THE WIDER CONTEXT: CONFLICTS BETWEEN LIBERTY AND HARM PREVENTION

A common diagnosis of one of the major moral wrongs done by the old eugenics was its infringement of many individuals' reproductive freedom, most blatantly in widespread sterilization programs, more subtly in discouraging those thought to have “bad genes” from reproducing. Our ethical autopsy of the old eugenics in Chapter 2 confirmed this assessment. In our own era, reproductive freedom is again being challenged by new genetic knowledge and technologies. But if we are to respond properly to the challenges to reproductive freedom posed by the new genetics, we need a systematic analysis of the scope, limits, and content of reproductive freedom, as well as a clear view of the moral values that ground its importance. To provide this is one aim of this chapter.

New knowledge about the risk of genetic transmission of diseases and other harmful conditions will give individuals both the opportunity and the responsibility to choose whether to transmit such harms to their offspring or to risk doing so. The information of genetic risk could be used by individuals prior to conception to decide whether to conceive when risk is present, or after conception but before birth to decide whether to abort an affected fetus. New genetic knowledge may also allow genetic or other interventions in vitro or in utero to prevent the development of the harmful condition.