This article explores the possibility that there is a parental duty to use preimplantation genetic diagnosis (PGD) for the medical benefit of future children. Using one genetic disorder as a paradigmatic example, we find that such a duty can be supported in some situations on both ethical and legal grounds. Our analysis shows that an ethical case in favor of this position can be made when potential parents are aware that a possible future child is at substantial risk of inheriting (...) a serious genetic condition. We further argue that a legal case for a duty to use PGD for medical benefit can be made in situations in which potential parents have chosen to conceive through in vitro fertilization and know that any children conceived are at substantial risk of having a serious genetic condition. (shrink)

Abstract It is common practice to regard participants in assisted and collaborative reproduction (gamete donors, embryologists, fertility doctors, etc.) as simply providing a desired biological product or medical service. These agents are not procreators in the ordinary sense, nor do they stand in any kind of meaningful parental relation to the resulting offspring. This paper challenges the common view by defending a principle of procreative responsibility and then demonstrating that this standard applies as much to those who provide reproductive assistance (...) in the form of medical services or gametes, as it does to coital reproducers or intending parents. Drawing on vocabulary from the common law tradition, I suggest that it may be helpful to refer to the various participants in assisted and collaborative reproduction (ACR) as accessories to procreation. Referring to the participants in ACR as accessories to procreation highlights the fact that these agents are not just providing medical services or products. They are participating in a supply chain designed to bring about new persons. I conclude by arguing that regulative standards in the fertility industry should be structured such that they permit, facilitate, and encourage agents to satisfy the requirements of procreative responsibility. Content Type Journal Article Pages 1-16 DOI 10.1007/s10677-011-9330-7 Authors Melissa Seymour Fahmy, Department of Philosophy, University of Georgia, 107 Peabody Hall, Athens, GA 30602, USA Journal Ethical Theory and Moral Practice Online ISSN 1572-8447 Print ISSN 1386-2820. (shrink)

Non-Identity arguments have a pervasive but sometimes counter-intuitive grip on certain key areas in ethics. As a result, there has been limited success in supporting the alternative view that our choices concerning future generations can be considered harmful on any sort of person-affecting principle. However, as the Non-Identity Problem relies overtly on certain metaphysical assumptions, plausible alternatives to these foundations can substantially undermine the Non-Identity argument itself. In this paper, I show how the pervasive force and nature of Non-Identity arguments (...) rely upon a specific adoption of a theory of modality and identity and how adopting an alternative account of modality can be used to reject many conclusions formed through Non-Identity type arguments. By using Lewis’s counterpart-theoretic account to understand ways we might have been, I outline the basis of a modal account of harm that incorporates a person-affecting aspect. This, in turn, has significant implications for ethical decision-making in areas such as reproductive choice and the welfare of future generations. (shrink)

The controversial question of whether a future child can be harmed by the use of reproductive technology turns on the way that the future child's identity is understood. As a result, analysis of the ethical and legal obligations to the children of reproductive technology that are based upon the possibility of such harm depends upon the conception of identity that is used. This paper reviews the contributions of two recent books, David DeGrazia's Human Identity and Bioethics (2005) and Philip Peters' (...) How Safe is Safe Enough? (2004) to this area of inquiry. It suggests that the use of a narrative rather than numerical conception of identity makes it possible to coherently claim that future children can be harmed by the use of reproductive technologies and that, as a result, potential parents can have obligations regarding the use of those technologies based upon that possibility of harm. (shrink)

: New genetic technologies continue to emerge that allow us to control the genetic endowment of future children. Increasingly the claim is made that it is morally "irresponsible" for parents to fail to use such technologies when they know their possible children are at risk for a serious genetic disorder. We believe such charges are often unwarranted. Our goal in this article is to offer a careful conceptual analysis of the language of irresponsibility in an effort to encourage more care (...) in its use. Two of our more important sub-claims are: A fair judgment of genetic irresponsibility necessarily requires a thick background description of the specific reproductive choice; and there is no necessary connection between an act's being morally wrong and its being irresponsible. These are distinct judgments requiring distinct justifications. (shrink)

In this article, I explore the ethical dimensions of same-sex reproduction achieved through epigenome editing—an innovative and transformative technique. For the first time, I analyse the potential normativity of this disruptive approach for reproductive purposes, focusing on its implications for lesbian couples seeking genetically related offspring. Epigenome editing offers a compelling solution to the complex ethical challenges posed by traditional gene editing, as it sidesteps genome modifications and potential long-term genetic consequences. The focus of this article is to systematically analyse (...) the bioethical issues related to the use of epigenome editing for same-sex reproduction. I critically assess the ethical acceptability of epigenome editing with reproductive purposes from multiple angles, considering harm perspectives, the comparison of ethical issues related to gene and epigenome editing, and feminist theories. This analysis reveals that epigenome editing emerges as an ethically acceptable means for lesbian couples to have genetically related children. Moreover, the experiments of a reproductive use of epigenome editing discussed in this article transcend bioethics, shedding light on the broader societal implications of same-sex reproduction. It challenges established notions of biological reproduction and prompts a reevaluation of how we define the human embryo, while poses some issues in the context of gender self-identification and family structures. In a world that increasingly values inclusivity and diversity, this article aims to reveal a progressive pathway for reproductive medicine and bioethics, as well as underscores the need for further philosophical research in this emerging and fertile domain. (shrink)

Ever since the publication of Derek Parfit’s Reasons and Persons, bioethicists have tended to distinguish between two different ways in which reproductive technologies may have implications for the...

In a common example of the non-identity problem, a person deliberately conceives a child who she knows will have incurable blindness but a life well worth living. Although Wilma’s decision seems wrong, it is difficult to say why. This paper develops and defends a version of the “indirect strategy” for solving the NIP. This strategy rests on the idea that it is wrong to deliberately make it impossible to fulfill an obligation; consequently, it is wrong for Wilma to create Pebbles (...) because doing so makes it impossible to fulfill her obligation to protect her child from harms like blindness. A challenge for the indirect strategy is the well-known “rights waiver problem”: Since Pebbles’s very existence depends on Wilma’s having made herself unable to fulfill an obligation to Pebbles, Pebbles is likely to waive that obligation. I address this problem by recasting the indirect strategy in terms of a non-grievance evil. I argue that deliberately making it impossible to fulfill a moral obligation manifests a defective attitude toward morality—an attitude which sees moral obligations as things to be dodged whenever they are inconvenient. Next, I argue that acting on this attitude is a wrong-making feature that is independent of any wrong that might be done to Pebbles. I conclude that Wilma’s decision remains wrong even if Pebbles waives any objection to it. (shrink)

In 2008 the Human Fertilisation and Embryology Act amendments made deliberately choosing to bring disability into the world, using assisted reproduction, a criminal offence. This paper considers whether the legal prohibition above, should influence other policy areas concerning the welfare of future children such as new possibilities presented by foetal surgery and in utero gene therapy. If we have legal duties to avoid disability in one context should this influence our avoidance of disability in this other context? This paper investigates (...) whether the State might have a stake in wider promotion of practices to reduce the degree of disability in foetuses that will come to exist. Not selecting for disability does not affect the welfare of any future individual, whereas treating in utero abnormalities can optimize the eventual child’s welfare; antenatal interventions stand to improve clinical outcomes and welfare should that specific child be born. I explore why the State may want to intervene in the antenatal setting and to what extent, if at all; the State should implement these technologies. I argue that if the State is justified in intervening to outlaw the choosing to create disabled lives using assisted reproductive techniques, it is also justified in putting pressure on prospective parents to accept therapies in utero to help their child be born less disabled. However, I qualify this with the argument that the State is not justified in using force or the criminal law in this situation during pregnancy. (shrink)

Has the time come to put to bed the concept of a harm threshold when discussing the ethics of reproductive decision making and the legal limits that should be placed upon it? In this commentary, we defend the claim that there exist good moral reasons, despite the conclusions of the non-identity problem, based on the interests of those we might create, to refrain from bringing to birth individuals whose lives are often described in the philosophical literature as ‘less than worth (...) living’. (shrink)

Philosophers concerned with procreative ethics have long been puzzled by Parfit’s Non-Identity Problem (NIP). Various solutions have been proposed, but I argue that we have not solved the problem on its own narrow person-affecting terms, i.e., in terms of the identified individuals affected by procreative decisions and acts, especially future children. Thus, the core problem remains unsolved. This is a nagging concern for all who hold the common intuition that actions that harm no one are permissible. I argue against Harmon’s (...) and Woodward’s direct, narrow person-affecting solutions, and in favor of a new solution to the NIP. My solution, or, rather, dissolution, is based on the argument that merely possible people, i.e., hypothetical people who could possibly, but will not actually, exist, are morally irrelevant. I show that the NIP only arises when we concern ourselves with merely possible people. Once we are careful to restrict our concerns to only those that do or will exist, the NIP is dissolved. (shrink)

This article discusses the ethics of the use of preimplantation genetic diagnosis to prevent the birth of children with intersex conditions/disorders of sex development , such as congenital adrenal hyperplasia and androgen insensitivity syndrome . While pediatric surgeries performed on children with ambiguous genitalia have been the topic of intense bioethical controversy, there has been almost no discussion to date of the ethics of the use of PGD to reduce the prevalence of these conditions. I suggest that PGD for those (...) conditions that involve serious medical risks for those born with them is morally permissible and that PGD for other “cosmetic” variations in sexual anatomy is more defensible than might first appear. However, importantly, the arguments that establish the latter claim have radical and disturbing implications for our attitude toward diversity more generally. (shrink)

The American Journal of Bioethics, Volume 12, Issue 4, Page 15-17, April 2012.

The non-identity problem is the problem of grounding moral wrongdoing in cases in which an action affects who will exist in the future. Consider a woman who intentionally conceives while on medication that is harmful for a fetus. If the resulting child is disabled as a result of the medication, what makes the woman's action morally wrong? I argue that an explanation in terms of harmful rights violations fails, and I focus on Peter Markie's recent rights-based defense. Markie's analysis rests (...) on the notion of an indirect harm, and I show that the calculation of an indirect harm relies on an improper baseline for the determination of whether or not an action adversely affects a patient's interests. I also defend an impersonal duty-based analysis of the wrongdoing in non-identity cases against an objection by Markie. I close by arguing that the rights-based analysis is insensitive to context and that context is morally relevant in the determination of the moral valence of actions in cases of non-identity. This failure provides a pro tanto reason to favor an impersonal duty-based analysis of the wrongdoing in non-identity cases. (shrink)

Some opponents of reproductive human cloning have argued that, because of its experimental nature, any attempt to create a child by way of cloning would risk serious birth defects or genetic abnormalities and would therefore be immoral. Some versions of this argument appeal to the consent of the person to be conceived in this way. In particular, they assume that if an experimental reproductive technology has not yet been shown to be safe, then, before we use it, we are morally (...) obligated to get either the actual consent or the presumed consent of the person to be conceived. In this article, I attempt to explain the appeal of such consent-based arguments as deriving from a mistaken view of personal identity. I then argue that since this view is false, such arguments are unsound. Finally, I argue that even if reproductive cloning is unsafe, it may still be morally permissible in some circumstances. (shrink)

This article argues that practitioners have a professional ethical obligation to dispense emergency contraception, even given conscientious objection to this treatment. This recent controversy affects all medical professionals, including physicians as well as pharmacists. This article begins by analyzing the option of referring the patient to another willing provider. Objecting professionals may conscientiously refuse because they consider emergency contraception to be equivalent to abortion or because they believe contraception itself is immoral. This article critically evaluates these reasons and concludes that (...) they do not successfully support conscientious objection in this context. Contrary to the views of other thinkers, it is not possible to easily strike a respectful balance between the interests of objecting providers and patients in this case. As medical professionals, providers have an ethical duty to inform women of this option and provide emergency contraception when this treatment is requested. (shrink)

This paper develops a future-oriented and person-centred normative argument based on expectancies that is immune to most of the problems identified in the rights of future persons. The argument unfolds in four parts. The first draws on the notion of expectancies present in inheritance law and maintains that it is possible to formulate a rule of prospective beneficiaries that correlates with entitlements and legitimate claims without necessarily acquiring the status of rights. The second extends expectancies to future persons and concludes (...) that the latter can be considered present holders of such currently binding entitlements. The third section raises the question of whether democracies are bound to a principle of fidelity towards expectancies in such a way that outweighs current people’s rights in cases of conflicts. The response does not prove particularly future-beneficial in such cases. However, section four clarifies why expectancies still carry a crucial moral weight in democracies, one that is not sufficiently established by depersonalised forms of future-oriented ethics. (shrink)

The paper focuses on the question of whether it is morally permissible to use reproductive technologies to select children with congenital deafness. I review the arguments that have been presented to support the claims that the lack of hearing is not overall bad, that disability is caused by social discrimination rather than impairment, that the community of deaf people gives its members plenty of opportunities to lead a happy life, and that procreative decisions need not improve the world. I argue (...) that although the claims are, to a certain extent, reasonable, they fail to establish the conclusion that selecting for deafness is morally permissible. I further argue that the decision to select a deaf child is morally wrong because it results in imposed and needless dependency, that the happiness of a deaf child is conditioned by their confinement to a relatively small community, and that the deaf parents who reject their child’s potential biculturalism are motivated by questionably self-regarding reasons. (shrink)

This paper aims at answering some of the objections to the NIP’s criticism of the idea of rights of future persons. Those objections usually adopt different perspectives depending on how they understand differently the nature of the correlativity between rights and duties – some adopt a present-rights-of-future-persons view, others a future-rights-of-future-persons view, others a transitive present-rights-of-present-persons view, and others still an eternalist view of rights and persons. The paper will try to show that only a non-transitive present-rights-of-present-persons view can survive (...) the challenges posed by the notion of correlativity inherent in the NIP, and thus preserve rights language when discussing the future. This view is proved also more suitable for the legal and political realms, where policies and law-making are usually more concerned with present addressees and short term effects. (shrink)

Can appealing to children’s rights help to solve the non-identity problem in cases of procreation? A number of philosophers have answered affirmatively, arguing that even if children cannot be harmed by being born into disadvantaged conditions, they may nevertheless be wronged if those conditions fail to meet a minimal standard of decency to which all children are putatively entitled. This paper defends the tenability of this view by outlining and responding to five prominent objections that have been raised against it (...) in the contemporary literature: the identifiability objection; the non-existence objection; the waiving of rights objection, the lack of legitimate complaint objection; and the unfairness objection. (shrink)

Criminal behaviour is but one behavioural tendency for which a genetic influence has been suggested. Whilst this research certainly raises difficult ethical questions and is subject to scientific criticism, one recent research project suggests that for some families, criminal tendency might be predicted by genetics. In this paper, supposing this research is valid, we consider whether intervening in the criminal tendency of future children is ethically justifiable. We argue that, if avoidance of harm is a paramount consideration, such an intervention (...) is acceptable when genetic selection is employed instead of genetic enhancement. Moreover, other moral problems in avoiding having children with a tendency to criminal behaviour, such as the prospect of social discrimination, can also be overcome. (shrink)

Until recently, genetics counselors and medical geneticists considered themselves lucky if they could provide parents with predictive information about a small number of severe genetic disorders. Testing and counseling were indicated primarily for conditions of thithis s sort. Out of respect for the autonomy of parental reproductive decision making, the prevailing ethic of genetic counseling stressed nondirectiveness and value neutrality As summarized by Arthur Caplan, the hallmarks of this stance includea willingness to provide testing and counseling to all who voluntarily (...) seek it, the presentation of information concerning findings in a manner that is balanced and comprehensible to patients or clients, the fair and balanced presentation of all options for action if a problem is discovered, a willingness to answer all questions asked by those seeking services, and an obligation to protect privacy and confidentiality at all times regardless of societal needs or benefits. (shrink)

Since the first sex reassignment operations were performed, individual sex has come to be, to some extent at least, a technological artifact. The existence of sperm sorting technology, and of prenatal determination of fetal sex via ultrasound along with the option of termination, means that we now have the power to choose the sex of our children. An influential contemporary line of thought about medical ethics suggests that we should use technology to serve the welfare of individuals and to remove (...) limitations on the opportunities available to them. I argue that, if these are our goals, we may do well to move towards a “post sex” humanity. Until we have the technology to produce genuine hermaphrodites, the most efficient way to do this is to use sex selection technology to ensure that only girl children are born. There are significant restrictions on the opportunities available to men, around gestation, childbirth, and breast-feeding, which will be extremely difficult to overcome via social or technological mechanisms for the foreseeable future. Women also have longer life expectancies than men. Girl babies therefore have a significantly more “open” future than boy babies. Resisting the conclusion that we should ensure that all children are born the same sex will require insisting that sexual difference is natural to human beings and that we should not use technology to reshape humanity beyond certain natural limits. The real concern of my paper, then, is the moral significance of the idea of a normal human body in modern medicine. (shrink)

For now, the best way to select a child's genes is to select a potential child who has those genes, using genetic testing and either selective abortion, sperm and egg donors, or selecting embryos for implantation. Some people even wish to select against genes that are only mildly undesirable, or to select for superior genes. I call this selection drift– the standard for acceptable children is creeping upwards. The President's Council on Bioethics and others have raised the parental love objection: (...) Just as we should love existing children unconditionally, so we should unconditionally accept whatever child we get in the natural course of things. If we set conditions on which child we get, we are setting conditions on our love for whatever child we get. Although this objection was prompted by selection drift, it also seems to cover selecting against genes for severe impairments. I argue that selection drift is not inconsistent with the ideal of unconditional parental love and, moreover, that the latter actually implies that we should practise selection drift – in other words, we should try to select potential children with the best genetic endowments. My endowment argument for the second claim works from an analogy between arranging an endowment prior to conception to fund a future child's education, and arranging a genetic endowment by selecting a potential child who already has it, where in both cases the child would not have existed without the endowment. I conclude with some programmatic remarks about the nonidentity problem. (shrink)

An objection often is raised against the use of reproductive technology to create "nontraditional families," as in ovum donation for postmenopausal women or postmortem artificial insemination. The objection states that conceiving children in such circumstances is harmful to them because of adverse features of these nontraditional families. A similar objection is raised when parents, through negligence or willful disregard of risks, create children with serious genetic diseases or other developmental handicaps. It is claimed that such reproduction harms the children who (...) are created. In reply to this Harm to the Child Argument, it has been pointed out that the procreative acts that supposedly harm the child are the very acts that create the child. This reply has been developed into an argument that, in most of the types of cases under consideration, creating the child does not harm her. This reply, the No Harm Argument, has been stated in three main ways, and it is one of the most misunderstood arguments in bioethics. This paper examines the main rebuttals that have been made to the No Harm Argument and argues that none of them is successful. (shrink)

In his recent paper, Adam Cureton presents a compelling case in support of the right of parents with disabilities to conceive and raise children. Cureton argues that caring for a parent with a disability may be beneficial for a child and the creation of a child with the intention of him/her being a carer for his/her disabled parent is objectionable. This response to Cureton's paper will focus on the creation of children with the purpose of them being carers for their (...) disabled parents. I will respond to Cureton on three counts. First, I propose that claims and are incompatible. Second, I will argue that even from a Kantian perspective it is not clear that creating a child as a carer is objectionable. Third, I will argue more broadly that the intentions with which parents bring children into the world are not predictive of the concern parents should show their children once they come into existence. (shrink)

Disability activists influenced by queer theory and advocates of “human enhancement” have each disputed the idea that what is “normal” is normatively significant, which currently plays a key role in the regulation of pre-implantation genetic diagnosis (PGD). Previously, I have argued that the only way to avoid the implication that parents have strong reasons to select children of one sex (most plausibly, female) over the other is to affirm the moral significance of sexually dimorphic human biological norms. After outlining the (...) logic that generates this conclusion, I investigate the extent to which it might also facilitate an alternative, progressive, opening up of the notion of the normal and of the criteria against which we should evaluate the relative merits of different forms of embodiment. This paper therefore investigates the implications of ideas derived from queer theory for the future of PGD and of PGD for the future of queerness. (shrink)

Incest taboos are universal, but it is questionable whether consensual incest should continue to be illegal. The most common argument in favor of the illegalization of consensual incest appeals to genetic risks and the harm to potential offspring. In this article, we examine whether public health concern is a sufficient reason to illegalize consensual incest. We posit that indeed, incest represents a risk, but this is not reason enough to illegalize incest. For, other circumstances of sexual intercourse may lead to (...) similar risks, and yet, such practices are not illegal. While those practices may represent an added risk to public health, to forbid them as a way to improve the genetic pool would be akin to eugenic program, and that is morally objectionable. This does not imply that consensual incest ought to be legal, for there may be other good reasons to illegalize it. But they do not relate to public health and genetic risks, and consequently, medical practitioners and public health officials ought to avoid using their medical authority as a platform to make moral pronouncements. (shrink)

A theory of intergenerational justice consists in the study of the moral and political status of the relations between present and past or future people, more specifically, of the obligations and entitlements they can potentially generate. The challenges that justify talking about responsibilities between generations are myriad. And the disputes they prompt can focus on the past just as much as on the present, even though the fact that the human species has reached a state of technological progress that enables (...) it to have an irredeemable impact on the planet and perhaps even endanger future human existence tends to make concerns about the future more pressing. Debates on intergenerational justice are twofold. The first revolves around the issue of whether claims of justice across generations whose members' lifetimes do not necessarily overlap could be justified. And the second revolves around the specific conception of justice in play, that is, around the nature of the standard that must be applied as well as around the identification of the contents of the duties that present generations supposedly have vis-à-vis past or future generations. This survey article depicts the conceptual and argumentative framework in which these debates are set. It aims to outline certain of the main features shared by the most influential contemporary theories of intergenerational justice, and the problems inherent in them. It concludes by suggesting that, even though the idea of succeeding generations is merely an abstraction, there are specific empirical states of affairs that require different theoretical responses to intergenerational justice. (shrink)

This article introduces a non-human version of the non-identity problem and suggests that such a variation exposes weaknesses in several proposed person-focused solutions to the classic version of the problem. It suggests first that person-affecting solutions fail when applied to non-human animals and, second, that many common moral arguments against climate change should be called into question. We argue that a more inclusive version of the person-affecting principle, which we call the ‘patient-affecting principle’, captures more accurately the moral challenge posed (...) by the non-identity problem. We argue further that the failure of person-affecting solutions to solve non-human versions of the problem lend support to impersonal solutions to the problem which avoid issues of personhood or species identity. Finally, we conclude that some environmental arguments against climate change that rely on the notion of personal harm should be recast in impersonal terms. (shrink)

Joel Feinberg and Dan Brock have independently developed a solution to the Problem of Nonidentity as it occurs in cases where a mother's negligent act of conception causes her child to be born with a severe disability. I display three problems in the Feinberg‐Brock proposal and develop an alternative view that explains both cases of wrongful conception and additional instances of the Problem of Nonidentity presented by Derek Parfit and others.

Journal of Social Philosophy, EarlyView.

The advent of omic technologies and, more specifically, the progress made with specific second- and third-generation sequencing technologies, gives us the possibility of knowing the particular sequence of individual genomes at a relatively affordable cost. In the not too distant future, these sequencing technologies combined with specific functional analysis will be used, at a genomic level and with a much finer degree of detail than the old molecular diagnostic tests, to identify the diseases associated with each person’s genetic map. New (...) dilemmas in different contexts have emerged with the advent of these technologies. From a bioethical perspective, the problem is not rooted in detailed research on the human genome per se, but in the purpose that can be given to information derived from this type of scientific research, which could become a useful tool for selecting, rejecting and discriminating against persons, because they have a hereditary disease or the potential to develop specific diseases in the future. This article analyzes the relationship between the eugenic mentality, the concept of quality of life, and genomic molecular diagnosis, when applied to human embryos for the purpose of preventing their implantation. Such action threatens the very life and dignity of a human being in its early stages of development. (shrink)

We consider whether intervening in the criminal tendency of future children is ethically justifiable. We argue that, if avoidance of.

If Solomon is correct in labeling businesses as community citizens because they “are part and parcel of the communities in which they live and flourish, and the responsibilities that they bear are ... intrinsic to their very existence as social entities,” then it follows that other community citizens have reciprocal duties toward them that they, as community citizens, have to any other community citizen. One of these duties is not to harm needlessly another community citizen without its permission. One issue (...) affecting business is genetically engineering children to have characteristics, e.g., deafness, which render them disabled in work environments. Since business is a very large part of society, citizen responsibilities toward it in regard to intentionally creating deaf children should be examined. It is my contention that designing disabled offspring is unethical on the grounds that it causes undue injury to businesses without their permission in any form. (shrink)

The American Journal of Bioethics, Volume 12, Issue 4, Page 17-19, April 2012.