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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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Other’s might disagree, but they are obviously wrong, at least if they believe moderate, at most, psychological harm constitutes a reason to deny existence. If this radical, and I would argue evil, position is really the main counter-opinion, I don’t know how this conversation will be fruitful.
Er, no. I don’t think I suggested that you and anyone else should be forced to use ART if you don’t want to. If you don’t like it, don’t do it, and try to persuade others to do likewise. Convince enough people, and those companies will die. Good luck.
And I’m only going to be impressed by the second point if you can come up with a substantial number of ART births who are willing to say ‘I wish I’d never been born’. Good luck. I’m sure their parents would have rather done it the ‘traditional’ way, but you’re suggesting their failure to be able to do so is and should be the end of the story. Such compassion.
Right now this is a fringe issue. I don’t know how many ART births there are right now, but I’m willing to bet it’s a smaller %age of births than – say – SSMs are of all marriages. The ‘traditional’ way is fun, cheap and reasonably effective, so ART at its current state is always going to be a niche. You don’t end up at such a clinic unless life deals you a tough hand.
Literal genetic editing is on the horizon, and it will change the equation as it becomes possible to remove harmful genes in the process of inception. Body birth, two parent family, using both parents’ genetic material, but lab intervention up the yin-yang. Today’s alternative is post-conception genotyping often followed by abortion. Still want to walk away?
Sal, it was a passing point meant to show that worldwide this is considered an important ethical issue, and intended to further the discussion. Now tell me what you think about the various aspects of ARTs. Sperm donation, egg donation, surrogacy, payment for these things, deliberately depriving children of their natural parents. Do you have views on these issues?
As I said, your vote is noted.
Your last paragraph shows why this won’t remain a fringe issue.
Look, we are all in this together, so if you want to leave these things unregulated, you are trying to force your morality on me because that is a big factor in what the nation we both live in is. Life issues have never been seen as strictly free market propositions, nor should they be, because they are far too important to the moral fiber of our nation. Would you like Planned Parenthood to be telling us all how many months pregnancies can go before abortion? It would be nine and infanticide would be legal. That’s why we can’t leave these issues to the free market either.
This is all very newish, so data isn’t over plentiful, but there is some. We can combine what there is with moral reasoning to come to agreements on what is ethical and what isn’t.
Merina- I do have views on all those issues. I view them as being morally unobjectionable.
Mike, here’s the thing. Prospective children don’t yet exist, right? So they don’t really have a right to life because they could be created in a number of different ways. We don’t think that all of those ways are morally equal, do we? We all agree that we should do all we can to prevent children from coming into the world in bad ways, like through rape. So that means we all agree that even though children could be brought into the world through rape, that wouldn’t be a good thing. In spite of that, though, there are children who have been brought into the world that way, and we love and welcome them. So that is a separate thing. But the point is that we agree that we can’t just say that any and all ways of bringing children into the world are good. We have no moral obligation to bring children into the world in any way possible, quite the contrary. There are moral issues connected with that process, and as thinking, moral humans we have to try to determine what those are and how they will affect the children that result from them. That’s why this is a very sensitive and difficult issue. Just because someone wants a child, does that mean they should have one? Do you think people have a “right” to a child? I would answer no to both those questions. What are your thoughts on that?
So if something is really, really morally important, it shouldn’t be left up to the market?
I agree with you, but no one else has a “right” to say who cannot produce a child.
Thank you Midge, I didn’t want to have to make that necessary point.
Let’s give you some real cases. Over 500 clinics in India have sprouted up to provide babies for people worldwide. Very poor women are brought to the clinics to live away from their families (so diet and health care can be controlled) while gestating a baby for someone else. Many are pressured by their husbands to do this because the money is very good for poor people. Very few do it more than once because it is so emotionally traumatizing. Do you think this is morally unproblematic?
In case you’re curious, I don’t believe that anyone has a right to children, either. Children are wonderful blessings, and humanity’s continued survival depends on adults wanting to raise them, however they were conceived. But they’re not a right. (Nor is good health a right, etc, etc.)
I don’t, based in the limited information you presented.
Not life issues, no. I mean, we know that everybody dies and superhuman medical resources cannot be used to prolong life when they won’t help. But on the other hand, we don’t hurry death along. So that’s not exactly a market force, that’s just a fact of life. But no, I obviously think the ARTs market should be regulated, as should abortion and euthanasia.
Market forces are not a fact of life?
Sure they are, but we don’t let market forces control everything, now do we?
No, but that’s probably universally immoral.
I don’t think that’s exactly what regulating ARTs does. No one is going to tell a woman she can’t have a child the old-fashioned way. But I think it behooves us to carefully examine how it happens in other ways so that abuses and exploitation don’t occur, and so that the needs and desires of children are put front and center.
Merina- I actually don’t consider those cases to be particularly morally problematic. Certainly not problematic enough so as to justify state regulation or prohibition. If I recall correctly, we discussed this issue at some length on Rachel’s post on baby selling.
Well, you’re (mostly) wrong about the most important aspects, but that’s ok! I’m sure I’m wrong about a lot of things too!
That’s not what any of these countries are regulating. They are regulating certain aspects of the use of ART. Such as the use of anonymous donors.
A certain amount of regulation is necessary in the complex life we live. For heavens sake’s, hair dressers are regulated–they use dangerous chemicals.
As Ralph Nader said, a person shouldn’t need an engineering degree to buy a car with brakes that work.
Maybe a horse and buggy a hundred and fifty years ago, but our lives today are a lot more complicated.
All adoptions are overseen by the state. Why wouldn’t ART be too?
I don’t think you really believe that Mike.
Merina- re #138, doesn’t that bring us back to the question of whether natural qua natural is superior to artificial?
Mike, did you get past the idea yet that just because something could exist it should? It’s really important to get past that.
I think the rape analogy is quite apt. Look at the photograph illustrating this post.
But of course we are. Why is that wrong? To learn from other countries? We can benefit from their experience, right? :)
I’m sorry Marci, but this is an appeal to popular convention, and what is popular is often wrong. Complexity is an argument against regulation.
I don’t think so at all. There are all kinds of questions involved about the moral use of various people in the equation, living and potential. It’s far beyond a natural/artificial debate. The question I posed to you about surrogates for example.
Do you write for HuffPo?
Mike, I’m with you about regulation in most cases, but not in life issues. Let me ask you, do you think abortion should be unregulated, as in available for the full nine months to anybody?