arguing that synthetic gametes would help ‘democratise reproduction’. Yet, even here, the defence of gay men and lesbians as parents comes as the conclusion to a long and involved argument, which Testa and Harris concede could have gone on to even greater lengths!
In the early days of bioethics, some commentators analysed homosexuality relative to various theories of disease and health.19–21 Ironically, many of those early discussions occurred after the interpretation of homosexuality as pathological had already faded in credibility and significance. The UK Wolfenden Report repudiated the view of homosexuality as pathological in 1957, and the American Psychiatric Association followed suit in 1973.22,23 Bioethics busied itself with this question for some time afterward. Since those discussions, however, most analysts have moved on from questions about the ‘pathology’ of homosexuality, and focused on questions of healthcare access and equity for gay men and lesbians. Yet some commentators have used synthetic gametes to throw the integrity of homosexual men and women into question again, at least as far as parenthood is concerned. In different ways, Somerville, Velleman and Callahan treat the legitimacy of gay and lesbian parenthood as objectionable. As I have tried to show, however, their very objections can sometimes work in favour of synthetic gametes for same‐sex couples, especially by rendering moot worries about the relationships between parents and children.
At this stage of bioethics, though, why should we not assume in an axiomatic way that gay men and lesbians should be respected in their sexual identities, in their relationships in general, and in relationships with their children in particular? How many times must bioethics relitigate parenthood for gay men and lesbians? Questions of ethics do arise in the use of synthetic gametes by same‐sex couples, but the most important questions are not about the suitability of same‐sex couples as parents or even the welfare of their children. The most important questions involve access and equity. Are prevailing clinical standards – with their framing of infertility in terms of anatomical or physiological deficits involving opposite‐sex partners – a hindrance in any way to fertility medicine for same‐sex partners? If insurance companies in the USA cover infertility treatments for straight couples, is there any morally compelling reason they should not extend the same benefits to opposite‐sex couples, some of whom will be in lawful marriages? Given the historical arc of homosexuality in bioethics, the field may eventually move to embrace these kinds of questions fully, after the novelty of synthetic gametes wears off, and bioethics may yet embrace homosexual men and women as the presumptive equals of everyone else in regard to fitness as parents. The sooner, the better.
References
1 1 West, F. D., Shirazi R., Mardanpour P., et al. In vitro‐derived gametes from stem cells. Semin Repro Med 2013; 31:33–8.
2 2 Den, J. M., Satoh, K., Wang, H., et al. Generation of viable male and female mice from two fathers. Biol Reprod 2011; 84:613–18.
3 3 Gates, G. LGBT parenting in the United States. The Williams Institute of UCLA, 2013. https://williamsinstitute.law.ucla.edu/wp‐content/uploads/LGBT‐Parenting‐US‐Feb‐2013.pdf
4 4 Ethics Committee of the American Society of Reproductive Medicine. Access to fertility treatments by gay, lesbian, and unmarried people. Fertil Steril 2009; 92:1190–3.
5 5 Murphy, T. F. Lesbian mothers and genetic choices. Ethics and Behavior 1993; 3:220–2.
6 6 Newson, A. J., and Smajdor, A. C. Artificial gametes: new paths to parenthood? J Med Ethics 2005; 31:184–6.
7 7 Beatie T. Labor of love: the story of one man’s extraordinary pregnancy. Berkeley, CA: Seal Press, 2008.
8 8 Murphy, T. F. The ethics of helping transgender men and women have children. Perspect Biol Med 2010; 53:46–60.
9 9 Mathews D. J. H., Donovan, P.J., Harris, J., et al. Pluripotent stem cell‐derived gametes: truth and (potential) consequences. Cell Stem Cell 2009; 5:11–14.
10 10 Somerville, M. The case against ‘same‐sex marriage’. Canada: Brief presented to the Standing Committee on Justice and Human Rights, 29 April 2003.
11 11 Somerville, M. It’s all about the children, not selfish adults. The Australian 23 July 2011.
12 12 American Psychological Association Council of Representatives. Sexual orientation, parents, and children. 28 and 30 July 2004. [Updated to Sexual Orientation, Gender Identity (SOGI), Parents and their Children. February 2020. https://www.apa.org/about/policy/resolution‐sexual‐orientation‐parents‐children.pdf]
13 13 Lippman, A., and Newman, S. The ethics of deriving gametes from ES cells [letter]. Science 2005; 307:515.
14 14 Testa, G., and Harris, J. Genetics: ethical aspects of ES cell‐derived gametes. Science 2004; 305:1719.
15 15 Velleman, J. D. Family history. Philos Pap 2005; 34:357–78.
16 16 Callahan, D. In search of the good: a life in bioethics. Cambridge: The MIT Press, 2012.
17 17 Murray, T. H. Three meanings of parenthood. In: Rothstein, M. A., Murray, T. H., Kaebnick, G., et al. eds. Genetic ties and the family: the impact of paternity testing on parents and children. Baltimore: Johns Hopkins University Press, 2005:18–34.
18 18 Testa, G, and Harris, J. Ethics and synthetic gametes. Bioethics 2005; 19:146–66.
19 19 Boorse, C. On the distinction between disease and illness. Philos Public Aff 1975; 5:49–68.
20 20 Ruse, M. Homosexuality : a philosophical perspective. Oxford: Blackwell, 1988.
21 21 Engelhardt HT. Foundations of bioethics. New York: Oxford University Press, 1986.
22 22 Committee of the Offenses of Homosexuality and Prostitution. The Wolfenden report. New York: Stein and Day, 1965.
23 23 Bayer, R.. Homosexuality and American psychiatry: the politics of diagnosis. Princeton: Princeton University Press, 1987.
7 Rights, Interests, and Possible People
Derek Parfit
Do possible people have rights and interests? Professor Hare has argued that they do. I shall claim that, even if they don’t, we should often act as if they do.
We can start with future people. Suppose that the testing of a nuclear weapon would, through radiation, cause a number of deformities in the people who are born within the next ten years. This would be against the interests of these future people. These people will exist whether or not the weapon is tested, and, if it is, they will be affected for the worse – they will be worse off than they would otherwise have been. We can harm these people though they don’t live now, just as we can harm foreigners though they don’t live here.
What about possible people? The difference between these and future people can be defined as follows. Suppose that we must act in one of two ways. “Future people” are the people who will exist whichever way we act. “Possible people” are the people who will exist if we act in one way, but who won’t exist if we act in the other way. To give the simplest case: if we are wondering whether to have children, the children that we could have are possible people.
Do
