In a recent publication Tom Douglas and Katrien Devolder have proposed a new account of genetic parenthood, building on the work of Heidi Mertes. Douglas and Devolder’s account aims to solve, among other things, the question of who are the genetic parents of an individual created through somatic cell nuclear transfer (i.e. cloning): (a) the nuclear DNA provider or (b) the progenitors of the nuclear DNA provider. Such a question cannot be answered by simply appealing to the (...) folk account of genetic parenthood, according to which the genetic parents of an individual are those individuals who produced the egg and sperm, respectively, which fused to create the embryo. It cannot be so as in cloning there is no fertilization as such. In this article I critically examine Douglas and Devolder’s new account of genetic parenthood and demonstrate that it is vulnerable to counterexamples that exploit the lack of a condition specifying that genetic parents should cause a child’s coming into existence. (shrink)

We seek to develop a plausible conception of genetic parenthood, taking a recent discussion by Heidi Mertes as our point of departure. Mertes considers two conceptions of genetic parenthood—one invoking genetic resemblance, and the other genetic inheritance—and presents counter-examples to both conceptions. We revise Mertes’ second conception so as to avoid these and related counter-examples.

Bioethics, Volume 35, Issue 7, Page 680-687, September 2021.

Researchers are pursuing various ways to synthesise human male and female gametes, which would be useful for people facing infertility. Some people are unable to conceive children with their partner because one of them is infertile in the sense of having an anatomical or physiological deficit. Other people—in same sex couples—may not be individually infertile but situationally infertile in relation to one another. Segers et al have described a pathway towards synthetic gametes that would rely on embryonic stem cells, rather (...) than somatic cells. This pathway would be advantageous, they say, for same-sex couples even though it would not offer those couples 50%–50% shared genetics in their children but only 50%–25%. It is unclear, however, why this approach should be preferred morally speaking since it represents a falling off from the kind of shared genetics in children that are functionally a gold standard in parents' expectations generally. Despite raising concerns about whether genetic relatedness is necessary or sufficient as a condition of parental interest in children, Segers et al cede the sociocultural importance of that standard. If so, same-sex couples seem entitled to press a case for some measure of research priority that would offer the same level of access to that social good as everyone else. (shrink)

This paper explores the implications of human reproductive cloning for our notions of parenthood. Cloning comes in numerous varieties, depending on the kind of cell to be cloned, the age of the source at the time the clone is created, the intended social relationship, if any, between source and clone, and whether the clone is to be one of one, or one of many, genetically identical individuals alive at a time. The moral and legal character of an act of (...) cloning may, moreover, differ in light of these distinctions. Surprisingly, however, reproductive cloning in all its variety seems to undermine the view of parenthood that is most popular among proponents of reproductive technology in the bioethics literature. This view, geneticism, has much to recommend it. I will show, however, that as commonly understood, geneticism is incompatible with the reproductive view of cloning. I then canvass alternative accounts of parenthood—namely, conventionalism, gestationalism, and intentionalism—but none succeeds in explaining reproductive cloning. I thus return to a reconstructed version of geneticism. I argue that the problem for geneticism rests not with the notion of genetic parenthood as such but with a particular, flawed, understanding of it, which I call informational geneticism. Informational geneticism should be rejected in favor of a “physicalistic” version of geneticism, which treats genes as particular objects, not abstract types, and takes seriously the essentially embodied character of reproduction. For these reasons, physicalistic geneticism survives the challenge represented by reproductive cloning. Additionally, physicalistic geneticism accommodates attractive aspects of competing views of parenthood, meeting some powerful objections in the process. (shrink)

The proposal for reproducing human generations in vitro raises the question to what extent parenthood is possible in embryos and to what extent human rights and interests are dependent on conscious awareness. This paper argues that the interest in not being made a parent non-consensually for the benefit of others persists throughout the lifespan of the individual human organism. We do not become genetic parents by learning that we are parents; rather, we discover (or fail to discover) an (...) existing genetic relationship between our offspring and ourselves. The claim to genetic parenthood of an embryo used for reproduction in vitro is, if anything, clearer than the claim of the adult for whom gametes are derived via ips cells, in that an embryo’s cells, unlike an adult’s somatic cells, are already functionally geared to producing gametes (among other types of cell). An embryo used to make gametes that are used in reproduction is immediately and non-consensually made a genetic parent and to that extent is wronged whether or not the parent embryo survives – as some could survive – the harvesting of cells. All human individuals carry objective interests in benefits appropriate to the kind of being they are; these include the stake in not being made a parent without one’s consent, whether posthumously or otherwise. (shrink)

One of the most prominent justifications for the use of germline gene editing (GGE) is that it would allow parents to have a “genetically related child” while preventing the transmission of genetic disorders. However, we argue that since future uses of GGE may involve large-scale genetic modifications, they may affect the genetic relatedness between parents and offspring in a meaningful way: Due to certain genetic modifications, children may inherit much less than 50% of their DNA from (...) each parent. We show that the reduction in genetic relatedness between parents and offspring has three important social and legal implications. First, the desire for a genetically related child may end up not being the strong justification it is currently thought to be for the use of GGE. Second, prospective parents may be reluctant to use GGE because of a potential loss of genetic relatedness. Third, in some jurisdictions, parents who would not pass on “enough” DNA to their child may not be recognized as the child's legal parents. We further argue that the reduction in genetic relatedness challenges current conceptions of genetic parenthood that rely on the quantity of DNA shared with the child or on whether the child was directly derived from the parent's genes. We suggest that genetic parenthood should instead be determined based on the nature of the genetic modifications and whether the child's numerical identity has been preserved after the editing process. (shrink)

Recent decades have seen the facilitation of unconventional or even extraordinary reproductive endeavours. Sperm has been harvested from dying or deceased men at the request of their wives; reproductive tissue has been surgically removed from children at the request of their parents; deceased adults’ frozen embryos have been claimed by their parents, in order to create grandchildren; wombs have been transplanted from mothers to their daughters. What is needed for requests to be honoured by healthcare staff is that they align (...) with widely shared expectations about what people’s reproductive potential ought to be, what marital relationships ought to result in, and which kinds of ties are desirable between parents and children. Costly and invasive technologies are not considered excessive when they are used to support the building of appropriate families. However, deviations from dominant reproductive norms, even if technologically simple and convenient to the participants, are unlikely to receive support. In this paper, we offer examples of such deviations and explore their implications. If reproduction is important as a way of creating genetic relationships, should reproductive material in storage be offered to genetic relatives other than the people from whom it originated? And if parents are allowed to have reproductive material collected from their offspring, or even to use it to create babies, should offspring likewise be allowed to use their parents’ reproductive material? We tackle these questions and suggest ways in which interests in genetic ties could be operationalised in a more coherent and less-invasive manner than they currently are. (shrink)

Establishing the nature of genetic parenthood is an important task. This is, firstly, because many people desire that relationship and it is in their interest to know what that is, and secondly, because there is a view that it may incur certain moral obligations between the genetic parent and their child. Many theorists have made attempts to define exactly what genetic parenthood is. I show that these definitions are deficient if they wish to fully capture (...) all reproductive scenarios in ways that are intuitive and/or meaningful. Through a series of cases involving technologies such as cloning and genome editing, we see that in lieu of the traditional two parents, there are possible beings who have no genetic parents, one genetic parent, or many genetic parents. Establishing these cases complicates our understanding of genetic parenthood. From this, we must reconsider current definitions, as well as the usefulness of defining genetic parenthood in these complex cases. Here I do not aim to establish a new definition, but rather to suggest that this complexity makes it necessary to re‐assess the importance of the connection between genetic parenthood and parental obligations and authorities. (shrink)

The recent success in generating live offspring from embryonic stem cell –derived gametes in mice sparked visions of growing tailor-made sperm for men faced with infertility. However, although this development will almost certainly lead to new insights into the processes underlying spermatogenesis and thus in the possible causes of male infertility, it is less certain if deriving sperm from ES cells, which are in turn derived from a sterile man, can make someone a genetic parent. As the gap between (...) newly envisioned reproductive technologies and natural reproduction widens, the question thus needs to be asked if these possible therapies still lead to genetic parenthood. (shrink)

Mitochondrial replacement techniques are designed to allow couples to have children without passing on mitochondrial diseases. Recently, Giulia Cavaliere and César Palacios-González argued that prospective parents have the right to use MRTs to pursue genetic relatedness, such that some same-sex couples and/or polygamous triads could use the process to impart genetic relatedness between a child and more of its caregivers. Although MRTs carry medical risks, Cavaliere and Palacios-González contend that because MRTs are identity-affecting, they do not cause harm (...) to an existing human being, and our intuitions otherwise arise from the non-identity problem. Here, I review several attempts to address the non-identity problem, and propose a solution to the problem. Furthermore, I argue that regardless of one’s stance on whether MRTs are identity-affecting, the use of MRTs to pursue genetic relatedness alone falls outside the scope of the medical profession, as they involve substantive medical risk for no medical benefit. (shrink)

Robert Sparrow has recently raised the possibility that stem cell technology could in the future be used to create multiple generations of embryos in the laboratory before transferring one embryo to a woman’s womb to create a pregnancy. Sparrow argues that any children produced in this way would be genetic orphans—they would lack living genetic parents—and explores the possible moral implications of this. A number of other authors have raised objections to Sparrow’s moral claims, but his descriptive claim (...) remains unchallenged. In this chapter, we challenge it, arguing that Sparrow’s imagined technology could be performed in such a way that the children produced would have living genetic parents. (shrink)

Common sense morality and legislations around the world ascribe normative relevance to biological connections between parents and children. Procreators who meet a modest standard of parental competence are believed to have a right to rear the children they brought into the world. I explore various attempts to justify this belief and find most of these attempts lacking. I distinguish between two kinds of biological connections between parents and children: the genetic link and the gestational link. I argue that the (...) second can better justify a right to rear. (shrink)

In this paper I examine what I take to be the best case for reproductive human cloning, as a medical procedure designed to overcome infertility, and argue that it founders on an irresolvable tension in the attitude towards the importance of being ‘genetically related’ to our children implied in the desire to clone. Except in the case where couples are cloning a child they have previously conceived naturally, cloning is unable to establish the right sort of genetic relation to (...) make couples the parents of their cloned child. If anybody is the genetic parent of a cloned child it is the natural parent(s) of the DNA donor. Paradoxically, in order to resist the claims of the parents of the donor to the cloned child, the argument for human reproductive cloning must place more weight on the intention to parent a child, than we do in cases of ordinary reproduction. It must insist that the parental relation is established by the intentions of the couple who bring a clone into the world and not by their genetic relation to the child. The emphasis placed on intention as establishing the parental relationship works to undermine the justification for cloning in the first place. For cloning to play a useful role as a reproductive technology, it must allow couples to become parents who could do so no other way. However, to the extent that intention is sufficient to establish parenthood, adoption or surrogacy, which are existing alternatives to cloning, will serve equally well to allow couples to become parents. (shrink)

Definition of the problem The present article focuses on the current international ethical debate on “responsible implementation” of expanded carrier screening to public healthcare systems. Expanded carrier screening is a novel genetic test which aims to provide information to couples about whether both partners carry a genetic variation for the same recessively inherited condition. It was introduced to the market by commercial laboratories in the U.S. in 2010; since about 2015, however, international debates have emerged on how and (...) why to offer the screening as a public health service. Arguments It is shown that, initially, enhancement of couples’ reproductive autonomy, not prevention of recessive disorders, has been established as the ethically well-founded aim and guiding principle of responsible implementation. Recently, however, in 2019, three well-known Dutch bioethicists argued that this aim has been embraced without much reflection and should therefore be replaced with the guiding principle of “responsible parenthood”. According to the latter, autonomous reproductive decision-making of couples or women is morally acceptable solely when carrier screening is done only during pregnancy. Before pregnancy, by contrast, couples are held to have a moral duty to take preventive measures if their future children are at risk of being affected by one of the “worst” recessive conditions. In the present paper, both of these conflicting ethical framings of expanded carrier screening are critically examined. Conclusions While the aim of reproductive autonomy also has problematic aspects, the notion of “responsible parenthood” is much more objectionable since it challenges voluntary participation in carrier screening, argues for directive genetic counseling, limits reproductive self-determination of women and couples, and introduces dubious concepts to the debate. (shrink)

The Perfect Baby is the most popular introduction to ethical issues in genetics. This new edition has been updated to discuss and debate advances in high tech reproduction, genetic testing, gene therapy, human cloning, and stem cell research. It includes a new epilogue by cloning pioneer Ian Wilmut and Glenn McGee.

What exactly is it that makes someone a parent? Many people hold that parenthood is grounded, in the first instance, in the natural derivation of one person's genetic constitution from the genetic constitutions of others. We refer to this view as "Geneticism". In Part I we distinguish three forms of geneticism on the basis of whether they hold that direct genetic derivation is sufficient, necessary, or both sufficient and necessary, for parenthood. Parts two through four (...) examine three arguments for geneticism: the property argument, the causal argument, and the parity argument. We conclude that none of these arguments succeeds. (shrink)

It is widely assumed that there is value in the biological tie between parent and child. An implication of this is that adoption is often considered a less desirable alternative to procreation. This paper offers a philosophical defence of adoptive parenthood as a valuable and authentic form of parenthood. While previous defences have suggested that society’s valorisation of the biological tie is unjustified, I argue herein that the conception of the biological tie that features in the normative discourse (...) on parenthood is too narrowly genocentric. Against this genocentric conception, recent work in the philosophy of biology has emphasised the roles of joint determination, dynamic construction, and extended inheritance in development, which I suggest can substantiate a more inclusive conception of the biological tie. Accordingly, I propose that adoptive parents form a rich variety of biological ties with their children, some of which are as heritable and formative as genetic relatedness. (shrink)

According to the causal theory of parenthood, people incur parental obligations by causing children to exist. Proponents of the causal theory often argue that gamete donors have special obligations to their genetic offspring. In response, many defenders of current gamete donation practices would reject the causal theory. In particular, they may invoke the ‘too many parents problem’: many people who causally contribute to the existence of children – for instance, fertility doctors – do not thereby incur parental obligations. (...) This article argues that the conclusions commonly drawn by causal theorists, and by their critics, are premature. Causal theorists have a promising response to the too many parents problem. This response, however, defuses the moral concern that many causal theorists have raised about gamete donation. A similar point, it is argued, applies to Rivka Weinberg’s ‘Hazmat Theory’. -/- . (shrink)

Reproductive techniques and practices, ranging from ordinary birth-control measures and artificial insemination to embryo transfer and surrogate motherhood, have greatly enhanced our range of reproductive choices. As a consequence, they pose a number of difficult moral and legal questions with regard to the formation of a family and our conception of parenthood. A view that is becoming increasingly common is that parental rights and responsibilities should not be based on genetic relationships but should instead be seen as arising (...) from agreements or contracts between individuals. Accordingly, a man who consents to his wife's artificial insemination by donor (AID) and not the sperm donor, is the legal father of the child; in surrogacy agreements, the intending mother, and not the surrogate, has the right to raise the resulting child. While agreeing that biology should not form the basis for assigning legal parenthood, I argue that the theory of intentional parenthood, despite being put forward as a liberal theory, is geared toward or will have the function of protecting the nuclear family and inhibiting the formation of alternative family forms. (shrink)

Reproductive techniques and practices, ranging from ordinary birth-control measures and artificial insemination to embryo transfer and surrogate motherhood, have greatly enhanced our range of reproductive choices. As a consequence, they pose a number of difficult moral and legal questions with regard to the formation of a family and our conception of parenthood. A view that is becoming increasingly common is that parental rights and responsibilities should not be based on genetic relationships but should instead be seen as arising (...) from agreements or contracts between individuals. Accordingly, a man who consents to his wife's artificial insemination by donor (AID) and not the sperm donor, is the legal father of the child; in surrogacy agreements, the “intending mother,” and not the surrogate, has the right to raise the resulting child. While agreeing that biology should not form the basis for assigning legal parenthood, I argue that the theory of intentional parenthood, despite being put forward as a liberal theory, is geared toward or will have the function of protecting the nuclear family and inhibiting the formation of alternative family forms. (shrink)

In recent years, a number of writers dealingwith questions over parenthood that arisein the context of reproductive technologies andsurrogate motherhood, have appealed to thenotion of ``intentional parenthood''. Basingtheir argument on liberal values such asindividual autonomy, the freedom to entercontracts, the right to privacy, and individualself-fulfilment, they argue that contractuallystated intentions, rather than genetic orgestational relationships, should form thebasis of parental rights. Against this I arguethat parental rights do not derive fromcontractual agreements, but are based in theirobligations towards (...) the child. I then examinethe nature of the obligations that the variousparties have towards the child both pre- andpostnatally. (shrink)

Cases of non-traditional family-making offer a rich seam for thinking about normative parenthood. Gamete donors are genetically related to the resulting offspring but are not thought to be normative parents. Gestational surrogates are also typically not thought to be normative parents, despite having gestated a child. Adoptive parents are typically thought to be normative parents even though they are neither genetically nor gestationally related to their child. Philosophers have paid attention to these kinds of cases. But they have not (...) paid attention to what the people who have engaged in these forms of family-making have to say about what they’re doing and, more specifically, how they answer the questions: “Who is the normative parent? And why?” Paying attention to their answers reveals two things. First, accounts of parenthood from people involved in two forms of non-traditional family-making – reproduction with gestational surrogacy and reproduction with donated eggs – are mutually inconsistent. This is not surprising. What is surprising is that the contradictory aspects of the views evince a common commitment to, as I shall put it, naturalizing parenthood. The central goal of this paper is to explain what that means, but rough idea is that in naturalizing parenthood, prospective parents aim to put the features that make someone a normative parent beyond the reach of human agency. I conclude by briefly suggesting that we should think of the grounds of normative parenthood – and the very task of theorizing about the grounds of normative parenthood – in a way that avoids the need to naturalize altogether. (shrink)

ABSTRACT Does genetic relatedness define who is a mother or father and who incurs obligations towards or entitlements over children? While once the answer to this question may have been obvious, advances in reproductive technologies have complicated our understanding of what makes a parent. In a recent publication Bayne and Kolers argue for a pluralistic account of parenthood on the basis that genetic derivation, gestation, extended custody and sometimes intention to parent are sufficient (but not necessary) grounds (...) for parenthood.1 Bayne and Kolers further suggest that definitions of parenthood are underpinned by the assumption that ‘being causally implicated in the creation of a child is the key basis for being its parent’.2 This paper examines the claim that genetic relatedness is sufficient grounds for parenthood based on a causal connection between genetic parents and their offspring. I argue that parental obligations are about moral responsibility and not causal responsibility because we are not morally accountable for every consequence to which we causally contribute. My account includes the conditions generally held to apply to moral responsibility, i.e. freedom and foreseeability. I argue that parental responsibilities are generated whenever the birth of a child is a reasonably foreseeable consequence of voluntary actions. I consider the implications of this account for third parties involved in reproductive technologies. I argue that under some conditions the obligations generated by freely and foreseeably causing a child to exist can be justifiably transferred to others. (shrink)

What is it that makes someone a parent? Many writers – call them ‘monists’– claim that parenthood is grounded solely in one essential feature that is both necessary and sufficient for someone's being a parent. We reject not only monism but also ‘necessity’ views, in which some specific feature is necessary but not also sufficient for parenthood. Our argument supports what we call ‘pluralism’, the view that any one of several kinds of relationship is sufficient for parenthood. (...) We begin by challenging monistic versions of gestationalism, the view that gestation uniquely grounds parenthood. Monistic and necessity gestationalism are implausible. First, we raise the ‘paternity problem’– necessity gestationalists lack an adequate account of how men become fathers. Second, the positive arguments that necessity gestationalists give are not compelling. However, although gestation may not be a necessary condition for parenthood, there is good reason to think that it is sufficient. After further rebutting an ‘intentionalist’ account of parenthood, in which having and acting on intentions to procreate and rear is necessary for parenthood, we end by sketching a pluralist picture of the nature of parenthood, rooted in causation, on which gestation, direct genetic derivation, extended custody, and even, sometimes, intentions, may be individually sufficient for parenthood. (shrink)

Since mitochondrial replacement techniques were developed and clinically introduced in the United Kingdom, there has been much discussion of whether these lead to children borne of three parents. In the UK, the regulation of MRT has dealt with this by stipulating that egg donors for the purposes of MRT are not genetic parents even though they contribute mitochondrial DNA to offspring. In this paper, I examine the way that the Human Fertilisation and Embryology Act in the UK manages the (...) question of parentage. I argue that the Act breaks the link typically made between genetic causation and genetic parenthood by redefining genetic causation solely in terms of nuclear genetics. Along with this, mtDNA is construed as a kind of supplement to the nuclear family. Drawing on the account of the supplement developed by Jacques Derrida, I argue that mtDNA and the women who donate it are seen as both essential to establishing the nuclear family but also exterior to and insignificant for it. (shrink)

The ethical and legal challenges posed by assisted reproduction techniques are both profound and breathtaking, with most societies unable to fully comprehend one technique before another one, even more daring, emerges. The wrongful implantation of embryos in two women undergoing in vitro fertilisation treatments at two separate clinics in the UK seriously vitiates the traditional concept of who is a parent. In one case, a patient’s embryos were wrongly implanted into another woman seeking similar treatment, and in the second, a (...) woman’s eggs were fertilised using sperm from a man other than her husband.In the first mix-up, neither member of the recipient couple was the genetic parent of the child, while in the second case, the recipient mother was the genetic mother and her husband was not the genetic father. The mix-ups resulted in litigation to determine who the rightful parents were. First, I will show in this paper that, although the outcome of the application of English law in both cases was in agreement with the outcome prescribed by basic principles of Islamic law and bioethics, that agreement is based on different reasoning in the two traditions. Next, I will show that the profound ethical implications of reproductive technologies begs for a more pluralistic bioethical discourse than the one-dimensional analysis applied by secular Western societies that currently dominates the enquiry, particularly as most Western societies are more or less multicultural and multireligious. (shrink)

_ Source: _Page Count 30 Millions of children worldwide could benefit from adoption. One could argue that prospective parents have a pro tanto duty to adopt rather than create children. For the sake of argument, I assume there is such a duty and focus on a pressing objection to it. Prospective parents may prefer that their children are genetically related to them. I examine eight reasons prospective parents have for preferring genetic children: for parent-child physical resemblance, for family resemblance, (...) for psychological similarity, for the sake of love, to achieve a kind of immortality, for the genetic connection itself, to be a procreator, and to experience pregnancy. I argue that, with the possible exception of the pregnancy desire, these reasons fail to defeat a duty to adopt a child rather than create one, even assuming that we do have some leeway to favor our own interests. (shrink)

This article defends the morality of heterologous embryo transfer (HET) against those who claim that HET is wrong because it makes a woman a mother through someone other than her spouse. I contrast genetic parenthood with gestation to show that gestation alone does not make someone a mother in the focal sense. Genetic parenthood gives rise to the full obligations of parenthood—i.e., makes someone a parent in the focal sense—because the child’s relationship to his (...) class='Hi'>genetic parents is (1) permanent, (2) identity-defining, and (3) initially (at conception) the child’s closest human relationship. While the gestational relationship importantly influences the child’s identity, it lacks the unique closeness, permanence, and identity-defining nature that characterize the genetic parent-child relationship, and therefore gives rise only to temporary obligations akin to those of a foster parent. Recognizing these crucial differences between gestation and procreation helps to show that HET is not inherently immoral. (shrink)

This article defends the morality of heterologous embryo transfer against those who claim that HET is wrong because it makes a woman a mother through someone other than her spouse. I contrast genetic parenthood with gestation to show that gestation alone does not make someone a mother in the focal sense. Genetic parenthood gives rise to the full obligations of parenthood—i.e., makes someone a parent in the focal sense—because the child’s relationship to his genetic (...) parents is permanent, identity-defining, and initially the child’s closest human relationship. While the gestational relationship importantly influences the child’s identity, it lacks the unique closeness, permanence, and identity-defining nature that characterize the genetic parent-child relationship, and therefore gives rise only to temporary obligations akin to those of a foster parent. Recognizing these crucial differences between gestation and procreation helps to show that HET is not inherently immoral. (shrink)

Millions of children worldwide could benefit from adoption. One could argue that prospective parents have a pro tanto duty to adopt rather than create children. For the sake of argument, I assume there is such a duty and focus on a pressing objection to it. Prospective parents may prefer that their children are genetically related to them. I examine eight reasons prospective parents have for preferring genetic children: for parent-child physical resemblance, for family resemblance, for psychological similarity, for the (...) sake of love, to achieve a kind of immortality, for the genetic connection itself, to be a procreator, and to experience pregnancy. I argue that, with the possible exception of the pregnancy desire, these reasons fail to defeat a duty to adopt a child rather than create one, even assuming that we do have some leeway to favor our own interests. (shrink)

Advances in assisted reproductive technologies can give rise to several ethical challenges. One of these challenges occurs when the reproductive desires of two individuals become incompatible and conflict. To address such conflicts, it is important to unbundle different aspects of (non)parenthood and to recognize the corresponding reproductive rights. This article starts on the premise that the six reproductive rights—the right (not) to be a gestational, genetic, and social parent—are negative rights that do not entail a right to assistance. (...) Since terminating or continuing a pregnancy is a form of assistance, the right (not) to be a gestational parent should enjoy primacy in conflicts. However, while refusing assistance may hinder the reproductive project of another person, “prior assistance” does not entitle someone to violate a reproductive right. Therefore, our analysis provides reasons to argue that someone has a right to unilaterally use cryopreserved embryos or continue the development of an entity in an extracorporeal gestative environment (i.e., ectogestation). Although this could lead to a violation of the right not to be a genetic parent, it does not necessarily entail a violation of the right not to be a social parent. (shrink)

In a recent case in Great Britain, a couple described as “white” underwent in vitro fertilisation and gave birth to twins described as “black”. In the sense of a fair adjudication of this particular case, serving justice requires a thick description and a sensitive understanding of the relevant facts. We have only a few facts, but they may be sufficient to serve justice in this first sense.We are told that the couple wants to keep the twins. We are told further (...) that British law holds that the woman giving birth is to be regarded as the legal mother . Finally, we are told that DNA testing has established that the gestational mother is also the genetic mother of these infants. Her husband, whose sperm were supposed to be used to fertilise his wife’s eggs, is not the genetic father. A black couple was also undergoing IVF at the same clinic; it may be that this man’s sperm were used by mistake.We know enough to reach a defensible decision in the case. The couple caring for these children has contributed a half share of the children’s genes, and the woman was also the gestational mother, so they have at least an equal argument from biology. Their intention was to have these children and they also wish to raise them; they went through the rigours of IVF, and are willing to take on the responsibility of parenthood. Since the children were born, furthermore, they have shouldered the hard work of parenthood. We don’t know their particular circumstances; perhaps they’ve had help from family or others; but in all likelihood they’ve had an ample share of sleep deprived nights, soiled nappies, and exhausted days. …. (shrink)

The ethical and legal challenges posed by assisted reproduction techniques are both profound and breathtaking, with most societies unable to fully comprehend one technique before another one, even more daring, emerges. The wrongful implantation of embryos in two women undergoing in vitro fertilisation treatments at two separate clinics in the UK seriously vitiates the traditional concept of who is a parent. In one case, a patient’s embryos were wrongly implanted into another woman seeking similar treatment, and in the second, a (...) woman’s eggs were fertilised using sperm from a man other than her husband.In the first mix-up, neither member of the recipient couple was the genetic parent of the child, while in the second case, the recipient mother was the genetic mother and her husband was not the genetic father. The mix-ups resulted in litigation to determine who the rightful parents were. First, I will show in this paper that, although the outcome of the application of English law in both cases was in agreement with the outcome prescribed by basic principles of Islamic law and bioethics, that agreement is based on different reasoning in the two traditions. Next, I will show that the profound ethical implications of reproductive technologies begs for a more pluralistic bioethical discourse than the one-dimensional analysis applied by secular Western societies that currently dominates the enquiry, particularly as most Western societies are more or less multicultural and multireligious. (shrink)

Recently in Israel, a woman was mistakenly implanted with an embryo that is genetically related to another couple. Unfortunately, this case is not an isolated occurrence, as other cases of embryo mix-ups have been reported in several countries, including the USA, China, the UK and various other countries within the European Union. Cases of mixed-up embryos are ethically and legally complex: the woman who carried the pregnancy and the woman who is genetically related to the resulting child—both of whom endured (...) emotionally and physically demanding infertility treatments—along with their partners, may be unwilling to relinquish parental rights over the child.This article explores four possible approaches, found in numerous common law jurisdictions, which can be used to address cases involving embryo mix-ups. Our analysis reveals several avenues through which legal parentage can be established. It can be done through gestation and the marital presumption, genetic connections, by adhering to the principle of the best interests of the child, or by recognising multiple individuals as legal parents. We review the advantages and disadvantages of each approach, but we have one clear recommendation: resolving embryo mix-up cases should be done proactively through the establishment of legislation and guidelines, rather than relying on post hoc individual court decisions. Such legislation and guidelines should guarantee the consistency of values throughout diverse reproductive contexts and mandate that fertility clinics and medical professionals provide individuals with comprehensive information regarding the potential risks associated with assisted reproductive treatments. (shrink)

Expanded universal carrier screening (EUCS) entails a population‐wide screening offer for multiple disease‐causing mutations simultaneously. Although there is much debate about the conditions under which EUCS can responsibly be introduced, there seems to be little discussion about its aim: providing carrier couples with options for autonomous reproductive choice. While this links in with current accounts of the aim of foetal anomaly screening, it is different from how the aim of ancestry‐based carrier screening has traditionally been understood: reducing the disease burden (...) in the population. The reasons why the aim of EUCS is presented in terms of ‘autonomy’ rather than ‘prevention’ have not been spelled out in the literature. This paper seeks to fill this gap by considering the morally relevant similarities and dissimilarities between foetal anomaly screening, ancestry‐based carrier screening and EUCS. When carrier screening is performed in the prenatal period, enhancing autonomy appears the most appropriate aim of EUCS, as the alternative of ‘prevention through selective abortion’ would urge women to terminate wanted pregnancies. However, when screening is conducted in the preconception period, carrier couples can avoid the birth of affected children by other means than selective abortion, for instance preimplantation genetic diagnosis. To the extent that this increased control over passing on a genetic disorder raises questions of parental responsibility, it seems necessary that the account of the aims of EUCS is wider than only in terms of enhancing reproductive autonomy. (shrink)

This case is another in a series intended to highlight the new questions emerging from advances in mapping the human genome and the application of genetic findings to clinical practice. The National Human Genome Research Institute, a component of the National Institutes of Health, by law is directed to designate a portion of its annual budget to furthering understanding of the ethical, legal, and social questions emerging from research on the human genome. As part of the effort, the Institute (...) supports research by scientists and scholars around the nation with the aim of clarifying and resolving the tough ethical and research choices facing this endeavor. But recently it has launched an intramural program, which is expected to take a catalytic role in grappling with the array of issues the researchers face in carrying out investigations in human genetics. (shrink)

Preimplantation genetic diagnosis (PGD) raises serious moral questions concerning the parent-child relationship. Good parents accept their children unconditionally: they do not reject/attack them because they do not have the features they want. There is nothing wrong with treating a child as someone who can help promote some other worthwhile end, providing the child is also respected as an end in him or herself. However, if the child's presence is not valued in itself, regardless of any further benefits it brings, (...) the child is not being treated as an end in the full sense of the term. In this paper, I argue that these principles apply to human embryos, as well as to born human offspring: the human moral subject is a bodily being, whose interests and rights begin with the onset of his or her bodily life. The rights of the living, bodily human individual include a right not to be attacked/abandoned because of his or her genetic profile. PGD is harmful to the parent-child relationship, and we give mixed messages to parents by expecting them to show unconditional commitment to offspring after birth, while inviting them to take a very different approach at the prenatal stage. (shrink)

Internationally, there is considerable inconsistency in the recognition and regulation of children's genetic connections outside the family. In the context of gamete and embryo donation, challenges for regulation seem endless. In this paper, I review some of the paths that have been taken to manage children' being closely genetically related to people outside their families. I do so against the background of recognising the importance of children's interests as moral status holders. I look at recent qualitative research involving donor-conceived (...) people and borrow their own words to make sense of a purported interest to know (of) their close genetic ties. I also review ways in which gamete donation may have facilitated new kinds of kinship, which are at the same time genetic and chosen. In short, in this paper, I explore what meaning there could be in genetic connections that is not about parenthood. Further, I argue that the focus on parenthood in previous work in this area may be detrimental to appreciating some of the goods that can be derived from close genetic connections. (shrink)

Expanded universal carrier screening (EUCS) entails a population‐wide screening offer for multiple disease‐causing mutations simultaneously. Although there is much debate about the conditions under which EUCS can responsibly be introduced, there seems to be little discussion about its aim: providing carrier couples with options for autonomous reproductive choice. While this links in with current accounts of the aim of foetal anomaly screening, it is different from how the aim of ancestry‐based carrier screening has traditionally been understood: reducing the disease burden (...) in the population. The reasons why the aim of EUCS is presented in terms of ‘autonomy’ rather than ‘prevention’ have not been spelled out in the literature. This paper seeks to fill this gap by considering the morally relevant similarities and dissimilarities between foetal anomaly screening, ancestry‐based carrier screening and EUCS. When carrier screening is performed in the prenatal period, enhancing autonomy appears the most appropriate aim of EUCS, as the alternative of ‘prevention through selective abortion’ would urge women to terminate wanted pregnancies. However, when screening is conducted in the preconception period, carrier couples can avoid the birth of affected children by other means than selective abortion, for instance preimplantation genetic diagnosis. To the extent that this increased control over passing on a genetic disorder raises questions of parental responsibility, it seems necessary that the account of the aims of EUCS is wider than only in terms of enhancing reproductive autonomy. (shrink)

In this paper, we argue that lesbian couples who wish to have children who are genetically related to both of them should be allowed access to mitochondrial replacement techniques. First, we provide a brief explanation of mitochondrial diseases and MRTs. We then present the reasons why MRTs are not, by nature, therapeutic. The upshot of the view that MRTs are non-therapeutic techniques is that their therapeutic potential cannot be invoked for restricting their use only to those cases where a mitochondrial (...) DNA disease could be ‘cured’. We then argue that a positive case for MRTs is justified by an appeal to reproductive freedom, and that the criteria to access these techniques should hence be extended to include lesbian couples who wish to share genetic parenthood. Finally, we consider a potential objection to our argument: that the desire to have genetically related kin is not a morally sufficient reason to allow lesbian couples to access MRTs. (shrink)

This paper discusses whether prospectiveparents ought to find out about their geneticconstitution for reproductive reasons. It isargued that ignoring genetic information can bein line with responsible parenthood or perhapseven recommendable. This is because parenthoodis essentially an unconditional project inwhich parents ought to commit themselves tonurturing any kind of child. Besides, thetraditional reasons offered for theunfortunateness of impairments and the tragicfate of families with disabled children are notconvincing. Other morally problematic outcomesof genetics, such as discrimination againstindividuals with impairments, and (...) limiting freeparental decision making, are alsoconsidered. (shrink)

This article explores commonalities between parental claims for lesbian co-mothers and other contexts in which intention is a key aspect to family formation for (mostly) heterosexual families: in particular, surrogacy and pre-birth disputes over embryos. Through a series of case studies drawn from recent reproductive controversies, the paper uses the lens of empathy to argue for social or non-genetic modes of parenthood connecting lesbian mothers and other ‘reproductive outsiders’.

People who are involuntarily childless need to use assisted reproductive technologies if they want to have a genetically related child. Yet, from an ethical point of view it is unclear to what extent assistance to satisfy this specific desire should be warranted. We first show that the subjectively felt harm due to the inability to satisfy this reproductive desire does not in itself entail the normative conclusion that it has to be met. In response, we evaluate the alternative view according (...) to which the satisfaction of this desire is regarded as a way to meet one’s presumed intermediate need for parenthood. This view presupposes that parenthood is one of those general categories of experiences and activities that contribute an irreplaceable value to people’s lives, but the central difficulty is to find those characteristics that mark out parenthood as an irreplaceable constituent of a valuable life. We go on to argue, however, that even if one assumes that parenthood is such an irreplaceable constituent that makes life more valuable, this does not necessarily entail a moral duty to satisfy the desire for genetic parenthood. We conclude that there is a pro tanto obligation to help people conceive a genetically related child (if this is what they prefer), but that this can be outweighed by other moral considerations, such as safety and justice concerns. (shrink)

A number of recent papers have described the successful derivation of egg and sperm precursor cells from mouse embryonic stem cells—so-called “artificial” gametes. Although many scientific questions remain, this research suggests numerous new possibilities for stem cell research and assisted reproductive technology, if a similar breakthrough is achieved with human embryonic stem cells. The novel opportunities raised by artificial gametes also prompt new ethical questions, such as whether same-sex couples should be able to access this technology to have children who (...) are genetically related to them both.THE CREATION OF “ARTIFICIAL” GAMETESOver the past two years, a number of papers have been published detailing the first successful attempts at differentiating mouse embryonic stem cells into egg1 and sperm2 precursor cells. Previously, researchers had used embryonic stem cells to generate tissues such as brain, liver, and pancreatic cells, but not germ cells of any kind. Production of gamete precursor cells was achieved initially through allowing stem cell lines to differentiate more or less randomly, but recent research has focused on identifying the precise ways in which differentiation into gametes can be precipitated and controlled. These breakthroughs make it seem likely that ongoing research on human stem cells will yield similar possibilities,3 raising questions over the practicalities of what might be achieved with such “artificial” gametes. In turn, the novel opportunities presented by artificial gametes raise a number of ethical concerns.The initial breakthrough, namely the obtaining of egg cells from mouse stem cells, was achieved by means of relatively simple science. Rather than coaxing stem cells to develop into eggs using complicated cocktails of growth factors, researchers adopted standard cell culture conditions, but grew the cells at higher density than usual.3–6 Growing the cells in this way led to the formation of ovary-like cell aggregates, which (when separated and stimulated with …. (shrink)

Book reviewed in this article: Coping with Genetic Disorders. By John C. Fletcher. Genetics, Ethics and Parenthood. Edited by Karen Lebacqz. Screening and Counseling for Genetic Conditions: The Ethical, Social, and Legal Implications of Genetic Screening, Counseling, and Education Programs. A report of the President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research.

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Conceiving People: Genetic Knowledge and the Ethics of Sperm and Egg Donation by Daniel GrollMelissa MoschellaGROLL, Daniel. Conceiving People: Genetic Knowledge and the Ethics of Sperm and Egg Donation. New York: Oxford University Press, 2021. 256 pp. Cloth, $74.00In Conceiving People, Daniel Groll argues that, generally speaking, those intending to conceive with the help of donor gametes have a moral obligation to use an open donor (...) rather than an anonymous one. This obligation is grounded on the likelihood that their children will have a significant future interest in acquiring genetic knowledge, defined as "knowledge of who one's genetic progenitors are." Groll labels this view the significant interest view, which he argues for largely on empirical grounds.Before beginning his defense of the significant interest view, Groll dedicates chapter 2 to arguing that parents who conceive with the help of donor gametes should not keep this a secret from their children. His position on this point reflects the current consensus on the subject, but he offers a novel argument for it, based on the claim that keeping "the secret" in itself harms the parent–child relationship by inherently compromising the intimacy proper to that relationship.Chapter 3 presents the significant interest view in greater detail, distinguishing it from two other approaches: (1) the "Profound Prudential Good view," taken from the work of David Velleman, according to which "genetic knowledge is a profound prudential good and people who lack it will have tremendous trouble figuring out who they are," and (2) the view that "people have a right to genetic knowledge." Unlike these competing approaches, Groll's view "does not directly depend on claims about the value of genetic knowledge" but is based primarily on the fact that "many donor-conceived people are subjectively interested in having genetic knowledge," combined with the claim that parents have an obligation to promote their children's well-being by satisfying their worthwhile significant subjective interests. Because Groll's argument depends on the worth and significance of genetic knowledge, it is vulnerable to what he calls the "sideshow objection"—that is, that the significant interest view is just a sideshow, and the worth of genetic knowledge is what actually does the important normative work. At the same time, Groll's view that the interest in genetic knowledge is worthwhile and significant also leaves him open to the "bionormativity objection," according to which the interest in genetic knowledge "is morally problematic in virtue of evincing and entrenching a kind of bionormative prejudice" that sees the biological family as a normative ideal. [End Page 141]Responding to these two objections is the task of chapters 4 and 5. Chapter 4 argues that genetic knowledge is an objective but "prudentially optional good," meaning that "its value is not fungible, but a life that lacks it is not thereby impoverished." This distinguishes Groll's view from the profound prudential good view, which he characterizes as a form of "genetic chauvinism." Groll argues that genetic knowledge is valuable because it can provide insight into personal identity by answering questions about how I came to be and who I am like, but that the genetic knowledge is not the only or best way to answer these questions (thus explaining why it is optional, and why the significant interest view is not just a sideshow).Chapter 5 addresses the "bionormativity objection," which includes both "heteronormativity" (privileging families headed by a mother and father) and "biogenetic normativity" (privileging genetically related families). Groll ultimately responds to this objection by arguing that, even if (as Groll believes) our current society overemphasizes the importance of genetic relationships, "the interest in genetic knowledge is rationally intelligible quite apart from the bionormative social milieu that surrounds it."Chapters 6 through 8 present the implications of the preceding argument. Chapter 6 argues that the reasons to use an open donor are generally conclusive, because most reasons parents might have to use an anonymous donor do not outweigh the child's significant interest in obtaining genetic knowledge. Chapter 7 considers the responsibilities of gamete donors, arguing that gamete donation is not morally objectionable because it is permissible for donors to transfer prospective parenthood responsibilities... (shrink)

Should the law recognize an individual's right not to be a genetic parent when genetic parenthood does not carry with it legal or gestational parenthood? If so, should we allow individuals to waive that right in advance, either by contract or a less formal means? How should the law's treatment of gestational and legal parenthood inform these questions? Developments in reproductive technology have brought these questions to the fore, most prominently in the preembryo disposition cases (...) a number of courts have confronted - disputes over the use of stored frozen preembryos that couples have fertilized in the course of In Vitro Fertilization (IVF) - but other examples abound.In this Article, I argue that in analyzing these cases it is essential to unbundle the possible rights not to be a genetic, gestational, and legal parent, and to recognize that the three rights do not stand and fall together. I show that we cannot move from the discourse surrounding the rights not to be a gestational and legal parent to a justification for a right not to be a genetic parent. Instead, I argue that the normative mooring of the right not to be a genetic parent is best understood as a way of protecting individuals from what I call "attributional parenthood," a harm that stems from the social assignment of the status of parent to the provider of genetic material that persists notwithstanding the fact that the legal system has declared him or her a non-parent.Using this framework, I argue for the recognition of the right not to be a genetic parent. However, I reject the claim, common among courts and commentators, that this right should not be capable of advance waiver. I instead conclude that we should permit advance waiver of the right through contract, with several interventions aimed at improving contractual consent. In preembryo disposition disputes where the parties have not contracted, I argue for a general default rule of non-use, perhaps with a sub-rule permitting use when non-use would mean the impossibility of one party ever having any genetic children. (shrink)

Book reviewed in this article: Coping with Genetic Disorders. By John C. Fletcher. Genetics, Ethics and Parenthood. Edited by Karen Lebacqz. Screening and Counseling for Genetic Conditions: The Ethical, Social, and Legal Implications of Genetic Screening, Counseling, and Education Programs. A report of the President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research.