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J Med Ethics 2007;33:717-720 doi:10.1136/jme.2006.017459
  • Law, ethics and medicine

Ethical reflection on the harm in reproductive decision-making

Abstract

Advances in reproductive technologies continue to present ethical problems concerning their implementation and use. These advances have preoccupied bioethicists in their bid to gauge our moral responsibilities and obligations when making reproductive decisions. The aim of this discussion is to highlight the importance of a sensibility to differences in moral perspective as part of our ethical inquiry in these matters. Its focal point is the work of John Harrisi, who has consistently addressed the ethical issues raised by advancing reproductive technologies. The discussion is aimed at a central tenet of Harris’s position on reproductive decision-making—namely, that in some instances, giving birth to a worthwhile life may cause harm and will therefore be morally wrong. It attempts to spell out some of the implications of Harris’s position that the author takes to involve a misplaced generality. To support this claim, some examples are explored that demonstrate the variety of ways in which concepts (such as harm) may manifest themselves as moral considerations within the context of reproductive decision-making. The purpose is to demonstrate that Harris’s general conception of the moral limits of reproductive autonomy obscures the issues raised by particular cases, which in themselves may reveal important directions for our ethical inquiry.

Footnotes

  • Competing interests: None declared.

  • i In a previous paper, I addressed John Harris’s views on the morality of reproductive decisions (see Murtagh, 2004).1 However, I do have serious misgivings about the argument presented there, and this discussion aims to rectify those misgivings as well as my original portrayal of Harris’s position.

  • ii Part of the backdrop to Harris’s position concerns the ethical and legal issues surrounding actions for wrongful life. However, an in-depth exploration of the question of wrongful life is beyond the scope of this paper. In setting out his own view on the wrongful-life action, Harris distinguishes his position from that of Bonnie Steinbock and Joel Feinberg. See Harris, 1992 (p140–61).4

  • iii Harris’s approach to the question of harm can be found in Harris, 1980.5 See also Harris, 1985.6

  • iv In his discussion of what makes existence valuable, Harris does acknowledge this point. However, his urge to theorise these matters takes precedence. See Harris, 1985 (p16).6

  • v “Nor can it be said that “society could not go on” if people insisted on pressing sectional interests. That is how society does go on.” See Rhees, 1969 (p91–6).13

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