have a way of doing
this without killing anybody, but by able to selection through
cellular biological work, that this becomes a gift itself
of our advancing science.
Janet says she's had four boys. Well, in my family we had
a girl and we had five guys, one after another, one set of
wonderful males. Then finally a girl came just a year ago,
and boy was there a celebration. Man, we loved it. It was
a little girly.
It strikes me, well, supposing without killing anybody and
without saying that the boys are better than the girls or
the girls are better than the boys, I haven't made my mind
up, but that's the default position that a kind of a doctor
response to, I suppose, and kind of thinks about, and I'd
like to be argued out of it, but that's what
CHAIRMAN KASS: Let me try. This isn't an
argument, but a test of an intuition on this matter. Would
you like to be responsible for the maleness of your son? Right
now you're responsible for having said, along with your spouse,
yes to his existence.
Do you want to be held responsible for whether or not he,
in fact, likes to be a boy and for the particular relations
that you now enter into with him on that basis?
DR. MCHUGH: Well, that would certainly be
problematic for me if I had no offspring. If I were saying
I'm going to manufacture a boy and be responsible for that.
But if my wife had given me several boys, and begged me that
we could have a girl, it's hard to say no to her. She's powerful
anyway. She has this great influence on me. I'd say no to
But at any rate, not just at that, you know, Leon.
CHAIRMAN KASS: Do both of you want to be
responsible for the possibility that the daughter is unhappy
to be one daughter amongst a houseful of men?
DR. MCHUGH: Oh, I think I could handle
that. That would not be I think she could be happy or
unhappy in all kinds of circumstances. I could manage that.
You know, I'm the dad, I can handle that one.
CHAIRMAN KASS: You did this to me, Pop.
I could have been a boy like my brothers.
DR. MCHUGH: I could've been a contender.
Yes, well, as I say, I think I could handle that, and I think
that would be something I'd be happy to talk with her about.
I would be happy to talk with her about what a treasure she
is. Now, since I don't think if it were done at that level,
the kind of level that Janet and I are talking about, I don't
think it would be a big thing in our world.
It would be small. I doubt that it would have huge influences
on ratios and the like. Okay? So if there's no killing going
on, and if we're in a community where we appreciate women
and men alike, and we understand that we are contributing
to the future as members of the community, then the cellular
biological enterprise doesn't sound so bad.
CHAIRMAN KASS: Michael Sandel. Thank you
for your patience, Michael.
PROF. SANDEL: First, I'd like to comment
on one feature of this paper that we haven't discussed, which
is the attempt to shift the term for this practice from sex
selection, which is the common, familiar term, to sex control.
I think that's a mistake. It's a mistake, it seems to me,
because it's a transparent attempt to make it seem to the
American public less attractive. The American public, we know,
is in favor of selection and choice and it's against control.
Control sounds bad, it sounds tyrannical, it sounds authoritarian,
and I think this is a transparent attempt to just rejigger
the term in order to bias the discussion. I don't think we
should do that.
Having said that, I think that sex selection is morally objectionable
and should probably be banned. So here I'm going to try to
bring out the libertarian instincts of Gil, who will rise
up to say why it shouldn't be.
But I agree with Robby, and I don't think that we can get
to the real heart of this question by talking about sex ratios,
because it may well be that the sex ratios would turn out
just fine in the United States with a regime of sperm sorting.
I don't think we can get to the heart of the issue by worrying
about prejudice or discrimination, because prejudice and discrimination
are simply a matter of preferring one over another without
a good reason.
If we're against prejudice at the level of society and a
culture and its prejudice, then why shouldn't we also be worried
about prejudice at the individual level?
If it's preferring one over another without a good reason,
then it's objectionable. Well, then there's no good reason
to support it, but there is a reason, and I think it has to
be the moral account has to be given, but it goes back
to the distinction between a gift and a product regarding
It goes back to the discussions we've had about trying to
characterize, when we've been talking about enhancement in
general, the issue of mastery versus gift.
I think there is no case this, in a way, is the best
case, and may be the most fateful insofar as we're worried
about the attitude of mastery. It's the best and most fateful
case precisely because it needn't involve killing embryos,
so that issue is put to one side, and it needn't involve various
externalities that can trigger utilitarian worries of the
kind that Frank raises, assuming that the sex ratio problem
isn't a problem for the United States, which it might well
So, it's a perfect issue to get at the question, how seriously
do we worry about allowing a new practice that would have
as its point and as its purpose turning child-bearing and
procreation essentially into product selection.
Not for the good of the child, it's nothing to do with health.
The prejudice or the discrimination for healthy over unhealthy
children is a perfectly worthy prejudice or discrimination.
But the health of the child is not involved here at all,
and so it really presents the issue we've been wrestling with
in the enhancement discussions in its pure form, and it seems
to me if we want to insofar as we're bothered by a practice
that will transform our understanding of children and child-bearing
from gift to product, or into objects of our will, here is
The closest example, comparable case, would be allowing a
market, not in organs, but in children. What would be wrong
with buying and selling children, provided we didn't allow
abuse, we didn't allow enslavement, all of those things, but
simply allowing a market in the purchase and sale of children
for the same reason.
Not because we're afraid that the market would place a higher
price on boys reflecting cultural prejudices. That wouldn't
be the fundamental reason. The fundamental reason is that
it would transform the understanding and the practice of having
children and raising children in ways that would, in line
with a lot of tendencies already powerful in our culture,
transform further in the direction of producing a product
or an object of our will.
So on those grounds, since there is no compelling reason
on the other side. There's no compelling reason of health
or of any other kind to allow this kind of technology.
It seems to me it's both morally objectionable, and there
are good grounds to ban it, but we should ban it by calling
it what it is commonly understood to be, sex selection.
In fact, it's important if we're going to ban it to call
it selection and not control so that it's clear that it's
for that reason that we're standing up precisely to the consumerist
aspect of this, rather than saying, "Oh no, this is a kind
of social authoritarian control."
CHAIRMAN KASS: Response to Michael's
a man who's grabbed the bull by the horns and we can now see
where we are.
DR. MCHUGH: Can I get in there, because
that is a wonderful and powerful, but there is I just
want to come back, there is a reason for this alternative,
It wouldn't be done trivially. As I say, I'm working this
out myself. You say this is an example, an expression of our
manufacture, of our control, our enhancement of our family
But isn't that a worthy thing? Shouldn't that weigh a little
bit on the scales, that a family that has three or four girls
might have a boy or three or four boys might have a girl,
and that the you're just really speaking really to the
emotional attitudes of the parents themselves that's so uncalculating
at one level.
They just have a feeling, oh, if only, and I've been in lots
of delivery rooms when disappointment was registered at the
fact that this is the fifth boy, and I don't know, but you
say there's nothing there.
I mean, there is something there. That's all I'm saying.
PROF. SANDEL: But there's a preference
there. I agree there's a preference, but is it a preference
to which we should attribute some moral weight, do you think,
DR. MCHUGH: Well, I'm certainly giving it
emotional weight, and since I spend most of my time telling
people their feelings have too much salience in everything
they're doing, I'm arguing against myself today.
Don't let my patients know that I've said this. Block it
CHAIRMAN KASS: It's on the Internet.
DR. MCHUGH: It's on the Internet, I know,
but I'm just saying that what I'm trying to feel my way along
is this idea that there's a deep, heartfelt sense in both
parents that they would love to have both boys and girls in
their life this way, and that if they could have it, they
pray for it, they hope for it.
Having a boy and a girl is called the King's Blessing. So
PROF. SANDEL: But then why do you shrink,
Paul, from the case from the preferences that people have
as a result of what you call social and cultural prejudice?
Why not give way to their preferences too? They have a heartfelt
DR. MCHUGH: Well, I think that those social
preferences, those heartfelt desires are aspects of a culture
that needs improvement.
CHAIRMAN KASS: Careful.
DR. MCHUGH: Yes, I know it's dangerous,
PROF. SANDEL: What I'm suggesting is that
our culture needs improvement, too, our consumer culture.
DR. MCHUGH: Yes, yes, I hear you, sir.
CHAIRMAN KASS: Robby.
PROF. GEORGE: Paul, I think you get to
where you're getting precisely by abstraction, by taking this
one element out of a larger picture and abstracted from that
larger picture it looks relatively trivial, but you have to
see it in context.
This kind of social analysis requires that each element of
a larger picture be analyzed in relation to the other elements.
I think we should ask ourselves why the killing?
Why would anybody destroy a perfectly healthy female fetus?
Apparently a not insignificant number of people are prepared
to do that. Why would they kill a perfectly healthy female
Some people are apparently prepared to do that. I think that
manifests, it reflects, it's a consequence of our failure
to maintain a cultural structure, a public understanding of
the child as a gift, precisely as a gift.
What happens when you start to treat something as a product,
whatever it is? You apply quality controls. When the products
don't measure up, the controls have to be put into place.
You throw out what didn't measure up and you make new ones
that are better. So I think we're already pretty far down
the line here. I mean, the cultural understanding has already
been eroded to the point where these things can happen.
I'm not quite sure how we correct it or rectify it, but I
certainly think that we have to see it in context as contributing
to an attitude that we really should be trying to overcome.
CHAIRMAN KASS: Paul did stipulate for the
record that he wanted he was willing to countenance
this only if there was no killing; that this was just the
micro sort technique. But you want to say that that's of a
piece with these other things?
PROF. GEORGE: Yes, let me say this very
carefully, because I realize that Paul proposed no killing
prenatally, post-natally, no killing of any sort.
CHAIRMAN KASS: I want to make sure we clarify
PROF. GEORGE: No, my problem is not to
focus on the particular case, whether it's killing or just
sex selection that doesn't involve killing. But to look at
the role of sex selection as an element in a general attitude
which licenses the designing of children, that sex selection
is just one part.
If we look at that attitude, why would we think that attitude
is a bad thing? What are the consequences of that attitude?
Now let's shift the focus back a little bit and look at something
that we know is going on already, and is responsible for some
imbalance already, and that is killing in the cause of sex
Now how can that be? Babies are cute, and ordinarily, a healthy
baby, we can't say we're doing an intervention of any kind
for the baby in this case, because the baby's perfectly healthy.
How can it be happening? Well, it's because, I think, people
are already tending to see procreation as the manufacture
of a product, and if I don't get what I bargained for, if
I'm getting a boy when I wanted a girl, a girl when I wanted
a boy, then it's okay to apply the quality controls, shut
that one down and redo the process and get what I want.
DR. MCHUGH: These are very powerful arguments,
and I'm digesting them, and I appreciate just exactly what
you're saying, that this kind of commodification and manufacture
can be a problem.
On the other hand, I think Janet and I together, Janet help
me out, are just saying, gee, leave it alone for awhile. See
whether in fact it does have the corrupting influence that
we have, or whether that we can anticipate, which, I hear
your arguments very strongly, Robby, on how it could lead
us into all these other things.
On the other hand, it's new, a new world, it's new opportunities.
Leaving it alone might give us a better picture, just like
maybe we got a better picture with IVF or something of that
I'm Listen I'm on thin ice out here fellows.
PROF. GEORGE: If I could continue
CHAIRMAN KASS: The trouble is when you get
on thin ice, you like to stay there. We've got to be very
DR. ROWLEY: Let me just make a few comments
here, and I think that we do have to recognize that we are
discussing things in the context of the practice in the United
States, and I think that it's true that as we watch certain
practices elsewhere, one worries whether they might become
more common here.
I think we do have different cultural values. We aren't an
agrarian society dependent on sons to till the fields and
so that some of those pressures that lead to sex selection
elsewhere are not really so are not pressing here.
I think we also have to have a certain humility ourselves
on what our role either on the Council is or trying to set
rules and regulations that can affect individuals in ways
that we may not foresee.
So we're not God, and I think that we have to, as I say,
have a certain sense of humility about what our role is. That's,
I guess, part of my reason for saying that I'm not sure that
this is of sufficient public urgency now that we need to make
a judgment, and I agree with Paul, obviously, in the sense
that to tell a family that they cannot make a choice if it
were available for them to make the choice, and again, I agree
with Paul, that it's certainly preferable to do this with
no killing involved.
For us to say to a family you cannot do it because you are
engaged in immoral behavior, I think is very dangerous ground
for us to be on, and I commented at lunch time to John Opitz
that I thought that his slide from "Non Sequitur" was really
One sign, "The facts as they are, the truth as I see it,"
and I think that a lot of what we're discussing now is the
truth as I see it, and I think I'm reluctant to move ahead
with that as the basis.
CHAIRMAN KASS: Gil.
PROF. MEILAENDER: This is just a small
question, Michael, with respect to what you were willing to
ban, and I mean, you understand that I, of course, am quite
sympathetic to the moral argument you put forward, but I just
found myself thinking about the kind of case that someone
will raise, and let's suppose we're just talking about sperm
sorting techniques to accomplish this, and you said it's morally
objectionable and I'd be prepared to ban it.
Somebody's going to say to you, what about people who want
to do this because the mother carries an X-linked recessive
disorder, and they want to avoid having a son who has it.
Now somebody's going to ask you that question, which, you
know, what are you going to say? Are you going to say, no,
if we ban it, we ban it, or are you going to say, I'm going
to begin to distinguish between circumstances in which I guarantee
myself that they are doing this for the morally objectionable
reasons, which I don't disagree with you about.
How are you going to deal with that sort of question?
PROF. SANDEL: I think I would try to make
those distinctions. Where it's for a matter of health I would
PROF. GEORGE: I would say that a scheme
that did permit it in those kinds of circumstances where health
was the concern would substantially alleviate concerns I have
about the impact on the public culture and public understanding
So it seems to me if that's what our fundamental concern
is, then it wouldn't necessarily have to be an absolute ban.
The ban would be on sex selection as a simple matter of preference.
DR. ROWLEY: And are you going to make this
a criminal offense?
PROF. GEORGE: Do you think that baby-selling
should be a criminal offense?
DR. ROWLEY: That's a totally different
issue. You know, we went through this in the cloning of the
slippery slope. Unfortunately, it was Jim Wilson who said,
you know, that's not an appropriate argument.
So that's a totally different problem, and I think shouldn't
cloud the issue.
PROF. GEORGE: No, it's not a different
problem. It's not a question of the slippery slope, it's a
question of the principle. Do we have a principle that children
are not commodities that can be treated as products?
That's where the similarity is.
DR. ROWLEY: Well, I, you see, I don't think
that that's so. I think that to give parents a choice of the
sex of their children is not to turn that child into a commodity.
PROF. GEORGE: Okay, we have a disagreement
about that particular point, but
DR. ROWLEY: So this is the "I think, and
the facts are."
PROF. GEORGE: Well, but let's stay with
baby-selling for a moment. We can certainly imagine, Judge
Posner has argued in the Wall Street Journal in defense of
a scheme of baby-selling.
We can certainly imagine circumstances in which an individual
couple who wanted a baby of a particular description and could
not obtain that baby by adoption except by purchasing that
baby, perhaps a purchase in a foreign country of that baby,
could bring that baby to the United States and raise that
baby in circumstances that are far superior to what that baby
might be experiencing in his home country.
So the situation for the baby is much improved, and the parents
get what they want. Now I would argue that there's still a
moral reason, although neither the parent nor the child is
harmed in that case, there's still a moral reason having to
do with the impact on the public culture of baby-selling for
prohibiting the baby-selling.
DR. ROWLEY: Now how do you distinguish
that from individuals who go to China or to the Ukraine and
elsewhere to adopt children?
PROF. GEORGE: In the one case, children
are being purchased. In the other case, they're not.
DR. ROWLEY: And you're so sure that there
is no money when children are being adopted from China?
PROF. GEORGE: You're asking me whether
I'm sure of the question of empirical fact of whether money's
DR. ROWLEY: Yes.
PROF. GEORGE: I don't know, but if money
is changing hands, then I think that an immoral transaction
has taken place. I wonder if you agree with me.
DR. ROWLEY: I don't think it's that simple.
I think that for individuals whom I know, and I have no idea
whether they paid or not, though maybe as I think about it
more, I'd be surprised if orphanages were just giving children
away without some kind of remuneration.
But I have no idea about this, but if parents cannot have
children, and there are children elsewhere whom nobody wants,
and most often in China they are girls that are being offered
for adoption, I guess I have a hard time seeing that parents
should not be able to offer a child a good home and a good
life, that that's morally objectionable.
PROF. GEORGE: Well, the question is not
whether it's objectionable to offer a child a good life; the
question is whether it's objectionable to buy the child.
DR. ROWLEY: And I'm saying I just wonder
whether, in fact, this practice which certainly some individuals
are applauding because it has unwanted children now with good
homes, whether I'm asking the question. Whether money
changes hands or not.
I guess I'm not I hear I guess I'm willing to
say that the ends of parents who want a child and a child
who has no home, getting them together, if some part of that
involves the exchange of money, I guess I'm willing to say
that the ends justify the means.
PROF. GEORGE: Well, that was my only point,
that these two cases are on a parallel.
DR. ROWLEY: Well
PROF. GEORGE: I think that should be your
position if you have the position you have in the other case.
DR. FOSTER: I really had no intent to say
anything this afternoon, but let me since there's a
lot of discussion going around, and I don't want to get into
I think that there are situations where there could be exchange
of funds for a child that were no direct payments for the
child. I mean, for example the number one adoption agency
in Dallas, Texas, there is a payment to keep them going.
Let's suppose there was an orphanage in Russia or something
that you didn't pay a family, but because they're protecting
things. I think to make I solely that dollars have changed
hands is not either moral or immoral, it depends on how it
My philosophy throughout all of this, I just want to make
two points, has always been, I guess, from a person who's
a physician, an academic physician, is that I'm very much
in favor of things that prevent premature death and help in
terms of disease.
I thought that that is the reason that I strongly favored
what the Council in general said was a lesser good, that is
to use cloning for the obtaining of stem cells, and to study
this to find out if we could substitute adult cells or whatever,
but not put it into a moratorium where we don't get the answer
I felt strongly about that, and I do still feel strongly
about that, even though I know that there may be problems
there. That issue, and all of us, if we had a fair hearing
about that, but that's a momentous issue and was a momentous
report, however it came out.
I mean, to decide whether you're going to clone to make babies
is a momentous issue that forces any council that has an ethical
or moral component to act on.
That's the case. Now my own personal view is more in view
of what we were talking about at lunch today, that I guess
Daniel Callahan calls the sacro-symbiotic approach to life
and nature, instead of the power-plasticity model, where that
everything you could do that you do.
I personally would be most comfortable with the whole idea
of letting nature be nature, and in a sense that's why I'm
pretty much against some of the aspects of enhancement that
we're talking about.
I mean, I never cared whether I ended up with three boys,
but I didn't care about that. I mean, I just think that in
general, we ought to be satisfied with those things that are
normal and natural and have always been a happy part of life,
and then try to change those things that have been negative
in life, disease and so forth.
Having said that, I think there could be a perfectly innocent
thing to want to have a boy or a girl, and if there is ways
that somebody could do that, I'm not sure that I would object
to that as a general rule of an ethical problem, but what
I can say in my view is that it is a trivial ethical problem
at this point, and therefore puts us in danger of the concept
of taking on things that are not momentous.
I would say that pharmacologic enhancement things, those
are at least quasi-momentous, but the cloning thing was truly
momentous, and I think we ought to limit our ethical recommendations
to those things which are serious and are on even if
they have potential wrong.
So in this case, I might be, whereas I objected to the moratorium
in the first place, because I thought it kept us from answering
the question that all of us really wanted to know and where
we could've gotten out of any problem of making embryos if
it showed that the adult cells and so forth work and so forth.
Here I would be willing to have, as Janet and I hope
I'm not getting your cold, Robby. I'm just kidding. I'd be
willing at this point, in fact, I would strongly say that
this ought to be an issue of moratorium and keep an eye on
things that's going on.
If we began to see sex ratios coming up, then I think we
ought to hop into it very fast, if we still exist, to do something
about it. But I'm worried about having this constellation
of bright people and so forth being labeled in some sense
with not taking care of what I think is a more serious problem
of commodification of organs, things of that sort.
So my simple point is that I prefer nature as it exists when
it's healthy and happy, and see no need to try to make it
super-happy, but I am very much in favor, when something goes
wrong in nature, that we try to fix that for the larger good.
So I think I want to weigh in by saying that I think there's
strong reason, despite the potential moral arguments, and
I understand that I mean, I don't like sex selection,
but I'm not saying we ought to ban it at this point.
CHAIRMAN KASS: The hour is late. Let me
make one comment in response to Dan's last, and then to the
rest, just simply see if I can sniff out where we are with
a view to the future on at least this draft.
I would agree, I think, that at least this doesn't
look momentous, I would grant you that. It might be deceptive,
however, in not looking momentous, insofar as people like
Michael or Robby are right in saying the principle here is
established of selection, even if the thing selected seems
relatively, not inconsequential, but relatively innocent.
In fact, it is an issue which the Brits are now, in fact,
having had a stricture against this are now having a public
consultation about it. The American Society of Reproductive
Medicine is, I think, reconsidering its position.
The practice is, I think, on the rise. In the poll that the
Genetics and Public Policy Center over at Hopkins took very
recently, there's a footnote here, one-quarter of American
women and one-third of American men said that they would approve
of this, of use of PGD to determine the sex of the child.
I don't think, by the way, such a statement is worth very
much. I mean, it's one thing to say it to a pollster, and
another thing to actually act upon it when you actually have
to go to the trouble of doing all of that.
I mean, not everybody's going to go have PGD in any case,
but I would at least suggest, because there are really two
questions here, one is the question of the control issue that
has been raised, and the other really is the social consequence
With respect to the second, it certainly seems to me that
the Council could recommend that there be demographic attention
to what is happening in the country, and that there be some
kind of at least monitoring and reporting of the various clinics
that are engaged in this practice, so that we could at least
find out the magnitude of the practice and what it's being
This simply is a matter of keeping abreast of the practice
from the point of view with social consequences. With respect
to the moral argument, it may very well be that the proper
document of a case study here would not be simply one-sidedly
condemnatory, but that one include in here the arguments in
favor as well as the arguments against, and in other words,
to adapt this draft so that the reasons that have been offered
here are, in fact, incorporated, and we'll take this through
another draft and allow people to have their comments.
In the meantime, be thinking about also, in addition to questions
of ban, whether or not this body could exercise some influence,
for example, over the American Society for Reproductive Medicine
as it considers this policy.
Maybe they would like to have, at least, the analytical discussion
that we've had here to consider when they meet again and establish
some kind of professional self-regulation.
I mean, there are lots of things in between saying nothing
and having a ban that are appropriate for our discussion.
We will try, I think, at the staff, to incorporate as much
as we can this really quite rich discussion of this topic
in another draft.
If people have comments on the draft as it now exists, please
let's have them so that the next round will be improved. I
think, Bill, did you want to comment before we break, please?
DR. MAY: Well, I suppose I don't, like
Dan, I don't see it as momentous, because I think, yes, you
may have chosen to have a girl, but there's so much unelected
in what in fact you get in that girl, that very quickly you
learn that parenting is more than willfulness, a willful design.
It seems to me there's a comic element in all this that shouldn't
be overlooked. I've often thought that women that I've known
eventually wanted a girl because they didn't want to end up
entirely in the hands of daughters-in-law in their old age.
There's all sorts of interesting issues. It's not that they
objected to having five sons and so forth, but kind of nice
to have a daughter in those later years.
All through these meetings, I have spoken on behalf of the
gift and beholding instead of excessive molding and so forth,
but I think this is one of these cases when the child is born,
even though there was that element of choice at the beginning,
so much in life would lead to a very different relationship
to the parenting experience.
So why, I think in the moral we're not dealing with
the moral and the immoral sometimes, but sometimes a good
that may be less good than the perfect understanding of something,
but one hopes that in the course of the relationship, a more
perfect understanding develops as to what parenting entails.
CHAIRMAN KASS: As usual, thank you very
much. Look forward to seeing you at dinner. We will meet tomorrow
again, 8:30. We have guests starting in the early session,
so please be prompt. Thank you.
(Whereupon, the foregoing matter went
off the record at 5:33 p.m.)