Bioethics. Группа авторов

a doctor removes a person’s limb to save his life. It would not be true, at least in a morally relevant sense, that the doctor harmed this person, or affected him for the worse. We seem bound to say the same about my second woman.

I conclude, then, that if the second woman deliberately conceives a disabled rather than a normal child, she would not be harming this child. The first woman, if she deliberately neglects the treatment, would be harming her child. Notice next that in every other way the two acts are exactly similar. The side‐effects on other people should be much the same. These side‐effects would provide some person‐affecting grounds for the claim that the second woman’s act would be wrong. But it is obvious that if we judge the two acts on person‐affecting principles, the first woman’s act must be considerably more wrong. In her case, there are not just side‐effects – her child is seriously harmed. The second woman’s child is not harmed. Since this is the only difference between the two acts, the case provides a test for person‐affecting principles. The impersonal principle tells us to reduce misery and increase happiness, whether or not people are affected for better or worse. If there is any plausibility in the restriction to acts which affect people, it must be worse to harm someone than to cause equivalent unhappiness in a way which harms no‐one. The second woman’s act must, in other words, be less wrong than the first’s. It we think that it is not less wrong, we cannot accept the restriction to acts which affect people.

      The acts which I have described are of course unusual. But this does not make them a worse test for the person‐affecting restriction. On the contrary, they are unusual because they are designed as a test. The two women’s acts are designed to be as similar as they could be, except in one respect. Each woman deliberately brings it about that she has a disabled rather than a normal child. The only difference is that in one case the disabled and the normal child are the same child, while in the other they are not. This is precisely the difference which, on the person‐affecting principle, matters. If we think that the two acts would be just as wrong, we cannot believe that it does matter.

Some of you may think that the person‐affecting principle survives this test. You may think: “Since the second woman doesn’t harm her child, what she does is less wrong.” But there are other cases where such implications seem harder to accept. Take genetic counseling. We could not advise the dominant carriers of diseases to accept genetic counseling for the sake of their children, for if they reject this counseling, and marry other dominant carriers, it will not be true that their children will have been harmed, or affected for the worse. Or again, Dr. Kass has argued that it would be wrong to use certain kinds of artificial fertilization, on the ground that if children are conceived in these ways, rather than in normal ways, they run greater risks of certain deformities.⁷ But these particular children cannot be conceived in normal ways. For them, the alternatives are artificial fertilization, or nothing. So we can only claim that we would be harming them, or affecting them for the worse, if the risks of deformities were so great that their lives would probably be not worth living.

      When we turn to population policy, the implications become much harder to accept….

      [Editorial note: the rest of Parfit’s talk is not reprinted here. His more recent thoughts about the problems discussed in this talk, and the larger problems of population policy, will appear in a future issue of the journal, Philosophy & Public Affairs, under the title “Overpopulation.”]

      Notes

      1 1 Cf. Michael Tooley, “Abortion and Infanticide,” Philosophy and Public Affairs, 2, No. 1 (Fall 1972) [see chapter 1 in this Anthology].

      2 2 Quoted in G. Tedeschi, “On Tort Liability for ‘Wrongful Life,’ ” Israel Law Review, October 1966, p. 514, footnote 3.

      3 3 The logic he describes in his books, The Language of Morals, OUP, 1952, and Freedom and Reason, OUP, 1963.

      4 4 For a legal discussion of related issues, see “A Cause of Action for ‘Wrongful Life,’ ” Minnesota Law Review, 55, No. 1 (November 1970).

      5 5 This asymmetry is discussed in Jan Narveson’s two articles: “Utilitarianism and New Generations,” Mind, January 1967, and “Moral Problems of Population,” The Monist, January 1973. I have learned much from both of these.

      6 6 For a different view, take a remark in Gwen Raverat’s Period Piece, Faber and Faber, 1952, “It is always a fascinating problem to consider who we would have been if our mother (or our father) had married another person.”

      7 7 “Making babies – the new biology and the ‘old’ morality,” Leon Kass, The Public Interest, Winter, 1972.

Prenatal Screening, Sex Selection, and Cloning

8 Genetics and Reproductive Risk: Can Having Children Be Immoral?

       Laura M. Purdy

      Is it morally permissible for me to have children? A decision to procreate is surely one of the most significant decisions a person can make. So it would seem that it ought not be made without some moral soul‐searching.

      There are many reasons why one might hesitate to bring children into this world if one is concerned about their welfare. Some are rather general, such as the deteriorating environment or the prospect of poverty. Others have a narrower focus, such as continuing civil war in one’s country or the lack of essential social support for child‐rearing in the United States. Still others may be relevant only to individuals at risk of passing harmful diseases to their offspring.

There are many causes of misery in this world, and most of them are unrelated to genetic disease. In the general scheme of things, human misery is most efficiently reduced by concentrating on noxious social and political arrangements. Nonetheless, we should not ignore preventable harm just because it is confined to a relatively small corner of life. So the question arises, Can it be wrong to have a child because of genetic risk factors?¹

      Unsurprisingly, most of the debate about this issue has focused on prenatal screening and abortion: much useful information about a given fetus can be made available by recourse to prenatal testing. This fact has meant that moral questions about reproduction have become entwined with abortion politics, to the detriment of both. The abortion connection has made it especially difficult to think about whether it is wrong to prevent a child from coming into being, because doing so might involve what many people see as wrongful killing; yet there is no necessary link between the two. Clearly, the existence of genetically compromised children can be prevented not only by aborting already existing fetuses but also by preventing conception in the first place.

Worse yet, many discussions simply assume a particular view of abortion without recognizing other possible positions and the difference they make in how people understand the issues. For example, those who object to aborting fetuses with genetic problems often argue that doing so would undermine our conviction that all humans are in some important sense equal.² However, this position rests on the assumption that conception marks the point at which humans are endowed with a right to life. So aborting fetuses with genetic