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The Impact of Science
Neill Furr on some of the mistakes people make when thinking about reproduction.
Thanks to advances in sciences such as genetics and fertility provision, we find ourselves having to make moral decisions about situations that are unfamiliar to us, that we have had no cause to consider before. However, we often apply the moral attitudes that we have used in more familiar situations, in which those attitudes might be thought of as tried and tested. This is a natural and practical tendency but perhaps a dangerous one. The precise nature of these situations is not always obvious and the attitudes we apply to them may not be appropriate, leading us to make errors in judgement and unwittingly cause injustice rather than prevent it.
I would like to focus on some common mistakes in thinking about the reproductive sciences and to look at how these affect the way we approach problems. It is not my intention to argue too much for any particular conclusions, nor to cover a comprehensive range of cases. My aim is simply to warn against hasty thinking.
Choosing a Donor
In America, a deaf couple have decided to have a baby and being a lesbian couple they must seek a male donor. However, for reasons I will not look at here, they wish to have a deaf baby and so they sought a court’s permission to find a genetically deaf donor to maximise the chances of this. The court gave its permission and for a few days the British media picked up the story and everyone was condemning the decision, from the Sun to the panel of Any Questions. But what were their grounds for condemnation and are they really applicable to this extraordinary case?
The objections that I heard boiled down to these:
a. It is cruel to inflict a disability on a child.
b. It would be better to have a hearing child.
To inflict is to do something to a person and this presupposes that that person already exists. You cannot do anything to someone who does not exist. This is also true of kindness and cruelty; an animal, for example, must exist for us to do it kindness.
Let us suppose that this couple has a choice of two donors, one genetically deaf and the other hearing. Now, let us further suppose that their choice of donor will result in one of two possible babies, and call them potential person A, or Albert, who would be deaf, and potential person B, or Bertha, who would be hearing.
To bring Albert or Bertha into existence is not to do something to them, because to do to, as we’ve noted, requires something to exist beforehand and so bringing to be is distinct from doing to. Albert’s deafness is genetic and as a consequence Albert does not come without deafness. To choose to have a hearing child is not to have Albert with hearing, it is to bring Bertha, a different person, to exist. The upshot of this is that in bringing Albert to exist, we will not be inflicting deafness upon him, we will be bringing a person to exist for whom deafness is a part of that existence.
It may be objected that because I have simplified the scenario there is a disanalogy. But this is not significant. The difference is that in my version Albert will certainly be deaf, whilst in fact, he will only probably be deaf. This is not important because Albert can only be brought to be with this probability and this is not inflicted.
The claim that it is better to have a hearing child is more involved. My first response would be to wonder for whom is it better? It cannot be better for Albert. Better implies benefit and if Albert does not exist there can be no experience of benefit. Clearly, the couple does not think it would be better for them. That only leaves us, the rest of society. But to what extent does what is better for the rest of us carry prescriptive weight?
I see two related lines of argument here. Firstly, it would be irresponsible to intentionally bring into existence a person for whom we could not adequately care. This could perhaps be used in (unlikely) cases of severe disabilities, however, it does not seem to apply here as the court will have addressed the couple’s competence as parents. Secondly, we could point out that any disability will create responsibilities for all members of society. In the UK it might create a further burden on health and social services. Again, this does not seem to apply to this case given that this is in the USA, where state funding of healthcare is minimal. Whatever promise this line of thought has for grounding our objections, it could have far reaching consequences. For example, ought such foetuses be aborted for these reasons? Should some people be prevented from having children? We should proceed with these thoughts with due care and caution.
Alternatively, by ‘better’ we may be attempting to use an objective measure. By seeking the greatest happiness, the utilitarian quantifies the value of persons; a person’s value is contingent upon their contribution to the happiness in the world. Some people find the idea of quantifying the value of lives offensive; rather more, I suspect, do not. Now, deafness is not a great disability and deaf people lead happy and satisfying lives, so it would require some powerful or perhaps nit-picking argument to tip the scales against them in this way. Suffering from social exclusion would be an obvious attempt but that is not simply caused by being deaf but by society failing to include the deaf; fault could be directed away from deafness to the complacency of the hearing.
So, the two grounds given for condemnation are not clearly applicable to this situation and we may need to adjust our responses to our new understanding of what is actually being done and accept that there is no wrong in it.
A related issue to this is that of screening for defects and disabilities in the unborn foetus in time to allow the option of abortion (defects are not all disabilities, being very small is just inconvenient in a world where everything is made for the tall). Deafness is not considered serious enough to justify this kind of action but many conditions are. And screening can now be done at a much earlier stage with a number of fertilized eggs examined and a choice made between them, this option may make it easier for people to justify selecting against even the relatively minor conditions.
There are from some quarters, growing concerns about this: should we allow this kind of screening? Is it obviously wrong or something that at least demands caution?
These are the two objections to screening that I hear most often:
1. It devalues the lives of those living with the defect/disability screened.
2. It violates the right to life.
The first of these may rest on the assumption that the choice is utilitarian. If this is the case, then we require a reasoned rejection of utilitarianism that requires the quantification of value. However, this ignores the possibility that parents may not consider the life of less value but might be making a decision based upon their ability to cope with that child’s upbringing. This must surely be a fair consideration. Alternatively, there is often a sociological point that is being made. By selecting babies this way, we may contribute to or cause a phenomena of social (rather than moral) devaluation of existing people with these disabilities. This sort of devaluation is not posited as a necessary consequence of selection but could obtain if we do nothing to actively prevent it.
The second objection takes two forms. The first is a principled objection to abortion which is beyond the scope of this essay. The other is the claim that the foetus or egg, that is, the potential person, has an equal right to exist. In the last case, we would be saying that Albert and Bertha have equal right to exist and to make a conscious choice between them would violate that. But how can a potential person, a nonexistent, have rights? There can only be potential rights here and we cannot violate rights until they are actual.
Genetic manipulation is sometimes held to be a natural progression from selection. This is not obviously the case but the possible reasons for selection and manipulation may overlap; furthermore, our brief re-thinking of selection may also bear on the common objections to manipulation. Whilst this has not yet come to be a reality, the idea and the moral objections to it are very familiar, so familiar that we might not see a need to question them. The idea is now familiar but we made the mistake of applying familiar attitudes from the outset when it was not. Now that we are so close to the reality of human cloning, this might be the time to begin rethinking.
Some of the objections made are that when we genetically manipulate we are:
a. going against nature;
b. exerting control over a person;
c. denying the person freedoms;
d. exploiting a person.
I do not wish to dwell on the first of these here, the problems with defining ‘natural’ with moral weight are much discussed. The word ‘natural’ is simply too vague to be of any moral use to us, at one extreme too much is included as unnatural and at the other, nothing can be unnatural. The remaining three are things that we do to a person and so, as noted before, cannot easily apply to bringing to be. But they should not be so quickly dismissed, as the element of design sets this problem apart from the last two, we should look a little more closely.
It is worth pausing and asking if, through manipulation we may indeed do to in bringing to be. In the earlier example I said that Albert could not be brought to exist without deafness and with donor selection, this is the case. But now consider the case of Claude and the zygote from which Claude develops. We can in large part agree that, whatever its potential, a zygote is not an actual person. So in doing something to a zygote, can I be doing anything to a person? Imagine that I plant a time bomb in a populated area but set the timer for 100 years from now; I do this with the intention of it killing future people. Imagine that it goes undetected and detonates, killing people who, at the time of my planting the bomb, did not exist. I don’t think it too contentious to claim that I killed those people. Returning to the zygote, if I make a genetic change that will have only one effect, deafness, will I be making Claude deaf? The answer seems now to rest upon another question: would Claude with deafness be a substantially different person to Claude with hearing? If the answer is no, then I have indeed inflicted deafness in bringing Claude to be. This introduces the tip of a very large iceberg: the question of the indeterminacy of personal identity. If personal identity is a matter of degree, then whether we are doing anything to a person may depend upon how many manipulations we make and upon the extent of their effects. But can this allow us to apply the other common objections to manipulation?
The matter of freedom seems the most problematic to me: just what freedom do we have in mind here? What do we think is being denied in design that would be present without? As an undesigned person, I possess genetically determined predispositions and potentials. But I was never free to choose these, they are a part of my identity, I came with them. This would be true of the designed person. The only freedom I might have with regard to these things (and this is contentious among philosophers and psychologists) is how I live with them, whether to act upon or try to resist a disposition, which potentials to try to meet, or how to compensate for my failings, perhaps employing technologies to improve some potentials. This would also be true of the designed person.
Exerting control and exploitation are things that are practised in the world in different forms and degrees, both legally and illegally. Manufacturers exploit our dispositions for profit, it is also argued that they try to create new dispositions and preferences to exploit, which is a form of control. Control over our choices and perhaps dispositions may be exerted by companies and governments alike by releasing or withholding information or disinformation. Some of this we accept happens within certain moral boundaries, some of it we find clearly wrong. Perhaps the extent to which we find it wrong could assist us. If a person were designed specifically to make such immoral exploitation and control possible or easier to achieve, then we have grounds to object, not because the act of design is wrong, but to prevent wrong-doing. This does not say enough for us as we live in a capitalist framework which requires us to be good producers and consumers, a framework most of us find acceptable. But the thought of producing people predisposed to be good producers and consumers is repugnant. But if this production is not itself an act of control or exploitation and the control and exploitation of those produced persons is within moral limits, then how can we object?
Perhaps the only way forward is to reassess our values and beliefs about ourselves and the kind of world in which we live.
When people talk of wanting to make these manipulations affecting their children, they do so because they want those children to be somehow better, and more successful in life. We should ask what we think makes a person better, and in what sense do we mean successful? Not everyone measures the success of their lives by the same standards; are our standards the best or right ones? More fundamentally, from where do our beliefs about these things come; to what extent are they given to us? By whom are they given and from what motive?
The other thought comes from a response familiar to most of us, the feeling that manipulation and selection seem to devalue human life, to reduce it to a product that conforms to the wishes and/or interests of others, be those for profit, vanity, convenience, or to save the life of an existing child. We don’t always want to condemn these choices but we often feel that there is a violation of what we might call the sanctity of human life. This is possibly an entirely personal value, that should not be quickly imposed upon others, if at all. But perhaps it is a value that must be held to some degree, in some form for us to be at all moral.
There isn’t space here to discuss my objections to utilitarianism but I would like to introduce a Kantian thought that is beginning to appear in debates. Immanuel Kant’s imperative, that we ought only to treat people as ends in themselves and never as means, is often criticised but I would like to suggest a different approach. I would find in Kant not an imperative but a way of valuing people. That is to say, to value people morally requires that we value them as ends in themselves and not as means. This does not give a tidy formula for moral rules but it is an approach that alters our perspective on these issues and perhaps gives us grounds for some restraint.
I shall close by returning briefly to the matter of selection and a new problem in the light of this Kantian thought. Recently screening technology has been put to a new use. In what are rare and extraordinary cases, parents have tried to select embryos from IVF treatment for a tissue-match with their existing child. This tissue match allows the selected child to act as a tissue donor (usually bone marrow) to save the life of the existing child. This is an extreme measure and is only considered as a last resort. In England the legality of this practice is uncertain, with one couple recently granted a license and another refused one.
The objections to this practice have in large part been made on the grounds that it is ‘unnatural’. But there has been a more persuasive argument employing the Kantian attitude above, claiming that this is wrong in principle as we are valuing a child as a means to another’s end. I have suggested that to value morally is to value persons as ends in themselves, but does it follow that to value persons as means is always, if at all in itself, immoral? A salesman may value his customers as means to his own income, but this does not preclude his valuing them morally also. There are honest salesmen. So, if a couple values their second child as a means to saving their first child, this does not preclude their loving her as much and in the same way as their first.
A second important consideration concerns the status of omissions. An outcome is the product of a set of necessary conditions and these conditions may include omissions. In this way omissions affect outcomes and are themselves actions. By not shaking hands, I insult. By not feeding someone, I kill them. The point is that not permitting the selection is choosing, and taking (at least) a measure of responsibility for, the death of the first child. It is a killing. The objectors’ contention must be that it is a justified killing. But it is still a killing. This puts us on the horns of a dilemma. On the first horn is the evil of selecting a child to save the life of another (though I hope I have shown that this is not necessarily an evil). On the second, is the evil of choosing the death of that other child. Do we consider one a greater evil than the other? Do we need to be utilitarians to make such a choice? I would suggest that the creation of a child, if it is an evil, would at least be a consolable one. The new child may, as noted above, be loved in itself. However, the death of a child can have no consolation and on this ground alone I would wish to reject it. The matter is not black or white but again the media has shown little sign of giving it due consideration.
© J. Neill Furr 2002
Neill Furr studied philosophy at the Manchester Metropolitan University. He has a particular interest in applied ethics.