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Reductio Ad Hermaphroditum

At the James Martin Seminar in Oxford this week, Melbourne philosopher Rob Sparrow presented an argument against enhancement and procreative beneficence. His work had raised some interest in the popular media when he presented it a few months ago, and I posted a short potential response to his argument at Practical Ethics News [1].

In this post, and (if I can find time) subsequent posts I would like to explore the implications and possible responses to Rob’s intriguing reductio argument. First, an outline of the argument. Rob’s presentation was based upon a series of cases. I will reproduce them as faithfully as I can (from memory).

1. A couple are having in-vitro fertilisation, and undertake pre-implantation genetic diagnosis of the two embryos that they have available to implant. One of the embryos carries a gene for bowel cancer (A). The other embryo does not carry the gene (B). There are no other known differences between the embryos.
Should the couple choose embryo B? Yes, No, or toss a coin?

2. A couple are having in-vitro fertilisation, and undertake pre-implantation genetic diagnosis of the two embryos that they have available to implant. One of the embryos carries a gene associated with life expectancy X (A). The other embryo has a gene associated with life expectancy X+5 (B). There are no other known differences between the embryos.
Should the couple choose embryo B? Yes, No, or toss a coin?

3. A mixed race couple are having in-vitro fertilisation, and undertake pre-implantation genetic diagnosis of the two embryos that they have available to implant. They live in a racist society in which white individuals have a longer life expectancy, and other health and social advantages compared to those with dark skin. One of the embryos carries a gene for dark skin (A). The other embryo has a gene for white skin (B). There are no other known differences between the embryos.
Should the couple choose embryo B? Yes, No, or toss a coin?

4. A couple are having in-vitro fertilisation, and undertake pre-implantation genetic diagnosis of the two embryos that they have available to implant. One of the embryos carries a gene for Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome (A). The other embryo does not carry the gene (B). There are no other known differences between the embryos.
MRKH [2] is an uncommon condition in which phenotypically and genetically female infants are born without a uterus. It usually only becomes evident when they fail to menstruate or are found to be infertile. They can only have biologically related children if they have their ova implanted in a surrogate mother. The gene for this condition is not yet known. But in this thought experiment the gene has been found. Suppose that this gene is also associated with a life expectancy 5 years less than individuals who do not have this gene.
Should the couple choose embryo B? Yes, No, or toss a coin?

5. A couple are having in-vitro fertilisation, and undertake pre-implantation genetic diagnosis of the two embryos that they have available to implant. One of the embryos carries a gene for Mayer-Kuster-Rokitansky-Hauser (MKRH) syndrome (A). The other embryo does not carry the gene (B). There are no other known differences between the embryos.
MKRH is an (imaginary) syndrome in which infants are born without a uterus. They can only reproduce using a surrogate. The gene for MKRH is also associated with a life expectancy 5 years less than individuals who do not have this gene.
Should the couple choose embryo B? Yes, No, or toss a coin?

Rob’s argument is dependent upon a series of intuitive responses to the above scenarios. On Wednesday there was a parade of hands supporting embryo B in cases 1 and 2. Case 3 there was a fair amount of shifting in seats, but no one seemed keen to espouse that the parents should choose to have a white child in a racist society. Case 4 there was again a show of hands for embryo B. Case 5 seemed so similar that there was a suspicion that there must be something else about it, but again most in the audience put their hands up. Drum-roll…

Rob then suggested – but what if MKRH syndrome is actually maleness! Rob argues that for all the talk of possible future gene enhancements, one currently available gene enhancement has been overlooked. Female embryos are likely to live longer lives than male embryos. They have a biological advantage in being able to gestate children. If parents ‘should’ choose the child of possible children that they could bring into existence who will have the best chance of wellbeing, and most opportunities – they ‘should’ choose to have female children. Although it might be suggested that males are needed to reproduce, Rob asserted that all that would be needed would be a large frozen sperm bank. Additionally – in the near future it is likely that women will be able to create offspring from two female parents using genetic technology. The inevitable consequence of procreative beneficence if we take it seriously (argues Rob) is an all-female world. And Rob believes that is absurd. He argues that this is a reductio ad absurdum of the argument for enhancement.

As I suggested, there are a number of potential lines of response to Rob’s argument. I will focus in this post on the question of the nature of the normative reason to choose a better child. In his talk Rob deliberately avoided specifying the nature of the should in the above questions – pointing out that some of the pro-enhancement arguments equivocate about whether this is a moral obligation, or a pro tanto reason.

I think (having debated a similar question with Julian previously) that procreative beneficence provides a pro tanto reason to bring into existence a child with a better chance of a good life. If – as in case 1, there is literally no other reason to choose embryo A over embryo B, then the couple should (have most reason to, are rationally required to) choose embryo B over embryo A. But there may be other reasons not to choose the better child. For example, there are good reasons why reproducing in the the normal way would be preferred to in-vitro-fertilisation with PGD (for fertile couples). So even if there were an obligation for couples having IVF and PGD to choose female fetuses – that wouldn’t mean that everyone should use IVF and PGD to conceive.

Second, there may be countervailing reasons to choose embryo A over embryo B. For example if embryo A is a male fetus, and embryo B is a female, the fact that one or both parents would like to have a male child (for whatever reason) provides a countervailing pro tanto reason to choose A over B.

I think the interesting question is how to weigh up these reasons. If parents have an (objective) reason to choose a female embryo over a male embryo, but personal prudential reasons to choose a male embryo over a female – what should they do? After all – as Rob might argue (but didn’t on Wednesday), if mild or moderate preferences can outweigh the non-person-affecting reason to have a child with a greater chance of wellbeing – what does that say about the normative weight of procreative beneficence?

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#1 Comment By Thom Blake On December 15, 2008 @ 10:23 pm

I also fail to see the reductio here. I see nothing inherently wrong with the all-female scenario. And in fact, there would likely be increasing advantages for male children in this world dominated by females, thus offsetting the average life expectancy. Not to mention the risk mitigation of keeping a couple of males around in case the tech goes kaput.

#2 Comment By Mats Volberg On March 22, 2009 @ 10:40 am

For example if embryo A is a male fetus, and embryo B is a female, the fact that one or both parents would like to have a male child (for whatever reason) provides a countervailing pro tanto reason to choose A over B

But this option is eliminated by the ‘There are no other known differences between the embryos’ clause