Abstract
It is natural to think the evaluation of reproductive decisions is subject to the same ethical standards that apply to relations between existing persons. If so, prospective parents should be able to extrapolate from the latter to the former when thinking about whether to have children, how to have children, what sort of children to have, and so on. Yet there are well-known features of certain reproductive decisions that make it hard to grasp how some of the most basic ethical standards that apply to relations between persons also apply to them. These features obtain in scenarios where reproductive decisions are made in the absence of any distinct or identifiable person who fills the role of primary beneficiary or victim. I call such scenarios pre-conception scenarios, and any scenario where the causing to exist of an entity is at stake a non-identity scenario. The problem of how to evaluate decisions ethically where the identity of the entity affected is itself determined by those decisions is sometimes called the non-identity problem.1 I shall follow this usage. Pre-conception scenarios form a subset of nonidentity scenarios. This chapter is primarily about the non-identity problem as applied to pre-conception scenarios, although I also discuss a number of other non-identity scenarios.
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Notes
D. Parfit (1984) Reasons and Persons (Oxford: Oxford University Press)
J. Woodward (1986) ‘The Non-Identity Problem’, Ethics, 96.
A. Buchanan, D. W. Brock, N. Daniels and D. Wikler (2000) From Chance to Choice (Cambridge: Cambridge University Press).
J. Glover (2001) ‘Future People, Disability and Screening’, in J. Harris (ed.), Bioethics (Oxford: Oxford University Press).
Parfit, Reasons and Persons; Buchanan et al., From Chance to Choice; J. McMahan (2001), ‘Wrongful Life: Paradoxes in the Morality of Causing People to Exist’, in J. Harris, Bioethics (Oxford: Oxford University Press).
D. Parfit (1986) ‘Comments’, Ethics, 96, pp. 854–62.
This example is adapted from Case C in R. M. Adams (1972) ‘Must God Create the Best?’ Philosophical Review 81, pp. 329ff. Adams uses this case to argue against a principle he formulates as follows: ‘It is wrong to bring into existence, knowingly, a being less excellent than one could have brought into existence’ (p. 329).
A similar case is criticized in D. Parfit (1982) ‘Future Generations: Further Problems’, Philosophy and Public Affairs 11, pp. 127–8.
The deaf case is an actual case from recent history (L. Mundy (2002) ‘A World of Their Own’, Washington Post, 31 March, p. W22
H. Lillehammer (2003) ‘Who Needs Bioethicists?’, Studies in the History and Philosophy of Biological and Biomedical Sciences, pp. 131–44). The case provoked substantial controversy, although not necessarily for the right reasons. One reason for the controversy was the ethical status of the IVF technique. Another reason was the gender of Sharon and Candace, a lesbian couple from California. We can ignore these sources of controversy here. The ethical problem of selecting for disabilities would remain had the biological mother procreated with a deaf male in the conventional way. An additional issue that affects the present argument is that the children of Sharon and Candace are educated in a specialised school paid for by public funds. It is a controversial issue whether public funding of specialised schools for deaf children would be a just requirement of nondiscrimination or an unjust burden on others if deafness were easily avoidable. As this feature is not essential to the case either, I shall ignore it. Finally, I shall ignore the question whether in avoiding any form of treatment for the deafness of their children, Sharon and Candace thereby committed themselves to the claim that it would be right to produce a disability in an existing normal person. This conclusion would follow only if there were no ethically significant distinction between omitting to treat a disability on the one hand, and acting to produce a disability on the other. Some consequentialists reject this distinction; cf. J. Bennett (1994) The Act Itself(Oxford: Oxford University Press). Consequentialists are also the most likely defenders of impartial and non-person-involving considerations like Q and the beneficence principle. It is a moot question how consequentialists should account for the partial values discussed in the present chaper.
Cf. G. S. Kavka (1982) ‘The Paradox of Future Individuals’, Philosophy and Public Affairs 11, pp. 110–11, who explicitly extends the categorical imperative to ‘forbid treating rational beings or their creation … as a means only, rather than as ends in themselves’ (my italics).
Cf. R. Kumar (2003) ‘Who Can Be Wronged?’ Philosophy and Public Affairs 31.
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© 2005 Hallvard Lillehammer
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Lillehammer, H. (2005). Benefit, Disability and the Non-Identity Problem. In: Athanassoulis, N. (eds) Philosophical Reflections on Medical Ethics. Palgrave Macmillan, London. https://doi.org/10.1057/9780230273931_2
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