Discussing social hierarchies and the importance of genetic ties: a commentary on Petersen

Abstract

I am happy to comment on T S Petersen’s examination of the ‘individualization argument against nonmedical egg freezing (NMEF)’. Petersen intervenes in the ethical discussion on egg freezing by critically reconsidering a specific type of argument against oocyte cryopreservation for reasons that are not directly related with medical issues. Petersen dissects the claim that such nonmedical usage is ‘an individualistic and morally problematic solution to the social problems that women face, for instance, in the labour market’. Proponents of this argument believe that egg freezing should not be used by women on an individual level to solve social problems but that one should instead address gendered inequalities on the labour market. Petersen asserts that this individualisation argument is unconvincing— although morally appealing—because of empirically and ethically flawed assumptions. I am enthusiastic—with some minor reservations—about his unravelment of the individualisation argument and his call for more empirical backing. As I understand his presentation, the argument that is the subject of Petersen’s analysis is a recurring argumentative trope in the broader realm of assisted reproduction ethics. For instance, the anticipated positive effect of artificial womb technology in terms of liberation from reproductive and related social inequalities is one of the most dominant ectogenesis related strands in bioethics. Commentators have warned that such a solution would distract from the social structures at the root of the very ‘problem’ that it is meant to solve. I take it that this is a variant of the individualisation argument that Petersen discusses. Similarly, a closer look at the argument (which was more popular in the early days of assisted reproductive technology (ART) than it is now) that ART as such is a medical solution to a ‘social problem’, might just as well turn out to be a variation on the individualisation argument. I therefore agree with Petersen’s assertion that his investigation is relevant to practices other than NMEF. The application of the individualisation argument may play out differently depending on the case at hand, but it seems that a generally shared trait of the argument is that it is motivated by a felt need to address (unjust) social practices. Petersen’s refutation of this type of argument in the context of NMEF does not contradict such a felt need for societal change. He notes that we should both help women gain reproductive autonomy—by allowing them to use NMEF provided that it is safe and that people are informed about the consequences—and improve the labour market ‘in a way that gives more women opportunities’. However, improving the labour market to make it more just, in a way that it also strikes a right balance between professional aspirations and personal life plans, does not happen overnight. Working towards assumed social solutions is desirable, but this should not in principle detract from providing individual solutions to women and their partners who could benefit from it now which, in turn, is not a pretext for evading discussions on deeprooted social inequalities. I will return to that notion of ‘benefit’ shortly. Let me first contextualise this point by adding that there is empirical reason to believe that these societal interventions in the labour market will not remove the incentive for healthy women to freeze their egg cells. Several empirical studies point out that the main reason for healthy women to cryopreserve their eggs is not because of their career, but because they have not yet found a suitable partner. This is a point that is also taken by Petersen, and I sympathise with his view that empirical input is relevant in these matters—and that more is needed. We would want to know more, for instance, about the relationship between career aspirations and the difficulty to find the right partner. This does not tell the whole story, however. Crucially, if NMEF is suggested as a solution for individual women, one should be aware of the risk of reducing ‘women’ to a homogeneous group, where insufficient attention is paid to the views of potential beneficiaries who commonly face a higher bar to access and benefit from such technology. When ethical analyses are made about individual benefit, one should include empirical input about the experiences of less privileged groups and how their access to reproductive technology is structured by power relationships in society. As said, considering NMEF as an individual solution to (some) women should not be an excuse to pay less attention to existing social hierarchies, inequalities and respective (reproductive) justice concerns. In addition, the individual benefit of NMEF is perhaps stated in a somewhat excessively sensational way by Petersen. I share with Petersen the belief that reproductive autonomy is a central ethical value, but when he notes that ‘NMEF is able to increase the probability of some women having a child at all’ (emphasis added), this seems to reveal a problematic assumption—one that might actually be symptomatic of societal presumptions of what it means to be a parent. It is not a matter of pedantry to add that it is more correct to say that NMEF could increase the chance of having a genetically related child. Reducing parenthood to genetic parenthood is problematic. Nongenetic parenthood and genetic parenthood are on the same footing in terms of the value that they may add to a person’s life, even though many people strongly prefer the latter, and nongenetic parenthood opportunities often involve possible (societal) impediments. One should take seriously the individual desires of people wanting to become genetic parents, but here as well, it may be added that this is not a pretext for evading scrutiny of deeprooted socioreproductive understandings of the importance of genetic ties in parent–child relationships. This is consistent with social efforts to make nongenetic parenting opportunities less onerous and more recognised as valued alternatives.