AT Jefferson Medical College in Philadelphia, virtually all of the Indian women patients give birth to boys.
It is not coincidence -- and there's nothing in the drinking water. The Indian women, along with uncounted others around the nation, are using prenatal testing and abortion as a way to select the sex of their children.
Abortion on demand has given birth to boys on demand.
Abortion for sex selection has been made possible by medical tests -- amniocentesis and C.V.S. (chorionic villus sampling) -- originally designed to detect birth defects like Down's Syndrome in the developing fetus. Current techniques can determine the health and the sex of the baby as early as the first trimester of pregnancy.
It is impossible to measure the number of sex selection abortions being performed nationwide, but when the New York Times interviewed leading geneticists -- the doctors who perform prenatal testing -- all said they are routinely asked, or sometimes even tricked, by patients into testing fetuses for gender.
Some don't need to be tricked. "It is very hard to make a moral argument about terminations for sex when you can have abortions for any reason," said Dr. Mitchell Golbus of the University of California in San Francisco.
Dr. Golbus is disturbed about the trend, but many others are not. In 1973, only 1 percent of geneticists said abortion for sex selection was morally acceptable. By 1989, the number had jumped to 20 percent. So you can, to a degree, "legislate morality." Legalizing abortion has had the effect, in many minds, of legitimizing it.
But 80 percent apparently continue to believe that aborting a healthy child because of its sex is morally wrong. Some are concerned that matters like the ratio of males to females ought best be left to nature and not tampered with by man. Others are distressed by the fact that super-modern technology is in many cases being made to serve pre-modern values about the worth of boys vs. girls. But most are simply offended by the casualness with which a life-and-death decision is now being taken.
Certainly, in my informal poll of pro-choice acquaintances, the idea of sex selection abortion was met with a shiver of disgust.
When pressed, most will admit that the visceral abhorrence is not intellectually consistent with their pro-choice stance. If it is morally reprehensible to abort a child for its sex, is it less morally wrong to abort a child because it was conceived at a terrible time for the mother? Or, for that matter, because it is afflicted with Down's Syndrome?
To be perfectly honest, this is an issue I struggle with constantly. My intellect tells me that the only morally consistent position is that all life is sacred -- and that there is no morally meaningful distinction between an embryo at one month and a fetus at nine months or a baby 30 seconds after birth. If we call smothering a child after birth murder, how can we arbitrarily say that aborting the child three months earlier is anything less?
And yet, at least for me, the intellectual position is clearer than the emotional one. I cannot bring myself to condemn a woman who aborts a fetus she knows will be profoundly retarded, or a Tay Sachs victim she knows will suffer terribly and die before the age of 2. I think they are wrong -- but I don't feel that they are.
They say hard cases make bad law. That may be true. But they do make for clearer thinking. The pro-choice advocates constantly invoke the image of the destitute rape victim being forced to undergo the "back alley" abortion. Now the pro-life advocates can invoke the image of perfectly healthy babies washing down drains because they are the wrong sex or (in time) the wrong hair or eye color.
Truth does not always lie between two extremes -- but in this case it may. Surely the start of a more humane approach would be to forbid abortions for such repugnantly frivolous reasons as gender by withholding that information from pregnant women. It will be a start toward regaining our moral footing, so that we can better handle the truly hard cases.
Mona Charen is on maternity leave. This column was first published in January 1989.