Finding the right ethical boundaries

In last week’s blog I mentioned that once an ethical barrier is broken we tend to pursue the breach as far as we can. I was trying to say that our nature as fallen human beings requires ethical boundaries to keep us from doing things we should not. Another example of that comes from Israel where a person is undergoing sex reassignment surgery to be changed from being female to being male. This person has requested the preservation of ovarian tissue for future reproductive use. Since this was denied by the Israeli Ministry of Health it has been appealed to the Israeli Supreme Court.

Ravitsky and Heyd argue in a commentary in Bionews that the reproductive rights of transgender individuals and their reproductive autonomy through the use of available fertility preservation techniques should be acknowledged. They base their argument on this case not being significantly different from things that have already been ethically accepted. They note that the Israeli Ministry of Health already considers sex reassignment surgery to be a legitimate medical procedure and that they allow IVF with donor gametes and surrogate mothers. They argue that having the social father of a child be the genetic mother of the child would not be ethically different than those situations that have already been accepted. They do express concern that there could be some psychological impact on the child, but suggest that having your social father be your genetic mother is no more confusing than having two male or two female parents. The door has been opened, so why not go through as far as possible?

It is interesting to think about what ethical boundaries have been broken to get to this place. One has to do with the acceptance of gender reassignment. If we see ourselves as people who have been created by God who has known us before we were born and loves us just as we are, it is hard to justify surgically altering our sexual identity. If the sexual reassignment is not permissible then the rest of this does not come up. Another has to do with our concept of procreation. If we see children as a gift from God, intended to be given to a husband and wife as a result of the physical expression of their love, rather than the result of a person’s presumed reproductive rights, then the use of third party gametes and surrogate mothers are outside of the permissible ways if creating children and the rest is not an issue as well. If we clearly draw the ethical lines on more basic issues then it is not hard to see that it is wrong to create a child whose father is also the child’s mother.

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John Kilner
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John Kilner

You make a great case for the importance of thinking through all the implications of bioethical decisions that people and society are making today. In approving a practice, we are approving all of the other practices that are logically entailed by them. This kind of analysis has sometimes been given a bad name by crazy (illogical) applications of “slippery slope” arguments. Perhaps bioethics would benefit from more careful (or at least more visible) attention to what distinguishes legitimate and illegitimate “slippery slope” analysis.