The perfect person1. The moral landscape of new reproductive technologies

David Carpenter

30th September 2015

Portsmouth Cathedral

Choice Chance

Pre-Conception

Neonate

Choice Chance

Pre-Conception

Neonate

Choice Chance

Pre-Conception

Neonate

Pre-Conception

Neonate

Moral questions related to status

Choice Chance

Moral questions related to autonomy and liberty

Why would you?

• Eradication of disease• Eradication of disability• Promotion of choice• Combatting childlessness• Saving resources• Scientific advancement

Why wouldn’t you?

• Eugenics• Slippery slopes• Interference with nature / God’s will• Demographic consequences• Socio-political issues

Interventions

• Pre-relationship• Pre-conception• IVF – selective implantation• Genetic modification• Pregnancy screening• ToP• Selective treatment of severely handicapped

neonates

Pre-Relationship /Conception

So how do our genes match up?

Genetic Risks

Relationship R

Parent-child 1/2

Full Sib 1/2

Half Sib 1/4

Double First Cousins (first degree) 1/2

Double First Cousins 1/4

Grandparent-grandchild 1/4

Uncle-niece and Aunt-nephew 1/4

Selective Implantation

Genetic Modification

Available foetal and pregnancy screening testsThere are a number of foetal screening tests that are offered as part of your antenatal care. this article covers:the anomaly scanscreening for spina bifidascreening for sickle cell and thalasaemiascreening for Downs syndromeamniocentesis and chorionic villus samplingcystic fibrosis.non-invasive prenatal diagnosisBefore you make any decisions, it is important that you (and your partner) think about the implications of going ahead with any pregnancy screening tests.

https://www.nct.org.uk/pregnancy/foetal-screening-pregnancy

Termination of pregnancy

• Section 58 - offence of using drugs or instruments to procure abortion, replaced section 6 of the Offences against the Person Act 1837, and provides:

• 58. Every woman, being with child, who, with intent to procure her own miscarriage, shall unlawfully administer to herself any poison or other noxious thing, or shall unlawfully use any instrument or other means whatsoever with the like intent, and whosoever, with intent to procure the miscarriage of any woman whether she be or be not with child, shall unlawfully administer to her or cause to be taken by her any poison or other noxious thing, or unlawfully use any instrument or other means whatsoever with the like intent, shall be guilty of felony, and being convicted thereof shall be liable . . . to be kept in penal servitude for life .

Later Legislation

• Infant Life Preservation Act 1929 (28 weeks)

• Abortion Act 1967 (28 weeks)• Human Fertilsation and Embryology Act

1990 (24 weeks)

Key Issues

• ‘Social’ abortions• Selective reduction• Late abortions

Selective Treatment of Severely Handicapped Neonates

Charlotte – The FactsBorn 3 months premature, weighing 1 lb and measuring only 5 inches in lengthSeriously damaged heart and lungs – brain not growingConstant oxygen and tube fedResuscitated 3 timesBlind, deaf and unresponsiveFeels pain

Charlotte is resilient – she has bounced back 3 timesWe must keep fighting all the time there is some hopeGood chance of survivalCharlotte’s a fighter – her future is in God’s handsLife must be preserved at all costs

Parents’ Views

It would be cruel to resuscitate Charlotte again – she can only face a future of further pain and sufferingIt is not in her best interests to perform further aggressive treatmentShe will never leave hospitalTreatment would be futileIf she arrests, all reasonable attempts will be made to keep her alive until her parents are able to be with herAll attempts should be made to manage her current condition aiming to reduce pain and keep her as comfortable as possible

Doctors’ Views

Key Ethical Issues

Right to life

Letting die vs killing

Duties

Pleasures and pains

Slippery slopes

Selective Treatment of Severely Handicapped Neonates

1. It is morally permissible to let severely handicapped neonates die

2. Intentionally letting babies die is morally equivalent to killing them

3. It is morally permissible to kill severely handicapped neonates

Selective Treatment of Severely Handicapped Neonates

1. It is morally permissible to let severely handicapped neonates die

2. Intentionally letting babies die is morally equivalent to killing them

3. Killing is wrong

4. Intentionally letting babies die is wrong

Acts and omissions

Sanctity of life

Ordinary and extraordinary means

Problematic Arguments

The conjoined twins example