Are attempts to have impaired children justifiable?

Journal of Medical Ethics

Volumn 28, Issue 5, 2002, Pages 286-288

  Anstey, K W ^a  

^a UNIVERSITY OF MELBOURNE   (Australia)

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; ARTIFICIAL INSEMINATION; AWARENESS; CHILD; CULTURAL ANTHROPOLOGY; DECISION MAKING; FEMALE; HEARING IMPAIRMENT; HUMAN; MEDICAL ETHICS; MINORITY GROUP; RESPONSIBILITY; UNITED STATES;

ANALYTICAL APPROACH; GENETICS AND REPRODUCTION;

ATTITUDE TO HEALTH; CHILD; CHILD WELFARE; CHOICE BEHAVIOR; DEAFNESS; DISABLED CHILDREN; FEMALE; HOMOSEXUALITY, FEMALE; HUMANS; MOTHERS; PREGNANCY; UNITED STATES;

EID: 0036791660     PISSN: 03066800     EISSN: None     Source Type: Journal    
DOI: 10.1136/jme.28.5.286     Document Type: Article

References (23)

1. Spriggs M. Lesbian couple create a child who is deaf like them. Journal of Medical Ethics Online eCurrent Controversies, 2002 May 2;
2. Mundy L. A world of their own. The Washington Post 2002 Mar 31: W22.
3. See reference 1: Spriggs M.
4. Overall C. Ethics and human reproduction: a feminist analysis. Boston: Allen & Unwin, 1987: 25-27. Although some women lack this capacity, their identity will nevertheless be shaped by their awareness of this.
5. See reference 3: 26.
6. See reference 3: 24.
7. This argument is often articulated as the assurance of a "right to an open future," the selection of the "best potential child," or the obligation to "reduce suffering and limitations of opportunity in the world". See Davis DN. Genetic dilemmas and the child's right to an open future. Hastings Centre Report 1997;27:7-15;
8. Savulescu J. Procreative beneficence: why we should select the best children Bioethics 2001;15:413-26;
9. Harris J. Wonderwoman and Superman: the ethics of human biotechnology. Oxford: Oxford University Press, 1992.
10. See Bickenbach JE, Chatterji S, Badley EM, et al. Models of disablement, universalism, and the international classification of impairments, disabilities, and handicaps. Social Science and Medicine 1999;48:1173-87.
11. Some will resist this conclusion, and point out that some experiences remain closed off to the deaf regardless of changes in social support to those with this impairment. Indeed, the account of identity argued for above presupposes an inherent prevention of certain experiences. The prevention of experience is not, however, synonymous with the prevention of opportunity. Indeed, as I have argued elsewhere, surely it is not the availability of particular opportunities, or the mere number of available opportunities, that is ethically significant, but instead the individual's ability to pursue opportunities associated with the projects and relationships that serve their life plans.
12. Anstey KW. Sex selection and disability avoidance: is their opposed treatment conceptually consistent? Monash Bioethics Review 2002;21:10-28. Where certain life plans appear to be closed off by impairment, it is important to bear in mind the possibility of the individual participating in "alternative modes of those same activities".
13. See Asch A. Prenatal diagnosis and selective abortion: a challenge to practice and policy. American Journal of Public Health 1999;89:1649-57. For example, while the deaf may not be able to appreciate musical pleasures, they may experience the artistic enjoyment in the visual arts. Further, hearing impairments may open particular opportunities to those possessing them. For example, there is conflicting research on the issue of whether the deaf have enhanced visual perception skills.
14. See Rettenbach R, Diller G, Sireteanu R. Do deaf people see better? Texture segmentation and visual search compensate in adult but not in juvenile subjects. Journal of Cognitive Neuroscience 1999;11:560-83.
15. Overall C. Ethics and human reproduction: a eminist analysis. Boston: Allen & Unwin, 1987:25-27.
16. Mundy L. A world of their own. The Washington Post 2002 Mar 31: W22.
17. In addition to being born or becoming deaf, identifying as Deaf, and participation in the activities of Deaf culture are widely viewed as necessary to gain and continue membership in Deaf culture. See Newell C. Access to opportunity or oppression? An Australian policy analysis of the ethics of the cochlear implant. Interaction 2000; 13:16-23;
18. Padden C, Humphries T. Deaf in America: voices from a culture. Cambridge, MA: Harvard University Press, 1988;
19. Tucker BP. Deaf culture, cochlear implants, and elective disability. Hastings Center Report 1998;28:6-14.
20. For a good critique of minority group approaches to impairment and disabilities, see reference 7.
21. To be sure, the linkage between group size and political power is contestable. A study of political activism in an American deaf community found, however, that its small size was viewed as a major barrier to political recognition and access to sufficient services. See Bateman GC. Community issues and political activism. In: Garretson M, ed. Viewpoints on deafness [Deaf American monograph No 2]. Silver Spring, MD: National Association of the Deaf, 1992: 19-23.
22. Coleman notes that this is the extent to which the US Supreme Court has recognised a principle of procreative liberty. See Coleman C. Is there a constitutional right to preconception sex selection? American Journal of Bioethics 2001;1:27-8.
23. For a discussion of this "any/particular" distinction, see Parens E, Asch A. The disability rights critique of prenatal genetic testing: reflections and recommendations. Hastings Center Report 1999;29(supp): 1-22S.