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  • Reproductive Technology:Overcoming the Objections
  • Mary B. Mahowald (bio)

The subtitle of this book nicely identifies its focus. While limiting itself to the medical aspects of infertility treatment, the book provides an empirically and theoretically rich account of the impact of reproductive technology on children. It does not address the extent to which socioeconomic factors, including the ability of parents to provide adequate nurturance, also affect the health and welfare of children born through reproductive technologies. Obviously, these factors affect all children, not only those conceived through medical assistance.

The author, Philip Peters, Ruth L. Hulston Professor of Law at the University of Missouri and the director of its Biotechnology and Society Program, is personally as well as academically well qualified to address his topic. The fact that he has studied reproductive technology as a patient as well as a professor lends his views credibility that allegedly impersonal accounts may lack. Peters acknowledges, however, that two events in his personal life could also bias his work: each of his daughters "owes her life to reproductive technology," and "one was erroneously diagnosed mid-pregnancy as being microcephalic." The latter experience prompted his "first soul-searching about the welfare of future children." These experiences are certainly relevant, but input from people who addressed infertility in other ways, such as through adoption, and from those for whom treatment was unavailable or unsuccessful, would have strengthened the book beyond what his own experience and scholarship could bring to it.

As seems appropriate for a professor of law, Peters deals mainly with policy issues and governmental regulation rather than with decisions made by individuals or couples. Because ethical principles or values inform policies and laws in any society, however, the two domains are inevitably related. For example, if one applicable ethical principle is respect for the autonomy of individuals, regulatory measures should be broad enough to accommodate a diversity of defensible positions. In arguing along these lines, Peters emulates another well-credentialed law professor who has written prolifically on reproductive technologies, John Robertson.

The premise of the book is "that the interests of future children matter and that their interests are frequently misunderstood." The first part of this statement is undoubtedly true, and the second part is probably true. His careful delineation of medical risks and benefits to children born through reproductive technologies succeeds well in promoting better understanding of the interests of future children. But Peters' overall support for "the fertility industry" (a term he uses), even when it entails greater risks than unassisted reproduction, relies crucially on a different, disputable premise: that individuals or couples have a "fundamental right" to have a child who is biologically (genetically or gestationally) related to at least one of them.

Peters grounds this right mainly on the prevalent, natural "urge" or desire of people to have "their own" children. This argument illustrates the pattern of argument that G.E. Moore called the naturalistic fallacy, by which natural desires are judged adequate determinants of what is morally good or right. Peters also cites broad societal acceptance in support of his endorsement of most forms of infertility treatment; this argument suggests a fallacy based on the "is/ought distinction": contending that something is morally permissible solely because it is done, or because many or most people consider it morally justified. As philosophers put it, the problem with this reasoning is that "is" does not imply "ought."

Peters' framework for understanding the interests of future children delineates three types of harm that may be inflicted on them through reproductive technologies. First is "ordinary harm," which involves carelessness or neglect of practices that would have allowed a child to escape an injury. Second is harm that might have been avoided by substituting one child for another—for example, by implanting a "healthy" embryo rather than one found to have a genetic disorder. And third is the harm of a life "that is worse than never existing at all"—that is, one whose burdens outweigh its benefit to the child.

While examining each type of harm, Peters attempts to answer the "disability rights" critique of prenatal testing and termination of embryos or fetuses that would otherwise be born with disabilities. This critique...

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