Multimedia: The Future of Human Reproduction: Ethics, Choice, and Regulation
Authors: Arthur Caplan
Journal: BMJ (1999)

Eds John Harris, Soren Holm


Oxford University Press, £35, pp 264 




ISBN 0 19 823761 8

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Rating: ★★★

It is very hard to produce a timely book about a subject that changes as quickly as technologically assisted reproduction, but John Harris and Soren Holm have managed to do exactly that. The 14 essays in this small volume provide an extremely useful and highly readable overview of the key moral, legal, and social themes raised by new ways of making babies. The topics covered range across a broad intellectual terrain: the moral status of embryos, whether gametes can be treated as property, the usefulness of a framework of “rights” for thinking about assisted reproduction, who should control the use of genetic information and reproductive materials, and whether there is any reason to set limits by age for women who wish to reproduce after menopause. The book is unique in that it offers perspectives on all these topics from a variety of disciplines and professions as well as from a broad range of national and cultural perspectives.

Of all the topics considered, I found the contributions on postmenopausal reproduction the most interesting. Inez de Beaufort, of Erasmus University, Rotterdam, offers a moving and fascinating hypothetical letter written by a woman who conceived at the age of 54 to her now 18 year old daughter. The technique works nicely in highlighting the complex motivations and thinking that might lead someone to decide to use technology to reproduce late in life.

Guido de Wert, of the Institute for Bioethics, Maastricht, offers a succinct overview of the major moral concerns about honouring the wishes of older women to reproduce and finds them inadequate. He is especially persuasive in noting that there is no compelling reason to think that helping a 55 year old woman to have a baby is “unnatural,” a misplaced use of medical skills, or an unjust use of scarce medical resources. He is less persuasive in arguing that older parenting might not be in the best interest of a child created in this way. Fleur Fisher and Ann Somerville of the BMA also make this point in a trenchant review of the data about the health of older women who procreate and the risks they face.

Proponents of permitting older women to use technology tend to focus on the argument that many older men sire children and no one challenges their right to do so. But, until recently, older men always had younger partners so that any offspring ought to have at least one parent around during their childhood. De Beaufort does a better job of explaining why having a parent who is suffering the ills of old age might not really be in the best interest of a child. To put the argument succinctly, whoever requests the use of technology to have a child in old age needs to be reminded by society that making orphans is not good public policy.

The debate about setting limits by age in using reproductive technology is just one of a number of issues usefully presented in this book. Those who are looking for a resource that can help them explore what is often an ethically complex and emotional topic could not do better then to spend some time reading these essays.