Cesarean delivery rates have been steadily increasing worldwide. In response, many countries have introduced target goals to reduce rates. But a focus on target goals fails to address practices embedded in standards of care that encourage, rather than discourage, cesarean sections. Obstetrical standards of care normalize use of technology, creating an imperative to use technology during labor and birth. A technological imperative is implicated in rising cesarean rates if physicians or patients fear refusing use of technology. Reproductive autonomy is at (...) stake since a technological imperative undermines patients’ ability to choose cesareans or refuse use of technology increasing likelihood of cesareans. To address practices driven by a technological imperative I outline three physician obligations that are attached to respecting patient autonomy. These moral obligations show that a focus on respect for autonomy may prove not only an ideal ethical response but also an achievable practical response to lowering cesarean rates. (shrink)

In England and Wales, there is significant controversy on the law related to abortion. Recent discussions have focussed predominantly on the health professional's right to conscientious objection. This article argues for a comprehensive overhaul of the law from the perspective of an author who adopts the view that all unborn human beings should be granted the prima facie right to life. It is argued that, should the law be modified in accordance with this stance, it need not imply that health (...) professionals should enjoy an unqualified right to object to participating in the provision of abortion. Indeed, it is proposed that – in some situations – women should be granted a positive right to abortion. While the focus of this article is on changing the law in England and Wales, it is hoped that the position developed here will also inspire legal debate and reform elsewhere. (shrink)

I argue that it is possible for prospective mothers to wrong prospective fathers by bearing their child; and that lifting paternal liability for child support does not correct the wrong inflicted to fathers. It is therefore sometimes wrong for prospective mothers to bear a child, or so I argue here. I show that my argument for considering the legitimate interests of prospective fathers is not a unique exception to an obvious right to procreate. It is, rather, part of a growing (...) consensus that procreation can be morally problematic and that generally talking of rights in this context might not be warranted. Finally, I argue that giving up on a right to procreate does not imply nor suggest giving up on women’s absolute right to abort, which I defend. (shrink)

The argument for the moral permissibility of killing newborns is a challenge to liberal positions on abortion because it can be considered a reductio of their defence of abortion. Here I defend the liberal stance on abortion by arguing that the argument for the moral permissibility of killing newborns on ground of the social, psychological, and economic burden on the parents recently put forward by Giubilini and Minerva is not valid: because they fail to show that newborns cannot be harmed (...) and because there are morally relevant differences between foetuses and newborns. (shrink)

We argue that the fragility of contemporary marriages—and the corresponding high rates of divorce—can be explained (in large part) by a three-part mismatch: between our relationship values, our evolved psychobiological natures, and our modern social, physical, and technological environment. “Love drugs” could help address this mismatch by boosting our psychobiologies while keeping our values and our environment intact. While individual couples should be free to use pharmacological interventions to sustain and improve their romantic connection, we suggest that they may have (...) an obligation to do so as well, in certain cases. Specifically, we argue that couples with offspring may have a special responsibility to enhance their relationships for the sake of their children. We outline an evolutionarily informed research program for identifying promising biomedical enhancements of love and commitment. (shrink)

Benatar’s central argument for antinatalism develops an asymmetry between the pain and pleasure in a potential life. I am going to present an alternative route to the antinatalist conclusion. I argue that duties require victims and that as a result there is no duty to create the pleasures contained within a prospective life but a duty not to create any of its sufferings. My argument can supplement Benatar’s, but it also enjoys some advantages: it achieves a better fit with our (...) intuitions; it does not require us to acknowledge that life is a harm, or that a world devoid of life is a good thing; and it is easy to see why it does not have any pro-mortalist implications. (shrink)

Most people take it for granted that it's morally permissible to have children. They may raise questions about the number of children it's responsible to have or whether it's permissible to reproduce when there's a strong risk of serious disability. But in general, having children is considered a good thing to do, something that's morally permissible in most cases (perhaps even obligatory).

Definition of the problem The creation and selection of children as tissue donors is ethically controversial. Critics often appeal to Kant’s Formula of Humanity, i.e. the requirement that people be treated not merely as means but as ends in themselves. As many defenders of the procedure point out, these appeals usually do not explain the sense of the requirement and hence remain obscure. Arguments This article proposes an interpretation of Kant’s principle, and it proposes that two different instrumental stances be (...) distinguished. I argue that the creation of “saviour children” is a form of instrumentalization that I dub “preemptive instrumentalization” and that it is categorically different from earlier forms of instrumental attitudes concerning human reproduction. Conclusion Critics are wrong to claim that Kant’s principle is either compatible with the selection of saviour siblings or too vague to serve as an ethical principle. (shrink)

I shall briefly evaluate the common claim that ethically acceptable population policies must let individuals to decide freely on the number of their children. I shall ask, first, what exactly is the relation between population policies that we find intuitively appealing, on the one hand, and population policies that maximize procreative freedom, on the other, and second, what is the relation between population policies that we tend to reject on moral grounds, on the one hand, and population policies that use (...) coercive methods such as laws or economic incentives and deterrents, on the other. I shall argue that when changing a population policy, it may be morally desirable to affect people's procreative decisions more rather than less, and that sometimes it may be morally desirable to prefer a population policy that does not maximize procreative freedom to a population policy that does maximize it. I shall also point out that indirect population policies that use incentives and deterrents are not necessarily incompatible with liberal principles. Finally, I try to show what is assumed by those who defend the view that coercive population policies are morally wrong in all circumstances. (shrink)

The paper discusses the practice of genetic counseling and elective abortion in the German Democratic Republic. Keywords: elective abortion, embryo transfer, in vitro fertilization, protection of human life, reproductive ethics, German Democratic Republic, bioethics CiteULike Connotea Del.icio.us What's this?

The United Kingdom's Human Fertilisation and Embryology Bill, introduced into Parliament on the 8th of November 2007 contains a number of controversial proposals inter alia expressly permitting the creation of inter-species embryos for research and destruction and increasing the scope for human cloning also for destructive research. It is supposed that there ought not to be a blanket ban on the creation of human clones, hybrids, cybrids and chimeras because these embryos are valuable for research purposes. The prohibition on the (...) gestation of non-permitted embryos and interspecies embryos is used to generate confidence that embryos with compromised origins would not be gestated and reared. The argument outlined here demonstrates how uncertain are any legal prohibitions on gestation. Accordingly, the practical import of the distinction between compromised embryos for research and the same for live birth is equally dubious. The legislation would not, on this analysis, supply effective controls over this reproductive technology. (shrink)

This article challenges the view most recently expounded by Emily Jackson that ‘decisional privacy’ ought to be respected in the realm of artificial reproduction (AR). On this view, it is considered an unjust infringement of individual liberty for the state to interfere with individual or group freedom artificially to produce a child. It is our contention that a proper evaluation of AR and of the relevance of welfare will be sensitive not only to the rights of ‘commissioning parties’ to AR (...) but also to public policy considerations. We argue that AR has implications for the common good, by involving matters of human reproduction, kinship, race, parenthood and identity. In this paper we challenge presuppositions concerning decisional privacy. We examine the essential commodification of human life implicit in AR and the systematicity that makes this possible. We address the objection that it is an ethically neutral way of having children and consider the problem of ‘existential debt’. After examining objections to the thesis that AR is illegitimate for reasons of public policy and the common good, we return to the issue of decisional privacy in the light of considerations concerning the legitimate role of the state in matters affecting human reproduction. (shrink)

Rather than to focus upon a particular ‘right to life’, we should consider what rights there are pertaining to our lives and to our living. There are different sorts. There are, for instance, rights that constitute absences of particular duties and rights that correspond to the duties of other agents or agencies. There are also natural and non-natural rights and duties. Different people in different contexts can have different moral duties and different moral rights including rights to life. The question (...) of the moral rights there are to and pertaining to life is considered with reference to James Griffin’s account of human rights. Also considered is the question of who or what can be a bearer of them. (shrink)

A critical overview of the latest discussion of anti-natalism, with particular reference to David Benatar's work and three additional rationales for anti-natalism that differ from Benatar's.

In his book Better Never to Have Been, David Benatar argues that it is generally all things considered wrong to procreate, such that if everyone acted in a morally ideal way, humanity would elect to extinguish the species. I aim to carefully question the premises and inferences that lead Benatar to draw this anti-natalist conclusion, indicating several places where one could sensibly elect to disembark from the train of argument heading toward such a radical view.

Issues in reproductive ethics, such as the capacity of parents to ‘choose children’, present challenges to philosophical ideas of freedom, responsibility and harm. This book responds to these challenges by proposing a new framework for thinking about the ethics of reproduction that emphasizes the ways that social norms affect decisions about who is born. The book provides clear and thorough discussions of some of the dominant problems in reproductive ethics - human enhancement and the notion of the normal, reproductive liberty (...) and procreative beneficence, the principle of harm and discrimination against disability - while also proposing new ways of addressing these. The author draws upon the work of Michel Foucault, especially his discussions of biopolitics and norms, and later work on ethics, alongside feminist theorists of embodiment to argue for a new bioethics that is responsive to social norms, human vulnerability and the relational context of freedom and responsibility. This is done through compelling discussions of new technologies and practices, including the debate on liberal eugenics and human enhancement, the deliberate selection of disabilities, PGD and obstetric ultrasound. (shrink)

Some commentators argue that conception constitutes the onset of human personhood in a metaphysical sense. This threshold is usually invoked as the basis both for protecting zygotes and embryos from exposure to risks of death in clinical research and fertility medicine and for objecting to abortion, but it also has consequences for certain religious perspectives, including Catholicism whose doctrines directly engage questions of personhood and its meanings. Since more human zygotes and embryos are lost than survive to birth, conferral of (...) personhood on them would mean – for those believing in personal immortality – that these persons constitute the majority of people living immortally despite having had only the shortest of earthly lives. For those believing in resurrection, zygotes and embryos would also be restored to physical lives. These outcomes do not mean that conception cannot function as a metaphysical threshold of personhood, but this interpretation carries costs that others do not. For example, treating conception as a moral threshold of respect for human life in general, rather than as a metaphysical threshold of personhood, would obviate the prospect of the afterlife being populated in the main by persons who have never lived more than a few hours or days. (shrink)

Should parents be able to select the sexual orientation of their children, if that were possible through prenatal interventions? _Ethics, Sexual Orientation, and Choices about Children_ reviews the history of this debate which started in the 1970s and has been invigorated by scientific reports about the origins of sexual orientation. This book describes the debate and offers an evaluation of key issues in parental rights, children's rights, and family welfare.

n some areas of clinical medicine, discussions about fertility preservation are routine, such as in the treatment of children and adolescents facing cancer treatments that will destroy their ability to produce gametes of their own. Certain professional organizations now offer guidelines for people who wish to modify their bodies and appearance in regard to sex traits, and these guidelines extend to recommendations about fertility preservation. Since the removal of testicles or ovaries will destroy the ability to have genetically related children (...) later on, it is imperative to counsel transgender people seeking body modifications about fertility preservation options. Fertility preservation with transgender people will, however, lead to unconventional outcomes. If transgender men and women use their ova and sperm, respectively, to have children, they will function as a mother or father in a gametic sense but will function in socially reversed parental identities. There is nothing, however, about fertility preservation with transgender men and women that is objectionable in its motives, practices, or outcomes that would justify closing off these options. In any case, novel reproductive technologies may extend this kind of role reversal in principle to all people, if sperm and ova can be derived from all human beings regardless of sex, as has happened with certain laboratory animals. (shrink)

There are no technologies at the present time that would allow parents to select the sexual orientation of their children. But what if there were? Some commentators believe that parents should be able to use those techniques so long as they are effective and safe. Others believe that these techniques are unethical because of the dangers they pose to homosexual men and women in general. Both sides point to motives and consequences when trying to analyse the ethics of this question. (...) These arguments are reviewed, and it is concluded that opponents of these technologies have not shown good reason why the law or policy should override parental choice in this matter. In general, therefore, if technologies become available to choose the sexual orientation of children, parents should be allowed to use them, provided they are safe and disrupt no interest of the child. This use will, at the very least, protect homosexual children from parents who do not want them, but it will also allow parents who want homosexual children to make that choice as well. (shrink)

This book will attempt to show that these and other problems are ultimately resolvable, given careful and unbiased application of established ethical principles ...

David Benatar argues that coming into existence is always a harm, and that – for all of us unfortunate enough to have come into existence – it would be better had we never come to be. We contend that if one accepts Benatar’s arguments for the asymmetry between the presence and absence of pleasure and pain, and the poor quality of life, one must also accept that suicide is preferable to continued existence, and that his view therefore implies both anti-natalism (...) and pro-mortalism . This conclusion has been argued for before by Elizabeth Harman – she takes it that because Benatar claims that our lives are ‘awful’, it follows that ‘we would be better off to kill ourselves’ (Harman 2009: 784). Though we agree with Harman’s conclusion, we think that her argument is too quick, and that Benatar’s arguments for non-pro-mortalism deserve more serious consideration than she gives them. We make our case using a tripartite structure. We start by examining the prima facie case for the claim that pro-mortalism follows from Benatar’s position, presenting his response to the contrary, and furthering the dialectic by showing that Benatar’s position is not just that coming into existence is a harm, but that existence itself is a harm. We then look to Benatar’s treatment of the Epicurean line, which is important for him as it undermines his anti-death argument for non-pro-mortalism. We demonstrate that he fails to address the concern that the Epicurean line raises, and that he cannot therefore use the harm of death as an argument for non-pro-mortalism. Finally, we turn to Benatar’s pro-life argument for non-pro-mortalism, built upon his notion of interests, and argue that while the interest in continued existence may indeed have moral relevance, it is almost always irrational. Given that neither Benatar’s anti-death nor pro-life arguments for non-pro-mortalism work, we conclude that pro-mortalism follows from his anti-natalism, As such, if it is better never to have been, then it is better no longer to be. -/- . (shrink)

A liberal antinomy of parenting exists: strong liberal intuitions militate in favor of both denying special resources to parenting projects (on grounds of project-neutrality) and granting them (on grounds of respect for personhood). I show that we can reconcile these two claims by rejecting a premise common to both--viz. that liberalism is necessarily committed to extensive procreative liberties--and limiting procreation and subsequent parenting to adults who meet certain psychological and especially financial criteria. I also defend this argument, which provides a (...) Kantian complement to utilitarian arguments for restricting procreation, against a variety of objections. (shrink)

David Benatar claims that everyone was seriously harmed by coming into existence. To spare future persons from this suffering, we should cease having children, Benatar argues, with the result that humanity would gradually go extinct. Benatar’s claim of universal serious harm is baseless. Each year, an estimated 94% of children born throughout the world do not have a serious birth defect. Furthermore, studies show that most people do not experience chronic pain. Although nearly everyone experiences acute pain and discomforts, such (...) as thirst, these experiences have instrumental value. For example, when a person picks up a hot object, in response to the pain, the person releases the object, thereby preventing serious harm. The standard that Benatar uses to evaluate the quality of our lives is arbitrary, as I will demonstrate. His proposal that we phase humanity out of existence by ceasing to have children is misguided and an overreaction to the problem of human suffering. The ‘threshold conception of harm’, which is a targeted approach for preventing future persons from suffering, is a more sensible approach. (shrink)