A Demand For Opportunities, Not A Call For Coercion
Procreative beneficence when applied in a strict sense cannot help but lead to a coercive-eugenics state or society, in which one trait after another is pathologized on the basis that anyone who cannot function optimally in the existing society is better off not existing at all (a mindset which plunges firmly into the territory of naturalistic fallacy, since it assumes that the way society is now is is somehow superlative).
And it is important to note that with diagnostic criteria widening and new "disorders" showing up on the scene at a frenetic pace, it definitely seems plausible that some of the very people in favor of strict, narrowly-defined procreative beneficence today might tomorrow be in one of the very groups of people up for elimination. Part of the solution to this issue can likely be found in techno-progressive policies that favor widespread access to consensual modification technologies and services -- this would, of course, eliminate the need to define certain variations as pathologies for the sake of allowing people with these variations access to helpful services and technologies.
If a progressive technology-access policy were implemented, the compulsion to group people along the lines of "healthy" and "defective" for the purpose of deciding who should get the (apparent) lion's share of the resources would likely evaporate. Access to consensual modification technologies and treatments would allow people who want to change their morphology or cognitive abilities in any way to do so, without fear that their doing so would define, for all time, that type of change as either therapeutic or cosmetic. I don't think anyone should have to prove they have "subnormal" memory abilities in order to gain access to a memory-enhancing treatment, but the way society is set up at the moment, people who desire to change their ability set for any reason are at the mercy of whatever the major, large policy-making bodies have defined as pathological or nonpathological.
One only need walk into any local drugstore (or open their e-mail spam folder) to see that "enhancements" are a hot commodity. From Viagra (and its numerous herbal knockoffs) to dubiously-effective focus-enhancers to Retin-A creme to caffeine pills, shelves are stocked to brimming with things that fall far outside the "therapy" category. I don't see this as a bad thing at all; I see it as evidence that people want the freedom to define their own ability sets and configurations, based on whatever meta-goals they might have for themselves.
I also see similar phenomena in the prenatal nutrition and early childhood care and education market. Women are quite concerned about the future health of the children they carry, and most these days try very hard to make sure they eat nutritious meals and supplement appropriately while pregnant. I've also seen baby formulas and foods appearing over the past few years that include such things as DHA and omega-3 fatty acids, which are thought to help promote brain development.
And in the non-chemical, non-food realm, I see such things as "Baby Einstein" videos and educational computer software designed for toddlers barely able to control a mouse. I heard an amusing anecdote recently about an acquaintance's preschool-aged daughter -- she is apparently already quite adept at navigating her own computer games, and one day turned to her parents to solemnly announce, "Just wait. It's loading" (when the screen froze briefly between activities). The next generation of middle-class youngsters is growing up "enhanced", or at least changed, right before our eyes, and even in advance of the existence of more serious genetic and somatic modification technologies.
And while again there are certainly plenty of "pushy parents" seeking to live out their own unrealized dreams through their offspring inappropriately, this group by no means includes all parents, and (as noted by Ron Bailey in Liberation Biology), "a ban on cloning [as an example of one of the more controversial biotech breakthroughs likely to arrive in coming decades] won't abolish pushy parents."
So, if it's okay for parents to make choices for their offspring before these offspring even fall under the umbrella of "persons" (such as in the case of prenatal nutrition), how can a concept like biodiversity in humans survive? After all, shouldn't parents by default (or according to social pressures) simply select, if possible, the potential offspring with the lowest risk of experiencing hardship? If not, what are the possible justifications for not doing so?
Avoiding Oversimplification
Well, for an illustrative example, consider the case of a couple incapable of producing any embryo which does not show evidence of some kind of genetic "abnormality" (which honestly probably encompasses all couples, since there's really no such thing as a "standard human" in the first place, except within the pages of anatomy texts). If none of these abnormalities are fatal -- consider, perhaps, a couple who produces three embryos, one with a propensity toward blindness, one to deafness, one to autism -- what is the proper course of action? Certainly, it should not be to deny these parents the right to have a child at all; that would fall under the category of the kind of Nazi-esque eugenics policies that transhumanism must maintain a more-than-comfortable distance from.
The very idea that some kinds of people should not exist because they represent a "drain on society" is utterly reprehensible -- this attitude also flies in the face of progressive ideals that would encourage the provision of needed survival and enrichment resources to everyone. Remember that artists, musicians, and poets have been put in the category of "useless" at various times throughout history in the minds of certain groups.
So it seems that in cases of nonfatal conditions, procreative beneficence degrades into pointlessness at best and anti-choice claptrap at worst. If parents are allowed to abort a developing fetus, for any reason (a right I fully support as a pro-choice woman), I also think that parents should be allowed to have whatever child they want, even if this means taking no steps to assure that the child that pops out is maximally normal.
The idea of coercing women to abort (or not select) potentially deaf, blind, or autistic children is completely at odds with reproductive freedom. Just as nobody should be forced to have a child, nobody should be forced not to have a particular child. As noted above, regardless of the fact that pre-implantation embryos are not technically persons, this doesn't mean that these embryos are interchangeable. A given embryo isn't just defined by "disability" or lack thereof, but by a robust and complex set of initial conditions. You could have a child that is deaf, extroverted, and talented at drawing and painting, or a child that has no apparent disabilities but who ends up becoming a bully or a drug addict (again, based on genes, but so far I haven't heard of anyone looking for "bully genes").
The simplest solution here seems to be to not force or oblige parents to undergo pre-implantation genetic diagnosis. Parents with potentially deadly conditions in their families will likely seek out this technology themselves, no coercion required, when they decide to start a family.
Potential Persons, Rights, and Choice
The suggestion that bringing a child with a particular condition into existence is somehow the same as inflicting that condition on an existing child easily fails any sort of rational analysis -- after all, choosing to have a female child rather than a male child is not the same thing as taking a five-year-old boy and forcing him to undergo sex-reassignment surgery.
And moving for a moment into the "dissolving species boundary" realm of personhood discourse, if we put bonobos into the category of "persons" (which I certainly do), it makes absolutely no sense to suggest that since bonobos lack some of the cognitive and speech abilities humans possess (ignoring for a moment that bonobos certainly possess some superior abilities to those displayed by the average human), we ought to just sterilize all the bonobos in the world on the basis that the places of the babies the bonobos would have had will somehow be "taken" by human children.
That would frankly be genocide, and while anti-miscegenation laws are every bit as morally wrong as racism is, it should never be assumed that a group of people sharing a certain trait (whether it be something like skin color, "bonoboism", or dolphinhood) must be eliminated systematically, ostensibly for the good of "all persons" -- that way, as they say, leads to the Dark Side.
Sometimes, even the most benevolent intentions can end up drastically restricting freedoms that ought to instead be protected. It's possible that humans will some day "merge" with the machines we create, or that due to our tinkerings with genes and such, become unrecognizable to our future selves, and I don't think this would represent anything particularly tragic (in fact, I think both these possibilities are quite likely, regardless of what route we take into the future). But there's a difference between a society that evolves to be a certain way based on consensual modification and the exercise of free choice, and a society that is fairly molded to be a certain way based on coercive tactics.
Attempts to merge principles of procreative beneficence with pro-choice philosophy and personhood theory have so far created a muddled, tangled web of politics and confusion. If an embryo is not a person, then it cannot be said to have rights -- it has no "right" to be configured a particular way and certainly no "right" to be implanted and brought to term in the first place. And even if a fetus is defined as a person after a certain point during gestation, if it is still permissible to kill that fetus for whatever reason (which I think it should be, on the basis that women should have the final say regarding what goes on in their bodies), then it should certainly be permissible as well to bring that fetus to term and try to give it the best care possible once it is born, regardless of difference or disability.
While most people alive today would not jump at the chance to acquire a disability if given the opportunity, most people who already have disabilities don't sit around bemoaning the fact that they were ever born to begin with. And while I certainly think societies are obligated to help assist people in living effectively and obtaining appropriate care, treatment, and modification (if desired), I do not think that societies have any sort of obligation to prevent the existence of people who might be considered "disabled". Note that "obligation" is the key word here. Certainly, parents might wish to take folic acid so their baby won't have spina bifida, but if the condition occurs anyway, these parents should not be coerced to abort that child on the basis that they really ought to just try again for a nondisabled baby.
It should be permissible for parents to decide they want to select for an embryo not prone to a familial condition that causes death by the age of two, but this should be recognized as something the parents are doing for themselves, not for the sake of a child that only exists in the hypothetical realm. You cannot do a kindness to someone who does not yet exist -- who is not a person -- by making sure that they never exist! You can, perhaps, keep your own life at a more predictable level of convenience and economic stability by selecting for or against a certain potential child, but remember that this is about your life.
Trusting Parents, Eschewing Ignorance
A parent who feels perfectly up to the task of raising, say, an autistic child (or who might even prefer such a child, on the basis of being autistic themselves) should not be guilt-tripped or made to feel as if they're "hurting" their child by allowing him/her to be born, or that they are somehow draining resources in society that would be better spent on neurotypical children. To assume that just because someone is autistic that they're somehow by default not going to be able to contribute "meaningfully" to existence (or be happy, or intelligent, etc.) is to presuppose a lot of things on the basis of ignorance that borders on outright bigotry.
Anyone advocating the elimination of autism without first getting to know at least a few autistic people is guilty of a dangerous sort of intellectual laziness (as is anyone who tries to compare autism to things like cancer or pneuomonia or a "train wreck"). Just because the media is sloppy and prone to stereotyping in its descriptions and portrayals of a particular kind of person, that doesn't give anyone an excuse to just accept, unquestioningly, what they are spoon-fed by the same media machine that thinks celebrity breast implants make good headline news.
This does not mean parents ought to think it fine and dandy to drink radioactive waste and play tackle football while pregnant, however, this kind of behavior is so rare that we don't really even need a law against it. I have no doubt that consensual modification technologies (including germline therapies and alterations) are going to change the face, shape, and form of humanity over the years to come -- and I welcome the opportunity to see what the cross-section looks like in a few generations!
However, I think that as this occurs, it must occur in the absence of subscription to naturalistic fallacies, in defiance of intellectual laziness, and far from anything that looks like irrational prejudice. A transhuman/posthuman society must necessarily embrace difference, while acknowledging that a strength in one area can mean a constraint in another. In Citizen Cyborg, Dr. James Hughes notes that:
If people choose to modify themselves to live underwater, with gills and flippers, and then choose to have children to share their underwater society, would this be child abuse or enhancement? It takes away some abilities but adds others. Trusting parents to navigate the increasingly diverse choices will be hard, but nonetheless essential in a free society.
Hughes makes some points in the same book that I do not agree with, however, the ongoing technoprogressive dialogue taking place in response to the potential for various new modifications to emerge in the ever-nearer future exists precisely because everyone involved is still trying to work out a relatively new set of very sticky ethical and philosophical issues. It's challenging, and certainly, if everyone already agreed on everything there would be no need for dialogue.
But I wholeheartedly agree that a range of increasingly diverse choices is upon us, and responses to this range of choices must not be subject to undue scrutiny and restriction. Parents need to be trusted (and educated), and everyone needs to avoid making superficial assumptions about the quality of life of someone they themselves can't imagine being. Sometimes, apparent "sub-optimal" functioning of a person in a society is a warning sign that the society itself is built upon an unstable and transient foundation, based perhaps on primitive memes that are on their way toward obsolescence.