Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Medicine, Health Care and Philosophy
Published in: Medicine, Health Care and Philosophy 1/2020

Open Access 01-03-2020 | Climate Change | Review Article

The problem with reproductive freedom. Procreation beyond procreators’ interests

Author: Giulia Cavaliere

Published in: Medicine, Health Care and Philosophy | Issue 1/2020

Login to get access

Abstract

Reproductive freedom plays a pivotal role in debates on the ethics of procreation. This moral principle protects people’s interests in procreative matters and allows them discretion over whether to have children, the number of children they have and, to a certain extent, the type of children they have. Reproductive freedom’s theoretical and political emphasis on people’s autonomy and well-being is grounded in an individual-centred framework for discussing the ethics of procreation. It protects procreators’ interests and significantly reduces the permissible grounds for interference by third parties. In this article I show that procreative decisions have far-reaching effects on the composition and size of the population. The upshot of considering these effects allows for the appreciation of the inadequacy of a framework that solely considers individual (i.e. procreators’) interests to discuss the ethics of procreation. To address such inadequacy, I assess costs and benefits of past and present proposals to reflect on procreation in such a way as to consider its far-reaching effects. I conclude by arguing that reproductive freedom should be defended as an imperfect but instrumentally necessary tool. This framing would enable those participating in debates on the ethics of procreative decisions to work towards an ethical framework that accounts for the cumulative effects of these decisions.
Footnotes
1
I return to some of these critiques in “A broader framework: present proposals” section, where I limit my analysis to those motivated by a concern for the well-being and interests of others (i.e. others than the procreators and their close networks).
 
2
I am indebted to an anonymous reviewer for bringing these issues to my attention.
 
3
In this paper, I follow Hickey et al.’s (2016) distinction between size and structure and adopt these two categories in my analysis of the effects on third parties of procreative decisions. While what Hickey et al. (2016) mean by population ‘size’ strikes me as intuitive, when I discuss population ‘structure’ I am referring to the composition of the population: namely to the type of people who collectively shape the structure of the population.
 
4
It must be noted that here I remain neutral as to whether these changes are desirable or not as this depends on a number of variables (such as for instance how these changes are designed and implemented and to serve what interests). What matters for the present discussion is that population’s size affects the lives of other people than the individual procreators and their close network.
 
5
In Buchanan’s (1996) words: “choosing the dominant cooperative scheme means choosing who will and who will not be disabled” (Buchanan 1996, p. 40).
 
6
In discussing the history of eugenics, I follow the tradition of authors who engage with such history and with eugenics’ underpinning ideologies, practices and policies while resisting outright condemnations (see for instance: Agar 2008; Buchanan et al. 2001; Glover 2006; Selgelid 2014; Wilkinson 2010).
 
7
For a comprehensive review and assessment of these claims, see Giulia Cavaliere (2018).
 
8
The theses are: ‘replacement, not therapy’; ‘value pluralism’; violations of reproductive freedom’; ‘statism’ and ‘justice’ (Buchanan et al. 2001; see also: Wikler 1999).
 
9
As argued by Alison Bashford: “[i]f population growth was to be reduced, the eugenic question was derivative: which kind of person might be reproductively restrained or encouraged?” (Bashford 2014, p. 242).
 
Literature
Adams, Mark B. 1990. The wellborn science: Eugenics in Germany, France, Brazil, and Russia. Oxford: Oxford University Press.
Anomaly, Jonathan. 2014. Public goods and procreation. Monash Bioethics Review 32: 172–188.
Agar, Nicholas. 2008. Liberal eugenics: In defence of human enhancement. Oxford: Wiley.
Bashford, Alison. 2010. Epilogue: Where did eugenics go? In The Oxford handbook of the history of eugenics, ed. Alison Bashford and Philippa Levine, 539–558. Oxford: Oxford University Press.
Bashford, Alison. 2014. Global population: History, geopolitics, and life on earth. New York: Columbia University Press.
Bashford, Alison, and Philippa Levine. 2010. The Oxford handbook of the history of eugenics. Oxford: Oxford University Press.
Bostrom, Nick, and Toby Ord. 2006. The reversal test: Eliminating status quo bias in applied ethics. Ethics 116: 656–679.
Broberg, Gunnar, and Nils Roll-Hansen. 2005. Eugenics and the welfare state: Norway, Sweden, Denmark, and Finland. East Lansing: Michigan State University Press.
Brock, Dan W. 2005. Shaping future children: Parental rights and societal interests. Journal of Political Philosophy 13: 377–398.
Buchanan, Allen. 1996. Choosing who will be disabled: Genetic intervention and the morality of inclusion. Social Philosophy and Policy 13: 18–46.
Buchanan, Allen. 2011. Beyond humanity? The ethics of biomedical enhancement. Oxford: Oxford University Press.
Buchanan, A., Dan W. Brock, Norman Daniels, and Daniel Wikler. 2001. From chance to choice: Genetics and justice. Cambridge: Cambridge University Press.
Cafaro, Philip. 2012. Climate ethics and population policy. Wiley Interdisciplinary Reviews: Climate Change 3: 45–61.
Cavaliere, Giulia, and John Harris. 2018. Reproductive freedom and destiny: How new technologies are influencing ethics and policy of abortion. In Routledge handbook of ethics and public policy, Ch 35, ed. Annabelle Lever and Andrei Poama. Abingdon: Routledge.
Conly, Sarah. 2015. One child: Do we have a right to more? New York: Oxford University Press.
Connelly, Matthew J. 2008. Fatal misconception: The struggle to control world population. Cambridge: The Belknap Press of Harvard University Press.
Das Gupta, Monica. 2014. Population, poverty, and climate change. The World Bank Research Observer 29: 83–108.
Dove, Edward, Susan E. Kelly, Federica Lucivero, Mavis Machirori, Sandi Dheensa, and Barbara Prainsack. 2017. Beyond individualism: Is there a place for relational autonomy in clinical practice and research? Clinical Ethics 12: 150–165.
Dworkin, Ronald. 1993. Life’s dominion. London: Harper Collins.
Garland-Thomson, Rosemarie. 2012. The case for conserving disability. Journal of Bioethical Inquiry 9: 339–355.
Glover, Jonathan. 2006. Choosing children: Genes, disability, and design. Oxford: Oxford University Press.
Gyngell, Christopher, and Michael Selgelid. 2016. Twenty-first century eugenics. In The Oxford handbook of reproductive ethics, ed. Leslie Francis, 141–158. New York: Oxford University Press.
Haraway, Donna. 2015. Anthropocene, capitalocene, plantationocene, chthulucene: Making kin. Environmental Humanities 6: 159–165.
Harris, John. 1998. Rights and reproductive choice. In The future of human reproduction: Choice and regulation, ed. John Harris and Soren Holm, 5–37. Oxford: Oxford University Press.
Harte, John. 2007. Human population as a dynamic factor in environmental degradation. Population and Environment 28: 223–236.
Hickey, Colin, Travis N. Rieder, and Jake Earl. 2016. Population engineering and the fight against climate change. Social Theory and Practice 42: 845–870.
Kevles, Daniel J. 1985. In the name of eugenics. Cambridge: Harvard University Press.
Kitcher, Philip. 2001. Science, truth and democracy. Oxford: Oxford University Press.
Klausen, Susanne, and Alison Bashford. 2010. Fertility control: Eugenics, neo-malthusianism, and feminism. In The Oxford handbook of the history of eugenics, ed. Alison Bashford and Philippa Levine, 98–115. Oxford: Oxford University Press.
Koch, Lene. 2004. The meaning of eugenics: Reflections on the government of genetic knowledge in the past and the present. Science in Context 17: 315–331.
Lippman, Abby. 1999. Choice as a risk to women’s health. Health, Risk and Society 1: 281–291.
Lombardo, Paul A. 2008. Three generations, no imbeciles: Eugenics, the Supreme Court, and Buck v. Bell. Baltimore: John Hopkins University Press.
Löwy, Ilana. 2015. Norms, values and constraints: The case of prenatal diagnosis. In Value practices in the life sciences and medicine, ed. Isabelle Dussauge, Claes-Fredrik Helgesson, and Francis Lee, 187–205. Oxford: Oxford University Press.
Mackenzie, Catriona, and Jackie L. Scully. 2007. Moral imagination, disability and embodiment. Journal of Applied Philosophy 24: 335–351.
Meisenberg, Gerhard. 2009. Wealth, intelligence, politics and global fertility differentials. Journal of Biosocial Science 41: 519–535.
Meloni, Maurizio. 2016. Political biology: Science and social values in human heredity from eugenics to epigenetics. London: Palgrave Macmillan.
Mill, John Stuart. 1979/1859. On liberty, originally published: 1859. London: Dent.
Mills, Catherine. 2013. Reproductive autonomy as self-making: Procreative liberty and the practice of ethical subjectivity. Journal of Medicine and Philosophy 38: 639–656.
Murphy, Michelle. 2017. The economization of life. Durham: Duke University Press.
Murtaugh, Paul A., and Michael G. Schlax. 2009. Reproduction and the carbon legacies of individuals. Global Environmental Change 19: 14–20.
Nolt, John. 2011. How harmful are the average American’s greenhouse gas emissions? Ethics, Policy and Environment 14: 3–10.
Overall, Christine. 2012. Why have children? The ethical debate. Cambridge: MIT Press.
Paul, Diane B. 1984. Eugenics and the left. Journal of the History of Ideas 45: 567–590.
Porter, Dorothy. 2005. Health, civilization and the state: A history of public health from ancient to modern times. London: Routledge.
Rieder, Travis N. 2016. Toward a small family ethic: How overpopulation and climate change are affecting the morality of procreation. Cham: Springer.
Ritchie, Stuart. 2015. Intelligence: All that matters. London: Hodder & Stoughton.
Roberts, Dorothy E. 1997. Killing the black body race, reproduction and the meaning of liberty. New York: Pantheon Books.
Roberts, Dorothy E. 2015. Can research on the genetics of intelligence be “socially neutral”? Hastings Center Report 45: 50–53.
Robertson, John A. 1994. Children of choice: Freedom and the new reproductive technologies. Princeton: Princeton University Press.
Ross, Loretta. 2006. Understanding reproductive justice: Transforming the pro-choice movement. Off Our Backs 36: 14–19.
Rothman, Barbara K. 1985. The products of conception: The social context of reproductive choices. Journal of Medical Ethics 11: 188–195.
Rulli, Tina. 2016a. What is the value of three-parent IVF? Hastings Center Report 46: 38–47.
Rulli, Tina. 2016b. Preferring a genetically-related child. Journal of Moral Philosophy 13: 669–698.
Samerski, Silja. 2009. Genetic counseling and the fiction of choice: Taught self-determination as a new technique of social engineering. Signs: Journal of Women in Culture and Society 34: 735–761.
Sandel, Michael J. 2007. The case against perfection: Ethics in the age of genetic engineering. Cambridge: Harvard University Press.
Selgelid, Michael J. 2014. Moderate eugenics and human enhancement. Medicine, Health Care and Philosophy 17: 3–12.
Wikler, Daniel. 1999. Can we learn from eugenics? Journal of Medical Ethics 25: 183–194.
Wilkinson, Stephen. 2010. Choosing tomorrow’s children: The ethics of selective reproduction. Oxford: Oxford University Press.
Young, Thomas. 2001. Overconsumption and procreation: Are they morally equivalent? Journal of Applied Philosophy 18: 183–192.
Metadata
Title
The problem with reproductive freedom. Procreation beyond procreators’ interests
Author
Giulia Cavaliere
Publication date
01-03-2020
Publisher
Springer Netherlands
Keyword
Climate Change
Published in
Medicine, Health Care and Philosophy / Issue 1/2020
Print ISSN: 1386-7423
Electronic ISSN: 1572-8633
DOI
https://doi.org/10.1007/s11019-019-09917-3

Other articles of this Issue 1/2020

Medicine, Health Care and Philosophy 1/2020 Go to the issue

Scientific Contribution

Can self-validating neuroenhancement be autonomous?

Scientific Contribution

Heideggerian hermeneutic phenomenology as method: modelling analysis through a meta-synthesis of articles on Being-towards-death

Scientific Contribution

Mechanisms in clinical practice: use and justification

Editorial

All in the family

Scientific Contribution

Is it ever morally permissible to select for deafness in one’s child?

Scientific Contribution

The ethical obligation of the dead donor rule