Technology for choosing children

- IVF
- Pre-natal tests including ultrasound scanning during pregnancy
- Preconception: separation of X and Y sperm for sex selection

Life as a gift
- Michael Sandel
o ‘we appreciate them as gifts’
o ‘To be a good parent is to be prepared to accept and nurture one’s child,
regardless of that child’s talents or disabilities’
- Must balance acceptance of who they are, increasing capacities of wellbeing and
developing them
- Problem with genetic engineering – aspiration to remake human nature to serve our
purposes and satisfy our desires
- Acknowledging the giftedness of life = recognising that not everything in the world is
open to whatever use we may desire or devise
- William F. May
o The idea that we care deeply about out children and yet cannot choose the kind
we want teaches parents to be open to the ‘unbidden’

Playing God
- Arrogant assumption that anyone is qualified to play God and decide who is or is not
fir to be born
- Automatic negative assumption on the rights of disabled people
- It should be that all people are of equal value and that no one is in the position of
being able to estimate the worth of another person’s life
But
- Couples choose whether or not to have a child and this itself is a Godlike decision but
it is not criticised
- Hard to argue against reproductive decisions on the grounds that by making such
decisions we are presuming a Godlike power over the existence of other people

Changing the genetic composition of future generations

- Environmental changes
o Schemes for poverty relief can alter the selective pressure on genes
- Eugenic policies
o Policies are aimed at altering breeding patterns or patterns of survival of
people with different genes
o Environmental but the genetic impact is intended
- Genetic engineering
o Using enzymes to add to or subtract from a stretch of DNA
- Genetic engineering need not involve overriding anyone’s autonomy

Positive-negative distinction
- Genetic counselling is applied to those thought likely to have disorders such as
Huntingon’s chorea
o Screening done before pregnancy
 o Risks are so high and disorder so bad that potential parents decide not to have
children
- Screening programmes for pregnant women can lead to the option of abortion if
necessary
o Those who oppose abortion will object to such screening programmes
- Few people object to the use of eugenic policies to eliminate disorders unless those
policies have additional features which are objectionable
- Using genetic engineering to eliminate defects in the foetal stage seems agreeable to
those who prefer babies to be born without handicap and those who oppose abortion
o But accepting the case for eliminating genetic mistakes does not entail
accepting other uses of genetic engineering
- Negative genetic engineering
o Elimination of defects
- Positive genetic engineering
o Bringing about improvements in normal people
- Boundary between defective state and normality may be more blurred ie positive
negative distinction is sometimes a blurred one but often we can at least roughly see
where it should be drawn
o If distinction is only rough then how important is it ?
- Tinbergen
o Should not put yourself forward as a judge of the qualities for which we
should breed
o But others say that positive policies are the way to make the future of making
better than the past

Genetic supermarket
- Nozick
o Not true that positive engineering has to involve any centralised decision
about desirable qualities
o ‘Genetic supermarket’ would meet the individual specifications of prospective
parents and has the great virtue that it involves no centralised decisions fixing
the future human types
o Genetic supermarket should meet the specifications of parents within certain
moral limits
- For a liberal: good society is one which tolerates and encourages a wide diversity of
ideals of the good life
- Those of us who support restrictions protecting children from parental harm after birth
are likely to support protecting children from being harmed by their parents’ genetic
choices
o Hard to accept that society should set no limits to genetic choices parents can
make for their children
- If supermarket came into existence, some centralised policy should exist
- Should be some policy to precenting harm to the individual people being designed
Problems
- Could be an imbalance in the ratio between sexes
- Parents might think their children would be more successful if they were more
competitive and selfish
 - If enough parents acted on above thought then others would follow to make sure their
children weren’t disadvantaged
Nozick’s response
- Government could require that genetic manipulation be carried on so as to fit a certain
ratio
Reply
- Proposals for avoiding the sexual imbalance eg 1:1 ratio, without central regulation
are nor reassuring
- Either make a choice between allowing a sexual imbalance or imposing some system
of social regulation

Principle of Procreative beneficence

- Principle tells parents to aim to have the child who, given her genetic endowment, can
be expected to enjoy most well-being in her life
- Not suggesting that people should have no child at all rather than who is less
advantaged than other existing children ie not on absolute level
Replies
- Reproduction is a private matter immune to moral scrutiny
- Morality can allow people to aim at less than the best/ gives people complete freedom
when making procreative decisions

Common-sense morality
- If there is a rubella virus outbreak and couple decides to have a child – it is
uncontroversial that couple should wait a few months till the epidemic has passed to
have a rubella free child
- Woman is faced with an identity-affecting choice and the child with rubella would
have a life so bad it would not be worth living so has a reason not to bring it into
existence
- Even if the child with rubella’s life was tolerable, most people would wait to have the
child post-epidemic as they will have a better life
- Couples wait to become financially stable and grow right environment to have a child
and waiting – selecting a child who will have a better life
- Common-sense morality seems committed to favouring selection of children who are
more advantaged even if it may not give it as much weight as to the prevention of
serious disadvantage

Procreation asymmetry
- If you could only have a child whose life would be full of suffering, most would think
it morally wrong to bring such a person into existence
- If you could have child whose life would be well worth living, most would agree that
it is morally indifferent whether you decide to create this child or not
- If a future person would foreseeably have a life that is not worth living, this in itself
gives us a strong moral reason to refrain from bringing this person into existence
- There is no moral reason to create a person whose life would be foreseeably worth
licing just because her life would be worth living
- John Broome
o “We do not want to increase the amount of well-being in the world for its own
sake”
Expressivist objection
- Choosing to have a child to avoid a disability expresses an attitude that is harmful to
disabled people who do exist ie they are not valuable/ it would have been better had
they not been born
Instead
- Can affirm that choosing not to create a disabled child represents a commitment to
flourishing which should also show up in our attitude towards already disabled people
ie that they deserve assistance and resources

Deafness
- If deafness can be expected to be a disability in a welfarist sense then PB implies that
parents have moral reasons to select hearing children rather than deaf ones
- PB can acknowledge that the lives of deaf people are good and only tells us to prefer
another child if it is expected to have a better life
- If it can be shown that deafness does not reduce wellbeing/ in a given context
deafness is not expected to be a disability, then PB would not give any moral reason
to select against deafness

Causing a disabled person to exist

- Parfit
o Woman knows that if she falls pregnant now the child will be disabled but if
she waits 6 months, it will be non-disabled. She prefers to become pregnant
right away and gives birth to a disabled daughter
o It is supposedly wrong for woman to choose to have a disabled child since she
could have easily done the reverse
o But if being disabled is no worse than being non-disabled, it is mere
difference rather than bad difference so the action need not be wrong
- It is not wrong to knowingly cause a disabled child to exist rather than a non-disabled
child to exist
- The idea that it is wrong is predicated on the idea that it’s worse to be disabled than
non-disabled
However
- If a woman drinks alcohol, takes recreational drugs, we think of it as wrong to cause
the existence of a disabled child rather than a normal child
Reply
- Perhaps it is wrong to cause the existence of a disabled child simply in order to
smoke, drink alcohol etc
- There is a wrongdoing without claiming that there is wrongdoing in virtue of causing
a disabled person rather than a non-disabled person to exist
The choice to have a child without a disability
- Procreative liberty should include the choice to have a child without a disorder/
disability
- For many couples the decision to procreate may depend on the ability to have a
healthy child
Problem
- Frowned upon that parents should hope their child is born without a disability because
children need unconditional acceptance
- Preference for a child without disability is selfish – desire to avoid difficulty and
complication before the child’s need for unconditional acceptance
 Reply
- Some disabilities are so devastating that no parent or family should be blamed for
failing to cope or for choosing to have a child without these problems
- Special needs schools can be extremely expensive so saying a parent is selfish is cruel
and unfair
- Parents may have an interest in their child not having such a sever disability where
they carry a burden of empathy for the child’s own distress, and this interest is serious
and should not be disregarded because of misguided moral criticisms

Children’s interests as a constraint on choice

- Parents hopes for an able-bodies and healthy child should not be dismissed as
unimportant
- Parental desire for a healthy child fits with the interests of the child born as a result of
the choice ie child saved from disability will be glad
Problems
- Foetus aborted/ embryo not implanted is thought by some to have moral claims to life
Reply
- Not many people think this way
- Since the hope to have a child without disability is unproblematic from pov of the
child, procreative liberty is not in conflict with what we owe to our children

- Sex selection is often opposed

- Some have criticised giving fertility treatment to older women
- Onora O’Neill
o More is at stake than parental freedom; the interests of the child should set
limits to what potential parents do

Perfectionism
- Ethical view that a good human life consists in the flowering of certain aspects of
human nature which should be cultivated
- Procreative perfectionism
o View that we should aim to have children who will have the best chance of a
good human life
- Would lead to reproductive freedom with no outside restrictions advocated for
- Potential parents themselves have an obligation to aim for children likely to have the
best lives
- Most liberal version of the view says that potential parents should aim for the child
with the greatest chance of a good life that they can have
- Moral requirement to aim for a child who will have the best possible life is an open-
ended one, which may place too great a burden on potential parents

Minimum threshold
- Parents may be under some moral pressure to consider whether it is right to bring into
the world a child who life is by a small margin, just worth living
- Many think the zero-line view sets the standard far too low
- Frances Kamm
o Line should be normality
Problems with Kamm’s view
 - Unsure whether it is only the predicted medical normality of the child that is
necessary for the parent to avoid moral censure
- Predicted circumstances of a child born into serious poverty will be an equally serious
obstacle to flourishing
- Child may be seriously disadvantaged by racist/ religious hostility
- If inly medical disadvantage is relevant then why is that the only thing that matters
- If the child will not be harmed by being brought into the world, what is the basis on
which parental choice to have the child is judged to be wrong
- Steinbock and McClamrock
o Decision to have children is morally acceptable only if it satisfies a principle
of parental responsibility
o People should refrain from having children if they cannot give them a decent
chance of a happy life
o Cases where someone is glad to have been treated unfairly or to have been
denied what he or she was owed
Problem with their view
- If despite the pain, the child is glad to be alive then how can it be that we owed it to
the child to prevent his or her life

- Idea of a zero line below which life is not worth living is a philosophers’ abstraction
- There are extreme cases where you can clearly see but otherwise it is very blurred
- Zero line is often hidden inside a huge grey area
- It may be wrong knowingly to bring into the world a child whose life will fall below
the zero line but because of the grey area, decisions will more often be about serious
risk of life
- Parental responsibility suggests avoiding brining into the world a child who will run a
serious risk of a life not worth living ie saying that the child has to have a decent
chance of a happy life
- Thought that we owe our children a decent chance of a good life is intentionally
vague

Genetic disability as a natural injustice

- To the extent that genetic technology gives us increasing control, genetic disadvantage
should come to be seen as injustice
- Where genetic intervention to correct a child’s disability is possible, it should be seen
as part of what we owe to that child
- Reason for genetic intervention against disability is to promote the child’s chances of
flourishing
o Flourishing can be affected by other factors such as lack of money
- Sometimes parents have another child in order to use their stem cells to save their first
child with a disability but this can be seen as using an unborn child as a commodity
- For someone to be treated merely as a means there has to be a violation of his or her
autonomy or else a denial of some kind of respect they are owed
o Since there is no capacity for choice, the issue of respecting the child’s
autonomy does not arise

Self-creation and independence

 - Although self-creation and independence can each only be partial, many of us value
having a high degree of both
- Some parental choices may increase our abilities and so give us a more open future
with greater scope for self-creation
o Role of parental choices in itself reduces our independence
- Habermas
o Being genetically designed would transform our self-understanding
o Opposition to genetic design can be seen as the assertion of an ethical self-
understanding of the species which is crucial for our capacity to see ourselves
as the authors of our own life histories
- Too much genetic intervention might make us feel like mere puppets of our parents
and the technology they had at their disposal

Personal affecting and impersonal views of harm

- Parfit
o When we think about an act being wrong, we are moved by what he calls, the
person affecting intuition ie the idea that bad acts must be bad for someone
Response
- Can claim that we should adopt an impersonal perspective for these situations: the
wrong done consists in the world being a worse place as a result of one’s actions

- Parfit
o Some decisions that will probably make the world worse in a few generations
will also mean that different people are alive then from those who would have
been alive had we acted differently
o Could be that choosing the environmentally worse policy is not wrong since
no one is made worse off than they would have been but it seems wrong
because we have made the world a worse place
o Non-identity problem
 Morality cannot be simply a matter of what we owe to people – some
serious harms are impersonal with no one being denied anything owing
to them
- Non-identity problem shows that we can make the world a worse place without
harming particular people, and this matters
o But we do not have to accept that this is all that matters
- Probably no such moral obligation to choose a child with maximum potential for
human flourishing
o Parents should not be forced to choose children with maximum potential

Non-identity problem
- Focuses on the obligations we think we have in respect of people who are caused both
to exist and to have existences that are unavoidably flawed existences
- If existence is worth having and no one else’s interests are at stake, it is unclear on
what ground morality would insist that the choice to bring the one person into flawed
existence is morally wrong but it seems clearly morally wrong
- Conferring the existence that is unavoidably flawed and yet not so flawed that it is
less than worth having does not make things worse for the person whose existence it
is
 - Some existence-inducing acts are wrong even though they don’t make things worse
for or harm the future person

Depletion case
- Suppose depleting resources now makes future person 2 generations ahead have
slightly higher quality of life but for many centuries the quality of life would be much
lower
- In this situation conservation surely should have been chosen
- But depletion does not harm anyone
- Any suffering endured under the depletion choice would seem to be unavoidable
- Depletion does not harm or make things worse for, and is not bad for anyone who
does or will exist under the depletion choice

Slave child
- In exchange for $50,000 a couple can have a child who will be given to a wealthy
man to be raised as a slave
- This child suffers so seems like the couple’s choice is outrageous
- Had the couple not entered the contract then the child would not have been born,
rather a distinct child would have been born at a different time ie would not be
identical to the slave child
- For the slave child there is no better alternative so what the couple has done does not
make things worse for the child