Creating Humans: Ethical Questions, part 1

~To pass the time, lately I've been listening to audio courses in the Modern Scholar series, which I obtained from (where else?) the library. I've finished Ideas that Shaped Mankind, which was very enlightening, and now I'm working on Creating Humans: Ethical Questions Where Reproduction and Science Collide. The course lecturer (and reader) is none other than Alexander McCall Smith, who, aside from authoring the best-selling No. 1 Ladies' Detective Agency series of mystery novels, is also one of the world's foremost authorities on medical law and ethics.

Unlike the course in Ideas that Shaped Mankind, Creating Humans deals with extremely controversial questions that arouse intense feelings in some people over pertinent issues of intervention in the process of human reproduction. Some of the issues everyone has heard of and most have a strong opinion on (for example, abortion rights). Other issues fall into a more ambiguous ethical category, or are simply not something most people think about (for example, prenatal screening or the ethics of surrogacy or intensive care). And some emerging technologies will have a significant impact on human society. As for myself, the topic of ethics and technologies in reproduction has special significance because I have two young relatives who would not exist without the use of technology that did not exist scant decades ago.

It's up to us, as a nation and as a species, to decide how we're going to deal with these issues. Some people simply don't want to deal with the difficult questions of reproductive ethics, so their solution is to ban them all (such opinions are often religiously motivated). At the other extreme are those who think that reproduction is such an intensely private matter that nobody has the right to interfere with parental choice, and that whatever they decide to make use of is their own business. In listening to McCall Smith's lectures and considering the questions in the course guide, I believe the best (indeed, the only practical) response falls between the two extremes. Some of these technologies arouse little protest and have little potential for harm, while others are potentially very dangerous and need to be carefully regulated to prevent harm to both the resultant offspring and to human society as a whole.

All of what I've written up until now is a very broad outline of what the course is about, but I will soon get into specifics. For each of the fourteen lectures in the course, I've taken notes and written my own observations, thoughts, and questions -- which I would like to share with you, my dear readers. In some cases, I've drawn conclusions about how I feel and what I think should be done, but in general the complexity of the issues defies a quick and easy solution. I would love to hear (via comment or email) what you think about these issues, regardless of whether or not you agree with me. If you'd like to follow along, you can download a course guide from the course web site; if you want to know more, you may be able to find this course at (where else?) your local library. I've tried to divide up information and questions from the lecture from my own thoughts; the former are paragraphs, the latter are bulleted.

And so without further ado, here are my brief thoughts on...

--Lecture 1: An Overview of the Techniques for Creating Humans--

As the title suggests, this first lecture is a broad survey of current technologies for reproduction, including sperm and egg donation, in-vitro fertilization (IVF), surrogacy, and cloning (in the near-future). Each issue creates separate legal and social issues, and the emotional reaction to each is often very different. Most opposition to these technologies comes from those who feel, correctly, that the use of such technologies is somehow unnatural.  But what is really "natural" in human reproduction and raising children, especially from a legal perspective?

• What seems to bother people most is not so much the actual techniques -- the "mechanics" of various assistive technologies -- but rather the social and personal implications. Imagine, for a moment, a future society that births children in hospital "hatcheries" (such as in Huxley's Brave New World). If these children are raised communally and indoctrinated with drugs to control their development as they were in the novel, well, most of us would be horrified. But if the children were adopted into loving families who care for them as families do now, well, it's still unnatural...but not so bad.

• As another example, suppose a couple in which the man is infertile chooses to use donated sperm to have a child via IVF: is this a form of adultry -- legally, morally, or religiously? Who is the "real" father in this case? I suspect that, aside from deeply-held religious objections, this case is not really a difficult moral problem, because our society's definition of "fatherhood" is broad enough to encompass someone who is not genetically related to their child. Like a mug in my parent's cupboard attests, "Anyone can be a father, but it takes someone special to be a DAD."

What, if any, responsibilities (legal or moral) do donors have to their biological offspring?

• This is covered in much greater depth in a later lecture, but it bought to my mind a frightening aside from the novel Next by the late Michael Crichton. In this brief side-story, a wealthy businessman finds himself suddenly confronted by a young woman claiming to be his daughter, created from sperm he donated to a sperm bank when he was in college. The man isn't sure how to deal with this, but the woman is: she has a lawyer, and her eyes are on the cash -- she claims that he has a legal and financial obligation to provide for her.

Is it acceptable for a single woman to use donor material to have a child? Of course, single women have children all the time, but assistive technology allows for the possibility of children without a father playing any role at all in the relationship. Is that ok? Although studies have shown that children benefit from having two parents when growing up, is this evidence strong enough to consider children as having a "right" to a father?

• I think any legal attempt to limit this would be absurd; after all, we don't expect pregnant women whose parter/husband dies before the child is born to remarry, much less legally obligate them to do so.

Similarly, donor material allows for two women in a relationship to have children. With donor material, a resulting child would only be genetically related to one of the women, but new technology may allow for the child to actually be related to both. Do you think it's ok for a lesbian couple to raise children of their own? What about two men -- is it ok for them to adopt? Most objections to this are from those who believe that such couples aren't fit to raise children. Others fear that children raised by a homosexual couple will themselves be more likely to become gay (studies have largely disproven this) or will somehow be maladjusted (studies have also disproven this), while others simply dislike the deviation from the "natural" family on emotional or religious grounds. Here is a good summary of the debate.

• I personally see no harm in allowing such couples to raise children; these days, stable two-parent mom 'n dad families are becoming the ideal rather than the norm, and plenty of children are raised in "non-standard" family units. If a couple that is biologically incapable of producing offspring cares enough to go through the difficulties of having a child via technology or adoption, they're probably more committed to lovingly raising a child than many other couples (or single parents) are. While many people will disapprove of allowing such families to exist at all, I see no need for legal restrictions.

More questions to think about from this lecture:

1. Can the use of reproductive technologies be equated to life support for the terminally ill? They're both an "unnatural" intervention in life. (This issue is covered in much greater depth in a later lecture).
2. Is the availability and use of reproductive technology good or bad for society as a whole? If we somehow could, would it be better to just forget all about them and never use them?
3. Are children conceived via technology somehow unnatural themselves? Are they less "human" than naturally-conceived children? Many works of science-fiction depict dystopian futures were clones are somehow sub-human, or those who haven't (or have) been genetically enhanced are treated differently by society and the law. Is there any truth to this? Should they be treated differently by the law? Why or why not?