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.