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Monday, February 21, 2011

Of the Making of Kids there Is No End

Word came to me, a few months ago, of a friend of a friend in academe. The referenced individual was a lesbian university professor whose career would soon be interrupted by pregnancy.
Pregnancy? How does a lesbian interrupt her career to get pregnant?  This is a question only the innocent ask; the reply among the informed would be: artificial insemination, or some other arrangement with a human source of semen.  
This is not particularly astonishing in our era, but this case went further than similar ones, others I’d heard of, in testing standards of ethics.
It began fairly routinely. Professor X, as we’ll call her, decided she wanted to become a mom. She decided to end her non-mother status. Knowing the State would pay her one year’s pregnancy leave (and she’d suffer no consequences at work), she made the logical choice, given current technical means: she got herself inseminated. So far, this is fairly linear. But at this point, the story gets muddied.
Professor X had a spouse, a lady we’ll call Professor X-primed (nature chooses not to speak of X and Y among women, so these nicknames seem sensible). About two months after hearing that her spouse, Prof X, would be doing the insemination, Prof X-primed thought about her own status. She was about to become the “dad” in the marriage, so to speak, the non-mother, but without any genetic connection to the baby. She would see her partner pregnant, see her enjoy the fulfilment of birth. This made her an adjunct or spectator, or non-enjoyer, and perhaps that was not good enough.
According to the story, the lady realized that she was grievously deprived: I too want to be a mommy! So, with Prof X’s blessing, she too went out and got herself inseminated, so that, by golly, they could both be pregnant together.

Margaret Somerville is a university ethicist who writes in the mass media and often generates heated response. She has a record of posing difficult, even delicate questions of policy with regard to the way we lead our lives, and with particular emphasis on families.
             Professor Somerville might acknowledge the feelings of the two engineered lesbian moms feelings of being left out of Nature's Total Package and wishing, then, to circumvent nature. But that would not be Somerville’s first concern.
What might concern Somerville would be to know the fate of the progeny of this marriage. Inevitably, in the above story, we have two children engineered into existence, at approximately identical dates, in a marriage of two females, with no male content (except the body fluids). They will be the ultimate designer babies: non-biological twins who are nevertheless non-twins, programmed by a laboratory to help their mommies get through sad times, those patches of envy and bad feelings. Then, they would be sprung into two childhoods – ones that had to contextualize themselves as all childhoods do, within a matrix of other developing humans, where some identities are easily borne, while others totter to be affirmed, and groan to be owned. So what are the kids going to feel about themselves and these two engineered mommies?
                In an interesting article in the Globe and Mail, Somerville tackles another case of surrogacy, that of a 61-year-old grandmother who offered to become the surrogate mother for her daughter’s child. In other words, she was carrying her daughter’s embryo from her son-in-law’s sperm. Somerville first offers that, “[f]or the sake of exploring the issues, let’s assume some surrogacy will continue to be allowed,” but then she poses the question:  “What restrictions are ethically required?”
Somerville has real reservations about the 61-year-old granny-slash-mommy. She writes:
Grandmother Casey is compellingly described as “altruistic” and “giving the ultimate gift” to her daughter and her son-in-law….But let’s change the situation slightly and see if we make the same assessment of ethical acceptability.
   A young infertile man and his wife want to have a baby that is as closely genetically related to them and their family as possible, including because in their culture blood relationship is considered very important.
   The man’s father wants to donate sperm to artificially inseminate his daughter-in-law. The child will be the half-brother of his social father, and the biological child of his social grandfather. Is this ethically acceptable?
   If not, but the surrogate grandmother is seen as ethically acceptable, is it because she was not the biological mother? Would it be acceptable to inseminate a still fertile woman with the sperm of her infertile daughter’s husband? And what about a woman donating ova to her daughter, which results in a child of the daughter’s husband and his mother-in-law?

Who Needs the Surrogate Anyway?
We are, of course, living in an age that loves birth surrogacy and special arrangements that skirt nature’s limits.  Some of those techniques can be argued as ethical – conforming to the ethical standard, that they do no significant harm. For example, arrangements for informed, carefully managed “right to die” laws can enable doctors to perform assisted suicide, and the troubling ethics of that act can be discussed rationally.
             But much of the current view on making babies – and caring for children – is crude and disdainful of nature, or, for that matter, common sense; much of it is based on politics, fashion, and power. Of course, an embryo has no power – neither does a new-born child – so the ambitions of adults – couples, but also people pushing social agendas – often win the day.
             Somerville is a principled opponent of ALL forms of surrogacy, and, for that, she bucks the PC crowd (and at a university, wow!).  On that main matter of surrogacy, I agree with her: we should discourage it, perhaps ban it outright. We are a species that can survive without it – we’re not faced with extinction. We’ve managed to have infertile couples around us for lo! these 5 million years of evolution. Very few infertile couples were driven to madness or destruction or found they were being treated as pariahs. Only kings cared whether the wife hatched what she was supposed to hatch in babies.
                Ordinary people do things like adopt orphans. Others find ways to be around relatives’ children, and to support them, such that they can share the joys of child-rearing without being themselves biological parents. Why just today, on CNN, I heard the man touted as “the world’s greatest chef” broach the subject. He and his wife had decided never to have their own children because they had other, more demanding outlets. But here was his point: we are as creative as we would ever wish to be, without kids.
             Is there any sort of litmus test for these controversies? Is it all a matter of culture and what era we're in, and who gets to decide what? Not really. We have a long tradition of protecting children, ONLY children, and safeguarding their interests exclusively.
             Or, as Somerville says,

I believe that we must start from a basic presumption that the child’s rights to be born into a natural family structure in which the family relationships have not been intentionally confused, must be given priority. If surrogacy, in general, or any particular instance of surrogacy is not in a child’s “best interests” in such regards, it is unethical. The same “child’s- best-interests principle” should apply to all uses of reproductive technologies.

Now, what’s so complicated about that. Somerville does not touch upon lesbian surrogacy, concentrating in the article, on generational, heterosexual confusion that smacks of incest or other familial taboos. However, Somerville might agree to caution in the matter of lesbian parenting, all forms of it. We have reason to worry: for the lack of natural models at home; for the formation of sexual identities; and even for the threat of partner abuse that is so common among lesbians.
             And, in the extreme example above, of Profs X and X-primed, we are so very troubled by its bad odors – of crass indulgence and glib immaturity – that we would wish the State to step in. Time to ban behavior that puts two children manifestly at harm.
added reading: 
  • Dr. Somerville explores what makes a human human, and interrogates "The World's Most Dangerous Idea, that human=animal=robot."
  • Dr. Somerville reviews a new book on marriage and children's rights.


  1. It seems you think that since the human race has survived with infertile couples that it is an argument against treatment or surrogacy. That isn’t the point. Humanity has survived up until very recently without organ transplants and a vast array of modern medicine that prolongs life and improves the quality of life for many, if not most of us, over the course of our lifetimes. We don’t deny individuals medical treatment, even very “unnatural” treatments such as transplanting an organ based on evolutionary arguments that the human race will survive without them living a better quality of life, or surviving.

    I have no idea what coherent thought you are trying to express with the comment that few infertile couples were “driven to madness”. Sounds like you are suggesting that infertility isn’t a “big deal” in your way of thinking, so since it apparently won’t drive people mad, they should just accept their fate, and society should disallow treatment that is “unnatural” and by your view unnecessary since it doesn’t drive people to madness? Please correct me where I have gotten it wrong…

  2. pt.2 of my comment:

    Then you suggest that “ordinary people” do things like adopting orphans, as if deviating from that particular potential course of action suggest abnormal behavior. I am not sure how you came to that conclusion beyond your opinion of what is an “ordinary” person, and some guessed statistic on what those in that position typically have done and do (of course the changing medical options need to be factored in as well…but I am not sure how you worked that into your assumptions either). Adoption isn’t a problem equals solution equation for infertility. Infertility is a disease. Adoption is a way for children who are unable to continue being cared for by their biological families to be placed in suitable homes (regardless of the adoptive parents fertility status – since not all adoptive families have medical fertility challenges). Adoption is a choice some families faced with infertility make (while many others do not make that choice, instead undergoing medical treatment and/or choosing to live childless).

    Adoption was more common as a choice for some dealing with infertility before more advanced medical treatment because that was one of the only options for those who still desired to rear children despite their inability to conceive. Adopted children are not replacements for biological children (but that has nothing to do with the amount of love parents feel for their children). Adoption today is more difficult that in the past due to changing cultural beliefs and norms (more single young women choose to parent and there is no longer a stigma to do so, closed adoption is becoming less common and open adoption is changing the way adoption fits into our society, and a further shift in beliefs is happening with a ripple of anti-adoption views emerging). I would say there is no such thing as what “ordinary people” choose (or should choose) when faced with fertility challenges.

  3. part 3 of my comment:

    While I have come across this sentiment by many who generally don’t seem to have actual experience with being infertile and rather make leaps in assumption as to what they imagine would be fulfilling and a substitute for having children, being around relatives children is not in any way the same as “child-rearing” and does not generally provide the “joys of child rearing” without being a biological parent oneself. That is about as insightful and accurate as suggesting that watching romantic movies about courtship and marriage for a single person can provide them with the opportunity to share the joys of being in love and experiencing marriage without being in love and married themselves. While it can be incredibly rewarding to be an aunt, or a big brother, it does not provide a substitute for being an actual parent. And as to your thoughts on being creative without kids, huh? Do most people desire and choose to have children as creative outlets for themselves? That some people choose to not have children doesn’t make any argument that suggests if you want children and can’t due to infertility that you should be or can be just as happy as someone who has a choice and has made a choice to not have children.

  4. Faith,
    thanks for your longish post, above.
    The gist of my argument would be the following:
    a) Artificial insemination is a technical procedure (like the procedure that pre-dates and predicts it, farm-animal insemination; it is more appropriate to call it by its technical name, Assisted Reproductive Technology (ART).
    b) The debate in my blog-post is about ethics, not technology. Ethics is about how we USE technology.
    c) In medicine, when technology drives ethics, we potentially have something out of whack. This is true of many forms of medicine, e.g., pharmaceutics and cosmetic surgery.
    d) ART is not evil in and of itself-- even though it is largely superfluous to human needs; but it must be used ethically.
    e) Technologically-driven medicine is often consumer-driven. This is entirely true of ART. But it's not the consumer who should be driving the creation of children-- that's what we mean by making "designer babies."
    f) The starting point in ethics is "what do my actions mean to the lives of others?"
    g) On that score, ART is entirely unethical; no baby ever HAD to be created; no baby ASKED to be born to either a single-mom-on-welfare or a lesbian or gay couple.
    h) Even though I'm in favor of banning ART, I will admit that it's not by definition unethical to perform it; in the circumstances of a loving, longstanding heterosexual couple, ART is not completely unethical, just unnecessary.
    i) So-called infertility in couples is not a human tragedy (although declining sperm counts in males may be!). When we think of a couple's infertility as tragic, we're prone to melodrama (or we could also be Italian mamas). In other words, it's cultural.

  5. Are you actually trying to suggest that my use of the term medical treatment is inaccurate? Seriously? Interesting, but I guess not surprising.

    But the “ART” term generally does NOT include the “technical procedure” of “artificial insemination”, if we are talking about using terms “correctly”.* Further to that, while ART is an acronym for specific reproductive medical techniques that does not mean it is the only “correct” term to be used “technically” or otherwise. In fact, the Canadian legislation encompasses AI and ART as Assisted Human Reproduction (AHR) which is a more accurate term for the whole area of reproductive medicine (reproductive medicine is also “technically” correct and very appropriate to use by the way).

    And yes, the treatment is medical “technology”, as are many other medical treatments in other areas of medicine and it is correct to call those and ART/AHR medicine. Those medical professionals, doctors and nurses and other specialists who have undergone medial training and have medical licenses also refer to the treatment of their patients as “practicing medicine”, and they also call it “reproductive medicine” that they practice.

    I find it rather interesting that you bring the issue of “farm-animal insemination” into the conversation, seemingly to suggest a rather negative connotation to treatment in some way I suspect (consciously or subconsciously I don’t know). I am sure you are well aware that a great many medical treatments (“technical procedures”) were also first used or perfected and practiced on animals before becoming mainstream treatment in humans, so I am not sure what your felt was important about that in connection with AHR to point it out specifically except to denigrate it.

    *“Although various definitions have been used for ART, the definition used by CDC is: ART includes all fertility treatments in which both eggs and sperm are handled. In general, ART procedures involve surgically removing eggs from a woman’s ovaries, combining them with sperm in the laboratory, and returning them to the woman’s body or donating them to another woman. They do NOT include treatments in which only sperm are handled (i.e., intrauterine—or artificial—insemination) or procedures in which a woman takes medicine only to stimulate egg production without the intention of having eggs retrieved.” (CDC website)

  6. So-called infertility? What exactly are you meaning by “so-called”?

    Who said it WAS a –quote- “human tragedy”? But then, what constitutes a “human tragedy” (and by whose definition?) As to the issue of “tragic”, that is rather subjective now isn't it? Many people might call any disease “tragic” or maybe not, but that doesn’t change the issue that a disease is a disease, and I think most humans will agree that that is not a “good” thing in ANY instance generally speaking. Your suggesting that seeing a disease that causes any sort of pain and suffering as tragic constitutes “melodrama” is again rather subjective and useless as an argument.

    Oh, and your notion that AHR overall equates to making “designer babies” also lacks sound argument given the reality of the nature of the vast majority of treatment undergone by infertility patients using those treatments (which has nothing to do with "designer" anything).

  7. Faith, all you're reacting to is vocabulary; also, the gist of your reaction is to demand we use euphemisms -- your approved euphemisms-- not the unvarnished words. You make many quibbles over acronyms, but you only hide from debate. Logically, then, you're papering over the issue for politcal reasons. Paper on, but I'm using words as they are generally understood; and therefore am not persuaded by your own verbal diktats.
    Other than that, society adopts laws and positions for many reasons; one of them is our emotional response to the problems of life. That's where the debate occurs over the definition of "tragedy," as I say in my post. You believe, for example, that depriving a couple, lesbian or otherwise, of their "right" to do surrogate baby-making, or curtailing the right to implant embryos in non-reproductive couples, is "tragic." I think your lens is pointed in precisely the wrong direction. Tragic in most cases is to allow some people to manufacture a human for their own selfish reasons. The tragedy, as Dr. Somerville says, is not the feelings of would-be parents, it's the exposure of children to emotional risk and potential,life-long crises of identity. At heart, you really are indifferent to that.
    I believe the expression we should use, for such advocacy as yours, is "get over it," and get on with your productive lives.

  8. Oh by the way, embryos are NOT “implanted” in ART cycles, despite the oft made error in the use of the term by the media and the public. Embryos are transferred to the uterus in the hopes that the biological process of implantation will occur. While that might seem like a trivial point to you, I can assure you it is a vitally significant distinction technically, and to the clear understanding of the process.

    Using medical assistance to conceive a child is not “manufacturing” a human anymore than making love in your bedroom is “manufacturing” a child (in both contexts the word is “technically”
    correct actually, but I suspect you wouldn’t accept it being used in the context of the bedroom as that doesn’t suit your attempt to denigrate AHR by using derogatory language).

    Your unoriginal use of the “selfish” refrain for anyone who uses AHR is predictable rhetoric that simply DOESN'T stand up to any reasonable scrutiny. Unless of course if you really mean everyone who chooses to have children can be deemed selfish on some level, and then we can agree. Yes, EVERYONE has children for their own personal “selfish” choices and reasons (even if it is to supposedly fulfill a commandment or to meet a religious belief, or even if they assert with conviction they want children for co-called completely “selfless” reasons).

  9. Hate to point it out, but with the Somerville-esque circular ethical "arguments" that have little substance you might as well have said this to yourself:
    "I believe the expression we should use, for such advocacy as yours, is "get over it," and get on with your productive lives."

  10. Faith, your own rhetoric tells much of the story... a story of how you fail to see the point of this debate but are eager to make false distinctions.
    When you suggest that "EVERYONE has children for their own personal 'selfish' choices and reasons," you merely profess the glbness of contemporary ethics, if the term 'ethics' can ever be applied to your worldview; and the hollowness of your philosophy, which is crass instrumentalism for personal gain, and outright consumerism. In not a SINGLE one of your many replies have you addressed the rights of the future children, progeny of the baby lab, nor the risks that can flow from being born to such environments. This is telling, yet as Dr. Somerville often says, this is the crux.
    Of course, there is a whole industry of psychological counsellors, ready to do business (at State expense), primed to bump up the mood of the non-fertile, or non-heterosexual, but wannabee natural mothers. Why are we to be impressed by that? Why would their clients' feelings come into the ethical debate in the first place; why would this counselling industry override the needs of the children?
    Also telling is that you can't be bothered to address ethics beyond calling my concerns an "ethical soup." As for your terminological distinctions, they are a smokescreen, pure diversion from the issues at hand; and they are indeed a set of euphemisms; your demands that I conform to them is an attempt, not to clarify, but to ensnare the discussion in your own politico-linguistic cell -- your brand of "soup." Not very convincing -- because I'm not a part of your profession or clientele (or, I suppose, sexual identity group).
    Now, let`s allow some others into the discussion -- this particular thread will not be extended.