The Ethics of Selective Reproduction - Research Paper Example

The Ethics of Selective Reproduction In the past few decades, anticipated advances in technology and biological research have raised several ethical issues. Some of the ethical issues have been addresses prior to demonstration of their applicability to humans1. Often times, high expectations of their success have disappointed researchers and enthusiasts of such endeavors. Stephen Wilkinson’s book addresses policy and ethical questions raised by both the anticipated advances that have the potential of success or failure as well as the already available enhancements in the reproductive technology. The ethical concerns touch on several issues, most of them complex and risky. For instance, there was the 1980s attempt to eliminate or least reduce neurological disorders of Parkinson’s by transfer of fetal brain tissues2. The attempts are yet to materialize. Scientific feats that were thought impossible before have been achieved with persistent research and trial. This has been observed in the successful cloning of non-human animals3. Morality of Eugenics Eugenics refers to the attempt to improve the human gene pool. Different mindsets have agreed on the same definition of the term although not everyone has the same idea of what counts as eugenics4. One of the aspects of eugenics that is a source of ethical concern is the significance of parental choice in the matter. Given the fact that parents have the free will to choose what kind of a child they want, it loses state enforcement of coercive methods5. Liberal eugenics leaves room for misuse by both reproductive health providers and parents. Whereas this looks like a state of coercion to some people, others believe that the nature of services provided in eugenics cannot go without the free will and choices of parents. Wilkinson states that, “But other people think that some procedures which prospective parents can choose, such as pre-implantation genetic diagnosis (PGD), with embryo testing and the subsequent disposal or donation of unwanted embryos, are clearly cases of eugenics, even where events are entirely a matter of parental preference and there’s no state coercion at all”6 Despite the bad image the term eugenics had from the Nazi era, the present meaning and context of the term can be argued to be a moral and ethical position. Unlike the Nazi eugenics that involved mass murder of targets that ranged from assorted ethnicities to children with disabilities by the State, today’s eugenics does not compromise the lives of citizens at all7. The term has become so much tainted that individuals who support medical procedure like PGD may very likely not want the process termed as eugenics. On the contrary, those who do not support such medical procedures may favor the term eugenics so as to express the hostility of the process. They associate PGD with the Nazi practices in every way, and predict that the medical procedures associated with genetic improvement of human beings will eventually turn out to have the same adverse totalitarian effects8. Given the bad image that the term “eugenics” has on populations because of its historical associations, it would be best to consider restricted use of the term. The idea and actions behind eugenics are noble and well intended. There is morality and ethics of undoubted standards in the need for parents to bear children without complications9. For those arguing against eugenics from religious point of view, there is no religious belief that rejoices human suffering. If scientific innovations and enhancements can eliminate the chances of anyone suffering from hereditary health problems, it would be in line with religion to celebrate the birth of a healthy child that would have otherwise suffered without the eugenics intervention10. Considering the book, it would be necessary to abandon the use of the term “eugenics” based on all the three proposals of the authors. Foremost, the term is emotive and manipulative. It encourages people to form irrational and autonomous beliefs on an otherwise very ethical11. Secondly, the term should be avoided since it gives offence to processes that do not deserve the offences. Finally, the term “eugenics” needs to be avoided for it is used to make statements that are misleading even though the statements could be true12. Using “eugenics”, opponents of associated medical procedures could make misleading statements on the ethical standing of the processes. Selective Reproduction Developments in genetics and medicine have made it incessantly possible for prospective parents to choose to have children without disabilities. There are a number of ways of ensuring this including the use of Pre-implantation Genetic Diagnosis and parental genetic testing13. In PGD, embryos are created using In-Vitro Fertilization14. The embryos are then examined for presence of genes that may be likely to cause diseases or disabilities. According to the authors, PGD is already usable in selecting out over 100 conditions. The conditions include early stages of Alzheimer’s disease, cystic fibrosis, Huntington’s disease, BRCA1 that causes increased susceptibility to breast cancer, hemophilia and sickle cell anemia15. The techniques and other closely related processes have the potential to reduce and even eliminate a good number of diseases and sufferings. Even though these methods of avoiding procreation of people with sufferings may look marvelous and outright recommendable to some people, others feel they come with several unethical implications. Some people have serious reservations against the use of PGD and related methods to select against diseases and disabilities in future children. Opponents have ethical questions about the methods scientists choose to select populations against disabilities and diseases. In addition, there is often the ethical question of the goals and aims of having a “perfect” society16. Conservatives and opponents of the methods have concerns about the aim of scientists and medical practitioners of producing fewer children with disabilities. The use of PDG and other related methods to prevent disabilities and diseases holds sound moral grounds. The procedures provide an escape route to other universally acknowledged unethical practices such as abortion17. Where people’s concern is the means of doing things, they take refuge in the comfort that PDG and related techniques are more ethical than other problematic means of avoiding the birth of children with disabilities and diseases. Although considering a comparison between PDG and abortion gives PDG a leap over the latter, it is not completely uncontroversial18. Equal Value Principle Ethical unsoundness of PDG is evident when the main objectives of selective reproduction are considered. Selective reproduction through PDG enables the achievement of Equal Value Principle19. The first objective of selective reproduction is eugenics. This, as stated before, focuses on improving the human breed by reducing complications. However justifiable the claim of eugenics may sound to support selective reproduction, Equal Value Principle negates its suppositions. According to the principle, we ought to value disability and non-disability equally. Procedures such as PDG that reduce the chances of having a disabled child fall foul of the principle. If humanity behaved in a way that showed equal respect and value for the able bodied and the disabled equally, there would be no such efforts to create children without disabilities20. Before taking the Equal Value Principle as an absolute reason for objecting selective reproduction, it is imperative to consider the rationale of the principle. Is the principle convincing?21 The much the Equal Value Principle convinces depends on one’s interpretation of the principle. Foremost, interpreting the principle could take the literal diction of the phrase. For instance, one would attach the same value of walking or seeing to doing duties in the presence of these abilities and absence of the abilities22. Likewise, it would take the comparison of a sickle cell anemic child to fighting diseases and infections the same way a non-carrier would fight. Nevertheless, a look at the principle in literal view as this would be misleading. Equal Value Principle is naturally within human beings. This is why people struggle to treat their loved ones even when they know they may live with disabilities after accidents and serious illnesses. Insisting on having a population without disabilities derails the principle. The disabled become second-class citizens in their own eyes and in other people’s perspective. In this view, selective reproduction using PDG and related procedures is unethical. Harmful Consequences The other ethical concern surrounding selective reproduction is harmful consequences of the practice on the disabled. Success on reducing the number of people with disabilities may have adverse effects on the few people who may be born with disabilities. In the event that the numbers of people suffering from certain disabilities reduce, the few who remain disabled would suffer less acceptance and inclusion. They would look more unusual and attract treatment worth aliens in the hands of the non-disabled population. The other negative influence of the selective reproduction is that reduced numbers of the disabled would lead to little allocation of resources to make the environment and institutions disability-friendly23. Reduced significance of numbers of the disabled in the society would alter the political and economic calculations upon which the allocation of resources to help those with various abilities were made. It is also of ethical concern that if people will be able to influence and easily decide whether to give birth to disabled children or not, then parents of children born with disabilities and other health complications will be wrongfully blamed for allowing the birth of such children. They would be accused of causing suffering to their children and in some instances for imposing extra social and healthcare costs on taxpayers and the wider community. Expressive Argument Expressive Argument is the other ethical concern of selective reproduction. The authors say, “Finally, we must consider what is sometimes known as Expressive Argument-the claim that choosing not to conceive or bear a child with disability expresses and sends out a very negative message about people with disabilities, one that says that it would be better if they had not been born.24” To some extent, the message that the world sends to the disabled is that this could be a better place without them. It inflicts psychological torture on the disabled and those with undesirable complications25. Ethics and Newborn Genetic Screening: New Technologies, New Challenges This book is a crucial contribution to the policy discussions concerning newborn screening programs. It is specifically critical given the trend towards rapid expansion26. The editors and authors make a strong case for their framework for analysis and accurately assess the implications of its adoption. Following the distressing occurrence in the United States of the expansion in the compulsory newborn screening panel coupled with corollary demands on Medicaid funds as well as an appalling increase in infant mortality rate newborn screening is necessary. Ethical Concerns Irrespective of the necessity of newborn genetic screening, there are ethical concerns that come by the practice. Ethical acceptance of the newborn screening comes when the practice is evidence-based. Secondly, screening is ethical if it considers the opportunity costs of the investment27. Third, the screening must seek fairly distributed benefits and costs to be ethically accepted. Finally, newborn screening needs to respect human rights to be considered ethical. A crucial deduction from the moral framework of newborn screening is that the practice needs to be removed from its silo and allowed to defend itself alongside all other investments that may support the imperative of improved child and infant care28. This deduction remains sensible despite the fact that moral ends are more typically advanced by clinical epidemiologists, health economists, and political philosophers than bioethicists. Unethical Spending The chapter by Mary Ann Baily reveals the unethical issues associated with the widespread newborn screening in the United States. She describes newborn screening as a historical arc depicting what is at its roots a classic case of technology outpacing self-reflection. The historical arc covers everything from the original controversial screening of phenylketonuria to the present ease of checking many boxes without adding considerable costs or efforts29. There is unfair distribution of testing burdens. Additionally, there is unfairness in benefits that come with healthcare distribution. The screening program exposes one of the several odds of the America healthcare system. It is unethical and paradoxical that the state is willing to spend a lot of state and federal money to test for conditions that the fragmented system later allows to go untreated. The state’s affection for newborns does not last to extend to the resulting adults30. Bibliography Stephen Wilkinson, Choosing Tomorrow’s Children. The Ethics of Selective Reproduction, Oxford: Clarendon Press, 2010. Mary Ann Baily, Thomas H, Murray. Ethics and Newborn Genetic Screening. New Technologies and Challenges. Baltimore, Maryland: The Johns Hopkins University Press, 2009. Read More