of a multiple pregnancy in West Virginia where the woman refused selective reduction. As a result of taking such a risk, only one child survived and this child was blind, paraplegic, and severely retarded. The physician on the case said that henceforth he would no longer accept women who would not agree to selective reduction. He said he did not get into assisted reproduction to create severely damaged babies, and that, although women have the right to refuse abortion, they would need to find another physician who could accept such terrible outcomes.
Not too many people are interested in long‐term follow‐up, yet the details that emerge are not encouraging.
At their fourth birthday in 2001, the McCaughey septuplets lagged in development and were not all potty trained. Joel suffered seizures; Nathan has spastic diplegia, a form of cerebral palsy requiring botox injections (to paralyze spastic muscles) and orthopedic braces. Alexis has hypotonic quadriplegia, a cerebral palsy that causes muscle weakness. Nathan could not walk at age seven and had two major surgeries to help him do so. Alexis had an indwelling feeding tube for four years. Although the McCaugheys home‐schooled their children, they sent Nathan and Alexis to a school for developmentally challenged children financed by taxpayers.2
The Canadian Dionne quintuplets were born in 1934, and although all seemed healthy at birth, only three lived to 2000 (one died at age 20 of an epileptic seizure). Because their selfish parents exploited their fame, the children did not lead happy lives.
Nadya Suleman, aka the “Octomom,” of California, 32‐years‐old in 2009, had six embryos left over from previous in‐vitro fertilization treatments; she requested another cycle of IVF to implant them all. Two of the six embryos split into twins, resulting in eight embryos. When sonograms in the first trimester revealed at least five fetuses, Suleman refused reduction. At birth, physicians delivered eight babies. Nadya already had children from previous cycles of IVF, two of whom were disabled.
Kate and Jon Gosselin in Pennsylvania created a family of twin girls (born from insemination of Jon’s sperm in 2000) and sextuplets (3 girls and 3 boys). Fertility doctors started the sextuplets by injecting Kate with drugs to stimulate her ovaries (like the McCaughey case) and afterwards, introduced Jon's sperm. Informed of six pregnancies, the Gosselins chose not to reduce, so physicians delivered eight babies by caesarean in 2004.
The 2007 television series Jon & Kate Plus 8 filmed the controlled chaos of this family of ten glamorized having multiple babies. Shortly after birth, a plastic surgeon did free plastic surgery to correct the distortion of Kate’s stomach after gestating six babies.
In 2009, after both Gosselins had extra‐marital affairs, they divorced. Thereafter, Jon seemed to abandon his interest in the children. Both Gosselins and Nadya Suleman seemed immature, self‐absorbed, and not focused on the best interests of their eight children.
New York City's Major Guiliani was recently on a call‐in radio show when an Orthodox Jewish woman with five little babies (three of them identical triplets) said she felt like killing herself because her babies were driving her crazy. Although the Mayor quickly got her help (he was running for re‐election), what about all the other parents who don't get the free pampers and cars? In a similar case, Jacqueline Thompson, a black mother of sextuplets, and her husband Linden were living exhausted on the edge in Washington, D. C. until a radio caller publicized their plight.
Some argue that babies born as multiples cannot be harmed because if the mother had reduced to one embryo, the others would not have existed. Isn’t it better to exist as a disabled child than not to exist at all? My answer is that we must access morality not only from a consequentialist view but also from other moral perspectives, not just from thinking about harm to children but also from thinking about the motives of parents. Why would any parents deliberately choose a disabled child when they could have a healthy one? Can they universalize not choosing what is the best life for their subsequent children? Wouldn’t virtuous parents choose, not what is best for themselves, but what is best for the lives of their children? In the Ethics of Care, wouldn’t compassionate parents want the best for their own children?
Someone might here object that choosing only healthy children exhibits prejudice against people with disabilities. I answer that not supporting (or killing) disabled children differs dramatically from not creating them in the first place. Our principles, our moral intuitions, do not support abandoning or terminating babies with severe disabilities, but the same principles and intuitions support not intentionally creating such children.
Overall, in America we are a long way from a philosophically consistent policy on fetal rights and reproductive responsibility. In the Whitner case in 1997, the Supreme Court of South Carolina ruled that a pregnant mother can be prosecuted for using cocaine because such usage harms her fetus. In another example, in 2002 the President’s Council on Bioethics chaired by Leon Kass said that no child should be originated by cloning because of possible harm to the new baby. Yet the McCaugheys and other parents of multiples take terrible risks of creating disabled children and, when they invoke God's will, are seen as heroes. Something seems akilter here.
Notes
1 1 This essay originally appeared in the Birmingham News 1 December 1997 and was revised by the author for the 4th edition of this anthology.
2 2 Ann Curry, “After 10 Years, New Adventures for Septuplets,” Dateline, December 12, 2007. http://www.nbcnews.com/id/22223331/#.USAS0hzB‐AE
6 The Meaning of Synthetic Gametes for Gay and Lesbian People and Bioethics Too
Timothy F. Murphy
Researchers have had success in using synthetic gametes – sperm derived from female stem cells and ova derived from male stem cells – to produce live offspring in laboratory animals.1 The prospects for same‐sex couples to have children using only their gametes has been predicted in some of the earliest reports of success in the development of synthetic gametes, and some researchers have mapped this outcome as meaningfully within the range of possibility.2 Even so, considerable work remains to be done before human beings conceived with synthetic gametes could materialise this way,
Gay and lesbian people do already have children, of course, from opposite‐sex relationships, by adoption, through surrogacy arrangements, and – more recently – through various assisted reproductive treatments (ART). As many as six million people in the USA have a gay or lesbian parent.3 Because of shifting social views, it is likely that many more children of gay and lesbian parents are on the way. For example, the American Society of Reproductive Medicine now counsels its members to offer their services without regard to sexual orientation or marital status.4 Even so, two men or two women hoping to have children together cannot expect to share genetic parenthood, although certain symbolic gestures toward shared parenthood are available. For example, one woman might offer ova for fertilisation while her partner gestates the children.5 Two gay men may blend their sperm prior to insemination when relying on surrogate gestation for a child so that the child’s genetics are a matter of chance rather than choice. By contrast with these practices, the use of synthetic gametes – ova derived from males and sperm derived from females – stands poised to offer same‐sex couples ways to share full genetic parenthood of their children.
Despite the increasing social acceptance of gay men and lesbians around the world, the prospect of parenthood by homosexual men and women raises suspicion and even outright rejection in some quarters, and these objections carry over to bioethics as
