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Bioethics


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the best for their own children?

      Someone might here object that choosing only healthy children exhibits prejudice against people with disabilities. I answer that not supporting (or killing) disabled children differs dramatically from not creating them in the first place. Our principles, our moral intuitions, do not support abandoning or terminating babies with severe disabilities, but the same principles and intuitions support not intentionally creating such children.

      Overall, in America we are a long way from a philosophically consistent policy on fetal rights and reproductive responsibility. In the Whitner case in 1997, the Supreme Court of South Carolina ruled that a pregnant mother can be prosecuted for using cocaine because such usage harms her fetus. In another example, in 2002 the President’s Council on Bioethics chaired by Leon Kass said that no child should be originated by cloning because of possible harm to the new baby. Yet the McCaugheys and other parents of multiples take terrible risks of creating disabled children and, when they invoke God's will, are seen as heroes. Something seems akilter here.

      Notes

      1 1 This essay originally appeared in the Birmingham News 1 December 1997 and was revised by the author for the 4th edition of this anthology.

      2 2 Ann Curry, “After 10 Years, New Adventures for Septuplets,” Dateline, December 12, 2007. http://www.nbcnews.com/id/22223331/#.USAS0hzB‐AE

       Timothy F. Murphy

      Researchers have had success in using synthetic gametes – sperm derived from female stem cells and ova derived from male stem cells – to produce live offspring in laboratory animals.1 The prospects for same‐sex couples to have children using only their gametes has been predicted in some of the earliest reports of success in the development of synthetic gametes, and some researchers have mapped this outcome as meaningfully within the range of possibility.2 Even so, considerable work remains to be done before human beings conceived with synthetic gametes could materialise this way,

      Gay and lesbian people do already have children, of course, from opposite‐sex relationships, by adoption, through surrogacy arrangements, and – more recently – through various assisted reproductive treatments (ART). As many as six million people in the USA have a gay or lesbian parent.3 Because of shifting social views, it is likely that many more children of gay and lesbian parents are on the way. For example, the American Society of Reproductive Medicine now counsels its members to offer their services without regard to sexual orientation or marital status.4 Even so, two men or two women hoping to have children together cannot expect to share genetic parenthood, although certain symbolic gestures toward shared parenthood are available. For example, one woman might offer ova for fertilisation while her partner gestates the children.5 Two gay men may blend their sperm prior to insemination when relying on surrogate gestation for a child so that the child’s genetics are a matter of chance rather than choice. By contrast with these practices, the use of synthetic gametes – ova derived from males and sperm derived from females – stands poised to offer same‐sex couples ways to share full genetic parenthood of their children.

      When it comes to same‐sex couples turning to synthetic gametes, A. J. Newson and Anna Smajdor say ‘new ethical questions’ arise, ‘such as whether same‐sex couples should be able to access this technology to have children who are genetically related to them both’.6 I fully concede that the prospect of same‐sex couples as the genetic parents of children is a novel question, but the question of cross‐sex gamete production is not any more novel for them than for anyone else. If synthetic gametes become possible, any man or woman can be the source of sperm or ova no matter what kind of relationship they are in. Yet Newson and Smajdor do not treat the use of synthetic gametes for infertile opposite‐sex couples as a specifically ethical concern; they certainly do not frame the question of synthetic gametes for opposite‐sex couples as a question of access, presumably because they assume these couples to be fit as parents in all the ways that matter. In regard to same‐sex couples, Newson and Smajdor go on to ask ‘Will a man whose DNA is contained in the egg (used to produce a child) be recognised as a “biological” mother?’ (see page 186 from Newson et al.6). By contrast, they ask no parallel question of ethics and access for their own example of single men or women who might rely on their own sperm and synthetic ova to produce a child. In any case, why assume that a man whose synthesised ovum is used to produce a child cannot be recognised as the child’s mother in a biological sense even as he retains a male identity? After all, one transgender man who gestated his own children expresses no doubts about being the children’s father.7 Techniques of fertility preservation for transgender men and women – preserving gametes prior to body modifications that would otherwise leave people infertile – are likely to increase the ranks of transgender men who are the genetic mothers of their children, and the ranks of transgender women who are the genetic fathers of their children.8 Rather than trying to retrofit all parents into mutually exclusive categories of mother and father, why not ask a more searching question, namely whether these categories offer an adequate vocabulary for expressing the relationships progenitors can have with their progeny?

      Other discussions also represent the parenthood of gay men and lesbians as ethically controversial. In 2009, a study group of scientists, ethicists, journal editors and lawyers reviewed the science of synthetic gametes and suggested likely uses, some of which they said might require legal and policy oversight. This group indicated that the possibility of using synthetic gametes for reproduction in same‐sex couples is unlikely in the future, for genetic reasons related to conception and embryogenesis.9 Even so, their analysis does not rule out same‐sex reproduction as impossible. Perhaps for that reason, the group went on to say ‘same‐sex reproduction is inarguably a controversial, if highly unlikely, potential end result of this research’ (see page 13 from Mathews et al.9). The study group, therefore, identifies this kind of reproduction as ‘requiring deliberation and possible policy options’ (see table 1 from Mathews et al.).

      This interpretation of same‐sex reproduction as ‘inarguably controversial’ comes without any supporting rationale. By contrast, the study group did feel obliged to offer a rationale after describing other novel uses of synthetic gametes, such as the in vitro creation of human embryos for research that involves their destruction. The group noted that those practices offend people ‘who imbue such embryos with full moral status’ (see page 12 from Mathews et al.). By contrast, the idea that two men or two women conceive and raise a child together is represented as self‐evidently controversial, requiring no supporting explanation at all.