The Pros and Cons of Reproduction
Why Have Children? The Ethical Debate
Cambridge, MA: MIT Press, 2012, 253 pp., $27.95, hardcover
Reviewed by Rosemarie Tong
I am not sure I ever asked myself “why?” before my first husband (now deceased) and I decided to have a child. What I do remember is that despite our conversations about adopting a child like us—half Chinese and half Caucasian—we decided to have our “own” child (as if a child born from another woman’s egg or out of another woman’s uterus wouldn’t have been ours, too). And so, we had our two wonderful sons. After reading Overall’s relentlessly questioning book, I feel morally irresponsible for having waltzed into parenthood so unreflectively.
Overall writes from a feminist perspective, always conscious that the decision to have children affects women more than it does men. Although Overall thinks the right not to reproduce is more important than the right to reproduce, she nonetheless emphasizes that both of these rights should be protected from state interference. It is worrisome when the state limits women’s right to have an abortion, for example; but it is equally worrisome when the state limits women’s (and men’s) right to reproduce—as China did at the extreme edges of its one-child policy, forcing some six-months-pregnant women to abort hoped-for second children.
But just because people have a right to reproduce does not mean, morally speaking, that they should reproduce. They need, in Overall’s estimation, to have good reasons for doing so. When people procreate, they may bring into existence a human being that they do not have the resources to rear or that the earth cannot sustain. Moreover, when people procreate, they cannot do so alone (at least for now); they need genetic material from one another’s bodies and, in the case of men, women’s bodies themselves.
Of interest to philosophers, in particular, is Overall’s dismissal of standard deontological arguments (duty-for-duty’s sake arguments) and utilitarian arguments (the-greatest-good-for-the-greatest-number-of-people arguments) for having children. She does not think people have a duty to have children because it is “intrinsically worthwhile” to do so. Nor does she think that people have a duty to have children in order to preserve family genes, lines, or property (even if a kingdom is at stake). After all, asks Overall, “is anyone’s biological composition so valuable that it must be perpetuated?” Children do not owe their parents grandchildren; women do not owe the state their bodies to produce workers and/or canon fodder; and people should question a God who tells them to “be fruitful and multiply,” as the world collapses under the weight of the human population.
If Overall finds wanting most deontological arguments for having children, she rips to shreds the utilitarian arguments. For example, she pulverizes philosopher Derek Parfit’s “Repugnant Conclusion” (2004), according to which, “compared with the existence of very many people—say, ten billion—all of whom have a very high quality of life, there must be some much larger number of people whose existence, if other things are equal, would be better, even though these people would have lives that are barely worth living.” He means that the total aggregate of happiness of 100 billion awful lives might well be “better” than the happiness of the aggregate of one billion nice lives. One hundred billion awful lives might yield 100 billion happiness units in the aggregate whereas one billion nice lives in the aggregate might yield only 10 billion happiness units in the aggregate. Overall has no patience with hypothetical worlds. She reminds Parfit that the state would probably have to force women to churn out one child after another. The repugnant conclusion is unachievable because women’s collective suffering—not considered by Parfit—would likely make his world too miserable for any reasonable utilitarian to espouse it.
Another utilitarian view that Overall rejects is the purported rightness of creating “savior siblings”—children who are conceived to save children who already exist. A fictional savior sibling is one of the main characters in Jodi Picoult’s popular novel, My Sister’s Keeper (2005), in which parents have a child to serve at first as a bone-marrow donor and later as an organ donor for their dying first child. Things don’t go according to plan when the savior sibling rejects her fate and asks to be medically emancipated from her parents. Overall suggests that we ask ourselves, Would I feel comfortable adopting a child to play the savior role for my other child? Or for me? Whatever slippery slope using children as means to others’ ends sends us down, I fear what lurks at the bottom of the hill.
Overall’s book continues in this hard hitting manner. Specifically, Overall takes on David Benatar’s controversial book, Better Never to Have Been: The Harm of Causing Existence (2006). According to Benatar, “coming into existence is always (my stress) a harm.” Benatar’s argument for nonexistence is fairly arcane, but it is important to get it on the table so that Overall can push it off, lest we eat its bitter fruit. Benatar claims there is a radical asymmetry between the absence of bad and the absence of good:
The absence of bad things, such as pain, is good even if there is nobody to enjoy that good, whereas the absence of good things, such as pleasure, is bad only if there is somebody who is deprived of these good things.
Overall disagrees. As she sees it, it makes no sense to talk about the absence of bad and the absence of good in the abstract. Her general point is that unless someone actually exists, nothing can either benefit or harm him or her. Overall also makes the point that most human beings claim that their very existence compensates them for their suffering, pain, and death. They don’t think it would be better not to have existed, even if they are now dying from stage-four cancer, for example. Think here of the Dostovesky quote:
Where is it I’ve read that someone condemned to death says or thinks, an hour before his death, that if he had to live on some high rock, on such a narrow ledge that he’d only room to stand and the ocean, everlasting darkness, everlasting solitude, everlasting tempest around him, if he had to remain standing on a square yard of space all his life, a thousand years, eternity, it would be better to live so than to die at once! Only to live, to live and live! Life, whatever it may be!
Still, there are sometimes good reasons not to procreate, according to Overall. Some feminists argue, for example, that giving birth is bad for women; Shulamith Firestone compares it to “shitting a pumpkin.” Others claim that the institution of motherhood enslaves woman and even that children are “detestable.” Yet Overall points out that for some women, having a child “might be one of the few bright spots in an otherwise dreary life.”
The harm bearing and rearing children can cause to women is but one reason not to have a child. The bioethicist Julian Savulescu argues that couples and individuals should not procreate unless they heed the Principle of Procreative Beneficence (PPB), according to which, “[c]ouples (or single reproducers) should select the child, of the possible children they could have, who is expected to have the best life, or at least as good a life as the others, based on the relevant, available information.” Savulescu implies that the best way to procreate is to use in vitro fertilization (IVF) and pre-implantation genetic diagnosis (PGD) in combination. However, Overall points out that following Savulescu’s PPB is unreasonably demanding not only because it mandates high-tech, very costly, artificial reproduction but also because it seems to require women to create the best possible fetal environment for their progeny. It is at this point in her book that Overall expresses her dislike of abstract theories and thought experiments. Only men, exclaims Overall, could think up the Repugnant Conclusion, the PPB, and a host of other maxims that are totally oblivious to and/or dismissive of the role that gender plays in real people’s lives—especially those of women?
Having vented her philosophical fury, Overall goes on to discuss other plausible reasons for not having a child. Considering postmenopausal pregnancy, Overall says that a woman in her fifties or sixties should be permitted to have children, provided she has reflected on “the extent of the costs to the health-care system, the risks to herself and her infants, and the requirement of other women’s eggs.” Moreover, she says, lesbians should feel free to have children, as should single women, unless they have “no support group whatsoever.” Likewise, poor people may have children, since children aren’t luxury items for the rich nor must they have the best of everything in life. This permissiveness notwithstanding, Overall then claims that people shouldn’t have children if they “cannot meet a high standard of parenting capacity.” Regrettably, she does not explain in any detail in what this high standard consists, commenting only that “[d]espite the normative and epistemological difficulties of [this] statement, it is safe to say it is correct.” Safe? Correct? Maybe. Maybe not.
Overall reflects on the feminist philosopher Laura Purdy’s conviction that “It is morally wrong to reproduce when we know there is a high risk of transmitting a serious disease or defect.” Although Overall agrees with Purdy that it would be morally wrong to deliberately conceive and have a child with Tay-Sachs disease, for example, she does not think it is necessarily morally wrong to bring children with significant impairments into the world. In this connection, she recalls her Uncle Jack, who was born with significant cognitive impairments. Because of his mother’s decision to keep him in the family’s loving hold, Jack did not experience his impairments as disabling. Within the scope of his limited capacities, he was provided with all the opportunities and major life experiences he could handle. Lives like Jack’s, says Overall, are not “misfortune[s].” Rather, they have their own meaning, which may be different from that of the lives of people with higher cognitive abilities.
Toward the end of her book, Overall discusses overpopulation. By 2050, she says, human beings will number more than 9 billion, and the species may be on the brink of extinction. Fearing how repressive it would be for the state to control the size of people’s families, yet aghast at those who deliberately have as many children as they can (she references the book Nineteen Kids and Counting ), Overall proposes that people ought not have more than one child each. An ethics of restraint—of consuming less and shrinking one’s “environmental footprint”—would seem to be the only way to produce a sustainable world. If we refuse to be morally responsible, then perhaps our species should become extinct.
In conclusion, Overall emphasizes that although parenthood is not “the only or even the primary path to a flourishing life,” it is worthwhile. Like Overall, I am glad that I had children, even if I did so unreflectively. If my sons ever get around to procreating, however, I will recommend that they read Overall’s book first. I would like them to appreciate precisely what their decision to have a child means for the child, themselves, their partners, and the human species.
Rosemarie Tong is distinguished professor of Healthcare Ethics at the University of North Carolina, Charlotte.