The British Medical Association, meeting in Torquay, decided that sex selection on social or religious grounds was unethical and likely to aggravate problems of sexual discrimination. The decision, the leadership's first defeat, is bound to influence the forthcoming recommendations of the Human Fertilisation and Embryology Authority on sex selection. The HFEA is expected to report to the Government later this year on whether couples planning a family should be allowed routinely to opt for a boy or a girl.
At present, these relatively new techniques are unregulated and lack scientific validation, but one north London clinic has already begun offering services to couples.
In the light of yesterday's vote by rank-and-file doctors, the BMA's ethics committee will have to revise its advice to the HFEA, the statutory regulator of assisted conception services. It will urge the authority to bring in legal safeguards to ensure that sex selection, which can take place before or after conception, should only be allowed for sound medical reasons - where there are clear risks of a child being born with a sex-related genetic defect.
A study of the first sex-selection clinics to open in America, Asia and Europe, highlighted in this week's British Medical Journal, found that 236 couples chose to have boys, while only 15 picked girls.
In yesterday's BMA debate, Angela Thomas, from Lothian, warned that sanctioning gender selection could lead to an unhealthy shift in public attitudes. She added: 'What if they get it wrong, and a boy is born instead of the girl that the couple wanted? That child will feel it is the wrong sex and that it is not loved.' Robin Davies, a member of the BMA's consultants' committee, said: 'This is an example of positive eugenics. When governments do this, we tremble, and when individuals do it we should too.'
But Stuart Horner, chairman of the association's ethics committee, said that he did not object to the notion of a couple undergoing infertility treatment choosing whether to have a male or female embryo implanted in the woman's womb. 'I am as opposed to discrimination as anyone else. That needs to be addressed in political and educational frameworks. It does not have to be addressed in ethics.'
He was supported by Dr Jeremy Lee-Potter, chairman of the BMA council, who declared: 'We should come down on the side of patient choice and autonomy.'
Earlier, the BMA reasserted its long-standing opposition to euthanasia, despite some grassroots calls for its legalisation. Most doctors felt that pain-relief treatments were sufficiently widespread and effective to ensure terminally-ill patients no longer had to endure pain as they died.
Brian Hopkinson, a hospital consultant from Nottingham, warned that legalising euthanasia amounted to giving the medical profession a 'licence to kill', which would wreck the trust between a doctor and vulnerable patients. 'If the state wants to be rid of the demented, the frail and the mentally sick, because their care involves too much time, trouble and taxes, let it hire professional executioners - not cloak it under spurious medical respectability.'
However, the association reasserted its support for advanced directives, so-called 'living wills', in which patients may instruct doctors to withdraw treatment under specified conditions.Reuse content