J Med Ethics 36:217-221 doi:10.1136/jme.2009.034645
  • Ethics

Deciding against disability: does the use of reproductive genetic technologies express disvalue for people with disabilities?

  1. Janet Malek
  1. Correspondence to Dr Janet Malek, Department of Medical Humanities, Brody School of Medicine, East Carolina University, 2S-17 Brody Medical Sciences Building, Greenville, NC 27701, USA; malekj{at}
  • Received 20 November 2009
  • Revised 14 December 2009
  • Accepted 16 December 2009


This paper focuses on one objection to the use of reproductive genetic technologies (RGTs): the argument known as the expressivist objection. According to this argument, the choice to use reproductive genetic technologies to prevent the birth of individuals with disabilities is an expression of disvalue for existing people with disability. Many have been persuaded by this impassioned perspective. This paper shows that this argument is misguided and so does not constitute a sound objection to the use of RGTs to prevent disability in future children. It first identifies some responses to the objection that may be sound but not completely convincing to proponents of the expressivist position. It then describes a thought experiment designed to demonstrate more clearly that choosing to use RGTs to prevent disability in future children does not convey a negative message about people who have disabilities. After describing a decision that clearly does not send such a message, the paper walks through a series of cases and shows how, despite differences that might seem to be morally relevant, each is morally equivalent to the previous one with respect to the extent that it expresses disvalue for such individuals.


  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.