Academic journal article The Hastings Center Report

"Give Me Children or I Shall Die!" New Reproductive Technologies and Harm to Children

Academic journal article The Hastings Center Report

"Give Me Children or I Shall Die!" New Reproductive Technologies and Harm to Children

Article excerpt

"Be fruitful and multiply," God urged newly created humans. Those who take this command to heart cherish the opportunity to procreate and nurture children, to pass on their individual traits and family heritage to their offspring. Having children, for many, is a deeply significant experience that offers overall meaning for their lives. Not all who wish to do so, however, can fulfill the biblical injunction to multiply. Those who cannot often experience a terrible sense of loss. Rachel, in Genesis, felt such despair over her failure to conceive that she cried out to Jacob, "Give me children, or I shall die!" Some who echo her cry today turn to the new reproductive technologies.

There are ethical limits, however, to what may be done to obtain long-sought offspring. Having a deep desire and even a need for something does not justify doing anything whatsoever to obtain it. If die means used to bring children into the world were to create substantial harm to others or to these very children, this would provide strong moral reason not to employ them. It would be wrong, for instance, for infertile couples to place women at risk of substantial harm by enticing those who are not in peak physical condition to "donate" eggs with handsome sums of money. By the same token, it would be wrong to use reproductive technologies to create children if this bore a significant chance of producing serious disease and impairments in these very children. Questions are being raised about whether in vitro fertilization (IVF) and other reproductive technologies do, in fact, create serious illness and deficits in a small but significant proportion of children who are born of them. If these technologies were found to do so, it would be wrong to forge ahead with their use.

Yet advocates of procreative liberty reject this seemingly inescapable conclusion. They contend that even if children were born with serious disorders traceable to their origin in the new reproductive technologies, this would not, except in rare cases, provide moral reason to refrain from using them. Those who conclude otherwise, they maintain, do not understand the peculiar sort of substantial harm to which children born of these novel reproductive means are susceptible. Surely, John Robertson and like-minded thinkers claim, it is better to be alive--even with serious disease and deficits--than not. And these children would not be alive, but for the use of the new reproductive techniques. Therefore, they argue, these children cannot be substantially harmed by the use of these means to bring them into the world. Only if they are caused by these technologies to suffer devastating illness that makes life worse than nonexistence can they be said to be substantially harmed by them.

This startling claim raises intriguing questions. What do we mean by substantial harm--particularly when children who might experience it have not yet been conceived? What degree of disease and suffering that a child would experience as a result of the application of these novel means of conception would make it wrong to use them? Would it be wrong if the child's life would be so terrible that nonexistence would be better? Few conditions would be excluded by this standard. Would it be wrong if the child's life would not be awful, but would include major physical impairments, severe mental disability, and/or considerable pain and suffering?

In responding to such questions, we must consider the possibility that different standards of substantial harm may apply to children at the time when we consider conceiving them and after conception and birth. If so, we must develop a standard of substantial harm that applies to children who might be conceived that is distinct from one that applies to those already born--and must explain how children who are not born can be harmed. We must also address die concern that decisions not to conceive children because they would have serious deficits devalue the lives of those already living who were born with such deficits. …

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