Markets in deaf embryos

by on September 29, 2006 at 3:14 am in Medicine | Permalink

What do you think of this?  Consumer sovereignty anyone?

Several U.S. fertility clinics admit they’ve helped couples deliberately select defective embryos.  According to a new survey report, "Some prospective parents have sought [preimplantation genetic diagnosis] to select an embryo for the presence of a particular disease or disability, such as deafness, in order that the child would share that characteristic with the parents.  Three percent of IVF-PGD clinics report having provided PGD to couples who seek to use PGD in this manner."  Since 1) the United States has more than 400 fertility clinics, 2) more than two-thirds that answered the survey offer PGD, and 3) some clinics that have done it may not have admitted it, the best guess is that at least eight U.S. clinics have done it.  Old fear: designer babies.  New fear: deformer babies.

Of course Nick Bostrom will push us one step further and ask why the status quo bias?  Aren’t we all "deformed" compared to the Uebermensch of the future?

Justin September 29, 2006 at 8:44 am

Though there are some in the readership for whom this point will be obvious, it might nonethless be useful at the start of this discussion to note that the complaint against selecting for deafness couldn’t be that parents are harming their child. Suppose that they select for deafness and a child is born who grows up to be deaf. She is not harmed; though she is deaf, if her parents hadn’t selected for deafness SHE would not have come into existence. Assuming she has an adequately good life (as most deaf people do), we can say she was benefitted by this choice, since it resulted in her existence. There is much more that could be said about this kind of case, of course, but that’s all I’ve time for now.

josh September 29, 2006 at 9:16 am

Justin,
None of that means we can’t feel disgusted about their choice, which, on the margin, seems to be harming their future child.

Timothy September 29, 2006 at 10:02 am

When given the choice between raising a deaf child and raising a child who doesn’t have one of his or her standard mammalian senses crippled, choosing a deaf child seems egotistical, selfish, and morally questionable. And, yes, there’s a difference between selecting, say, a kid with brown eyes or blonde hair than selecting somebody with 20% of their senses destroyed.

Michael Stack September 29, 2006 at 10:17 am

I think the Slate.com link above is wrong. Try this:

http://www.slate.com/id/2149854

LisaMarie September 29, 2006 at 10:29 am

Question- would everyone feel the same way if they had conceived a child the old-fashioned way who had a high probability of inheriting deafness? Does that suggest that people with genetic defects shouldn’t reproduce?

Joel B September 29, 2006 at 10:45 am

LisaMarie- I don’t have a problem if 2 deaf people with (even) a 100% chance of having a deaf child have deaf children the “old fashioned” way. The biggest difference seems to be if I choose to make my child worse off. If I marry someone who is of my own “intelligence level” and the child is of average intelligence well hey that’s the way it should be. But if I make a choice to not educate my child to ensure that he does not exceed my intelligence (say when he had the opportunity to) that would be extremely problematic.

dj superflat September 29, 2006 at 11:50 am

justin’s argument is completely bogus. e.g., yes, father X beats his children silly, but he doesn’t kill them, so they’re better off. nonsense. we judge based on a standard, the standard is that parents try to optimize the health of their children, claiming that a deaf child has optimal health where hearing was an option is ridiculous (not criticizing deaf people, saying they are less than human, not deserving of rights, or anything along those lines, but being deprived of one of the major senses is not a benefit for the child, regardless of how it makes the parents feel). this is truly, truly offensive if true (bring back foot binding too?).

Cardinal Fang September 29, 2006 at 12:28 pm

How is the child going to feel when she grows up and discovered
her parents chose for her to be deaf? It’s my understanding that
there is an entire deaf culture that believes that being deaf is
not worse than being hearing– and obviously the child’s parents
are members of that culture. So it’s quite likely the child will
grow up being happy that her parents chose as they did… in which
case how can we second-guess her?

Justin September 29, 2006 at 2:52 pm

A few points:

Cardinal Fang writes, “How is the child going to feel when she grows up and discovers
her parents chose for her to be deaf?”

There was no way for her parents to choose HER such that she would not be deaf. If they chose to implant a different embryo, SHE would not have come into existence. As I’ve said before, it may be wrong to select for deafness, but that wrongness does not consist in harming the child.

To DJ Superflat (I am realizing I have such a boring name now): one reason why a child beater’s actions are wrong is that they harm the child. The child would have been better off had the child beater not beaten the child. This does not parallel the act of selecting for a deaf child, since it is not the case that the child would have been better off had the parents not selected for deafness. The child would not have existed, and thus would not have been better off (unless we assume that it is better to never exist than to be deaf, which seems to me an implausible assumption).

The Superflat DJ also writes, “we judge based on a standard, the standard is that parents try to optimize the health of their children.”

Suppose you are right that the standard is to optimize the health of one’s child, understood as saying that procreating parents have a duty to bring about the healthiest child they can. (And let’s leave aside for now the problem of “who” is being created.)
Suppose also that various embryonic genetic treatments become available to change the traits of one’s child in ways that would predictably make the child’s health better (e.g., direct changes like “superhuman” resistance to infection, stronger muscles and heart than normal, slightly thicker skin than normal, as well as indirect improvements such as greater intelligence so as to be more receptive to health news, quicker reflexes so as to better avoid physical danger, more attractive so as to increase one’s chances of finding a mate interested in looking after you, and so on). By failing to subject one’s embryo to such treatments, one would be failing to optimize one’s child’s health. Thus, on your view, failing to subject one’s embryo to such treatments would be immoral. That seems extreme. Even if we are willing to say that such treatments are morally permissible, are we willing to go that extra step further, implied by your view, to say they are morally required?

Finally, let me say that I am surprised no one is out here defending the couple on grounds of reproductive liberty.

Joel B. September 29, 2006 at 3:19 pm

LisaMarie – The moral problem is not in the odds. It is in the changing of the odds to make the child worse off.

dj superflat September 29, 2006 at 4:30 pm

it’s actually just a life boat problem: (1) what criteria should be used to select who survives where there are a number of candidates, any one of whom obviously wants to survive, but limited spaces; and (2) who decides. theoretically, we might be indifferent, because the choice is binary for each candidate (existence/non). but people don’t think of it that way, instead looking to utility — young before old, because they have better prospects even though the young can be hit by trucks, etc. so i guess the argument is that you should select the most viable candidate, the one with the best prospects, etc. someone who is missing one of the five major senses doesn’t strike most of us as the most viable candidate. sorry to ramble on, but it’s an interesting issue.

bhauth September 30, 2006 at 7:27 am

Bad argument Justin. If you say that you are doing the deaf child a benefit by choosing it, since this is a benefit done at an embryonic stage, you would also have to say that you have done far more harm by destroying the other embryos, and that abortion is immoral. And you would still by immoral by utilitarianism if you add one life that is deaf instead of another that isn’t and is better off.

bhauth September 30, 2006 at 4:29 pm

OK, I wasn’t arguing that it “harms the child” – but I would say that it is equivalent. You have a good point in that utilitarianism is inconsistent with some of the popular positions when it comes to embryos. Half of your point is the same point as “Status Quo Bias” made, and the other half is basically bringing up eugenics. Wikipedia covers this pretty well. http://en.wikipedia.org/wiki/Eugenics However, it doesn’t cover some implicit reasons for peoples’ objections. Classic eugenics impinges on a “right to reproduce” and genetic screening comes against jealousy and objections related to perpetuation of class. We hardly hold everyone to the same standard of nutrition, making rich folks feed their kids McDonald’s, which has as much effect, in the short term, as genetic screening. That, however, doesn’t pass on to grandchildren. If it is connection between class and “permanent” improvements that bothers us, we should allow genetic screening but past a certain extent only in cross-class relationships. My view is that these kind of restrictions won’t happen, progress marches on, and though some people will be disgusted, it’s inevitable.

Your response to superflat – about a “minimum standard” – makes no sense. Why should the standard be set at any one level? Do you really believe that it makes sense to say that there is no difference between a wide range of states of being but infinite difference between just above this standard and just below it?

As far as being deaf being bad goes – you can be “deaf” when you can hear by wearing sound canceling headphones, or just ignoring sounds. It doesn’t work the other way around.

Give yourself a break. Stick to counterintuitive conclusions for inescapable logic, not twisted logic.

Roger Sweeny October 1, 2006 at 10:45 am

TW brings up an interesting point. Right now American law says that “reasonable accomodations” must be made for people with recognized “disabilities.” A school district will probably have to send a deaf student to a special school or provide an aide and special equipment.

Should parents who affirmatively choose deafness be required to pay the price for the difficulties their children have?

Slocum October 2, 2006 at 7:43 am

A related (and stronger concern) with respect to deaf infants is that cochlear implants are now so good that deaf children can now grow up almost as if they did not have the disability. However, that is only if they are implanted when very young. If the procedure is done only when the child is old enough to make the choice himself, it is too late.

Is it morally acceptable for parents of deaf infants (however they are conceived) to deny hearing to their children in the early years during which normal hearing and speech are developed?

bhauth October 4, 2006 at 5:29 pm

Well, you could say that there is a value to your marriage that outweighs that.

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