MONTREAL - Does a pregnant woman have a right to medical information that may not be considered pertinent to her health or her baby’s? Should a physician limit the information he provides a patient if there is an even remote possibility that information could be used to abort an unwanted female fetus – a practice rampant in China and India but reviled here?
By Karen Seidman
An editorial in the Canadian Medical Association Journal urging doctors to conceal the gender of a fetus has stirred up a roaring cross-country debate.
The doctor who wrote the editorial, interim CMAJ editor-in-chief Rajendra Kale, said that “female feticide happens in India and China by the millions, but it also happens in North America in numbers large enough to distort the male to female ratio in some ethnic groups.”
Delaying the information until 30 weeks, he said, makes it much more difficult to get an abortion unless there’s a medical reason.
Kale argued that studies show some couples who have two girls and no son selectively get rid of female fetuses until they can ensure their third-born child is a boy.
While this may be occurring in small numbers in Canada – perhaps a few hundred cases a year – he doesn’t believe it can be ignored. And he said because the information is “medically irrelevant,” there should be no problem for doctors to delay providing it.
Doctors, in fact, seemed to have a big problem with it. Dr. Charles Bernard, head of the Collège des médecins du Québec, said most young couples want to know the gender in advance – and he vehemently defended their right to know.
“It is not acceptable to withhold information from patients,” said Bernard. “The doctor (who wrote the editorial) doesn’t represent the opinion of the majority of doctors in Canada.”
The Society of Obstetricians and Gynecologists of Canada agreed, noting that Kale omitted any reference to biochemical testing products on the market that will give expectant parents a fetal sexual determination of high accuracy as early as eight weeks into pregnancy – essentially making the withholding of the fetus’s sex a moot point.
But REAL Women of Canada welcomed the suggestion. “Statistics Canada has shown that a preference for males is showing up in demographics and that’s degrading to women,” said Gwen Landolt, national vice-president of the association, which has about 50,000 members. “We’ve been asking for this kind of legislation to be in place.”
Margaret Somerville, founding director of the
McGill University Centre for Medicine, Ethics and Law, said sex selection through abortion is a real concern, saying the normal birth ratio is 105 boys to every 100 girls, but it can be as high as 160 boys to 100 girls in some parts of China. She also said that a study in India showed that of 7,000 abortions performed there, 6,997 were girls.
“As long as you have a culture where it’s no big deal to have an abortion, why not do it for the reason of sex selection?” she said.
Victor Wong, head of the Chinese Canadian National Council, said the editorial “racializes” the issue.
“I really dispute the idea that girls are not valued in the Asian culture,” he said in an interview. He understands that there are some “old world” ideas in the culture and said he can’t dispute that sex-selection abortion takes place, but he believes it is changing and will continue to evolve.
Still, he agreed the editorial seemed to touch a raw nerve and had this advice for parents: “Boy or girl, you should count your blessings.”
