From Brute Luck to Option Luck? On Genetics, Justice, and Moral Responsibility in Reproduction

Journal of Medicine and Philosophy 35 (2):101-129 (2010)
Abstract
The structure of our ethical experience depends, crucially, on a fundamental distinction between what we are responsible for doing or deciding and what is given to us. As such, the boundary between chance and choice is the spine of our conventional morality, and any serious shift in that boundary is thoroughly dislocating. Against this background, I analyze the way in which techniques of prenatal genetic diagnosis (PGD) pose such a fundamental challenge to our conventional ideas of justice and moral responsibility. After a short description of the situation, I first examine the influential luck egalitarian theory of justice, which is based on the distinction between choice and luck or, more specifically, between option luck and brute luck, and the way in which it would approach PGD (section II), followed by an analysis of the conceptual incoherencies (in section III) and moral problems (in section IV) that come with such an approach. Put shortly, the case of PGD shows that the luck egalitarian approach fails to express equal respect for the individual choices of people. The paradox of the matter is that by overemphasizing the fact of choice as such, without regard for the social framework in which they are being made, or for the fundamental and existential nature of particular choices—like choosing to have children and not to undergo PGD or not to abort a handicapped fetus—such choices actually become impossible
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    Kurt Bayertz (2003). Human Nature: How Normative Might It Be? Journal of Medicine and Philosophy 28 (2):131 – 150.
    Yvonne Denier (2005). On Personal Responsibility and the Human Right to Healthcare. Cambridge Quarterly of Healthcare Ethics 14 (02):224-234.

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