Reading #10: Ethics of Reproductive Technologies

Introduction

In recent years many reproductive technologies have proven to be morally and/or legally controversial: abortion drugs, genetic testing and genetic engineering (for diseases, disabilities, or enhancement), embryonic stem cell research, fetal and/or infant sex change operations, reproductive cloning, and the artificial uterus. Most of these technologies are still in the developmental stage and will be used in conjunction with genetic engineering. There are three lines of argument: natural law (all reproductive technologies are morally unacceptable) libertarianism (all voluntary reproductive technologies are morally acceptable), and a variety of moderate views (some technologies are morally acceptable and some are not acceptable).

Natural Law.

In Health Care Ethics, the Natural Law Theory of Ethics is ultimately based on the idea that "life is a gift from God," and that "What is natural is good." After all, God is omnipotent, omniscient, omnipresent, and good. He created a universe imbued with purpose. Hence all biological systems are imbued with divine purpose: the purpose of eyes=to see, nose=smell, sex organs=make babies. Since the Middle Ages, the traditional view of the Roman Catholic Church has been that we all have a "duty to reproduce;" and that reproduction must be accomplished via sexual intercourse between married men and women.  Therefore the only acceptable reproductive technologies make sexual intercourse between husbands and wives more efficient. Any technology that replaces sexual intercourse is morally unacceptable. Any technology that deliberately interrupts that process including "artificial contraception" (condoms, birth control pills, and or abortion) is unacceptable. And any technology that enables humans to alter the outcome of that natural process, such choosing sex, eye color, height, weight. Intervention is permitted only cases where a fetal disease might be cured. In general, the Roman Catholic Church argues that most reproductive technologies are immoral and ought to be illegal.   

Libertarianism


Libertarians argue that individuals have a moral and/or legal right to access any technologies they choose, and that governments ought to neither force us to employ these technologies nor prevent us from employing them. In short, "anything goes." Among libertarians there is disagreement over the moral status for the fetuses at various stages of development, therefore not all libertarians defend the right to choose abortion. 

Moderate Views

There are many moderate views that fall midway between extreme conservative and extreme libertarian view. Some accept or reject these technologies based on social utility, and cite utility ratios reflecting costs and benefits as foundational. Some utilitarians embrace short-term utility, others embrace long-term utility... or "slippery slope" arguments.    

Issues

Let's take a look at a few contemporary issues: abortion drugs, genetic testing and/or engineering, cloning, artificial uterus.

Abortion drugs

Since the 1970s, the primary abortive technique in the United States has involve a surgical technique that removes the embryo or  fetus from the uterus. This technique has been relegated to specifically designed clinics that specialize in that technique. In recent years, most of these clinics have been regulated out of business. Therefore, if abortion survives this regulatory onslaught, it will no-doubt involve the use of abortifacient drugs. Many of these drugs walk a fine line between contraception and abortion. The most common contraceptive/abortive drugs prevent implantation of the zygote within the uterus. Issues include whether these drugs ought to legally require a prescription from  a physician (and/or why or why not?), whether these drugs ought to be sold "over (or under)-the counter" (and/or why or why not?),  age restrictions on purchaser, whether pharmacists and/or cashiers ought to refuse to sell these drugs for moral and/or religious reasons; and whether these drugs ought to be made available online. 

Genetic Testing and Engineering
 
Genetic testing of fetuses can serve both therapeutic and non-therapeutic purposes. There is also an overlap with Genetic Engineering... no only for existing fetuses, infants, and adults; but also for future humans or germ-line engineering.  Therapeutic testing is relatively non-controversial. It is often performed in order to treat existing fetuses that suffer from various genetic diseases and/or disabilities. Non-therapeutic testing may involve testing, not to cure a disease, but to enhance (via genetic engineering) the future life of that fetus or testing in order perform euthanasia on an fetus with a painful incurable or untreatable disease. Treatable diseases include some forms of Spina Bifida. Untreatable diseases include Tay-Sachs Disease. Enhancements might include testing for hair color, eye color, height, or sex. Genetic engineering for diseases and/or enhancements involving the germ-line, or future children is problematic, given that future generations cannot consent to research or treatment.    

Cloning

Cloning is a reproductive technology designed to create living things without the unification of ova and sperm. It usually involves the creation of an offspring genetically identical to the aspiring parent. Although no humans have been cloned (as of yet) many mammals have been cloned, especially in other countries; especially pets (usually dogs). There are two forms of human cloning: research cloning and reproductive cloning. The main arguments against reproductive cloning point to a "slippery slope" of potentially negative consequences. The moral status of clones in comparison to the original person has also drawn controversy.    


Artificial Uterus

Scientists have been developing an artificial uterus for many years. Many technologies already available in neonatal intensive care units are essentially late-term artificial uteruses; primarily respiratory, circulatory, and nutritive technologies. The goal is for NICUs to be able to nurture an embryo to an infant within an artificial environment. There are many arguments for and against their development. Most arguments against come from natural law theorists that argue that they represent a "slippery slope," into future where sexual intercourse and women carrying babies become obsolete, thus undermining human nature. Defenders argue that its the inevitable outcome of biomedical research designed to cure the "disease," of infertility.

Conclusions

In this course you may defend either Natural Law, Libertarianism and/or Utility; however, you MUST present arguments for/against. You many not simply invoke the authority of moral and/or religious experts.