Dr. Donald Demarco presented a brief to the Royal Commission on New Reproductive Technologies in Toronto on November 20, 1990. Because of time restrictions on that occasion, he has been given space in The Interim to expand and clarify his remarks to two of the Commissioners, Maureen McTeer and Grace Jantzen.
Disease and desire
Ms. McTeer stated that one of the chief issues the Commission faces is deciding on the extent to which the state should involve itself in so personal a matter as the decision of a husband and wife to employ reproductive technology for the purpose of helping them have a child.
Two distinctions must be made. The first is between disease and desire. A person has a right receive treatment for such problems in the hope of restoring reproductive wholeness. The State has a responsibility to ensure that these rights are secured, and the medical profession if fulfilling its obligation to respond to these rights.
However, the mere fact that husband and wife do not have a child, though they strongly desire one, does not constitute a disease. In the absence of a disease, doctors have no obligation to intervene. Doctors are trained to treat diseases, not desires. Consequently, the State has no obligation to facilitate the interaction of infertile couples in whom no disease has been established.
Fertility specialists are not responding to a disease but merely to a desire. It often happens that in responding to a person’s desire, doctors inadvertently cause diseases (know as “iatrogenic” disease). Fertility specialists have been known to cause infertility in otherwise healthy patients.
In addition, there can be no right to have a child, since such a claim would reduce the child to an object of someone’s rights. Such a reduction is dehumanizing and tends to establish a possessory relationship between parents and child. Moreover, it also regards the child as a product of technology rather than a gift of conjugal love. Hence, the moral significance of a second distinction, that between product and gift. Because our children are gifts, we want them to be treated accordingly; because they are not products, we do not want them treated in that way.
A person has a positive right to medical treatment where there is a disease. This positive right implies a corresponding duty on the part of the medical profession to treat that disease.
But persons have only negative rights to have a child. Husband and wife have the right to intercourse but there is no corresponding obligation on the part of anyone else to assist them in having a child. The medical profession should practice medicine and not treat people’s desires as if desire itself were a medical problem.
At the same time, people have only negative rights to get married. They may propose marriage, but do not have the positive right to oblige their partners to consent to marriage. A gentleman only proposes.
Dr. Grace Jantzen asked me whether any studies were available that indicate a correlation between having a child through in vitro fertilization (IVF), and having a possessory attitude toward that child. There are not such studies. But we do not need any such studies to know that IVF demands an initial possessory attitude which itself is wrong.
It is certainly possible to start off on the wrong foot, and then correct oneself in mid-course. It is also possible to begin on the right foot and then go astray. A couple may begin with the wrong parental attitudes toward their child and end up with the right attitudes and vice versa. IVF alone cannot predict whether or not one is going to be a good parent over the long haul.
We do not oppose IVF because it guarantees that parents will persist in having a possessory attitude to their offspring. We oppose IVF because it requires at the very outset an attitude toward one’s child that is possessory and therefore wrong.
The situation is analogous to a field of runners who are poised to run the 100-yard dash. At the start, all face the finish line waiting for the gun to go off except one who is positioned to run in the opposite direction. The misguided runner may collect himself, then turn around and actually win the race. The runners who face the right direction from the start may fall, become distracted, or lose heart and actually fail to win. But no coach would ever approve facing the wrong direction from the start. It is wrong in itself.
With IVF, parents are facing the wrong direction from the start. They begin with a possessory relationship toward their children, regarding them as objects of rights, as products of technology.
We do not say that parents of IVF children will inevitably be bad parents; nor do we say that parents who have children through loving intercourse will necessarily be good parents. But we say that we should promote all the right attitudes and discourage all the wrong ones.
IVF is the wrong attitude from the start. Therefore it should be discouraged. But we should also discourage all the other bad attitudes that parents may have toward their children, especially those that are possessory. At the same time, we should encourage all parental attitudes towards children that are benevolent.
Whenever we speak of human relationships we are not speaking about necessity but contingency. There is no ‘science’ of human relationships. Thus we say that government policy should be based on probability. Although it is true that an intoxicated driver may not get into an accident whereas a sober one might, the probability is that the drunk driver is more likely to have an accident. Consequently, there should be a policy to discourage drunk driving.
Likewise, government policy should encourage all those attitudes that are likely to contribute to good parental/child relationships and discourage those that are inimical to them. Reproductive technology is fine for dealing with diseases, but when dealing with desire, it encourages possessory and not benevolent attitudes toward children.
Dr. Donald DeMarco is Associate Professor of Philosophy, University of St. Jerome’s College.