What are the extents of our reproductive freedoms?

Reproductive freedom needs first to be conceptualized more broadly than simply contraception and abortion rights. They also include the freedom to have children, and to have the kind of children we prefer. So infertility and congenital disabilities are as much infringements on our freedom as the inability to contracept or abort.

Our de facto reproductive freedoms are also limited by both our social and legal environment, and our technological access. For instance it does little good to have a legal right to contracept if women are not sufficiently empowered and educated to exercise that right, or if their society does not ensure that they have access to contraceptive technology. Similarly, the right to control one's reproduction using prenatal diagnosis, and in the future with gene therapy, can be limited by social coercion, the law, and by their exclusion from publicly financed health care. So full reproductive freedom requires (a) technological innovation to permit full control over the timing and kind of children we want to have, (b) a society that tolerates individual choice in reproductive decisions, and (c) a publicly financed health care system that includes fertility treatments, contraception, abortion, prenatal diagnosis, and future reproductive therapies as a right of citizenship.


Why do you dislike the term "designer babies"?

"Designer babies" impugns the motivations of parents, who are generally trying to ensure the best possible lives for their children. If parents provide food, exercise and education for children to ensure that they are smart and healthy we praise them as responsible. When they try to ensure the same goods for their children with reproductive technology we imply that they have twisted, malign, instrumental values.

Even in the case of reproductive choices which are cosmetic, such as eye or hair color, we do not slander parents for how they dress or groom their children, but we do if they exercise a simple cosmetic choice before birth. We should stop using the term.

If everyone in, say, China could choose the sex of their child, wouldn't we see a huge gender imbalance as more people would choose to have boys?

Is it the state's responsibility to ensure a 1-1 gender ratio? If so, there are already too many women than men in the West and the state should be interfering in reproductive choices to produce more boys.

In China and India the growing gender imbalance is the inevitable result of permitting women to know the content of their wombs and to make reproductive choices in the context of a patriarchal society. Restricting women's reproductive freedom by banning sex selection will not make those societies less patriarchal. On the other hand the policy and social responses to gender imbalance in those societies are doing far more to correct patriarchal abortion biases. For instance the Indian dowry system and caste bias in arranged marriage is quickly evaporating as men find that getting a wife gets harder. Women who would not have been able to get married for a variety of reasons in the past, such as widows, are now found attractive. Both China and India have launched education campaigns to encourage the birth of girls. Protecting women's reproductive freedom is much more important than ensuring that every boy has a date to the prom.


Do you really think there will be equal access for this technology? Why wouldn't it create a caste system of the enhanced and the non-enhanced?

Equal access to any technological enablement is the result of ongoing political struggle. Societies with stronger civil liberties, trade unions and social democratic parties will provide better universal technological access, from sewers to the Net to gene therapy. In other more unequal societies genetic therapies may exacerbate inequality. The difference in outcomes will be determined by the strengthen of democratic movements and parties, however, not by policies governing the access to technologies. Because of the growth of medical tourism banning access to a technology will simply restrict access to the wealthy, and will not stem the emergence of a two-tier society.