GESTIÓN EN SALUD PÚBLICA: BioEdge: Is ‘reproductive freedom’ a dinosaur?

domingo, 25 de agosto de 2019

BioEdge: Is ‘reproductive freedom’ a dinosaur?

BioEdge: Is ‘reproductive freedom’ a dinosaur?

Bioedge

Is ‘reproductive freedom’ a dinosaur?

by Michael Cook | 25 Aug 2019 |

The 20 or so candidates for the Democratic nomination for the 2020 Presential run are hawking different policies to make them stand out from the crowd. New Jersey’s Senator Cory Booker has come up with one of the most original: a “White House Office of Reproductive Freedom”. This would coordinate policies on abortion and related issues throughout the Federal Government.

But Senator Booker may actually be behind the times. “Reproductive freedom” has been a progressive dogma for so long that the most progressive of the progressives are tiring of it. Quite a number of bioethicists are questioning whether the world can afford “reproductive freedom”.

In a very comprehensive article in the journal Medicine, Health Care and Philosophy, Giulia Cavaliere, of King’s College London, contends that reproductive freedom is an superseded concept which should be discarded as soon as bioethicists can cobble together its successor. Compared to the fire-breathing, barricade-smashing feminists of yesteryear, she offers a very lukewarm endorsement indeed: “reproductive freedom should be defended as an imperfect but instrumentally necessary tool”. She writes:

Hence, reproductive freedom should not be championed as what best protects people’s interests in well-being and autonomy. Rather, it should be championed as what at best (and ad interim) protects potentially vulnerable groups from harmful interferences.

What accounts for her lukewarm endorsement of the hard-won notion of “reproductive freedom”?

In a word, eugenics. Unrestricted reproductive freedom makes eugenics impossible. Cavaliere prefers the term “population engineering” to “eugenics”, but the thrust of her analysis is to problematize reproductive freedom and to make population control and eugenics acceptable.

There are two strands to population engineering: population control to protect the environment and eugenics to shape the “structure”, or composition of the population. Both are necessary and reproductive freedom is an obstacle to both of them.

Admittedly, “population engineering” has a bad track record – massive violations of human rights. But we can learn from mistakes of the past.

Population engineering programmes of the past were designed in such ways that the burdens would systematically fall on certain groups, such as ethnic minorities, disabled people, poor people and immigrants, while the benefits of these programmes would be enjoyed mostly by the ‘fit’, the rich and educated, many of whom were white. Epistemic and political problems were at the heart of this unjust distribution of burdens and benefits, which should be considered within any contemporary attempt to discuss the normative effects of procreative decisions whilst taking into account the interests of people other than the procreators.

The way forward to the future is not clear. But what is clear is that “reproductive freedom” as we know it is not necessarily part of that future. Cavaliere cites the words of another bioethicist, Dan Brock:

The effect of many individual decisions, themselves each rational and justified as individual choices, may be collectively undesirable [or desirable] for a group or society.

Michael Cook is editor of BioEdge

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