Ethical issues of reproductive technology

Reproductive technology
Ethical Issues
Reproductive technology and surrogacy. A
global perspective
Reykjavik 25-27 August
Nordic Committee on Bioethics

Hunger for children
• “When we speak of suffering of people who
want to have children but cannot, “suffering” is
neither metaphor nor hyperbole: people who
crave children to raise and love but cannot
have them suffer because, for many of us, our
children are a vital part of our own flourishing”
– Thomas H Murray, p. 14

Surrogacy
• Adoptions are often complicated
• People have rights to make contract and personal
arrangements
• Not much difference between surrogacy or ART and
what takes place in other context
• Willingness to give one of the greatest gift of all

Surrogacy
• Treats children as commodities.
• Treats women’s reproductive capacities or labor as
commodities
– analogy to slavery or prostitution
• It is morally wrong of a woman to decide to have a
child she does not want
• Disputes about parental rights and responsibility

Complex issues and interests
• The parents
• The children
• Egg and sperm donors
• Surrogate mothers
• Families of surrogate mothers
• The understanding of “families”
• Health care workers
• Societies

The right to have children
• Negative rights
– Right against coercive interference in decisions
regarding procreation
– Forced sterilization or abortions
• Positive right
– Entitlement or assistance in procreation
– Artificial Reproductive technology, surrogacy

Procreative Autonomy
• The right of procreative autonomy has an important
place […] in Western Political thought. The most
important feature of that culture is a belief in
individual human dignity: that people have the moral
right – and the moral responsibility – to confront the
most fundamental questions about the meaning and
value of their own lives for themselves: answering to
their own conscience and convictions. The principle
of procreative autonomy, in a broad sense, is
embedded in any genuinely democratic culture”
» Ronald Dworkin: Life’s Dominion

Or not?
• “Reproduction indeed matters to people; it is indeed
a part of life in which they express their deepest
belifes. But it does not follow that it is or should be
seen primarily as a matter of self-expression, or that
it should be protected as we protect self-expression.
Reproduction is unlike both contraception and
abortion, it that it aims to bring a third party – a child
– into existance […] reproductive decisions are
irresponsible unless those who make them can
reasonabley offer adequate and lasting care and
support to the hoped-for child”
• Onora O’Neill, Autonomy and trust in Bioethics

Intimate family relations
• We need a rich description of the moral life of
parents and children, one that captures the
complexity of motives for having and raising
children ant the significance of children in the
lives of adults – on of the two central meaning
of the “worth” of a child.
• Thomas H. Murray

The right to an open future
• Parents have responsibility to help their
children during their growth to adulthood to
develop capacities for practical judgment and
autonomous choice, and to develop as well at
least a reasonable range of the skills and
capacities necessary to provide them the
choice of a reasonable array of different life
plans available to members of their society
– Joel Feinberg

The right of children
• Right to be loved and cared for
– Welfare in up-bringing
• Right to know about biological parents
– Adopted children seek their origin
• Autonomy rights require information
– Genetic information
• A right to have two parents, or father and
mother?

Motherhood
• Gestational mother
– Full surrogacy: the birth mother is genetically unrelated to
child. Emotional ties during pregnancy
• Genetic mother
– The biological mother
• The one who will bring up the child
• Who has the weightiest moral claim?

Different understanding of family
• Our understanding of family is rapidly changing.
• Moving from the biological concept to legal
understanding and then to subjective intention.

Broad understanding
• “Family members are individuals who by birth,
adoption, marriage, or declared commitment
share deep personal connections and are
mutually entitled to receive and obligate to
provide support of various kinds to the extent
possible, especially in times of need”
• From Carol Levine

The parent-child relationship
• The child as property – egoistic model
– Biology is the base of ownership
• The parent as steward – altruistic model
– parents as serving or as caretakers – do not act out
of self-interest but the interest of the child
• Mutualism in the parent-child relationship
– takes the interest of both children and parents into
account. Flourishing of parents and children are
intertwined. Relationship is given greater weight

Mutualism
• Mutualism rejects this either-or. There are
circumstances—the parent-child relationship
being the leading example—in which you
cannot honestly describe what motivates the
actore—here, the parents—as strictly egoistic
or altruistic. It is some inextricable blend of
concern for other and concern for self”
• Thomas H. Murray

What if?
• When these things go wrong they go badly
wrong.
– The surrogate mother wants to keep the child?
– The surrogate mother wants to keep contact with the
child?
– The child does not meet expectations of the
parents?
• Obligations and responsibility

Salvör Nordal
Centre for Ethics, University of Iceland
salvorn@hi.is