ABSTRACT
From the twentieth century up to the present, questions concerning human reproduction emerged as one of the major battlefields of moral reasoning. Reproductive technologies (RT) are usually considered to embrace the “modern” technologies concerning reproduction emerging since the second half of the twentieth century, particularly assisted reproductive technologies (ART) and genetic tests applied to early forms of human life (pre-implantation and prenatal diagnosis). I will, however, start the discussion of RT as emerging from the context of birth control based on the assumption that, first, the “quantitative” control of reproduction is one important historical context of RT, and second, the ethical claim of reproductive autonomy embraces both birth control and RT. It might now be tempting to divide the global landscape into those parts of the world where couples – or states – try to establish efficient systems of birth control, and other parts of the world where individuals or couples, sometimes funded by their national healthcare systems, are medically assisted in procreating; while in this picture one part of the world is eager to control the quantity of children who are born, the other part is eager to assist couples who wish for a child of their own and at the same time to control the quality of the offspring. The concepts of “developing” and “developed” world could then serve as the dividing line between the quantitative and qualitative approach, and both would be addressed in the claim of reproductive rights. But this division conceals the fact that even if “development” is still a category of international politics,1 it is not constrained to geographical or political borders; rather, birth control and ART exist alongside each other in almost any country, and individuals may find themselves invested in both avoidance and assistance of reproduction over the course of their lives. Evidently, poverty, lack of education, poor healthcare and gender inequality are increased by
lack of access to birth control, and the major changes of adults’ biographies in those milieus where a decent standard of life, education, access to healthcare, and gender equality are available may serve as indications for the higher demand of ART. Technologies play a crucial role in both scenarios: the introduction of chemical contraceptives has or may have a major impact on the reproductive freedom of billions of people, and the introduction of assisted reproductive technologies as well as the development of genetic tests applicable in early stages of human development address infertility and/or inherited diseases. From a technological perspective, the newer developments of reproductive technologies are just one further step of scientific progress, helping couples and, moreover, women either to avoid pregnancies or to establish them at
a time of their life that they themselves may choose. Science and technologies are thereby considered as instrumental to individual and social values, reflecting and increasing the freedom of individuals and at the same time serving the public good.2 For political ethics, access to contraceptives is considered one of the central means of national or global policies to control population growth. Access to birth control can be considered as one field in which social policies aimed at raising especially women’s standard of living, and ecological policies aimed at reducing population growth while securing energy sources that at the same time decrease the effects of climate change, intersect. In the emerging debate on the interrelation of population control and social as well as climate policies, the perspective of the “public good” may easily result in trumping the individual reproductive freedom rights of those women who are most vulnerable to such policies. In bioethics, however, human reproduction has so far predominantly been presented as a ques-
tion of women’s reproductive freedom and autonomy, claiming the right not to be hindered in one’s own choices, whether to avoid or to seek procreation: a right that must be granted by the social and political institutions dealing with human reproduction and family policies. The negative formulation of this right is commonly shared by most ethicists. The positive formulation – the right to medical and/or social assistance in matters of reproduction – is contested; it requires justifying the scope and limit of the right.3 Apart from the normative question of reproductive rights, both birth control and RT must be seen in the context of the personal and social value of human procreation. Questions of (individual and social) values are primarily examined in anthropological and sociological studies, but they also need to be reflected in a hermeneutical ethics.4 Although the globally diverse contexts of social and cultural interpretations certainly shape the empirical discourse of RT, the relation between empirical studies, hermeneutical ethics, and normative ethics is far from clear.5 Studies in cultural anthropology show, for example, that the conceptual understandings of kinship, the family, parenthood or personhood are “embedded” in diverse traditions of interpretation; that these interpretations and traditions need to be addressed in ethical analyses, too, together with their implicit or explicit normative claims, is not contested; what is contested is the status of social values and social norms with respect to moral norms. In the Western context, the two major hermeneutical frameworks which are relevant for an
ethics of reproductive rights and reproductive technologies are, first, parenthood as a “gift of love” and second, parenthood as a “choice of a life-form”.6 Rather than resting with the descriptive analysis of these interpretations that emerge in social practices, hermeneutical ethics examines the ethical implications of the conceptual understandings and relates them to the normative argumentation of ethics; here, the validity of the claims will be scrutinized in view of established normative standards, such as the human rights framework. Looking at concepts of reproduction from the point of view of kinship relationships only
may easily result in indifference towards socio-economic frameworks underlying the understanding of reproduction: for many families who have no financial or other “life” insurance, having children is the only way to ensure they will be looked after in phases of dependence, either through illness or through age. Rather than emphasizing individual freedom rights, reproductive rights concern the socio-economic rights to a “decent” life, sustained by family planning rather than by political-legal institutions. If reproduction is constrained without replacing the social security of families by appropriate state systems, the results are catastrophic for the most vulnerable population: not (only) because an abstract freedom right is violated but (also) because the normative constraints of families are overlooked. Even though bioethics did not address global justice issues for a long time, reproduction is
one of the most important practices in which individual rights, social values and norms, and socio-political frameworks are negotiated. In the following, I will take a closer look at different
practices of reproductive technologies, and end with some thoughts about the future of reproductive rights and global ethics.
