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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.
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It’s not that it changes all assumptions immediately, but it seems to me pretty hard to argue that it changes no assumptions or that it won’t change more over time. And maybe we need to talk about how it is morally compromised in each case–anonymous sperm donation, surrogacy, egg collection, deliberately separating children from their biological parents, etc. I find all of these morally troubling. Which ones do you think are untroubling? I don’t at all think existing laws cover the problems because ARTs bring a whole new set of problems and issues.
I’m starting to get really annoyed by this argument. Its used all the time by SoCons who can’t point to any specific harms and actual negative externalities as a way to short circuit logical argument.
There are enough troubling aspects of certain ART procedures to justify a little caution without resorting to nebulous civilization threatening consequences that aren’t falsifiable and therefore do not engender good faith discussion.
Jamie, the fact that you are annoyed does not change the efficacy of the argument. As an historian, I can tell you that people behave according to their underlying assumptions. If you don’t or won’t see that, there is nothing I can do about it.
Merina: it is not even an argument. How can you have an argument about something that neither side can prove. Its like say “Well I just feel its wrong therefore it is.” Ummm, great? Its an argument made entirely in bad faith and does not serve to further discussion from either side.
Everyone has to make arguments about things they can’t prove all the time, especially when we are talking about proposed changes. It would be immoral not to speculate about this sort of thing. Everything in the world is not concrete and measurable. We are humans who are capable of abstract thinking–moral reasoning–that affects our actions.
Yes but at least they can explain the mechanism or process why which those negative externalities will occur. Take Obamacare for example: using economics one can show how various markets will be affected, how peoples rational choices will be shaped, and extrapolate this into all kinds of things such as increased costs for insurance, the collapse of certain insurance markets etc.
What your argument does is completely short circuit the bulk of that process. You can’t point to any specific mechanism or processes that will change, you can’t point to any specific behaviors or rational choices that will be shaped, instead you say “underlying assumptions will change therefore disaster”
That’s just not good enough.
I could do the exact same thing with a whole host of policy preferences that SoCons would love to implement:
Banning ARTs will change the underlying assumptions about medicine and technological progress as a whole leading people to shun future breakthroughs and creating a new scientific dark age.
You can’t prove that this won’t happen.
No, it isn’t like that. In principle cultural and sociological propositions are not like “feelings” about things. They are based on what is observable in the world, but they take longer to appear and are more abstract to discuss, though very, very real. Generally they manifest themselves in measurable ways over time, but they are the essence of people assumptions and understandings about life, which leads to behavior. And they are things we must talk about if we are to live moral lives.
No, you can show that. You can see it in the cases I cited above. The mother who is suing over getting the wrong color baby no longer has the assumption that the baby I get is right. And in a sense she is correct, but only because the way the baby came put her in that moral and legal situation. The couple who rejected the Down’s baby the same. You create situations that change how children are viewed and what behavior of adults toward children are valid.
You are extrapolating from two very specific cases to a society wide problem. That is on its face ridiculous. What about the thousands of (tens of thousands?) of children conceived through ARTs where this never happens?
As an aside: A few of the first test-tube babies born from anonymous sperm donations have pointed out that the parents cared so much about the genetic background of their would-be children that they controlled that embryo formation process. Yet the same parents expect these children not to care about knowing exactly who their biological parents are.
Taking this one step further: why are we creating new embryos since we already have hundreds of thousands of them? Why are prospective parents not using the existing embryos?
Because they want more of their own input into the embryo creation process. I guess they don’t trust the embryos created by other couples or something.
My point is that genetics seems to matter to the parents a great deal. We should expect the genetics to matter to the children too.
Merina- You’re correct that you did not explicitly state that being natural is good. You did, however, express a preference for procreation via seedy and drunken sexual encounters over procreation via artificial means. You based this preference on the fact that you believe most people can understand seedy and drunken sexual encounters. The implication of this comment is that most people do not find artificial reproduction understandable. Understandable can have two general meanings: it can mean comprehensible, or it can mean deserving of sympathy. Under either meaning I don’t think most people have a problem understanding artificial reproduction.
I’m somewhat at a loss as to why you find drunken and irresponsible sex to be more understandable than artificial reproduction. You don’t drink and I would be shocked to learn that you were generally prone to promiscuous sexual activity. In contrast, you have elsewhere made comments about the importance of a biological bond between child and parent. With that in mind I’m a bit surprised that you do not find the desire of parents to have children to whom they are biologically related to be understandable.
By the way, thank you.
Interesting. I haven’t had time to read all of it, but this passage jumped out at me:
The study makes this statistic out to be a very bad thing. But what it tells me is that, whatever negative emotions donor children report on surveys, their actions show that many of them are actually pretty OK with the donor and surrogacy process. If they weren’t, “inflicting” that kind of life on another human being themselves would be the last thing they’d do, rather than something they’re 20 times more likely to do than children raised by both biological parents.
The argument made around page 60 that having their wives artificially inseminated by another man’s sperm leaves husbands less comfortable with their offspring than they thought they would be does have some prima facie plausibility – but because of nature, not artifice: men throughout history have worried about paternity, virility, and being cuckolded.
That some men don’t have the self-mastery they think they have and end up feeling cuckolded by their wives’ artificial insemination even after agreeing to it would not surprise me. Nor would it surprise me to find that women who use donor eggs with their husbands’ sperm do not feel similarly cuckolded.
Should couples be cautious about using donor sperm in light of the age-old fears men have about emasculation and being cuckolded? Yes. Is that reason enough to ban sperm donation? Probably not.
One last random thought. I found the following quoted testimonial laugh-out-loud funny:
That is so obviously a quote from someone oblivious to how many medical problems work within the context of family life.
Contrary to this quote, it’s quite normal for entire families to suffer ill-effects from a family member’s medical treatment, whether it’s just economic hardship from the medical expenses, or having to care for and live around, say, a cranky, weakened, vomiting, fecally-incontinent chemo patient.
Suffering together is one of the things that families do. It’s one of the things that families are for. You can’t really expect otherwise.
Phenomenal example of how me must look at what people do rather than what people say in order to find truth.
Who said it has to be the feds? The question, it seems, is whether this should be regulated at all with the assumption that the regulation would be carried out by the legitimate authority.
I’m just gonna throw this out there and then run away because I have a mountain of work to do and a short time to do it. Oh, and I also don’t have a study to back up the following:
The same dynamic can be seen in victims of various abuse: they genuinely wouldn’t want to inflict that abuse on others, and yet they do exactly that at increased rates as a group. So “actions speak louder than words” may be true generally but it is problematic in some circumstances.
Ed- abuse is a pattern of behavior. When people grow up in an abusive household that is the behavior they learn, even though they recognize that it is harmful.in contrast, sperm donation is not a pattern of behavior which a child learns. For the child who is a product of donated sperm the donation is a one time event which occurred prior to the child’s existence. Unlike the victims ofabuse who grow up to themselves to be abusers because that is the behavior they learned in their formative years, children are created by sperm donation who grow up to themselves donate sperm are not acting on learned patterns of behavior.
It’s still true in your case. What is happening in both cases is social desirability bias. People know that the right answer is to say they would never abuse someone. They also likely feel that conveying negative experiences about being and ARTs baby are the answers that the questioners wanted. In both cases, people were wrong about themselves or were lying. Actions speak louder than words.
Midge, when I was growing up my Mom had a career. I told everyone that I wanted the same career because in the community I lived in, most Moms stayed at home. I felt like in doing so I was defending my Mom. I’m not the least surprised that a percentage of children of sperm donors do the same thing. It’s is in a way a defense of themselves and their unknown father. That is also cherry picking. The stats also show that children so conceived are far more prone to use drugs and other bad things. How is that to be explained?
But I agree with you that families are to help members through bad times.
Sal, we’re not communicating. I said earlier that I’m OK with ARTs between a married couple using their own biological material. Yes, I think the biological connection is very important. What I mean about the drunken couple is that I would rather be the child of that couple and then be adopted out than the child who is deliberately produced to be raised by someone other than biological parents. I can understand misbehaving young people. I make mistakes and other people do too. I would have a hard time understanding unrelated adults creating me and deliberately depriving me of my biological parents because they wanted a child. I’m pretty sure I would feel deprived of something that is my right (insofar as this is possible)–my biological heritage–in a way that the drunken couple did, but not deliberately. I don’t think everybody would feel this way, but I think a substantial number of people would. People who participate in ARTs do not, IMHO, take into account placing this burden on the child they help create. This is part of why I think it is wrong to create children and deliberately separate them from their biological heritage.
Even if this true, it is insufficient to override the obvious good of being alive and the pursuit of one’s own idea of the good, even if that includes producing children by means that makes others queasy.
The embryo stuff is suspect, but we should allow processes that increase the net good of the world (in this case the number of generally healthy people, even if somewhat less healthy than average) that is the result of the informed consent of the people involved.
In cases where there isn’t perfect knowledge, we must allow the acquisition of knowledge to maximize the good overtime. It’s a learning process, and we’re learning.
It is not difficult to find peer-reviewed medical studies on the risks associated with ARTs for parents and children.
See here (American College of Obstetricians and Gynecologists), here (Oxford Journal on Human Reproduction), here (Centers for Disease Control), and here (National Institutes of Health).
This would no doubt do awesome things for SoCons’ image as nannies who want to stick their noses into the most personal details of your life.
Not to mention the fact if I were an ART parent, I would probably stress from day one that my kids were special, not different. I would be probably making a big deal out of the fact that I had designed my child. I’m sure that is a good thing, and it bodes well for the emotional health of ART children going forward since it seems to be a fact of life. It would be the smart way to handle it.
Nevertheless, should things get stormy through the rebellious teenage years, those coping mechanisms that worked during the middle school years can so easily turn into a child fantasizing about his or her “real” parents. Heck, this happens in divorce. Kids in divorced households perceive themselves to have a lot of choices.
These are issues that will play out family by family. As they always have and always will.
Clearly there are some things about ART that need stiff regulation–donor anonymity, for example–and others that need only careful attention by everyone involved.
There are many problems with ART that occur with all adoptions as well. We want, for example, adoptions to be completely final and closed doors. That encourages adoptions, which benefits us as a society. But as much as we want to believe that an adoption ends with a sealed file on the biological beginnings of a child, that has not been a black-and-white issue. So many adoptees were not happy about that that there is a registry where biological children and their parents can find each other. In the eighties, the unsealing of adoption records was as controversial as ART is now.
Saying I found one of the testimonials incredibly funny is cherry picking?
No, it just made me laugh and I wanted to pass it along. I have a terrible sense of gallows humor. Some people consider this one of my more charming qualities.
To really answer this question would take an in-depth statistical analysis of the study in question, which I have neither the expertise to do quickly nor the time to do as slowly as it would take for me to do it well.
I did note, though, that donor children who don’t know that they’re donor children were left out of the study entirely. Apparently, many parents plan on keeping the details of their children’s conception a secret (not such an unreasonable plan, to my mind, considering the secrecy that naturally surrounds sex).
Of the children whose parents never intended them to find out they were donor children, many learned the secret during the course of family drama, such as divorce.
I also noticed that 27% of the donor children in that study were born to single mothers.
Divorce and single motherhood come with their own problems. I don’t know how big these confounding effects would be, but were they adequately controlled for? Maybe, maybe not.
Moreover, the genetic predisposition of the donors toward substance abuse and mental health issues wasn’t (and in many cases probably could not be) accounted for.
In short, the statistics in that study may or may not stand up to closer scrutiny. While I don’t have the expertise to make a judgment on that after a quick skim, I do have a sense of some potential holes here and there.
Mike, “the obvious good of being alive” is not a valid argument here. We’re talking about people who don’t exist and what is a moral way to give them existence. By the “obvious good of being alive” logic, any way of bringing people into existence would be good, but we already know it’s not. Rape is not a good way of bringing people into existence. The question at hand is what are moral ways of bringing people into existence. Being a “healthy” (I assume you mean physically) person is obviously not the only question at stake. There are a lot of other goods and values to worry about–connection to family, psychological well-being, cultural understandings and all the rest. Since we are moral, thinking beings, I don’t think we need to conduct experiments on humans in order to learn what is bad and good. There’s already quite a lot of evidence and we have history and tradition to guide us. That’s why I think we need to have a vigorous national debate (which is already going on, of course) and pass some legislation either in states or nationally regulating this in a moral and humane way.
Let me ask you–why do you think that almost every other Western nation regulates ARTs?
I like your sense of humor too. I meant the stat about numbers of sperm donor babies who themselves donate when grown. I think this study had a separate category for single mothers, but yes–all studies have holes. I’m going to spend some time looking over the info that Mama linked.
Everybody wants to control law and culture. You do too. That’s why we have national conversations, so we can figure out the wise, moral, humane way to formulate our mores and laws in ways that encourage and reward moral living while allowing maximum freedom. Is that a nanny state? Well, nothing is a nanny state compared to what the left does, but if you’re going to live in society with other people, you will have rules and mores and people who impart and enforce them. The question is, what form will they take? That’s what we’re talking about here.
Most other Western nations have socialized medicine. So what?
But that has nothing to do with ARTs. Why do you think they regulate those?