The Implications of Designing a Child

Gabriel Navarrete

Professor Ralph Jenkins

Philosophy Bioethics

28 November 2022 

John and Karen are members of the deaf community who were discouraged about having a child upon discovering the unlikelihood of having a deaf child. In hopes of finding a solution, they obtained methods of preimplantation genetic diagnosis allowing them to examine and select very early embryos with a genetic mutation; ultimately allowing the couple to obtain their desired deaf offspring. John and Karen’s motives to reproduce an offspring using preimplantation genetic diagnosis violate the principle of beneficence despite her right to autonomous bodily choices. Although we may at first believe that Karen should rightly exercise her right to autonomy regarding reproduction; the acceptance of allowing her to reproduce through IVF and using genetic selection lessens the overall quality of life for the child. Through an alternate interpretation of the non-identity problem, we begin to see a lesser of two evils without embracing the issue and enforcing negative morals.  

Defendants of the John and Karen case such as David Boonin in The Non-Identity Problem & the Ethics of Future People state that the quality of life of the child would still be greater than having no life. For instance, in arguing that John and Karen should not have a deaf child through IVF they are then having a different child, and therefore the deaf child would no longer exist and would not be worse off because he would not have existed. Therefore, the best case would be to accept that their decisions are not morally wrong because life is still better than no life. “The parents who deliberately create a deaf child rather than a hearing child in this manner, after all, do not make that child worse off than that child would otherwise have been.” (Boonin 15) Although Boonen’s claim is very thorough in defining the limits to morality in terms of future people, this acceptance in embracing the non-identity problem which states that existence is still better than non-existence creates some major cracks in other existing frameworks such as conservationists. Take for example the risky policy thought experiment proposed by Derek Parfit on the non-identity problem. Where a community must decide between two energy policies. Both would be completely safe for at least a few centuries but one would have certain risks in the future. The risky policy would involve the burial of nuclear waste likely to cause large catastrophes in the greater future. Boonin’s claim would result in the likelihood of accepting depletion by stating that the people in the future would not be worse off nor harmed as they are separate individual people from the future where conservational policies would be accepted; this point stands as the different number choice. However, intuitively this cannot be true as we know that pollution is definitely harmful or wrong to future generations including our own despite them being separate. In order to state our case between the parents we must argue the difference between harming and making them worse off. Much like the case at hand between John and Karen if we embrace the non-identity problem and reject the wrongfulness thesis we would then say that their actions are not wrong and that the child cannot be worse off nor are they harming the child because they are not making the child worse off. Through an alternate method of solving the nonidentity problem, we can state that you can harm someone without making them worse off. The counterfactual conception of harm states that event E harms person S iff E leaves S worse off than S would have been had E not occurred. This statement of the non-identity problem is wrong because if we take the case of a soldier at war proposed by Molly Gardner (6:59) where a soldier and his partner are both pointing their weapons at an enemy and one soldier shoots then the said enemy would not be worse off because the partner would have simply shot the enemy as well. Therefore stating that yes, we can harm someone without making them worse off and therefore the conception of harm would be wrong. For the situation between deaf parents and the future person’s case, it seems reasonable to take the same stance that Parfit took stating that there is no difference in harming between two people despite the people being different. This claim states that the different numbers choice does not matter regardless of the people being different. “This matches my reaction to our choice of Depletion. I believe that it would be bad if there would later be a great lowering of the quality of life. And I believe that it would not be worse if the people who later live would themselves have existed if we had chosen Conservation. The bad effect would not be worse if it had been, in this way, worse for any particular people.” (Parfit 369) Nonetheless we may settle on the following statements to be true. Existence conferring actions such as an action A is existence conferring with respect to S iff: A does not occur then S does not exist, and if A does not occur, then S exits. Further, the wrongfulness thesis would also be correct; and there are some existence-conjuring actions such that; they do not result in a wrongful life for the person created, they do not harm anyone else, and they are nonetheless wrong. The wrongfulness thesis and the existence conferring actions are true in the case of John and Karen such that they are making actions that cause the life of a person to be created from embryo selection and form that decision to choose the embryo is the existence conferring action and creates a wrongfulness for the embryo. In accepting these two views to be correct we now conclude by denying the counterfactual conception of harm. In these situations it is best to decide between the lesser of two evils; allowing the families to decide on certain genetic characteristics is allowing worse ethical principles to build up without constraint such as a parent’s choice of characteristics for racist motives. Lastly, we ought to provide a solution to the problem by denying that person affecting principle and further developing incomplete ethical frameworks that otherwise would have been sound had we not denied the counterfactual conception of harm. 

Lastly, why might a geneticist turn down the request of a couple similar to John and Karen? Considering that couples like John and Karen are not unique geneticists should certainly be considerate of the problem at hand. Although the non-identity issue plays a role in discussing moral values. A more relevant topic to the doctor regarding the final decision would be the principle of beneficence counteracting the autonomy of the patient. Beneficence is the moral principle that states we ought to prevent harm and we ought to promote good (Beauchamp and Childress 166); in this specific situation, the harm or evil would be the intent to search for this defect permitting the couple to have their selected child ultimately harming the infant. To prevent harm we ought to not promote such actions of nonbeneficial genetic selection as seen in the non-identity problem such actions similar to genetic selection lead to cases like the slave child case and resource depletion where often a wrongful life is not created for the person and no harm is done to anyone else yet the action remains wrong because of the no difference view. “W.D.Ross suggests that obligations of general beneficence “Rest on the mere fact that there are other beings in the world whose condition we can make better.” From this perspective, general beneficence obligates us to benefit persons whom we do not know or with whose views we are not sympathetic.” (Beauchamp and Childress 219) With this statement on beneficence, I ask what benefit does the parent provide to the child in designing them deaf? “As the benefits for a person increase and that person’s autonomy interests decrease, the justification of paternalistic action becomes more plausible. Preventing minor harms or providing minor benefits while deeply disrespecting autonomy lacks plausible justification.”(Beauchamp and Childress 235) Paternalistic actions are one of the few methods used to override the autonomous choices of another to benefit or prevent harm. The reasons behind paternalistic actions are to prevent patients from allowing themselves to make repugnant choices regarding their treatments. Oftentimes overriding one’s autonomy can be difficult in many ways as they are often subject to scrutiny. In the case of a geneticist, the overriding of Karen’s autonomy can be based on denying her request as it provides no benefit to the child. This case is known as passive paternalism. “Physicians do not have a moral obligation to carry out their patients’ wishes when they are incompatible with acceptable standards of medical practice or are against the physicians’ conscience.” (Beauchamp and Childress 240) In regards to patient benefit, the geneticist might take into consideration the fetus as a patient and display the benefits that the parents are providing the child by making them deaf or defective.  Therefore, there are cases in which the genetic selection of the embryo is justifiable for beneficial purposes such as the prevention of a specific gene that increases the likelihood that an infant would be born disabled. However, cases in which an embryo such as an intentional dwarf child or other defects provides no rational benefit and follows the reasoning as the wrongful life thesis. A defect could be seen as a lack of a specific thing when compared to the traditional or original. In this case, the lack of auditory perception is a defect when compared to the general human anatomy. For these reasons a geneticist could either turn them down or enable the procedure and aid in assisting the parents however, the decision would be based on moral judgment. 

Ultimately there is something wrong with what John and Karen desire. The couple would not be providing any sort of benefit to the child and therefore should not follow through with the operations. Nonetheless, if they do intend to follow through with the process they would be lowering the child’s quality of life by disabling them by choice. Lastly, taking a viewpoint from the non-identity problem we begin to see the faults in allowing the couple to make this decision as it would enforce negative morals and repugnant results from their decisions. Considering all of the many viewpoints that one could take, the couple should not continue with the IVF process. 

Citation Page

Beauchamp, Tom L., and James F. Childress. Principles of Biomedical Ethics. Oxford University Press, 2016. 

Boonin, David. The Non-identity Problem and the Ethics of Future People United Kingdom, Oxford University Press, 2014.

Cushing, Simon. “Derek Parfit: ‘the Non-Identity Problem.’ | Simon Cushing.” YouTube, YouTube, 23 Nov. 2022, https://www.youtube.com/watch?v=Z7NFgWQ5FYg. 

Gardner, Molly. “The Nonidentity Problem #2 – Ethics | Wireless Philosophy.” YouTube, Wireless Philosophy, 3 Oct. 2015, https://www.youtube.com/watch?v=oKpsU7sVwjc&t=49s.

Pappas, George S., et al. Philosophical Problems and Arguments – an Introduction. Hackett Publishing Co, Inc, 1992. 

Parfit, Derek. Reasons and Persons. United Kingdom, Oxford University Press, UK, 1984.