What Israeli policy can teach us about elective sex selection.

PIGD for gender selection for non medical reasons has been a subject of ethical, legal, and moral debate in many Western countries. This article discusses the background of elective sex selection, and highlights the impact of new technological developments on this dynamic discussion. The article published by Pessach et al., in this Journal, is an excellent study of Israeli health policy on non medically indicated preimplantation genetic screening for sex selection. In Israel, elective sex selection is prohibited, but exceptions can be made by application, for family balancing, and emotional and religious reasons. This review of a health policy over seven years is concordant with evolving views in many Western countries. The classic medical model for allowing sex selection for serious medical disorders may be too restrictive. There are different reasons that may be assessed in light of ethical criteria including a wider delineation of medical reasons, which may include emotional and psychological well being of the family, indirect medical reasons, as well as risk reduction for the following generations. The Israeli model may be a useful approach with wide application to reproductive health policies in many countries.