Bioethics Centre, Division of Health Science, University of Otago, Dunedin, New Zealand.
Br Med Bull. 2011;98:7-20. doi: 10.1093/bmb/ldr015. Epub 2011 May 19.
The rapidly growing imbalance of the sex ratio at birth (SRB) in China since the late 1980s demonstrates that, despite an extensive official prohibition, sex-selective abortion has been widely practised there in the past two or three decades. Given the reality of 30-40 million missing females, China has a more challenging set of ethical and social policy issues to be addressed regarding sex-selective abortion than is the case in Western and many other countries.
This article is based on a search and review of Chinese and English-language literature, including several very recent books in Chinese on the imbalance of the sex ratio at birth in China. It also draws on first-hand information gathered from the author's extensive fieldwork on Chinese views and experiences of abortion.
The current female deficit is a real and serious problem in China-not a 'false alarm' as earlier alleged. It is a direct consequence of the widespread practice of sex-selective abortion and is chiefly caused by the strong socio-cultural preference for sons in China. Chinese academics-demographers and medical ethicists-in general agree with the official position that sex-selective abortion is morally wrong and should be legally prohibited.
Some critical voices, mainly in the English-language literature, have asked whether coercive state intervention in this area is ethically justifiable. Another controversial question is whether and to what degree China's ambitious and rigorous population control programme, widely known as the 'one child' policy, is a contributing factor to the phenomenon of millions of missing females.
Much further research on the ethical and social policy issues surrounding sex-selective abortion in the Chinese context needs to be done. Systematic quantitative and in-depth qualitative sociological investigations into Chinese people's attitudes toward the subject, and the role of medical professionals, are long overdue.
自 20 世纪 80 年代末以来，中国出生性别比（SRB）迅速失衡，这表明尽管存在广泛的官方禁令，但在过去的二三十年里，性别选择性堕胎在中国已经广泛实施。鉴于 3000 万至 4000 万女性失踪的现实，中国在处理性别选择性堕胎方面所面临的伦理和社会政策问题比西方和许多其他国家更为复杂。
本文基于对中、英文文献的检索和综述，包括最近出版的几本关于中国出生性别比失衡的中文书籍。它还借鉴了作者在中国进行广泛的实地考察中收集的关于堕胎的第一手信息。
目前中国女性的短缺是一个真实而严重的问题，而不是早些时候所说的“虚惊一场”。这是性别选择性堕胎广泛实施的直接后果，主要是由于中国社会文化中对男孩的强烈偏好。中国的学者——人口学家和医学伦理学家——普遍同意官方立场，即性别选择性堕胎在道德上是错误的，应该被法律禁止。
一些批评性的声音，主要来自英文文献，质疑在这一领域进行强制性国家干预在伦理上是否合理。另一个有争议的问题是，中国雄心勃勃且严格的人口控制计划（俗称“一孩政策”）是否以及在多大程度上是导致数百万女性失踪的一个因素。
需要对中国语境下性别选择性堕胎的伦理和社会政策问题进行更多的研究。对中国人对这一问题的态度以及医疗专业人员的作用进行系统的定量和深入的定性社会学调查早就应该进行了。
