Laura J. Bruce

PHIL 132, Section 001

Andr Rosenbaum de Avillez

Due 12.16.13

The Harm in Cohens Arguments

Advancements in medical knowledge and technology have granted society the

astonishing ability to manipulate our own reproduction. With the increased utilization of

assistive reproductive technologies such as in-vitro fertilization (IVF) in combatting infertility, a

myriad of ethical questions arise (Vaughn, 392). It is important to assess the risks of such

practices on the developing child and the parents. In Cynthia Cohens essay, Give Me Children

or I Shall Die! New Reproductive Technologies and Harm to Children, she evaluates how such

implications provide a basis for judging the morality of these procedures. Specifically, she

highlights the Harm to Children Argument, finding new reproductive technologies (NRTs) to

be immoral because these processes can potentially harm the children that they help to conceive

(Cohen, 427). However, Cohen does not provide ample evidence to deem NRTs morally

impermissible, as her reasoning fails to override the major objections to her claims. Specifically,

she does not provide an adequate counterargument to the Interest in Existing Argument and

she does not sufficiently challenge the notion of reproductive freedom.

In her essay, Cohen stresses that if reproductive technologies are found to bring about

substantial harm to the conceived children, these technologies are morally impermissible

(427). She deems this viewpoint as the Harm to Children Argument, and points to research

evidence indicating that it is at least possible that NRTs can cause an increased risk of serious

disorders in children (429). Notably, Cohen herself states that the evidenceis conflicting,

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and that it is unclear as to how harm may be identified as substantial enough to warrant the

prohibition of NRTs (428, 433). Even so, the Harm to Children Argument forms the basis of

Cohens claims.

Cohen also addresses the main objection to the Harm to Children Argument, which is

known as the Interest in Existing Argument. In short, this view asserts that even if procedures

like IVF do result in serious harm to children, it is not immoral to employ them because they

have created a life, and typically, living with deficit is better than not living at all (429). Cohen

accurately points out that the Interest in Existing Argument relies on the assumption that there

are entities waiting in a spectral world of nonexistence where their situation is less desirable

than it would be were they released into this world (430). This makes sense, as the Interest in

Existing Argument is based on the notion that not allowing such children to be born will harm

them by negating their interest in existing (429).

Cohens counterargument makes an effort to separate the Harm to Children Argument

from this assumption, stating that there is no existence prior to conception, and that her

viewpoint does not assume there to be entities of nonexistence waiting to be born (430, 433).

She also maintains that pre-conceptive nonexistence is a neutral state that can be favorable to a

life of serious deficit, and so children ought not to be conceived via NRTs if these procedures are

identified as resulting in any definitive harm (433). This directly contrasts the Interest in

Existing Argument idea that life is generally better than nonexistence (428).

Yet, issues arise with Cohens aforementioned counterargument. It seems that the Harm

to Children Argument is invalid without also assuming the presence of some entities before

conception. In order for reproductive technologies to be banned on this accord, there would

need to be pre-conceptive entities to protect from the deficits brought about by the technologies.

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Thus, though Cohen claims that the Harm to Children Argument merely refers to children in

the subjunctive sense (non-existing before conception, but capable of being harmed if brought

into existence), it seems impossible for her to do so. In other words, it would not make sense to

ban NRTs in order to benefit a non-existing entity. In response to this, Cohen claims that even if

these children do not exist before conception, we can theorize about how their existence would

be if they were conceived, including harm that they might suffer (433). With this, she

emphasizes that when children are conceived via NRTs and subject to a disorder or disability,

they are simultaneously brought into existence and harmed because they have transitioned from a

neutral state to a state of deficit (432).

However, Cohens follow-up counterargument here is damaged by her discussion of the

interests of children who have not yet been conceived. She states that children who do not yet

exist can have interests, and that we can affect them causally for better or worse by our present

action (433). Yet the Interest in Existing Argument that she is trying to disprove is founded

upon the interest of pre-conceptive children in being born, so Cohens logic becomes

problematic. If children who have not been conceived have an interest in being born, their pre-

conceptive state does not seem to be more favorable than a life produced by NRTs, even with

deficit, because existing at all fulfills their interests and overrides any resulting harm that they

might encounter (430). Thus, the children cannot be simultaneously conceived and harmed as

she suggests. Overall, this spectral world of nonexistence debate is a very fragile concept for

Cohen to be relying on as she refutes her opponents. Cohen fails to provide a strong

counterargument to the Interest in Existing Argument, thereby weakening her claims.

Moreover, the Harm to Children Argument from Cohens essay is further undermined

when we consider individual autonomy in decisions regarding NRTs. Cohen states that, at this

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preconception time, the morally right decision is not to use such technologies until further

research establishes the degree of harm this might do to children who result (431). This is

based on the Harm to Children Argument and takes the futures of potential children into

consideration. However, respecting the reproductive freedom of the potential parents to

procreate with these technologies, even while the amount of risk is uncertain, is one of the

strongest objections to limiting procedures such as IVF, and it is one that Cohen largely neglects

(Vaughn, 396).

In contrast, Peter Singers essay, IVF: The Simple Case, expands upon the importance of

reproductive freedom. He points out that [i]f fertile couples are free to have large

familiesinfertile couples must also be free to do what they can to have their own families,

even if there is a higher risk of disease or disorder for these children (Singer, 413). In other

words, infertile couples cannot be rightfully limited from using IVF to try and conceive without

also limiting fertile couples, and thus we cannot prohibit IVF because it infringes upon

reproductive equality. This makes sense when considering that pregnancies in fertile parents

who may carry alleles for certain genetic disorders are typically not limited. Since the potential

children in these situations may face a similarly high risk for deficits as children conceived with

NRTs, it seems immoral to limit infertile couples.

Another important aspect of individual autonomy in medicine is the notion of voluntary

and informed consent. There is an inherent risk associated with all medical treatments, and this

risk must be accepted by patients prior to the start of a procedure or treatment plan. Connecting

this concept to IVF, Singer notes that we must not single out IVF for a harsher treatment than

we give to other medical techniques (413). Thus, even if IVF is found to pose more of a risk to

the child than an unassisted pregnancy, or even if the exact amount of risk is unknown, this can

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be accepted by the parents as a part of their consent, just as it would be for any other medical

procedure.

Likely, in response to the points made by Singer, Cohen would point to the fact that

couples interested in NRTs might be so desperate to conceive that they do not adequately

consider the risks of the procedure. Importantly, she would likely also find the superseding

notion of reproductive freedom to be disregard[ing] the welfare of children, whose rights are

equally as important (Cohen, 436). Though the individual autonomy of the parents is significant,

Cohen would maintain that in cases where others (the children) may be substantially harmed,

[t]here are ethical limitsto what may be done to obtain long-sought offspring (427).

Unmistakably, the balance between the reproductive rights of the parents and the responsibility

to avoid harm to children is one that is highly contested, especially when knowledge about the

exact risk that NRTs pose is limited. Yet, it still seems that Cohens arguments are lacking in her

stark disregard for the reproductive freedom of the parents.

In conclusion, Cohen does not adequately demonstrate that NRTs are morally

impermissible on the basis of the Harm to Children Argument. Though she tackles

complicated ideas such as the notion of pre-conceptive nonexistence, she fails to strongly support

her claim because of the potent objections related to the Interest in Existing Argument and

reproductive freedom. Evidently, the ethical questions surrounding the permissibility of NRTs

are highly debatable and are likely to persist even after more concrete evidence regarding risk is

established.

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Works Cited

Cohen, Cynthia. "Give Me Children or I Shall Die! New Reproductive Technologies and Harm

to Children. Bioethics: Principles, Issues, and Cases. Ed. Lewis Vaughn. New York:

Oxford University Press, 2013. 417-438.

Singer, Peter. "IVF: The Simple Case. Bioethics: Principles, Issues, and Cases. Ed. Lewis

Vaughn. New York: Oxford University Press, 2013. 410-414.

Vaughn, Lewis. "Chapter 8: Reproductive Technology. Bioethics: Principles, Issues, and

Cases. Ed. Lewis Vaughn. New York: Oxford University Press, 2013. 392-306.