Ethical pregnancy

[rcdavis]

Another posting got me to thinking in the abstract:

 

If a couple knew, with certainty, that a pregnancy would result in a genetic defect so severe that the child would be dependent on machinery, intensive medical care, unable to care for itself, throughout its life, would becoming pregnant be an ethical thing to do?

 

If not, what degree of certainty of disasterous outcome is required for becoming pregnant to become unethical? 90%? 75% 50%? 25%?

 

Remember, I am talking PREconception.. Not the abortion or not discussion.. But a set of circumstances where in, say, both parents have dominant genetic markers for devastating disease...

 

What considerations go into the mix?

 

Does it matter at all if they have insurance? ( eg would not be counting on society to pay for the child's health care) does it matter if they have had previous children, all affected, and they have placed those children into nursing homes?

 

Do prospective parents have any obligation to consider quality of life, if they are in a position to determine that quality of life before creating it?

 

Is there any point at which the state should prohibit a particular couple from procreating?

 

I honestly do not know the answers.. I have evolved and consider all life precious, and consider life to start at conception, so, for me, the option of well let's get pregnant and see what the amino says" would not app,y... Again, the parental knowledge of their baby's malady is a priori... Known before conception..

 

And they face the "should we or shouldn't we" question...

 

If they chose to become pregnant, have tey made an ethical decision?

[flyingsquirrel]

I don't have any answers for you, but another side of the picture...

 

Imagine a family from an ethnic minority that highly values marying within the culure and having children. There is an autosomal recessive genetic disease that affects this ethnic minority and is especially prevalent in this family in particular. While it is not the kind of defect you described above (dependent on technology to survive), this disease is uniformly fatal somewhere between infancy and the third decade of life. Symptoms are severe, painful, and greatly impact quality of life although not intelligence.

 

Before genetic testing for carriers was available, the children from this family faced a dillema; marry within the culture and risk having children who are affected by this disease or marry outside the culture and face all of the personal, social and cultural risks associated with that choice (and still have children who could be carriers themselves).

 

This second generation lives in an era where genetic testing is available, although being tested poses its own risk. If one is found to be a carrier (and wants to marry within the culture) they must then ask their fiancee/spouse to be tested. If they are both carriers they face the dillema posed in the first post. Do they break up? Would a more appropriate time for this testing be on the first date? The second date?

[rev ronin]

I'd question whether "insurance or not?" is actually a valid question. SOMEONE is going to end up paying, and even if it's not society as a whole (= the government, hospital write-offs, etc) then the insurance subscribers will split the bill that they would otherwise and avoidably have not had to.

 

I think the parents' ethical obligations are not properly the domain of the medical provider. It's really up to us to provide them with the best odds and consequences we know, and them to decide the ethicality of conception.

 

Nor do I think it's the state's job to prohibit pregnancy. Once we get into monkeying with genetic randomness, we cause all sorts of problems--consider that the third order effects of sex-selective abortions in India and China may be nuclear war (That's a LONG stretch, but in gross summary: marriageable women stabilize society while their absence destabilizes it. An excess of unmarried males in a particular society can lead to societal unrest and potentially armed conflict as a way to give the extra males something to do. And, of course, both India and China are nuclear powers)

 

Ultimately, in any sort of system where we allow freedom of conscience, the decision (or even not-so-much-a-conscious-decision) to procreate is one of the fundamental freedoms that cannot be safely taken away without doing far more in collateral damage. Is our right to conceive something granted us by the state? Care to think through the consequences of who might have been denied the right to conceive under recent-past regimes?

[jdtpac]

Is the question you are asking truly an ethical question or a question of morals, as an abortion or contraception? My son is facing an issue as in your example. He has a girlfriend that he has been dating for 3 years and they are now quite serious about one another to the point where have begun to cohabitate. The girlfriend's family has a history of Huntington's chorea and the father (age 55) was diagnosed as a carrier of the gene prior to conceiving his daughter. He is now experiencing all the of devastating symptoms of this disease. If you were born with the gene you have a greater than 50% chance of developing symptoms in around the third decade of your life. You also have a 50% chance of passing the gene to your offspring. My son’s girlfriend refuses to be tested for the gene because she does not want to know if there is a possibility she will end up one day like her father.

 

In light of this scenario, the father knowing he was positive for the gene was he "ethically or morally" irresponsible for possibly passing this gene onto his offspring, and if so, does the daughter have a "moral or ethical" obligation to herself to be tested for the gene to potentially prevent her from bringing other carriers of the gene into the world? what "ethical or moral" obligation does my wife and I have to our son to counsel him so that he should either encourage his girlfriend to be tested, terminate the relationship or if the relationship continues asked them what their intentions are about having children? Huntington's chorea and other similar genetic disorders could possibly be eradicated if only those individuals who knew they were carriers of a particular gene felt a moral obligation to not conceive. I do not believe we are a society that would pass legislation that would forcibly prohibit these individuals from procreating.

 

Interesting question, thank you for bringing it to the form.