Book Reviews

Françoise Baylis and Carolyn McLeod (eds), Family-Making: Contemporary Ethical Challenges, Oxford University Press, 2014

This fascinating anthology focuses on the question of how we make families, and how bionormative assumptions shape or distort our collective thinking about parenting, children’s welfare, and state obligations to parents and children. The editors are primarily interested in the question of whether parents’ moral responsibilities toward children differ for children produced through assistive reproductive technologies (ART) compared to children brought into the family via adoption. As the editors point out, in the realm of ART, most of the philosophical literature has been focused on parental autonomy and rights to assistance in reproducing, while the adoption literature is almost entirely focused on the protection of children. The anthology does an excellent job of exploring this disconnect, and probing assumptions about moral responsibilities within family-making. Taken as a whole, the chapters explore “whether people should rely on others’ reproductive labour in having children, whether they should ensure that they will have a genetic tie to their children or that their children will have some connection to genetic relatives, whether they should bring a new child into the world at all, whether they should agree to what the government would require of them for an adoption, where they should live if the family they make is multi-racial, at what age they should forgo having children, and the list goes on” (6).

The first section of the book sets the stage with two excellent chapters on the goods of parenting (Harry Brighouse and Adam Swift) and the goods of childhood (Samantha Brennan). The goods of parenting are distinguished from other related goodsintimacy with another adult or friend, friendship with a child, being an uncle, having a pet, etc.and understood to be extremely valuable and non-substitutable (13). Brighouse and Swift identify at least four things that distinguish parent/child relations from these other intimacies: 1) they cannot have equal power, given that children do not enter the relationship voluntarily, are dependent, and cannot exit at will; 2) parents have the power to (indeed are often expected to) coerce children; 3) parents set up the environment that creates a child’s values and possibility for autonomy; and 4) parents receive unconditional intimacy from the child, and presumed trust (15-16). These distinct features of the parenting role lead to unique goods of parenting, and highlight some of the reasons we often consider access to family-making to be a fundamental right. The authors note that parenting is “likely to be one of the most important things one does with one’s life” (19). Like romantic relationships, parenting may not be necessary for a good life, but it is often a very significant component. Importantly, though, the goods of parenting are not necessarily tied to biological parenthood, but are instead gained through the intimate, unique relational role and resultant experiences.

Brennan’s chapter on the goods of childhood takes on the question of how much of children’s welfare (and parental obligations to promote it) is attached to the present child vs. the future adult she will become. A parent’s job isn’t simply to get the child to survive until adulthood, or even to have an “open future,” but also to help her enjoy the unique goods of childhood, including for instance, free play, a sense of time as endless, a sense that all doors are open, and absolute trust in others (43). On Brennan’s view, children aren’t small or deficient adults, but developing relational, autonomous creatures who need help to pursue their own temporal goods.

Part two of the book critiques the ways in which bionormativity (the idea that the “gold standard” of the family is having parents who are genetically related to the child) influences our thinking and policy-making on family creation. The chapter by Charlotte Witt takes on David Velleman’s arguments (2005, 2008) regarding the importance of having “family resemblance” for developing a healthy and adequate identity or sense of self. Velleman considers it to be “universal common sense” to think it better to have one’s own biological parents (quoted on 54), and argues explicitly against making children with anonymous gamete donors. In his view, “Not knowing any biological relatives must be like wandering in a world without reflective surfaces, permanently self-blind” (quoted on 52). Witt does an excellent job of showing just how limited this view is, given the multiple ways we can see ourselves reflected in the behaviors, beliefs, and practices of our rearing parents, even if they are biologically unrelated. The fact that many adoptees seek information about their biological parents may show curiosity or the desire for medical information rather than “genealogical bewilderment” that impinges on healthy identity formation.

A more empirical chapter (Lucy Blake, Martin Richards and Susan Golombok) reviews the evidence regarding the health and well-being of children and families formed through natural sexual reproduction, ART, and adoption, and concludes that there is no good evidence in favor of the bionormative conception of the family. Children produced through ART with donor gametes had no significant health or psychological differences from children produced via natural sexual reproduction (78), and ART parents were just as likely (or more so) to have positive parenting ratings. Their comparisons for adopted children show somewhat greater psychological and behavioral issues, but they argue that these are more likely to occur in children adopted later in life, and are probably due to the lingering effects of early stresses (e.g., neglect, abuse, malnutrition) prior to the adoption rather than to having biologically unrelated rearing parents.

Part three looks at becoming a parent, with chapters from Christine Overall on the value of procreation, and Tina Rulli on the value of adoption. Overall argues that most of the reasons given in favor of procreation (e.g., bringing intrinsic value into the world, creating happy people, enjoying the experience of pregnancy, childbirth, and breastfeeding, fulfilling duties to family, obeying religious requirements, maintaining choice and control in reproduction) fail to justify procreation over adoption, because they misunderstand the parent/child relationship, have too narrow a vision of what parenting is, or lead to troubling implications.

Rulli offers a look at the unique goods of adoption, highlighting the ways in which adoption “provides a morally noble opportunity to extend to a stranger benefits usually withheld for one’s genetic kin” (110). She argues that adoption is sometimes superior to procreation; it’s a “pure and exemplary model of what is most valuable about parenthood” (110). Consider Rosalind Hursthouse’s claim (1987) that it is tempting to consider “bearing a child as analogous to sacrificing a fair amount of time and effort to saving someone’s life” (quoted on 114). Rulli uses this insight to note that not only does adoption satisfy the moral features that give procreation value (e.g., having the courage, fortitude and endurance to create something of intrinsic value, investing time and energy toward “saving” lives, developing intimate relational connections that are central to morality), it does so in clearer ways, given that adoption involves the risk of taking on a stranger in need, rather than creating a new life. (“Procreation doesn’t meet needs; it creates them” 113.) As such, Rulli suggests that “adoption is not second-best. Morally speaking, it is the exemplar” (115). Importantly, she is not arguing for a duty to adopt, but against the assumption that adoption is always second-best. Rulli also considers objections about the “myth of the world orphan crisis” that may create a demand for children (and a market for babies in less developed or more impoverished parts of the world). She rightly notes that concerns about unscrupulous adoption markets and practices call for better oversight, not abandoning or maligning the value of adoption.

The fourth part of the book looks at state interests related to people who want to become parents. Jurgen De Wispelaere and Daniel Weinstock consider whether the state has an interest in restricting access to ART (or at least not subsidizing it) in order to address the needs of already existing children who are awaiting adoption. They note that while some have argued for a positive right to ART (under the banner of a right to reproductive health), using ART often looks more like enhancing reproductive function as opposed to restoring it, and the reproductive health right frame over-medicalizes the process of family-making. One might make a claim instead to a positive right to parent, but that right does not require any biological connection between parent and child (137). If the state should recognize a fundamental right to parent, but remain neutral between modes of fulfilling that right (i.e., natural sexual reproduction, ART, and adoption), then it might seem that the state would have no justification for promoting any one mode of family-making. But third party interests (those of existing children in need of adoption) alter the situation, giving the state reason to promote adoption and perhaps restrict access to ART. Nonetheless, the authors resist the conclusion that access to ART should be restricted, because they recognize costs of the adoption process, the limited pool of potential adoptees (especially given restrictions on international adoptions), and the potential difficulty in providing a good home for a child with special needs. A solution might be to open up the adoption process a bit more (making it more feasible for some prospective parents), and to institute some restrictions on access to ART. Regarding the latter, they suggest that we manage demand for ART through pricing (with the state partially subsidizing it only for impoverished infertile people). They recognize the right to parent, but think that right ought to be focused on intimacy and special relations rather than biological connection.

In their chapter, Carolyn McLeod and Andrew Botterell offer lessons from their own experience as adopting parents. They note that prospective adoptive parents are in for a time-consuming, frustrating, sometimes intellectually numbing process that involves extensive interviews, home visits, required parenting classes, letters of reference, criminal background checks, and more, in a process that can last more than two years. Their question is whether the state should have the right to impose these constraints on adoptive parents (and, to be specific, on non-related adoptive parents) but not on “natural” parents (or familial or step-parent adopters). They argue that the differential treatment is not morally justified, because all the reasons offered to justify licensing only non-familial adoptive parents (harm to prospective children, feasibility of licensing, transfer of parental responsibility during adoption, and lack of claim by prospective parents to a particular child) are not non-familial-adoptionspecific worries. They conclude that we either ought to support licensing for many more prospective parents, or not licensing at all (155).

Julie Crawford’s chapter takes on the issue of bionormativity in the law’s treatment of “second parent adoption” vs. parental presumption. As a lesbian co-mother who helped with the “ontological choreography” of creating a child with her partner, Crawford was nonetheless required legally to adopt her child in order to be considered a legal parent. Contrast this with the legal practice of parental presumption (176-177), which allows a man in her role to bypass the adoption requirement. An anonymous sperm donor for a couple using ART is removed from the legal parenting equation and “the social father seamlessly takes his place” (174) and is automatically the baby’s legal father. (This is what Elizabeth Bartholet (1995) calls a “technologic adoption.” What could possibly justify this difference, given their structural similarities? Crawford notes also that second parent adoptions can run $4,000-6,000 and take time, during which the second parent does not have legal parental rights. She advocates for extending the parental presumption to parents in committed relationships (whether married or not).

Part five turns to special responsibilities of parents, with chapters on responsibilities of parents using ART (Jamie Lindemann Nelson), post-adoptive parental obligations in regard to openness and disclosure within and outside of the family (Mianna Lotz), and obligations for parents who adopt transracially to morally consider the geography (neighborhood of residence) of their new family (Heath Fogg Davis). Nelson’s chapter highlights how parental responsibilities are not the sorts of things that can be “unilaterally dissolved” (186). Nelson notes that what we cause to happen can matter morally, so even if we didn’t intend a particular effect, we can be morally responsible in relation to it (188). This means that the anonymous sperm donor may have some responsibility toward the child produced through ART, if only related to the provision of information. Similarly, parents who use ART and rely on a gamete donor may have the responsibility to share such information with their child. As Nelson smartly points out, “If some adults can find biological relationships with children so important that it makes going through ARTs with all their costs, risks, and inconveniences a rational choice for them, why should we assume that biological ties in the other direction won’t also matter greatly to some children?” (189).

Lotz argues that adoptive parents have obligations to communicate openly about the adoption within their family, in order to help address three vulnerabilities of adopted children: identity development, development of a sense of familial belonging and security, and development of emotional independence (201). Post-adoptive parental obligations, then, may involve initiating discussions about adoption and the child’s heritage rather than only being responsive to questions from the child. Still, she distinguishes between obligations of openness within the family, and outside of the family, noting that concerns about adoptee welfare may make extra-familial openness optional rather than required.

Fogg Davis’s chapter takes up the intriguing question of whether parents in transracial adoptions are morally obligated to make their homes in non-predominantlywhite neighborhoods. Fogg Davis argues that they are, not because a black adopted child cannot form a healthy self-concept in a white neighborhood (we have many examples to the contrary), but because such parents have a “magnified version of the general moral responsibility that we all have to make residential decisions that do not perpetuate longstanding patterns of racially segregated housing” (222). In transracial adoptions, the family itself is a site of racial integration (223), and the parents have assumed leadership roles in relation to racial integration. Parents are morally obligated to convey the message to their black adopted children that the racial integration of the family will not be entirely unidirectional, that they are willing to physically move out of their geographical racial comfort zones. The parents show good faith in leading the family’s process of racial integration by interrupting the unthinking cycle of selecting a neighborhood that is racially familiar to them” (227). He acknowledges that this obligation is held by all parents, but suggests that it is magnified in the case of white parents who adopt black kids.

The final part of the book includes chapters on contested practices, including the use of “right to know” analogies between ART and adoption practices (Kimberly Leighton), contract pregnancy in India (Françoise Baylis), and age restrictions for the use of ART (Jennifer Parks). Leighton argues that the circumstances of ART and adoption are different enough that the purported harms of not knowing one’s genetic parent are not easily comparable across these practices.

Baylis offers a damning look at contract pregnancy (surrogacy) practices in India, which in her view amount to unfair exploitation of impoverished Indian women by privileged Westerners, despite some surrogates’ testimony to the contrary. When a surrogate complains about the exhaustion of pregnancy but notes that her regular job (crushing glass 15 hrs/day for $25) is truly exploitative, Baylis acknowledges the truth of her testimony, but focuses on the structural injustices that make this kind of “choice” the best available option (268). She also points to less sanguine testimonies from women who say that contract pregnancy is far from what they would otherwise choose, but they really have no other feasible optioneven as their contracting couples from the West claim that the women think they are doing something good, and “in their eyes, they aren’t being exploited” (269). Paying the women more would not resolve the situation, given that in their situation, more money would simply constitute undue inducement (272). Baylis focuses less on the responsibility of individual women, and more on the governmental policies that encourage such international contract pregnancy: “The job of government is not to expand the range of exploitative work options available to its citizens, but rather to guard against exploitation and oppression” (274). She starts by examining the harms to the women who are exploited, but also considers the harms to the children who are created this way, including the potential difficulty of living with an autobiography that is incomplete or that includes complicity in exploitation, or being understood as a commodity. Finally, she does not let the contracting couples off the hook, but appeals here to the work of Iris Marion Young (2007), noting that we are individually responsible for structural injustices, given the ways that we play our parts in the process (282).

The final chapter takes on the issue of age restrictions for the use of ART. Several sensational media cases depict women in their sixties and seventies using ART in order to become parents. Critics raised concerns about the prospect of orphaning the children at a relatively young age, the parents not having the energy or ability to guide the child well (given the exhausting if joyful work of parenting), and the physical and psychological problems that might be associated with older age parenting (288). Parks argues that many of the reasons offered against the use of ART by older women) are not exclusive to them, but might be leveled against women in their usual reproductive years who use ART because of cancer or other health-related concerns. Additionally, she argues these objections could be assuaged through careful planning for help with chronic care, plans for transfer of guardianship, etc. Parks also notes that cryopreservation of one’s own eggs for possible use in IVF can aid women who want to be mothers beyond their typical reproductive years. While Parks recognizes critiques of those who frame cryopreservation as a feminist technologyBarbara Katz Rothmann (2012) wonders why we don’t make other options feasible during women’s reproductive years (quoted on 289), and Patricia Smith (1993) worries it is technology that reinforces the importance of a women producing a biologically-related child for her partner (299)—she ultimately argues that it is rightfully considered a feminist technology because it provides “tools plus knowledge that enhance women’s ability to develop, expand, and express their capacities” (quoting Linda Layne et al. 2010, on 297). It offers women the option to put off reproduction while they pursue careers or other interests, and can serve as a kind of “insurance policy” for the future. Cryopreservation also decreases the number of women who would otherwise rely on donor eggs to attempt procreation, and thus may help to address concerns about exploitation and physical risk related to third party donation of eggs.

In sum, Family-Making is filled with philosophically rich explorations of the nature and limits of parental obligations to their children, whether the children enter their families through sexual reproduction, ART, or adoption. In reading these essays, I found myself longing for the goods of childhood, cherishing the joys of parenting, and marveling at the many-splendored nature of our familial structures and the weighty (and sometimes confusing) moral responsibilities that attach to them.

Sara Goering

Department of Philosophy
University of Washington

Seattle, WA, USA

REFERENCES

Bartholet, Elizabet. 1995. Beyond Biology: The Politics of Adoption and Reproduction. Duke Journal of Gender Law and Policy 2 (1): 5-14.

Hursthouse, Rosalind. 1987. Beginning Lives. New York: Basil Blackwell.

Layne, Linda L., Sharra L. Vostral, and Kate Boyer, eds. 2010. Feminist Technology. Chicago: University of Illinois Press.

Katz-Rothmann, Barbara. 2012. Yet Another Technological Fix to a Social Problem. Retrieved 25 August 2017 from http://www.barbarakatzrothman.com/2012_07_01_archive.html.

Smith, Patricia. 1993. Selfish Genes and Maternal Myths: A Look at Postmenopausal Pregnancy. In Menopause: A Midlife Passage, edited by Joan Callahan, 92-119. Indianapolis: Indiana University Press.

Velleman, J. David. 2005. Family History.” Philosophical Papers 34 (3): 357-78.

— 2008. Persons in Prospect.” Philosophy and Public Affairs 36 (3): 221-88.

Young, Iris Marion. 2007. Global Challenges: War, Self-Determination and Responsibility. Cambridge: Polity Press.

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