Book Reviews

Bernard G. Prusak, Parental Obligations and Bioethics: The Duties of a Creator, Routledge, 2013

Parental Obligations and Bioethics: The Duties of a Creator collects and supplements Bernard G. Prusak’s work on the ethics of procreation and parenthood, and applies his unique theoretical approach to related issues in bioethics and social philosophy. In this review, I’ll first summarize what I take to be the argumentative core of the book, and then offer a brief critical assessment.

In an attempt to get a grip on the grounds and contents of procreators’ obligations to the children they create, Prusak focuses chapter 1 on the case of two people who conceive a child with the intention of giving it up for adoption once it is born, their only reason being that it would be fun or novel (10). Intuitively, it seems that acting on this intention (either by conceiving the child or by relinquishing it once it is born) would be wrong, but justifying this intuition proves tricky. After rejecting several possible justifications, Prusak explores the idea that the given, biological relationship with one’s birth parents is potentially valuable in a way that would make it wrong to intentionally create a child with the goal of preventing it from enjoying such a relationship (19). But, as Prusak notes, failing to involve oneself in potentially valuable relationships isn’t usually considered wrong (think of all the potential friendships you’re spurning right now!), so why is it wrong in the case of procreation (22)?

The question we are left with at the end of chapter 1 gets answered in chapter 2, where Prusak argues, pace Elizabeth Brake (2010) and others, that the costs imposed on a child by its procreators are significant enough to generate a prima facie moral obligation to parent the child. Even though it seems that, in typical circumstances, a child cannot be not harmed by being born (8–9), its being brought into existence makes it subject to various risks of harm, which is a cost that its procreators (provided their actions were sufficiently voluntary) must address (29). But why should this require anything more than finding adoptive parents for a child, perhaps in addition to subsidizing the cost of the child’s upbringing? In other words, why do procreators have a moral reason to parent the child that other similarly capable adults don’t have?

Prusak’s answer draws on Seana Shiffrin’s “equivocal view” of procreation (1999, 136), according to which creating children is morally problematic because it imposes risks of harm without the child’s consent and absent the threat of any greater harm (since had the child not been created, no harm could have befallen it). One of the features of a healthy parent-child relationship is that it provides the child with emotional and intellectual capacities needed to bear both ordinary and extraordinary harms (34). This explains why procreators must see to it that the children they create have parents; putting money into a trust fund would be insufficient. Further, procreators have a prima facie moral obligation to do the needed parenting themselves because, in Prusak’s words, “no one other than one’s procreators . . . can be called on to answer for the fact of one’s being” (35; cf. Shiffrin 1999, 140). The need to know the intimate details of one’s origins and to be able to engage directly with those responsible for one’s birth is evidenced in Mary Shelley’s tale of Frankenstein’s monster, and in the quests of adopted people and people created with anonymously donated gametes to know their biological origins (36). According to Prusak, since procreators are uniquely situated to address this important need, they have a special responsibility to take on the role of parent for their biological children.

The remaining chapters of the book defend and extend Prusak’s positive view of procreators’ obligations. In chapter 3 he considers an argument by Elizabeth Brake (2005), who builds off of insights from Judith Thomson’s “A Defense of Abortion” (1971) in order to show that men who do not voluntarily assume obligations to support their newborn children do not have such obligations. Prusak rejects Brake’s conclusion (which would spell trouble for his own view) on the grounds that Thomson’s defense of the morality of abortion relies on a flawed distinction between killing and letting die (53). Chapter 4, which consists of entirely new material, gives a partial defense of gamete donation and gestational surrogacy; in brief, while all parties causally involved in collaborative reproduction arrangements (contracting parents, gamete providers, surrogates, fertility clinicians, etc.) acquire parental responsibilities for any resulting children, these responsibilities can be partially alienated under certain conditions (75). In the final chapters, Prusak explores the perils of conceiving of a parent’s primary responsibility as providing his or her child with “an open future” (chapter 5), and the grounds of society’s obligations to provide for the well-being of all children (chapter 6).

There is a lot to admire about Parental Obligations and Bioethics. It demonstrates sensitivity about the limits of our pre-theoretical moral intuitions about procreation and parenthood, as well as about the questionable relevance of historically contingent cultural norms of childrearing. This sensitivity serves Prusak especially well in the fourth chapter, which is both a thoughtful and highly original discussion of the moral obligations of participants in technology-assisted reproduction. The book is thoroughly researched, and Prusak’s writing style makes an easy read of even the more technical portions of his argumentsThe book has its difficulties, however. First, Prusak’s own position on how we acquire moral reasons to parent our biological children remains somewhat obscure, despite its being the central focus of the book. Prusak describes his view as a “causal account,” according to which we come to have special moral obligations to parent by voluntarily acting in a way that foreseeably results in the birth of a child (24). However, this seems to be in tension with his explanation of the contents of procreators’ obligations, which obtain because procreators are in a unique position to “reconcile a child to the fact and conditions of his or her existence” (35). Prusak does not clearly explain what it is to reconcile a person to her existence, though he does attempt to illustrate it with evocative references to secular and religious literature (31-32, 35). Even if this were clarified, however, it isn’t clear that Prusak’s view qualifies as a causal account, since it seems that procreators would be just as specially situated to reconcile children to their origins even if their procreative actions weren’t strictly voluntary or their outcomes were insufficiently foreseeable. Why would a victim of gamete theft or rape be excused from acquainting a child with her genetic heritage or the circumstances of her birth?

While I think more explanation and argument could address the previous difficulty, the following might prove more intractable. Early in the book, Prusak countenances concerns about non-identity: in most cases, procreators cannot act against the interests of the children they create, since had they not procreated the child would not exist, and so the child is no worse off for having been brought into existence (8). He then makes the right move, in my judgment, and notes that “not all objections to reproductive decisions need turn on the interests of children so produced,” suggesting that he will go on to explain procreators obligations on some basis other than harm (9). Oddly, however, Prusak seems to reverse course in the following chapter. Rather than giving a rights- or respect-based explanation of procreators’ moral reasons, he adopts Shiffrin’s noncomparative analysis of harm, according to which a child can be harmed by an action even if that action leaves her no worse off (33). This could be a successful strategy for explaining procreators’ obligations, except that (1) it runs counter to Prusak’s previous recognition of the force and point of non-identity worries (which are relevant only given a comparative analysis of harm) and (2) nowhere in the text does Prusak offer a defense of a noncomparative analysis of harm. The question of how to understand the notion of harm in procreation has been, as Prusak seems to recognize, hugely controversial in reproductive ethics, and a mere appeal to Shiffrin’s approach renders most of his conclusions regrettably hypothetical: if this is how we should be thinking about harm in procreative contexts, then . . .

Despite these problems (which I sincerely hope Prusak works to address), the book is educational, easy to read, and gets to the heart of many very important issues in reproductive ethics. For this reason, the biggest bone I have to pick isn’t with the author, but with his publisher, Routledge. Although one of the virtues of this book is its manageable length (102 pages of substantive content), Routledge somehow couldn’t get it produced in hardback and sold at a profit for less than $140 when it was first released, though I see that it is now selling online for as little as $100 ($75 for the Nook edition!). One might call this “another sad example of exploitative academic publishing,” but I won’t say that, since I’d hate for the Kennedy Institute of Ethics Journal (or worse, me) to get sued for libel, so instead I’ll just say that I cannot in good conscience recommend a title at this cost to those librarians, students, and scholars who would find it interesting and helpful. Luckily, earlier versions of most of these chapters have previously been published elsewhere (Prusak 2008; 2009; 2010; 2011a; 2011b; 2012), except for chapter 4, but perhaps some intrepid soul who has already purchased the book will violate copyright and put a digital version online for the rest of us.

Jake Earl
Department of Philosophy
Georgetown University
Washington, DC, USA

REFERENCES

Brake, Elizabeth. 2005. “Fatherhood and Child Support: Do Men Have a Right to Choose?” Journal of Applied Philosophy 22 (1): 55–73.

———. 2010. “Willing Parents: A Voluntarist Account of Parental Role Obligations.” In Procreation and Parenthood: The Ethics of Bearing and Rearing Children, edited by David Archard and David Benatar, 151–77. Oxford: Oxford University Press.

Prusak, Bernard G. 2008. “Not Good Enough Parenting: What’s Wrong with the Child’s Right to an ‘Open Future.’” Social Theory and Practice 34 (2): 271–91.

———. 2009. “Reason in Context: Whither the ‘Offices of Nature’?” Proceedings of the American Catholic Philosophical Association 83: 113–28. doi:10.5840/acpaproc20098310.

———. 2010. “What Are Parents For?: Reproductive Ethics after the Nonidentity Problem.” Hastings Center Report 40 (2): 37–47. doi:10.1353/hcr.0.0244.

———. 2011a. “The Costs of Procreation.” Journal of Social Philosophy 42 (1): 61–75. doi:10.1111/j.1467-9833.2010.01519.x.

———. 2011b. “Breaking the Bond: Abortion and the Grounds of Parental Obligations.” Social Theory and Practice 37 (2): 311–32.

———. 2012. “Paying for the Priceless Child.” Proceedings of the American Catholic Philosophical Association 86: 103–13. doi:10.5840/acpaproc2012869.

Shiffrin, Seana Valentine. 1999. “Wrongful Life, Procreative Responsibility, and the Significance of Harm.” Legal Theory 5: 117–48.

Thomson, Judith Jarvis. 1971. “A Defense of Abortion.” Philosophy and Public Affairs 1 (1): 47–66.