Choosing Children: Genes, Disability, and Design
Andrew Hay's review of "Choosing Children: Genes, Disability, and Design" by Jonathan Glover.
Jonathan Glover, Choosing Children: Genes, Disability, and Design. Oxford: Oxford University Press, 2007. $19.95, paperback. 119 pages with index. ISBN-10: 0199238499
Choosing Children is the transcription of Jonathan Glover’s Uehiro Lectures at the University of Oxford. In his brief publication, Glover considers what limits ought to pertain to the use of genetic and reproductive techniques in choosing what sort of children we have. The dominate view supposes that such methods are permitted to ensure that children are born without disabilities, but not to advance the capacities of healthy children. In other words, enhancement is contraposed to therapy. Whereas therapy aims to repair something that has gone wrong, by curing particular diseases or injuries. Enhancement aims to improve the state of an organism beyond its normal, healthy state. Following a careful examination of both disability and human flourishing, Glover posits that the therapy-enhancement distinction is unjustified and considers the future of genetic modification.
In the first chapter of the book, “Disability and Genetic Choice,” Glover defines what a disability is: a restriction of normal functioning that impairs the potential for human flourishing. He then outlines what flourishing entails, noting that different people flourish in different ways, and the impact that a disability can have. Glover expands neatly on this idea by presenting several first-hand accounts of particular disabilities that exhibit some positive effects on a person’s life. For example, some deaf people value the deaf community so highly that they deliberately aim to have a deaf child. Despite such matters, however, Glover assumes that conditions like deafness and blindness are obstructions to flourishing, and that any desire a disabled person has to embrace his or her disability is due to such factors as societal compensations and a lack of knowledge about what a life void of disability would be like.
Having conceded that what flourishing consists of can vary between people, Glover next argues that deafness and blindness are barriers to flourishing, first, because they impair “safe navigation through the world,” and second, because the sufferer fails to perceive “a whole dimension of enriching experience” (p. 23). It is not clear, however, why benefits unique to deaf or blind people—such as the membership of a certain community—should count as compensations rather than as important components of flourishing. Glover needs to demonstrate why an ability to see or hear is more fundamental to flourishing than other abilities that may be important to the flourishing of some people but not others, such as an ability to play a musical instrument. He needs, essentially, an objective telos.
Glover’s philosophical and bioethical approach begins and ends with the human person, the self. While his foundation is in the flourishing of the individual, Glover lacks the proper end goal of fostering the actualization of the individual’s essential nature, the working out of one’s condition or attainment of a perceived innate telos. If there is no objective telos of human beings, in what could a person’s good consist except in his or her subjective preferences? The Christian ethic, however, departs radically from this focus of the self and its attendant agenda of making human beings “good.” By its very nature, Christian ethics must begin and end in God. The telos of human beings, the potential of humanity to meet its true ends, is to glorify God and enjoy him forever. Moreover, as opposed to Glover’s conception of human flourishing and purpose, the Christian idea of telos suggests that this “true end” of knowing God imparts to life meaningfulness—regardless of physical ability or disability—that would otherwise not have been.
In the second chapter, “Parental Choice and what we Owe to our Children,” Glover resumes by investigating the use of “pre-implantation genetic diagnosis” and “antenatal screening” to choose a child without inherited disability. After rejecting claims that such choices are equivalent to Nazi eugenics, Glover probes whether parental choices in selecting the best children should be restricted. Starting from the notion that the decision to have a child should be undertaken by the prospective parents themselves, he asks whether this autonomy should extend to choices about what kind of children to have.
If there ought to be limits on procreative choices, what sort of moral deliberations would establish these constraints? Glover considers “two dimensions” of ethics: “making the world a better place and what we owe to people” (p. 44). If there are bad choices about what kind of children to have, the badness of many such choices cannot consist in failing to give the child what it is owed. If parents choose an embryo with a deafness gene over a genetically healthy embryo, for instance, the resulting child is not harmed by the choice. If the choice is bad, this must be because it makes the world a worse place than it would have been had the other embryo been chosen. However, this explanation is insufficient. Many of our choices make the world a worse place than it would have been had we chosen differently—such as the choice to spend money on a new car instead of donating it to the needy—but not all such choices are immoral. If choosing to purposefully disable a child is different from making the world a worse place, Glover must explain why.
Glover claims next that we owe our children “a decent chance of a good life” (p. 50). He remains vague about what counts as a good life, noting that it falls somewhere between the “zero line,” below which life would be unbearable, and the “perfectionist” ideal of the best human life; yet he claims that if parents can remove an obstacle to their children’s flourishing without unreasonably burdening themselves, they owe it to their children to do so. As technology advances, this may entail a duty not only to cure disabilities, but also to enhance capacities in healthy children.
Glover then offers several principles to guide procreative choices. Applying a Kantian principle, he argues that the controversial practices of cloning a child so that its stem cells can save its sibling’s life are warranted, provided that the resulting children are not used merely as means, but are also valued in their own right. This outcome, avers Glover, “Depends on how much the parents love and care for the child” (p. 65). However, parents wanting to select what sort of children to have must strike a balance between the aversion of suppressing a child’s freedom in shaping their own future and making choices for them that will improve their chances of flourishing.
In the third chapter, “Human Values and Genetic Design,” Glover explores the measure to which society should restrict procreative choice. Using a variation of John Stuart Mill’s “harm principle” (see Mill, On Liberty, chapter II), restrictions of parental liberty should be considered only to safeguard human flourishing. The “medical boundary” (p. 75)—the idea that therapeutic, interventions are morally acceptable—cannot justify such a restriction: if disability is bad because it impairs flourishing, then non-disease states like shyness are also bad if they prevent our flourishing.
As Glover discusses whether human nature itself is worth preserving—a popular discussion in bioethics today—he arrives at two levelheaded conclusions. First, some qualities that parents choose for their children may not benefit society. He defined these as “positional goods” whose value to those who have them depend on others not having them. For instance, parents may choose for their children certain dispositions that tend to make them more successfully competitive; however, this may result in their having deep emotional coldness. Second, in considering which human qualities to preserve, Glover posits that the relevant question is not “Are they part of human nature?” but “Are they valuable?” He navigates this question by two tentative assumptions: first, human nature, as well as having many features that are good, also includes dispositions that can be destructive when unchecked. The second is the idea of the good life for human beings, which Glover defines as the overlap of happiness and flourishing. So, concludes Glover, human nature is something of a red herring: what is most important to humans is not found in concentrating on current issues or those that are most likely to arise, but on maximizing what is most valuable.
By contrast, the Christian view of human nature and flourishing is understood in the light of being creatures of God, made in the image of God. This means that humanity is to be seen as having originated through a conscious, purposeful act by God. Thus, there is a reason for human existence, a reason that lies in the intention of the Supreme Being. Because humans are God’s creation, they cannot discover their real meaning by regarding themselves, their happiness and flourishing—as Glover believes—as the highest of all values. Nor can they find happiness, fulfillment, or satisfaction by going out in search of it or, in this case, by genetically generating it. Their value has been conferred upon them by a higher source, and they are fulfilled only when serving and loving that higher being. Many of the questions raised by Glover concerning human flourishing and nature are answered by the Christian view of humanity. This view gives the individual a sense of identity, as opposed to a mere genetic project. Moreover, the Christian view accounts for the full range of human phenomena more completely and with less distortion than does any other view, namely Glover’s.
Nevertheless, to finish Choosing Children, Glover states that in “the further future” (p. 99) genetic intervention and technology may offer some astonishing opportunities, such as the ability to radically enhance intellectual abilities. However, any change must take place steadily, guided by our current values. Yet, as our values change, so might the genetic choices we make; thus, we must leave an “open future…for our descendants” (p. 104).
In summary, Choosing Children is a lucid, engaging, and interesting discussion of some important issues in contemporary bioethics. Its limitations stem chiefly from the length of the book. Several points would benefit from more extensive discussion, and a greater consideration of the more radical ambitions for genetic intervention would have taken the book beyond what it is. Nevertheless, while I appreciate the aspirations of Glover’s gene enhancement project, I also see the need for a limit to such practice. It appears that parental choice in genetically engineering what sort of children to have slides into “playing God,” in both the religious and secular sense. On the one hand, parents conducting such choices are essentially replacing God’s design with their own; on the other hand, parents should recognize their limitations as designers of life. Such hubris is partly a matter of being too dismissive of risks. For instance, the technology needed to achieve genetic engineering may be more or less safe than we can suppose. A disaster with this technology may do irreversible damage affecting someone’s whole life. Experimenting with children and making humankind itself our test-patient seems to be a risky enterprise—one not worth taking.
Andrew Hay, M.A.