Week 7

Savulescu: Procreative Beneficence

Savulescu argues in favor of proactive beneficence (PB) meaning parents should selct the child whonis expected to have the best life based on information given. basiclt during IVF the genetic selection should be what gives the child the best life meaning higher intenlegence or something like that but some people argue this might increase social inequality.

Getting into more of the backround IVF is in vitro fertilisation where we are able to make multiple embryos and PGD is preimplantation genetic diagnosis this allows us to test embryos before they are implated. we test them to find genetic diseases however we could use it to test for intelegence,personality and other.

its important to kniow the difference between disease gene and a noin disease gene

• disease - either causes a disorder or increases the risk of a disease

• non disease - gene that affects the trait (intenllegence,height,memory) not the disease itself

a main example used in the analogy of PB is the wheel of fortune analogy. so choosing an embryo is like choosing two boxes box A : is a known out come and box B : is the same outcome althought it might have extra risk. well anyone in this case would choose choice A and so selecting the embryo would follow the same logic you should choose the option that will produce the best outcome. basicly the author is trying to say that what matters is the childs impact on wellbeing ans we want to give them the best chance of having a good life

take for example this other scenario we have two embryos for IVF and embryo a has no abnormalities when embryo B has a predisposition to asthma so if we think about the wheel of fortune case it only makes sense to choose embryo A as chossing B is irrational.

Savulescu also talks about Dereck parfits philosophy and he talks about a rubella case. a women has rubella and if she were to conceive a child now that child could be born deaf or blind but if the women waited she could have a healthy child. in this case the child is not being harmed by being born but knowing the child is unhealthy or could be unhealthy you should wait. Sometimes wrong doing can happen without harming a specific person take for example children being exposed to radiation by accident will cause people to have a higher risk of cancer.

One objection states that what if because of a genetic defect you get rid of the next “einsten” but savulescu argues B coiuld also be einstin just without asthma without evidence both embryos can be smart but only one embryo still has the additional risk that is known.

In life we use other reproductive principles but the author says they do not tell parents what child they should choose so lets go throught the principles

• Procreative Autonomy - parents are free to choose any child but this does not give them guidence on what choice is better

• Non directive conseling - doctors provide information biut do not give recomendation so they wont be able to decide

• Best interest of child principles - both embryos could have lives woth living but we should act in the best interest of the future child and give life to the child that would have the best life

What is the best life tho - this is said in the article as a life being hedonistic (pain and pleasure, desire and fulfilement and having objectives like knowledge or relationships and some traits and genes might help fufill these goals and some genes might harm these goals.

Savulescu argues more so for intelegence to be one of the most important for wellbeing as it will helpo people acheive their goals and ,any philosophers agree with this as well.

The next objection is that would it not cause harm to the child as it can create prssure or expectations however the author says the harm may be minimal as parents should love their children regardless and conseling should be done. he also argues that is the enbryo is selected and then later suffers an illness doing the selection in the first place does not harm anything as the child would not be alive in the first place

at this point we should talk about how selection is choosing between different children and manipulation is altering the genome itself we are SELECTING not altering.

another objection would be inequality as PB could worsen duw to social inequality as we can select for intelegence,sex,attractiveness. this also might make people think that disabled lives are less valuable and so on but the author says that preventing a disability does not mean we are disrespecting a disabled person.

Some people might look at this and think maybe this is close to eugeneics but there are differences. eugenics is a state driven programa nd is coercive when PB is private desision by parents and the focus is on what is best for the child and familly.

however there are limits on OB like for example parents with dwarfisim m ight have a home adapted to their dwarfisim meaning if they chose a child without the gene navigating there own home might be hard

Holland - the case against PB

Holland is making a direct critic on PB he argues that he is conceptually confused and has a narrowvie on what a goodlife is,pntgood and other.

He argues that PB rest on mistaken views of what it mean exactly for a life to be considerd “better” as humains live are not comparible in that way and reproductive decisions dont arent like choosing products.

Holland biggest objection is what considerds a good life. we cannot posibly rank lives as better or worse on the expected assuming well being of the child. different lives might embody different values.

Holland suggests that there are manyb ways to livegood life this can be aetistic,attic,religious and so on they are all different lives but not one is nessecarily worse then the other as they reflect different values.

Holland also critiquers savulescu assumption that rational agents maximise expected value and that reproduction should follow similar reasoning but holland say reproduction is not like choosing between finacial investments or wanting to win the lotrery

Holland worries that Pb will ytreat children as a way to optimize products consumer good and projects. using PB makes it seem like the child is a design project. parenthood should be about welcoming a child however they tun out to be and “designing” the child undemines the unconditional acceptance that is the core reason of parenting.

Savulescu relies on the parfit identity problem where it is suspected no child is harmed by being selected but even thought no one is nessecarilly harmed there could still be something more troubling. so the absense of harm does not equal moral permissibility.

One major issue is that prenatal selection against disability sends the message that disabled lives are less valuable even thought sqavulescu argues the opposite Holland argues that again even if no one is harmed social meaning still matters

Holland also suggest that humain diveristy holds value and PB narrows forms of life .

he also writes about how with eugeneics even woithout state coarcion there is a strong moral pressure that could emerge to choose the best child wich will create a perfectionaist culture.

he also says parenthood is not grounded in comparative ranking but it is grounded in commitment to a child,love eds evaluation and acceptence rather then optimisation his framework encourages comparative advantage trait maximisation and other.

if both embryos have a life worth living and have possib;e opertunies to flourish in life then even with increased risk there is no obligation to choose the superior one.

Holland also suggest that doing repeated IVF cycles to get increasesed genetics makes reproduction burdensome and can make parenting into moral engeneering.

16. Saunders - First, Do No Harm

Saunders also responses to Savulescus PB paper saunders says that PB missapplies moral resoning and the principles of avoiding harm should guide reproductive desicions but there is a difference morally between harming someone and failing to create the best person.

In medical ethics one of the main principles is do no harm and saunders says PB shifts focus away from harm to maximization and questioned in maximising well being is morally required when no one is harmed. he also says that not giving someone the best possible enhancement and that being pB is not necessarily harm

Savulescu really looks at the non identity problem to support PB but saunders says even if no harm occurs that does not mean we need to maximize and that moral obligation often track harm not comparative

Sauder questions wheter mirality requires constant maximisation as he argues moral life is not always producing the best possible outcome and there is a difference between doing wrong and failling to the the best

Sauders explores ats caled moral asymmetey basicly the core is we have stronger duties to avoid harm then to provide benefit.

its common in ethics to say you shouldent injure someone and your not always required to maximise someones happiness and so if we apply that to reproduction not selecting th best embryo is tnot the same as harmong a selected one meaning that moral urgency is weaker than PBV suggest

PB expands parental duties as they now need to screen embryos,compare genofiles,and choose taPB also extends moral requirement turns reproduction into moral engennering and basicly maximisation becomes ecessively demanding

again if we look at medical ethics there are ffour ground principles autonomy,beneficient , non-maleficence, justice saunder says that non maleficence has a stronger moral weight as not causing harm is more important then creating the best possible conditions

he also says the preventing serious disease ia a therapy and enhancing beyond normal functiong is enhancement he also suggest preventing clear harm is morally stronger then optimizing traits like intelegence and PB will blur the distinction

Sauders expressses many concerns with PB as it can normalise genetic enhancement,create pressure on the children,shoft cultural expectation and this can risk social morals,er.

sauders in that case poposes therst do no harm alternative where parents should avoid causing harm to future children implying that knowingly creating a child will avoide seffere suffereing but not chose the best child and this means that it is less demanding then PB. as t focuses preventing harm,avoidig disadvandage,and not maximazing advantage he also says that this alows the childs life to be woth living and within the normal range of wellbeing

he also argues that just because something is better it dosent mean its required