The Hidden Cost of Following the Principle of Procreative Beneficence

Lately I've been thinking (and writing) about the principle of procreative beneficence that's been advocated by Julian Savulescu (lots of links here). Here's the basic idea, from an abstract to one of his papers--

It seems to me there is at least a tension between following the principle of Procreative Beneficence (PB) and having what you might call a "parental attitude".  But the tension is subtle. Let's see if I can convince you (dear reader)!

There's a phrase in the abstract that ought to make us scratch our heads.  Savulescu says "couples (or single reproducers) should select the child, of the possible children they could have, who is expected to have the best life..." (etc., my italics).  The italicized phrase makes it clear Savulescu respects the fact that people prefer to have their own child.  So suppose Dave and Donna are employing IVF and have 10 embryos sitting in the lab, ready for implantation. Brad and Betty are in the waiting room with them, and they're noticeably buff, beautiful, and brilliant, while Dave and Donna are noticeably not buff, not beautiful, and not brilliant. They all get to talking, and it turns out Brad and Betty have extra embryos.  B&B offer them to D&D, and they've got to admit that little B would probably have a better life than little D, considering all the advantages associated with brains and beauty. Savulescu clearly isn't saying D&D have to accept their offer.  According to PB, D&D only have to select the child who is expected to have the best life of the possible children they could have.

So D&D get to indulge their desire for their own, but hold on! We have lots of different thoughts and feelings about "our own". Why legitimate just the desire to have our own?  Once we have children "our own" makes a lot of differences. Not only do I care more about my two children than any other children (yes, I confess that I do), but their both being "my own" makes me care about them equally.  This is an unpleasant thought to have on a perfectly good Saturday morning, but if I were in a "Sophie's Choice" situation, hell no, I wouldn't apply anything like PB--I wouldn't save the child with the best chance of the best life.  There's a part of the parental attitude that concerns the way you care about your kids compared to other kids; and a part that concerns how you care about your kids compared to each other. I think this is true even before they come into the world.  You want your own and the sheer fact that two possible children are your own tends to eclipse small differences between them.

Now you might say I've just glued two attitudes together here--wanting your own (not other people's kids) and seeing all of your own as equally desirable.  If these attitudes are just glued together, there's no reason Savulescu should respect the second, just because he respects the first. But I say: no glue!  These things go together because they both emanate from a sense we have that our own biological child is a sort of second self. Our children come before all other children in much the way our selves have a certain natural priority. If two children are both sort of second selves, it's no wonder we're not going to choose between them based on who has the best chance of the best life. 

Now, Savulescu's happy to allow D&D to put their own embryos ahead of all other embryos.  But what if they have a "Sophie's Choice" reaction to PGD--they don't want to use it, because, as they might say, "all those future children are our own"? The principle of procreative beneficence forbids that.  But with what justification? Letting D&D prioritize their own embryos, and turn down the offer of B&B, obviously cannot be justified in any sort of consequentialist fashion.  The result of allowing them that preference is a worse, not a better, "crop" of kids. So let's not let Savulescu quickly make a consequentialist argument why D&D must use PGD to select among their own embryos.

Bottom line: if we're going to let the parental attitude play a role at all, we can't assume that half of it is legitimate and the other half not.  I see both as having a legitimate role to play throughout the time when people are parents, and even when they are trying to become parents.  They both have some weight, whereas Savulescu only gives weight to preferring our own. Now, "some weight" of course doesn't mean "all the weight." I hasten to add that I would also give weight to considerations about pregnancy outcome.  The more problematic the possible outcome, the less that people should let the parental attitude prevail--either the part that prefers "our kids" to other people's kids, or the part that makes us care equally about all of our kids.

But in the ordinary situation, where embryos differ only in some relatively minor way, it seems to me it's a good prospective parent, not a flawed parent, who says "I don't care, they're all my own."  Another way of making the same point: Savulescu says PGD has few costs for prospective parents who have already signed on for IVF. But not so. It always has a cost. It compromises the equal caring that's a natural part of the parental attitude. That's a cost worth paying to secure some improvements in pregnancy outcome, but not in every single case.


Sister Y said...

Just because you will love them does not mean life is good for them. We need to distinguish between caring about X as wanting-X-to-exist, and caring about X as genuine curiosity about whether existence is good FOR X. What is parental is heavily influenced by biological evolution; especially attitudes about existence are likely to not be maximally beneficient toward future children. A parent may care about a miserable child as much as a happy child, and that's evolutionarily adaptive (though equality of parental love in action is a myth), but it isn't good for the miserable child to be born. Rather, it is cruel to creat a miserable child, parental feeling or none.

Alan Cooper said...

Applying the "parental attitude" to embryos would impose an extreme version of "Sophie's choice" on every IVF client - and to claim that not participating in the choice is a solution is equivalent to saying that just tossing a coin would have saved Sophie any anguish. Any competent person who considers IVF must have already decided that embryos don't deserve the "parental attitude" and so it is not unreasonable for them to optimize the selection according to whatever criteria they choose - though there may be good reasons for society to object to some such criteria and/or to require others.

(Of course saying something is a reasonable social requirement does not make it a moral obligation, but if society did choose to make it a legal requirement some might argue that there is the same moral obligation to obey that law as any other - usually limited by the extent to which obeying the law conflicts with other values -etc.etc.)

Jean Kazez said...

Alan, I think you're right that I'm make it seem as if decisions about embryos are harder than they are, and maybe all that Sophie's choice stuff is not the best way for me to articulate what I mean by a "parental attitude." I don't think we take embryos anywhere near as seriously as we take children, but I do think for many parents there's something repellant about choosing between them, especially based on features like height, intelligence, etc. The discomfort is at least related to the dislike of choosing between existing children but you're surely right--not exactly the same. Will need to ponder more how best to talk about the "parental attitude."