Parental Planning and New Reproductive Technologies

Cambridge Quarterly of Healthcare Ethics, 2003

Margaret Brazier has argued that, in the literature on reproductive technology, women's "right" to reproduce is privileged, pushed, and subordinated to patriarchal values in such a way that it amounts to women's old "duty" to reproduce, dressed up in modern guise. 1 I agree that there are patriarchal assumptions made in discussions of whether women have a right to select which embryos to implant or which fetuses to carry to term. Forcing ourselves to see women as active, rational decisionmakers tends to counteract any lingering patriarchal assumptions. But rational decisionmaking requires information. Voting wisely requires information about the candidates. Taking women's reproductive rights seriously means taking seriously women's need for relevant information to make rational decisions, including decisions about which embryos to implant or alter. I argue that preimplantation genetic profiles and prenatal test information should be made available to prospective parents, especially prospective mothers, unless doing so threatens to harm the resulting child or the larger society in specifiable and important ways. Limiting Women's Access to Relevant Information In the foreseeable future, it may be possible for prospective parents participating in in vitro fertilization (IVF) to get relatively complete genetic profiles of their preimplantation embryos, as well as the already-existing information from prenatal testing. The very possibility of preimplantation embryo selection raises the issue of negative versus positive eugenics. "Negative eugenics" refers to the elimination of diseases or defects, whereas "positive eugenics" refers to the enhancement of traits. Some have argued that negative eugenics is morally permissible, but positive eugenics is to be avoided. 2 But Ruth Chadwick, among others, has argued that any embryo selection at all, even to eliminate embryos with the most devastating defects, involves both negative and positive eugenic decisions, because to say no to one embryo is, in most situations, to say yes to another, thereby favoring the "better" embryo, a positive eugenic decision: "it is not immediately obvious where removing defects ends and making improvements begins." 3 H. Tristram Engelhardt asks, "How may one clearly distinguish between curing forms of mental retardation and augmenting human intelligence?" 4 Granting the point that such positive eugenics is inevitable if we are to save helpless children from terrible suffering, Philip Kitcher, David King, Jacques Testart, and others are concerned about the possible social and political conse

Human Studies, 2004

In this article I will address the question of determining the moral limits of reproductive decisions. In so doing I will examine the contributions made by John Harris, who has over the years consistently addressed the ethical implications of advancing reproductive technologies. In addressing these matters, Harris has centred his arguments on the principle of harm and with this in mind has set out a specific theoretical framework from which decisions about disability and causing harm, as in the case of reproductive decisions, can be rationally addressed. This discussion will attempt to question the conceptual scheme that he proposes. The aim here is not to present an alternative theoretical contribution to the morality of reproductive choice. Rather, in the attempt to follow some of the directives in Wittgenstein's later philosophy, the aim is to demonstrate some of the pitfalls of what Wittgenstein has described as the "craving for generality" in contemporary philosophy. I propose that this craving can distort, in this instance, our ordinary usage of concepts such as harm, suffering and disability and their role in the moral vocabulary of reproductive decision making.

Bioethics, 1993

Preimplantation genetic diagnosis (PGD) is taken to mark the starting-point of a new phase in human reproduction, where the possibility of choosing children on genetic grounds without having to resort to dangerous or ethically controversial procedures (such as abortion) will gradually increase. Ethical and political issues actualised by this development are addressed. The discussion touches upon issues regarding the moral status of embryos and gametes, the moral import of respecting individual autonomy and its implications for the requirement of informed consent in health-care, the connection between disease, disability and the value of life, the moral status of possible future people, and the connection between choosing children and eugenic policies of the past. Practical policy issues are addressed on the basis of this, as well as an empirical case-study of the introduction of PGD in Sweden. The book ends up in a set of recommendations regarding the management of research on, introduction and routine use of pure selection, both within health care and from the point of view of society as a whole. It is argued that research on such procedures should be allowed and supported by society. However, tight restrictions regarding the clinical introduction of new procedures in this area is highly desirable. A rough model for implementing such restrictions is also presented. It is further asserted that, although reasons of economy and safety should limit the access to pure selection, society should not apply any explicit restrictions based on ideas regarding how different traits affect a person's quality of life. It is stressed that, in order to avoid a resurrection of eugenic policies of the past, the development in this field underlines the need for continued and strengthened public support to the sick, disabled and mentally retarded. Keywords: assisted procreation, bioethics, embryo experimentation, eugenics, genetic testing, in vitro fertilisation, medical ethics, medical genetics, polar body biopsy, preconception diagnosis, preimplantation genetic diagnosis, prenatal diagnosis, public policy, reproductive medicine, research ethics, sex preselection.

Journal of applied philosophy, 2001

The debate about the moral status of embryos has a long tradition in many western countries and is at issue not only with respect to stem cell research, but with respect to abortion or pre-implantation genetic diagnosis as well. Accordingly wide is the range of arguments presented in favor of the different views. Because of the intensive discussion of this question without any tendency towards a consensus, the debate is perceived as muddled. Therefore, it becomes more and more attractive to bring about a decision on an indirect way. One argument along these lines is the so called ‘argument for precaution’. It holds that in a situation with persisting doubts regarding the status of the embryo, we should treat embryos as if they were human beings as long as good doubts regarding their moral worth persist, since otherwise we run danger of killing a lot of human beings. This argument has become very popular in contemporary German debates. In this paper, I want to scrutinize this argument to see how well it works out and in how far it can help to find a decision in gridlocked debates like the one concerned with the moral worth of embryos. I try to show that it is difficult to make good sense of this very popular and widespread principle and that in its best formulation that can be found in German philosophy, it clearly collapses.

Journal of Law and the Biosciences

This article explores the enormous challenges to reproductive decision making that could result from two emerging technologies: the potential capacity to create vast numbers of embryos for preimplantation genetic diagnosis and the ability to obtain ever more predictive information about the embryo. Together these technologies could change our reproductive experience, exacerbate existing inequities, and profoundly affect reproductive decision making. Simply comprehending the dizzying amounts of predictive information about the health and traits of future children will overwhelm future parents. But trying to choose embryos with the 'best' combination of genetic variants could be paralyzing. Nevertheless, numerous pressures will make this technology alluring, compelling providers to develop remedies to assist future parents with these difficult reproductive decisions. The remedies, however, will create their own challenges. Some might test the limits of reproductive autonomy and heighten social inequities. A particularly vexing remedy would be the development of algorithms for embryo selection, which could routinize reproductive decisions, reduce societal diversity, exacerbate 'choice overload' effects, challenge professional norms, and raise the specter of eugenics. Ultimately, this article is a cautionary tale urging circumspection as technological advancements seem to propel us inevitably toward a reproductive future that could create a tyranny of choice.

Valparaiso University Law Review, 2011

Philosophy Compass, 2008

Advances in reproductive genetic engineering have the potential to transform human lives. Not only do they promise to allow us to select children free of diseases, they can also enable us to select children with desirable traits. In this paper, I consider two clusters of arguments for the moral permissibility of reproductive genetic engineering, what I call the Perfectionist View and the Libertarian View; and two clusters of arguments against reproductive genetic engineering, what I call the Human Nature View and the Motivation View. I argue that an adequate theory of the ethics of reproductive genetic engineering should take into account insights gained from these views.

Journal of Applied Philosophy, 2001

 One strategy for arguing that it should be legally permissible to create human embryos, or to use of spare human embryos, for scientific research purposes involves the claim that such embryos cannot be persons because they are not human individuals while twinning may yet take place. Being a human individual is considered to be by most people a necessary condition for being a human person. I argue first that such an argument against the personhood of embryos must be rationally conclusive if their destruction in public places such as laboratories is to be countenanced. I base this argument on a popular understanding of the role that the notion of privacy plays in abortion law. I then argue that such arguments against personhood are not rationally conclusive. The claim that the early embryos is not a human individual is not nearly as obvious as some assert.