Parental Obligations and Bioethics

The Duties of a Creator

Bernard G. Prusak

• Publisher: Taylor & Francis
• Year: 2013
• Print ISBN: 9781138245303
• eBook ISBN: 9781134475322
• Edition: 1
• Topic: Philosophie
• Subtopic: Déontologie en médecine

This book examines the question of what parental obligations procreators incur by bringing children into being. Prusak argues that parents, as procreators, have obligations regarding future children that constrain the liberty of would-be parents to do as they wish. Moreover, these obligations go beyond simply respecting a child's rights. He addresses in turn the ethics of adoption, child support, gamete donation, surrogacy, prenatal genetic enhancement, and public responsibility for children.

1
What Are Parents For?

A Thought Experiment

As Milton’s Adam observes in a fit of pique after his fall from grace, one of the things that parents do for children—analogizing God as father and mother both—is to presume to bring them into being. (When I refer to parents in the following, I normally have in mind parents qua procreators, as the context should make clear.) Neither informed consent, nor even mere assent is, of course, possible on the part of children-to-be. Moreover, once we are here, whenever that strange and remarkable event occurs in our development, there is no not having been here, and there is also no easy means of exit should we not be happy with the course that our lives are taking. In Adam’s words (in verse that reappears, significantly, as the epigraph to Shelley’s Frankenstein):

Did I request thee, Maker, from my clay
To mould me Man? Did I solicit thee
From darkness to promote me …?¹

The lament is ancient. Nietzsche refers to the “ancient story” of Midas’s capture of Silenus—and Silenus’s cackle that “‘[w]hat is best for [human beings] is beyond [our] reach forever: not to be born, not to be, to be nothing.’”² Job wishes that his creation could be undone in language that inverts the creation story in Genesis 1:

Let the day perish in which I
was born.
and the night that said,
“A man-child is conceived.”
Let that day be darkness!
May God above not seek it,
or light shine on it.
Let gloom and deep darkness
claim it.³

Philip Larkin’s vision in his oft-quoted poem “This Be the Verse” is funnier but perhaps even darker. I pass over the infamous first line (which as a rule is all that is ever quoted) for the final stanza:

Man hands on misery to man.
It deepens like a coastal shelf.
Get out as early as you can.
And don’t have any kids yourself.⁴

This last bit of advice is presumably for “the good of the child”; the poet or, in any event, the poem appears to deem all human life wrongful life.⁵ It is, obviously, an extreme judgment, and most bioethicists do not go nearly so far.⁶ Then there are the paradoxes that cluster under the bristling name of the non-identity problem. These appear to dissolve the worry that parents can harm a child in bringing him or her into being, and so absolve would-be parents of any culpability for a child’s existence in all instances but when it can be predicted that the child’s life would be so terrible that it would not even be worth living.⁷ The non-identity problem takes its name from the supposition that “in different outcomes”—for example, when parents conceive a child now though this child will have a disability (outcome 1) rather than delaying several months, in order for the problem in question to pass, and having a child without this disability (outcome 2)—“different people would exist.”⁸ In these different outcomes, to restate the point in different terms, the people who stand to come into being would not be identical with one another. Accordingly, it is not the case that the child with the disability might have been brought into being without this disability if only her parents had delayed trying to conceive; instead, if her parents had delayed, this child would never have existed at all. The only way for her to come into being was to come into being with her disability; and so (here is the kicker) it appears not to make any sense to say that her parents harmed her, which is to say acted against her interests, though they knew that she would come into being disabled. If we want to say that the parents committed some crime, it appears to be a crime without a victim. For the only alternative for the child, to speak nonsense for a moment, would be never to have come into being—which is nonsense since nonexistence is obviously no alternative for her.⁹ Yes, nonexistence might be preferable for her if we could predict that she would not have a “life worth living”—if the “bads” of that life would overwhelm any goods in it, or her existence were so terrible that it constituted an evil to her; but no, existence would not be worse for her than never having existed—she would not, strictly speaking, have been harmed in being summoned from darkness to light, to recall the imagery deployed by Adam and Job.

In bioethics, the non-identity problem is often deployed against those who, in the interests of children, would put limits on would-be parents’ reproductive liberty. In other words, it appears, not as a problem to be solved or circumvented, but as an argument used to dismiss objections to reproductive decisions made before a child is conceived or very early in its development. For example, according to John Harris, “[t]here is no complaint the ‘victim’ of gender selection [or surrogacy, or artificial insemination by donor, or cloning] can make because for her there was no alternative but never to have existed.” In fact, he goes on,

the same is true for any significant genetic manipulation that might be made to an embryo or indeed to the gametes prior to conception, if this ever becomes possible. So complaints that parents who would use gender selection are attempting to shape or mold their children [and thereby potentially harming them] are simply incoherent. [The parents] may of course be choosing what sorts of children will come into existence, but none of those children have any legitimate or even coherent complaint, for they could not have had an alternative life free of such externally imposed choices.¹⁰

Yet not all objections to reproductive decisions need turn on the interests of the children so produced; the non-identity problem, retooled as an argument,¹¹ does appear to undercut this kind of objection, but only this kind. It is a basic thesis of this book that parents, qua procreators, have obligations regarding future children that constrain the liberty of would-be parents to do as they wish. Moreover, these obligations go beyond respecting the oft-invoked child’s right to an open future (discussed in chapter 5). If it is objected that a person cannot have the obligations of a parent until a child, in fact, exists, the reply should be that, while yes a person would not have obligations to the child until she exists, a person is obligated not to create a child unless that person has a reasonable belief that he or she will be capable of carrying out the relevant obligations and is committed in advance to doing so. Analogously, a person does not have the obligation to repay a debt until he or she in fact borrows money. But that person would be wrong to borrow the money without a reasonable belief that he or she could repay the debt and without being committed in advance to the repayment.¹² The upshot is that, if we have reason to think that a reproductive decision would lead to the violation of parental obligations, then we can object to this decision without having to engage the paradoxes of the non-identity problem.¹³ Whether the parents who bring a child into being thereby incur the obligation to do any of the work of parenting themselves is a further question that this chapter goes on to investigate.

One way to elaborate my thesis is to think about adoption, and so this chapter proposes to do so. As Jonathan Glover has observed, the model of adoption is potentially misleading for thinking about reproductive decisions.¹⁴ For the child who is available for adoption already exists and so decisions concerning this child—for example, with what parents to place him or her—can harm his or her interests; not so the child who cannot come into being but in this particular condition with these particular parents. I want, however, to come at adoption from a different angle. It has traditionally been held, at least in cultures shaped by the several Abrahamic religions, that what can be permitted and may be the better course in extremis—namely, giving up a child—cannot be justified in ordinary circumstances, which is to say when there are not very good and pressing reasons, even if one could be confident that another individual or for that matter institution could do the job of raising one’s child just as well or even better.¹⁵ In other words, so-called abandonment— richly studied by the historian John Boswell in his book The Kindness of Strangers—is justifiable in some circumstances, but not all circumstances, again even if others could do the job just as well or even better.¹⁶ But why? I put the question this way: why would it be wrong—if indeed it would be wrong—for a couple to seek to conceive a child with the idea, in advance, of giving him or her up simply at will, which is to say without some reason other than that they wanted to do so? (In more current terms: why would it be wrong—if indeed it would be wrong—for a couple to plan to have to make an adoption or birth plan?) Trying to answer this question requires us to think about, not just what parents do for children, like presume to bring them into being, but what obligations becoming a parent brings: in the colloquial terms of this chapter’s title, “what are parents for.” Once we have this account, which I think would be valuable in and of itself for our appreciation of the role of parent, we can go on to consider in chapters to come whether, or under what circumstances, new ways of becoming a parent now and in the future—through gamete donation, surrogacy, and prenatal genetic enhancement—are likely to be compatible with the obligations of parents, qua procreators, to children. But first, in this chapter and the next, there is no little groundwork to be done. To prepare the reader, my argument in this chapter takes more than one twist and turn, and it is not until chapter 2 that the argument comes to a close.

§1. The Tradition and Two Answers

Alan Donagan articulates what he calls the “precept of parental responsibility” in the Hebrew-Christian tradition as follows: “It is impermissible for human beings voluntarily to become parents of a child, and yet to refuse to rear it to a stage of development at which it can independently take part in social life.”¹⁷ He further remarks that “[f]or a child whose natural parents cannot assume this authority, for any reason from death to temperamental unfitness, other arrangements must be made, for example, adoption; but they are considered to be intrinsically inferior.”¹⁸ Parental obligations or duties are then what are termed prima facie, which is to say obligations or duties that obtain not absolutely, but on the condition that there are not overriding considerations.¹⁹ In other words, according at least to the Hebrew-Christian tradition, procreators are prima facie obligated to parent the children whom they bring into being and so to carry out the duties of parenthood, whatever they may be (which at this point I do not presume to say). Remarkably, Jewish, Islamic, and the common law do not even have the category of adoption and instead only foster care. By contrast, “Modern American law (like the Code of Hammurabi, Roman law, and the Napoleonic code) has full legal adoption.”²⁰ The 1851 Massachusetts Act to Provide for the Adoption of Children, which became the model statute across the United States, declared the adopted child “the same to all intents and purposes as if such child had been born in lawful wedlock of such parents or parent by adoption,” while terminating the so-called natural parents’ “legal rights … as respects such child” and freeing him or her “from all legal obligations of maintenance and obedience, as respects such natural parent or parents.”²¹ The growing practice of open adoption since the 1980s is, of course, introducing significant changes to this model as well as challenges to the adoptive family; but the background for these changes and challenges is adoption understood more or less as the Massachusetts act conceived it.²²

Given the great changes in matters familial and sexual over the last fifty-plus years, it might come as a surprise that the traditional precept that Donagan articulates appears more or less to reflect common morality today, at least within cultures descended from the Abrahamic religions. Though it is legally permitted, giving up a child for adoption when one is competent to care for the child and there is nothing untoward in one’s life circumstances is seen as morally suspect.²³ Donagan’s claim that other arrangements like adoption are “intrinsically inferior” to rearing by birth parents has not fared as well, though it has perhaps fared better than it should. Recent empirical research supports the view that, as Elizabeth Bartholet puts it, adoption “should be recognized as a positive form of family, not ranked as a poor imitation of the real thing on some parenting hierarchy.”²⁴ After all, a child’s birth parents may prove terrible, and it can be a mercy to be given into the care of others, even the care of strangers. In any event, the current consensus appears to be that giving up a child for adoption may be commendable—indeed, it can be seen as “the last in a series of actions meant to provide care for the child”²⁵—but must also be undertaken with great seriousness.²⁶

At least one contemporary practice—namely, surrogacy—may well tell a different story,²⁷ but I want to put it aside for now in order to focus instead on my question of why it would be wrong, if indeed it would be, for a couple to seek to conceive a child with the idea of giving him or her up simply at will, which is the case neither in so-called traditional surrogacy (where the mother contributes both genes and gestation) nor in gestational surrogacy (where the mother contributes “only” gestation). Admittedly, the question is somewhat strange, perhaps even disturbing: for many birth parents, the decision to give up a child is traumatic, even tragic in some sense. As Paul Lauritzen has observed in a thoughtful and well-documented discussion, “many children surrendered f...

Table of contents

• Cover
• Title
• Copyright
• Dedication
• Contents
• Acknowledgments
• Introduction
• 1 What Are Parents For? A Thought Experiment
• 2 The Costs of Procreation
• 3 Abortion and the Grounds of Parental Obligations
• 4 Whose Child?
• 5 Good Enough Parenting? The Child’s Right to an Open Future and the Ethics of Prenatal Genetic Enhancement
• 6 Back from the Future: Paying for the Priceless Child
• Notes
• Bibliography
• Index