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Human Genetic Selection and Enhancement

Parental Perspectives and Law

Marta Soniewicka and Wojciech Lewandowski

Among all human practices, procreation seems the most paradoxical. It starts as a fully personal choice and ends with the creation of a new subject of rights and responsibilities. Advances in reproductive genetics pose new ethical and legal questions. They are expected to prevent the transmission of genetic diseases to progeny and also to improve genetically-endowed mental and physical attributes. Genetic selection and enhancement may affect a child’s identity, as well as the parent-child relationship. The authors are committed to a pluralistic approach that captures all aspects of this relationship in terms of moral virtues and principles. They elucidate that most of the conflicts between parental preferences and a child’s rights could be resolved with reference to the meaning and nature of procreation.

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5 Selective procreation and disability

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5.1 Introduction

The idea of the enhancement of reproductive choices rests on the assumption that increased genetic knowledge about one’s progeny is always an asset for prospective parents. Yet having more reproductive choices does not necessarily mean that the choices will be better. The use of genetic knowledge for selective reproduction gives rise to moral concerns, such as those expressed by Adrienne Asch:

The tests do nothing to promote the health of the developing fetus or the health of the pregnant woman. Rather, they are offered so that people may decide against becoming a parent of a child with a particular characteristic that clinicians and policy makers understand to be detrimental to a satisfying life for the child or the family, or that may require outlays of societal resources (Asch 2003, 336–337).

To elucidate the problem, let me invoke the distinction between phenotypic and genotypic preventive techniques in medicine emphasized by Eric T. Juengst (Juengst 2009). By phenotypic prevention one means avoiding the manifestation of a particular phenotype (a disease) and rests on the following assumptions: there is a living individual who may benefit from it; diseases are best defined at the level of their actual symptoms; disease is distinct from a person it burdens. Genotypic prevention, on the other hand, is aimed at avoiding the birth of people with particular genotypes and rests on such assumptions as: there are societal benefits (e.g. reducing healthcare costs) from the prevention of the...

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