Limits...
The Israeli National Committee for sex selection by pre-implantation genetic diagnosis: a novel approach (2005-2011).

Pessach N, Glasser S, Soskolne V, Barash A, Lerner-Geva L - Isr J Health Policy Res (2014)

Bottom Line: Most requested males, and the primary reason was the parents' intense emotional desire.Only one-fifth of the decisions were approvals, possibly reflecting reluctance to encourage non-medically-indicated PGD, a viewpoint not unique to Israel.Limitations include the relatively small number of cases and lack of access to Committee deliberation protocols.

View Article: PubMed Central - PubMed

Affiliation: The National Social Work Service, Ministry of Health, 15 Noah Mozes St, Tel-Aviv, 67442 Israel.

ABSTRACT

Background: Pre-implantation genetic diagnosis (PGD) for fetal sex selection raises complex dilemmas. In Israel, PGD is regulated by the Ministry of Health. It is basically prohibited, but exceptions can be made upon approval by the National Committee for Sex Selection by PGD for Non-Medical Reasons (the "Committee"). This report describes the Committee's work since its inception in May, 2005 through December, 2011.

Methods: Files were abstracted onto a structured form. Discrete variables were analyzed by chi-square analysis, and continuous variables by T-Test.

Results: During the study period 411 applications were received. Two-thirds of the applicants (n = 276; 67.2%) were Jewish and 26.8% were Moslem Arab. Over two-thirds (n = 285; 69.3%) had no children of the requested sex and ≥4 children of the opposite sex. Three-quarters of the requests were for a male (n = 308; 74.9%): 100% of Arab and 63% of Jewish applicants. Many noted more than one reason for their request. The most frequent category (n = 201; 48.9%) was a strong emotional desire, followed by medically-related reasons (n = 83; 20.2%). For 216 applications a decision was arrived at, with 46 (21.3%) approved. Of the remaining 195 for 192 over a year had passed since last contact with the Committee. The likelihood of approval was higher if applicants met the criterion of ≥4 same-sex children than if they didn't (33.7% vs. 11.6%, P = 0.001). The largest number of approvals were those requested for 'emotional' reasons, while the highest approval rate was for religious reasons.

Conclusions: This study reviewed the first seven years of Committee activity. Most requested males, and the primary reason was the parents' intense emotional desire. Only one-fifth of the decisions were approvals, possibly reflecting reluctance to encourage non-medically-indicated PGD, a viewpoint not unique to Israel. Limitations include the relatively small number of cases and lack of access to Committee deliberation protocols. It is recommended that longitudinal studies be conducted to gain insight into the consequences to individuals, couples and families--both those whose requests were approved and those denied-- of this major step in reproductive technologies and in society's effort to respond to them.

No MeSH data available.


Related in: MedlinePlus

Application and process of request for PGD for non-medical sex selection.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
getmorefigures.php?uid=PMC4230365&req=5

Fig1: Application and process of request for PGD for non-medical sex selection.

Mentions: The application procedure is described in Figure 1. Applicants to the Committee must explain their request on an official form, submit required medical documents, and undergo psychological assessment. Application forms are available to the public on the Ministry of Health’s website, and the Committee reviews all applications. All applications meeting the primary criterion of the couple’s having ≥4 children of the same sex and none of the opposite sex, as well as those exceptions deemed acceptable, are referred for psychological assessment and completion of additional medical forms. At a second Committee meeting each applicant’s file is presented. The file includes: (a) the original application; (b) a personal letter of request, explaining the motivation for the application; (c) medical documents regarding the couple’s health status and ob/gyn history; (d) a psychological assessment report. The psychological assessment is intended to evaluate the the extent of risk to the emotional well-being to either one of the partners and/or to their relationship, or to their family in the event that their request is denied. The assessment includes a clinical interview with each parent separately and with the couple together, and completion of a battery of objective and projective psychological tests (e.g., Rorschach Ink Blot Test, Dyadic Assessment Scale). The couple is referred to the psychologist only after the initial forms (application, medical, etc.) are completed and the request is not denied or approved outright. It should be stressed that the psychological assessment is a non-binding recommendation for the Committee’s consideration.Figure 1


The Israeli National Committee for sex selection by pre-implantation genetic diagnosis: a novel approach (2005-2011).

Pessach N, Glasser S, Soskolne V, Barash A, Lerner-Geva L - Isr J Health Policy Res (2014)

Application and process of request for PGD for non-medical sex selection.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4230365&req=5

Fig1: Application and process of request for PGD for non-medical sex selection.
Mentions: The application procedure is described in Figure 1. Applicants to the Committee must explain their request on an official form, submit required medical documents, and undergo psychological assessment. Application forms are available to the public on the Ministry of Health’s website, and the Committee reviews all applications. All applications meeting the primary criterion of the couple’s having ≥4 children of the same sex and none of the opposite sex, as well as those exceptions deemed acceptable, are referred for psychological assessment and completion of additional medical forms. At a second Committee meeting each applicant’s file is presented. The file includes: (a) the original application; (b) a personal letter of request, explaining the motivation for the application; (c) medical documents regarding the couple’s health status and ob/gyn history; (d) a psychological assessment report. The psychological assessment is intended to evaluate the the extent of risk to the emotional well-being to either one of the partners and/or to their relationship, or to their family in the event that their request is denied. The assessment includes a clinical interview with each parent separately and with the couple together, and completion of a battery of objective and projective psychological tests (e.g., Rorschach Ink Blot Test, Dyadic Assessment Scale). The couple is referred to the psychologist only after the initial forms (application, medical, etc.) are completed and the request is not denied or approved outright. It should be stressed that the psychological assessment is a non-binding recommendation for the Committee’s consideration.Figure 1

Bottom Line: Most requested males, and the primary reason was the parents' intense emotional desire.Only one-fifth of the decisions were approvals, possibly reflecting reluctance to encourage non-medically-indicated PGD, a viewpoint not unique to Israel.Limitations include the relatively small number of cases and lack of access to Committee deliberation protocols.

View Article: PubMed Central - PubMed

Affiliation: The National Social Work Service, Ministry of Health, 15 Noah Mozes St, Tel-Aviv, 67442 Israel.

ABSTRACT

Background: Pre-implantation genetic diagnosis (PGD) for fetal sex selection raises complex dilemmas. In Israel, PGD is regulated by the Ministry of Health. It is basically prohibited, but exceptions can be made upon approval by the National Committee for Sex Selection by PGD for Non-Medical Reasons (the "Committee"). This report describes the Committee's work since its inception in May, 2005 through December, 2011.

Methods: Files were abstracted onto a structured form. Discrete variables were analyzed by chi-square analysis, and continuous variables by T-Test.

Results: During the study period 411 applications were received. Two-thirds of the applicants (n = 276; 67.2%) were Jewish and 26.8% were Moslem Arab. Over two-thirds (n = 285; 69.3%) had no children of the requested sex and ≥4 children of the opposite sex. Three-quarters of the requests were for a male (n = 308; 74.9%): 100% of Arab and 63% of Jewish applicants. Many noted more than one reason for their request. The most frequent category (n = 201; 48.9%) was a strong emotional desire, followed by medically-related reasons (n = 83; 20.2%). For 216 applications a decision was arrived at, with 46 (21.3%) approved. Of the remaining 195 for 192 over a year had passed since last contact with the Committee. The likelihood of approval was higher if applicants met the criterion of ≥4 same-sex children than if they didn't (33.7% vs. 11.6%, P = 0.001). The largest number of approvals were those requested for 'emotional' reasons, while the highest approval rate was for religious reasons.

Conclusions: This study reviewed the first seven years of Committee activity. Most requested males, and the primary reason was the parents' intense emotional desire. Only one-fifth of the decisions were approvals, possibly reflecting reluctance to encourage non-medically-indicated PGD, a viewpoint not unique to Israel. Limitations include the relatively small number of cases and lack of access to Committee deliberation protocols. It is recommended that longitudinal studies be conducted to gain insight into the consequences to individuals, couples and families--both those whose requests were approved and those denied-- of this major step in reproductive technologies and in society's effort to respond to them.

No MeSH data available.


Related in: MedlinePlus