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The Ethics of Artificial Reproductive Technologies
Hand-in-glove with recent debates about marriage should be debates about artificial reproductive technologies, or ARTs. These have been largely unregulated in the US, resulting in a wild west of anonymous sperm donation, surrogacy, three party reproduction (egg, sperm and surrogate all from different people) and hundreds of thousands of frozen embryos awaiting….something.
Most Western countries regulate this industry. Though I’m generally against excessive regulation, I think we — as a nation — need to do the soul-searching and caution that the ART industry is seems so uninterested in doing for itself. In most Western countries, anonymous sperm donation is illegal, as is surrogacy. Many regulate the number of embryos that can be transferred per cycle, resulting in far fewer multiple births. These regulations arise from a great many legitimate ethical concerns. Most nations — and some U.S. states, to some degree — but not in America as a whole.
What are the problems with these under-regulated practices? Anonymous sperm donation means that the number of children conceived by sperm donors is unlimited. Donors are often medical students looking for a little extra cash. One young sperm donor passed on a serious genetic heart defect to 9 of his 24 children. Beyond such health concerns, imagine being the child of a sperm donor and wondering if everyone you meet might be your half-sibling. You could never even be sure about people who know their own two biological parents because the father might have been a sperm donor.
Not surprisingly, the incidence of drug and psychological problems is appreciably higher for children conceived in this way, and 50% report feeling sad when they observe biologically connected families. In countries that require that donor identity be attached to sperm, donation plummets. Many also severely limit the number of children that can be produced by any one donor. At a minimum, we should have both of these regulations.
Akin to sperm donation — though on a smaller scale for obvious reasons — is egg donation. Potential parents advertise for eggs at elite college campuses and on Facebook, often with emotional appeals about giving “the gift of life.” What they do not advertise is that stimulated egg production jeopardizes the reproductive health of the donor. And then there’s the commodity angle. It is obvious that parents are looking for high intelligence by seeking genetic material on elite college campuses, but many even seek other traits like ideal height and weight and attractive features. It is the ultimate commodification of children, short of the day (may it never come) when all traits can be specifically chosen. Methinks many purveyors of diversity don’t actually like the reality of diversity.
Surrogacy also carries with it multiple risks. Pregnancy is always a risk, many of these pregnancies result from multiple egg implantation, resulting in the birth of multiple children and far higher risk. In the U.S. and India, it is legal to pay women for surrogacy, so poor women can easily be manipulated. And of course, women’s bodies, hormones and natural human emotions prepare them to want and love the baby they carry, though they sign away all legal rights before this natural process begins. The cannot change their minds as they come to love the baby they carry, who is sometimes their own biological child. Very few women want to repeat the experience and many find it deeply damaging.
We all feel deep sympathy for people who want children and are unable to have them. But in all this ethical morass, the most important questions should always be about the children. People who pursue artificial reproduction are making a decision for a person — the resulting child or children — who will have to live with the consequences of that decision, which often means that they have been deliberately deprived of one or both biological parents. To those who say that the child would rather exist than not exist, I will just say that this is not how we think of children. By that logic, every time we pass up an opportunity to make a child, by rape or any other means, we have deprived a child of existence.
Many here have said in previous discussions that biological parentage doesn’t matter. I agree that the most important aspect of parenting is the emotional connection to the child. The adoptive parents I know are wonderful, and generally both parents and children are deeply grateful that they were brought together, the parents because they longed for children and were unable to have them, and the children because, though their biological parents were unable to care for them for some reason, they cared enough to find fine people who could give them a good, stable home.
But what about children who are deliberately created to be separated from their biological parents? This is a very troubling practice. Buying and selling humans has always been associated with slavery. Remunerative ART is not exactly the same, but it is not entirely different because it often deliberately breaks the parent/child bond that is understood to be so beneficial to children. Doing this risks changing the way we think about children.
Recently, an Australian couple went to Thailand to find a surrogate because surrogacy is illegal in Australia. The surrogate gave birth to twins, one of them with Down’s Syndrome. The parents refused to bring the Down’s child home, and the Thai mother, who wanted the child but had participated in surrogacy because she was poor, could not afford to raise him. Does anyone think for a moment that if that child had emerged from the body of the woman who contracted for his birth that she would have refused to take him home? Having a surrogate bear that child changed the way she thought about him.
All of this enters the philosophical territory about what it means to be human, to know who you are and have a place in the world. A child who is given to adoptive parents may not know the circumstances of his birth, but he surely knows that his birth parents made some kind of human mistake: most likely they were teenagers or college students who got carried away, and no doubt they suffered for that mistake and learned something in the process, as is so nicely illustrated in the movie Juno. But what about the child whose parents deliberately created him because they wanted a child, using a grab bag of genetic material? What does it mean to be deliberately deprived of your biological heritage, which connects us to a human chain that stretches behind us since the beginning of time and, if we have children, continues after us till the end of time?
This is deeply meaningful and integral to who we are. It gives us a place in the world. People can be adopted into biological chains, sure. In our family, there are 20+ cousins on each side, and both sides are happy to include an adopted child. Those children are every bit as much a part of the family as the other children. But our blood tie is strong because most of us share it. Like all families, we have our arguments and annoyances, but in the end we are family. Blood is thicker than water and we overcome our little tiffs because that’s what families do, partly in honor of those people we share who produced us. We often talk about them and speculate about the genesis of some of our traits. That’s what it means to be a family.
Years ago I read The Handmaid’s Tale, which I greatly disliked. The lefty author posited a silly fictional world where patriarchal religious leaders instituted a system of producing children that involved designated “handmaids” as child factories. No one who understood Christian reverence for life would ever write such a book, but change the background story to ART companies in search of profits, and that is exactly what we have today. It is a growing “industry” that it is time to regulate.
Published in General
In Canada, it’s illegal to sell any body part or fluid. That means there’s a perennial shortage of blood and blood plasma for transfusions.
The “pure libertarian” stance is that no person may initiate violence and/or coercion against any other person.
The question, therefore, revolves around the definition of “person”. For example, there are many pro-life libertarians, because they believe that embryos and fetuses are persons.
In the case of ART, many libertarians would take the position that one is free to do what one wants with one’s own genetic material, but that one is subsequently responsible for the consequences.
I would think then that libertarians would consequently be against ARTs because it usually involves producing children that one does not intend to take care of. But I suspect that the aversion to regulation overrides this for many. As for the harm principle, I’ve never thought it was much use at all because the definition of “harm” is necessarily subjective. Still, in these cases, there certainly is great potential for harm which would be a reason for libertarians to oppose it, but since the child doesn’t yet exist yet, who knows?. Actually, it looks like libertarians could justify either side.
Counterfactual: Australia allows paid surrogacy but requires — as any moral regime must — that those who commission a surrogacy bear all the legal responsibilities of parenthood.
These horrible, awful people would then rightly face child abandonment charges for leaving their Downs child. If I were a judge or D.A., I’d throw the book at them.
Interesting hypothetical, Tom. That would be the right thing to do, but you wouldn’t want to force these awful people to take the child. I do think that on a philosophical level, participating in the buying and selling of children in this way changes how we all regard children, whether we like it or not. We move away from our understanding that children are what you get and you love them no matter what, to a place where we think that we have a right to expect something in particular, as was the case with the lesbian mother who got the African American sperm. Her daughter is in for a lifetime of existential self-questioning because the case is famous and she will always know that she isn’t what her mother wanted. And the thing is, in a legal sense, the mother has a case. Creating that child artificially has in fact changed how the child is viewed.
You have to wonder at the ethics of the mother. I’m going to be judgmental here and say that no mother who cared more about her child than getting a big settlement would bring this case to court because she would understand that the potential damage to the child is enormous. Not only has she brought these circumstances to the attention of the entire nation so that this little girl can never escape the notoriety, she has told her in no uncertain terms that she was a “mistake”. You have to wonder if the state shouldn’t take her away from such a terrible, selfish mother, but then her only genetic tie to a parent would be severed, since her father is anonymous–as in nobody is really her father. Brave New World indeed.
I wouldn’t describe ART as so much changing things, as heightening the contrast. Stories like the one in Australia underscore some people’s selfishness and disgusting sense of entitlement. Stories of parents desperately wanting a child and embracing and loving them even if they didn’t get exactly what they wanted even after spending a lot of money, underscore their selflessness and compassion.
To cherry-pick a different example, I’d rather learn that my parents wanted me so badly that they sacrificed a years’ wages to make me than discover that I was the product of a seedy night of drunken sex between strangers.
Again, it depends on how the individual answering the question defines “person”. Those who consider embryos “persons” would presumably oppose any process which creates “surplus” embryos.
Actually, I wouldn’t. Because a seedy night of drunken sex is human and natural. It is something most people can understand. While I sympathize with parents’ desire for a child and even admire their sacrifice, the way parents pursue children–by seeking just the right sperm and egg in many cases–shows that they are also looking for a specific type of child who will make them proud instead of just wanting a child to love and raise, no matter what he or she turned out to be. It’s just an ugly world that changes expectations and incentives. Not all at once and not for everyone, but it is a subtle shift that over time becomes less and less subtle. I don’t think it is a road we want to go down.
Just as follow-up to #34, freedom always comes with responsibilities. When some responsibilities are not fulfilled — especially with regard to children — it’s entirely appropriate for government to have a role in enforcing them.
Merina, if we only focus on examples where ART is pursued for selfish and shallow reasons, then *of course* it’s going to look selfish and shallow.
Given how often people abort Downs fetuses — however conceived –I don’t think the problem here stems from ART.
But they highlight the problems in how ARTs change the way children are regarded. That’s my point. Sure, there are happy stories, but the underlying understandings about children don’t stay the same.
No, that is true. The ability to determine problems in utero has also changed the way people regard children.
When my youngest child was born I was 36. They encouraged me to have an amniocentesis to determine if there were genetic problems, since the likelihood goes up after 35. At the time there was a 4 percent chance of spontaneous miscarriage from the procedure. Because I would never have an abortion under any circumstances, and would not risk losing the baby, I refused the procedure. I was raised, however, with a strong respect for life and an understanding that life is valuable, whether a perfect baby emerges or a handicapped one. All babies were loved and valued. I grew up with many sweet Down’s people in my community, who were an integral part of it. I miss them.
All of these things contribute to diminishing respect for life. It impoverishes us all.
Merina, I’m interested in this subject and unlike SSM, I take your side of it very seriously. But there’s a difference between peer reviewed scientific research and publications simply put out by advocacy groups. Far as I can tell, the latter is all we have here, certainly in the case of your first citation and I’m pretty sure with the second as well.
I tend to think that technology doesn’t change how people think about things, so much as let them act on the things they believe anyway. Respect for life is both a cultural in innate thing, but like most qualities, it probably has less to do with upbringing than genetics and personal choice.
I wouldn’t want to see some sort of blanket ban on ARTs, and if there was one, like most every ban, it would make people turn to the black market. Then what would you do about the stigma, dangers, and legality of producing and being a black market baby? That seems worse.
Merina, I have a lot of reservations about some forms of ART, but you’re conflating a broad spectrum of technology with the motivations under which it is sometimes pursued.
I’d also like to point out that abandoned babies and parents who feel they’ve been “cheated” out of what they expected is hardly a novel problem.
Merina- re #38, simply being natural does not necessarily make something good. Being artificial does not necessarily make something bad. As someone who in his dissolute youth engaged in quite a bit of seedy and drunken sex, I can unequivocally state that I would prefer to be the product of artificial reproductive technology than two drunken college students bumping uglies in the parking lot of a dive bar. I know you think artificial reproduction is usually inherently selfish, but I don’t think that’s the case. Conscious and deliberate efforts to have a child are not anywhere near as selfish as running the risk of creating another human being with someone you barely know simply because you’re horny and inebriated. I would also argue that if we are genuinely concerned about the welfare of children we should prefer artificial reproduction to drunken couplings. The former results and children being raised by people who cared so much about having a child that they were willing to expend vast sums of money and undergo invasive medical procedures in order to have a child. The latter frequently results in children being raised by people with no particular interest in having a child and who consequently do not do a very good job of it.
No. I’m not. I’m talking about bad changes in underlying assumptions about children and about being adults who are moral persons who have to discuss the issues inorder to make decisions about what is moral and what is not, and then work to pursue legislation that assures a moral approach to bringing children into the world.
But this is irrelevant to bad consequences of using new technologies indescriminately, isn’t it? The existence of bad situations and abuses in the past is no excuse for opening up new avenues for abuses.
Sal, I did not say that being natural makes something good, now did I? I said that it makes it understandable. Can we stipulate that both situations are selfish? And that neither is justified.
BTW–congratulations on getting married!
I have to disagree with you emphatically Mike. People are naturally moral creatures as Midge has wisely pointed out in the past, but they are very malleable. They will drift into all kinds of immoral things left to their own devices because of selfish instincts. They have to be be taught to be moral in myriad ways. Forms of institutions and the law are part of what teaches morality, along with straight-up teaching. That is why we have to talk about what is moral so that we can teach people to be moral and shape our institutions and often the law to help them understand what is moral. Please don’t go off on me trying to impose my morality. As a nation we have to discuss this and make some decisions.
I’m not sure I’d put a blanket ban on ARTs. If a married couple uses their own genetic material and ARTs to produce a baby, that seems OK. But I think it is wrong to create too many embryos and then freeze the extra. Very, very wrong. I also believe is it very wrong to create children that you deliberately intend to separate from their biological parents.
If you want to talk about morality, lets start with the least controversial case. It would be immoral for you to physically try to stop a loving heterosexual stable married couple from producing a child they couldn’t otherwise produce with ARTs. This includes giving someone else the authority to do so.
Mike, I think our comments crossed. See my response to you above.
In addition to my concerns about what to do with leftover embryos, I have concerns about the surrogacy aspects of ART vis-a-vis the mothers.
This is so hard to describe, but: I think prostitution exploits vulnerable young women, and once they’ve done it, it changes them irrevocably. I think surrogacy does the same thing. Given the biological aspects of what’s involved in both, prostitution and surrogacy have to affect the women engaged in them.
Prostitution and surrogacy look harmless to the young women contemplating them because the people around them and the laws seem to be saying “It’s okay. Go ahead.”
We give surrogacy and prostitution an air of safety when we legalize them. And the women making these decisions are very young and unsophisticated. The issue is one of informed consent. I realize that women over the age of 18 (or is it 21 in Nevada?) are able to give “informed consent” to prostitution and surrogacy, but how “informed” can their consent really be?
When it comes to surrogacy, we like to pretend that the mother is just some kind of machine. I don’t accept that as the truth.
Exactly. The issue as far as a married couple using their own genetic material is a very different question. Unfortunately there are not enough of these couples to support the burgeoning ART industry.
I was thinking last night about the embryos. What would this warehouse look like? Products on shelves with pictures of the parents? Can people go shopping now?
Re #49, the means already exist for dealing with the worst offenders by simply applying normal parental laws to those who contract surrogates. That will discourage wierdos like those Australians from considering behavior that they’re nto willing to follow-though in a moral way. I can’t imagine anyone would object to this.
I further agree that artificial insemination methods that create multiple viable fetuses and either freeze or dispose of the unwanted one are deeply morally troubling (and I say that as someone who thinks abortion should be legal in the first trimester). I don’t think anyone is denying that there are specific moral problems that come through ART. I do however, disagree with your notion that ART changes fundemental assumptions and is inherently more morally compromised than natural conception.
It’s always a good time for Blue Sky, don’t you agree?
I think what you’re missing is that according to Merina’s world view – all use of ART is selfish and shallow.
Only by the people involved in those particular instances it is no reflection on society as a whole. The plural of anecdote is not data.