Thinking about Procreative Rights and Duties

We are commonly understood to have a right to procreate. For instance, it is a clear violation of that right to coercively sterilize those judged unfit. However, there is some question whether this right includes the right to assistive reproductive technologies, and whether it is defeasible in any circumstances, i.e. whether we have a corresponding duty not to reproduce under certain conditions.

Fertility treatments like in vitro fertilization come under fire because of larger health care access issues regarding which treatments should be covered by insurance or under a single-payer style medical system. Given how expensive they sometimes are, should these treatments be covered in the face of unmet medical needs of existing children? Is infertility a disability that requires reasonable remediation? What counts as reasonable, especially since the success rates of these technologies are quite low?

Moreover, the issues with assisted reproduction technologies are still there for couples who can conceive normally, they’re just not usually subjected to public debate. That doesn’t mean there are no public concerns. For instance, some countries incentivize procreation with a tax credit, including the United States. Environmentalists warn that childbearing is by far the largest “carbon footprint” decision an American can make. And we must also note that in the absence of population-replacing reproduction, first world countries must import labor, which enriches immigrants and their home countries through remittances.

So it’s an issue worth thinking through, and though the Parfit Reading Group has basically dissipated, I think there’s still room to discuss the Parfitian response that starts with something called the No Difference View, which is tied to this question.

Parfit asks us to imagine two scenarios in which a woman suffers from an easily treatable illness. In the first scenario, the woman is pregnant, and the illness will irreparably handicap the child if she does not receive a cheap and simple treatment. Obviously, the woman ought to receive that treatment. In the second scenario, the woman is thinking of becoming pregnant, but discovering the illness, she must decide between becoming pregnant now and postponing her pregnancy a few months for the treatment to take effect. Not postponing her pregnancy would leave the resultant child with an irreparable and serious handicap.

Parfit then points out that in the second scenario, we tend to think that the woman ought to postpone her childbirth so that her child may live without the handicap. But in so doing, the second woman guarantees that the child who lives without a handicap will be a different one than the child who would have suffered from the handicap. They might both have been named “Tom” for instance, but the earlier, handicapped child would have been the product of a different ovum and spermatazoon than the later, disability-free child. So in that scenario, it seems like we’ve effectively proclaimed that it is better for disabled-Tom not to exist at all than for him to exist with an irreparable handicap. And this seems a strange response to the question: “Is existence better than non-existence?” Here, it’s not the mother whose rights are at issue, but the child’s right to simple medical treatments. We commonly assume that an unborn child has a right to adequate medical care, but it’s strange to believe that that right could trump his right to exist at all!

The only way to justify the No-Difference View’s claim without also subscribing to some horrendous eugenics program is to specify that non-existent humans don’t have the same right to exist that existent humans have, and further, that we ought to be guided by some form of impersonal welfare-maximizing principle in making procreative decisions. Parfit calls the the Impersonal Totality Principle, and it’s a version of consequentialism: we ought to act so as to maximize the welfare of those who exist without regard for kinship or individuality.

But this seems a strange conclusion, especially in the context of a family. However, we do not normally think of childbearing as calculation, and many people are even offended at the prospect of deciding on family matters with such calculations in mind. In part, this is because procreation creates new subjects, with interests and rights of their own. Many parents take it as axiomatic that they ought to prefer the benefit of their own children to those of strangers precisely because these rights.

In contrast with other kinship obligations, however, this is a kind of chosen fidelity: we take on an obsessive obligation to our children only when we have children. It doesn’t make sense to say that I owe everything to a child that does not and may never exist. Thus, in the decision to take on parental responsibilities, we may well be choosing to take on an absolute and un-defeasible duty in which we can legitimately act selfishly so long as we understand our own interests to be closely allied with those of our children. In such a circumstance, many acts that would seem unreasonable self-centered can even gain the veneer of altruism. Taking on a massive and incommensurable duty simply renders the decision all the more consequential and deserving of moral theorizing.

Utilitarians have long reminded us that there is always someone who could use our resources more than ourselves: every cup of coffee I buy could treat ten cases of fatal diarrhea in Haiti or Thailand. Though I’m unlikely to do it, I really ought to brew coffee at home, and then send the difference to those who need it, and even that is at a minimum. It’s the very least I could do.

The same thing goes for procreative morality: forgoing parenthood may well be a mere extension of that utilitarian principle. While we might not want to give the state the right to coerce reproduction, we could still acknowledge that some form of consequentialism tells us what we ought to do when considering procreation. So if, say, adoption would be a better use of a couple’s love and financial resources than IVF, they ought to adopt  instead of having their own children. And the same argument is probably extensible to fertile couples, who ought to adopt an orphan rather than reproduce themselves.

A similar argument would undermine the preference for infant adoptions, and recommend instead the many older children who go without homes because adoptive couples prefer to adopt infants before language habits and personality traits are formed. Parents seem to prefer making brand new people who share their genetics: on the Impersonal Totality Principle, their preferences are wrong because they preserve suffering and inequity.

Of course, none of these considerations would apply to those for whom reproduction is not a choice. There can’t be a general duty to forgo reproduction, because not everyone has the ability to do so, and because the human race would disappear. Without family planning technologies like birth control, reproduction is closely allied with sexuality and intimacy, and for poor women in most of the world, the choice not to have children is not one that they can make autonomously. But this simply militates in favor of rich and well-educated couples in the developed world recognizing that they have obligations due to their class and access to birth control technologies.

A few questions…

First, exceptions: how would this analysis jive with the duty to procreate advised by Judaism? (“Be fruitful and multiply!”) What about the duty that members of minority ethnicities might experience to preserve their identity?

Second, authority: does being a man undermine my capacity to comment on these matters? I hear similar arguments from many women, but discussing general population ethics as a male in a misogynistic society seems like a fraught position from which to make a judgment. Yet I’m also married, and obligated to have a view if I’m to make decisions with my partner. I can respect her autonomy while simultaneously enunciating my own preferences and expectations. Perhaps the mistake is precisely this attempt to generate a normative view on what ought to be a personal (non)calculation?

Third, models: I’m aware of some different political/bioethical theories that ground differing philosophical views of the right to procreation. For my part, I tend to prefer the Nussbaum/Sen capability theory for this kind of evaluation, which rejects the rights/duties language in favor interests and flourishing. But that doesn’t really eliminate the question, which becomes: is childrearing an integral part of human flourishing? What are some other ways to think about this question outside the ordinary communitarian/liberal/feminist/Foucaultian matrix?

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