I am very happy to welcome Luara Ferracioli as the next featured philosop-her. She is an assistant professor in Political Theory at the University of Amsterdam. She works primarily on questions relating to the ethics of immigration and the ethics of parenting and procreation. Her work is forthcoming in the Journal of Value Inquiry, Review of International Studies and Ethical Theory & Moral Practice.
Her post follows.
–MK
On the Value of Intimacy in Procreation
Luara Ferracioli
What is wrong with anonymous surrogacy and gamete donation? Many feminists have argued that these practices are inherently exploitative or alienating. Yet, one can easily conceive of a world where donating a sperm or egg, and getting pregnant on behalf of someone else are considered highly valuable professional services, which are highly-paid and part of well regulated industries. In this ideal world, no one becomes a gamete donor or a surrogate out of economic necessity or desperation, but because there is a genuine fit between their conception of the good and the fact that procreation requires collective action. In my forthcoming paper “On the Value of Intimacy in Procreation,” I argue that what makes these practices morally wrong even under ideal conditions is the lack of intimacy between parties in the procreative chain.
Let me start by clearly stating the premises and conclusion of my argument:
P1. An agent contemplating procreation has a moral responsibility to only procreate when the social parent or parents (which may or may not include the agent herself) are willing and capable of discharging their parental responsibility sufficiently well.
P2. Assessment of the relevant capacity requires intimacy.
P3. There is no intimacy between parties in anonymous gamete donation and surrogacy.
C. Anonymous gamete donation and surrogacy are prima facie morally wrong.
While P1 seems to be uncontroversial, let me note that it actually departs from much liberal and conservative writings on the ethics of procreation. Conservatives have argued that the transferal of parental rights are necessarily problematic, either because we lack control over the actions of others or because children have a deep psychological need to associate with their biological relatives. Liberals, on the other hand, have argued that willingness alone is sufficient for the transferal of parental rights either because we can presume good enough parenting from those who are eager to parent, or because gamete donation and surrogacy are necessary to create a world where not only fertile heterosexual couples are capable of engaging in so-called “procreative parenting.” I lack the space to engage with all of these views here but let me say a few worlds in response to the liberal position.
First, if we think that children have a basic right to be parented by good enough parents, then morality requires that capacity and willingness obtain for each prospective social parent, and not for prospective parents in general. Second, everyone, not only homosexuals and infertile individuals are in danger of not finding a suitable partner with whom to procreate with. While it is certainly regrettable that some competent prospective procreators never become parents, morality has more pressing issues to address such as the fact that many children continue to have their basic rights violated because many adults continue to go ahead with procreation even though they are not fit for parenting.
So much for a defense of P1. Let me now defend both P2 and P3. The first question to ask here is this: why does intimacy matter? I take it that intimacy matters because the qualities that make for good enough parenting go beyond financial capacity and the lack of a criminal conviction. So when we ask what makes for a good enough parent, we can say that a good enough parent does not treat children with cruelty or disregard, for instance. We can also say that she or he understands that children need assistance in pursuing the good and is willing to assist them in engaging with meaningful projects and relationships throughout their childhood. And finally, we can claim that good enough parents are disposed to protect children’s basic interests by taking seriously advice from experts on their biological and developmental needs. Because these are the sorts of dispositions that present themselves in the course of intimate relationships with one’s partners, friends and family members, anonymous donors and surrogates are unable to transfer their parental responsibilities under adequate epistemic conditions. They are unable to ensure that those who will raise the resulting child are not only willing but also capable of parenting sufficiently well.
But there is a worry here. Can’t fertility clinics assess the parental skills of social parents via a well-trained psychologist? If anything, psychologists are likely to know more about our mental lives than those we are in intimate relationships with. To see whether or not psychologists in a fertility clinic could assess the parental competency of prospective social parents, let us start by asking what makes it the case that psychologists are more likely to know hidden aspects of our mental lives than other people we interact frequently with. It seems that the privileged epistemic position on the part of the psychologist is a direct result of her training and the sort of environment she can offer her client, where there is a clear focus on discussing the most uncomfortable and reveling aspects of the client’s inner life.
But note that when we imagine a psychologist who has a great degree of knowledge about her client’s dispositions and character traits, we are implicitly presupposing a therapy session that meets some standards of adequacy. We are, for instance, imaging that the client enjoys complete trust in the therapist, feeling safe to share the most unflattering aspects of her personality, embarrassing thoughts and morally problematic dispositions. This is why one would be tempted to assume that psychologists would be better placed than anyone else to assess the parental competency of prospective social parents and that my argument fails to show that intimacy is necessary for the assessment of a person’s capacity to parent sufficiently well.
But my argument would only fail if it were true that fertility clinics could in fact offer clients that kind of safe environment, where prospective parents would feel comfortable to reveal the most intimate aspects of their inner lives. And the worry is that precisely because the fertility clinic would be in the business of assessing the client’s parental competency, the trust required for such privileged epistemic access on the part of the psychologist would not obtain. The client, concerned as she would be with how she is being judged, would have very little incentive to open herself to the psychologist as she would if she was in the pursuit of self-knowledge. Because a successful therapy session requires that the therapist foster the belief that the clinician will always act in the client’s best interest, fertility clinics would not actually be in the position to adequately assess the parental competency of their clients. We are therefore back to the privileged aspect of intimate relationships in the assessment of parental competency.
Let me conclude this discussion by saying that my argument only applies to anonymous gamete donation and surrogacy. Those who donate their gamete or serve as surrogates to close friends and relatives do not do anything wrong if they are reasonably confident that their friends and relatives would be good enough parents. Those who assist strangers in their parenting enterprise, on the other hand, fail to transfer their parental rights under adequate epistemic conditions, and in so doing, violate a stringent moral responsibility to only procreate when reasonably confident that good enough parenting will follow.
Philosopher 
Hi Luara, good to read your post. I tend to agree with your position that it’s problematic to assist people with becoming social parents if one isn’t fairly convinced the prospective parent will be adequate. I wonder about the implications of this position, though. Many people, including fertile heterosexual individuals, depend on the support of medical stuff to have successful pregnancies. So, for instance, doctors these days do a lot to prevent spontaneous miscarriages. What, if anything, does your position say about the permissibility of working in those professions that enable people with whom one isn’t intimate to become parents?
Hi Anca, thanks for your question. You raise a really important point, and one that creates problems for causal accounts of procreative rights more generally. In terms of the specific point you make in response to my entry, I would say that health care professionals who assist intimates to procreate are justified in assuming that assessment of capacity has already taken place. In such cases, procreators do find themselves in an adequate epistemic position to discharge a stringent moral obligation that they have. Health care professionals who help strangers to procreate, on the other hand, cannot make similar assumptions, and so are doing something that is morally regrettable. But of course, once pregnancy has been confirmed, then the normative situation changes and women’s right to health care and bodily integrity come into the picture irrespective of their parental competency. Hope this answers your question, but let me know if not.
Thanks Luara, yes it largely answers the question; since most health professional work with strangers, the theoretical price of your account seems high. I wonder about the change in normative status once the pregnancy is confirmed; lots of miscarriages happen very early on, and pose no significant risk to the woman’s health. It seems that, on your account, it isn’t legitimate to help to prevent such a miscarriage if the pregnant woman in question is a stranger. (Not helping her wouldn’t entail risk to her health, nor any autonomy-threatening intervention.)
Hi Anca, so when I talk about “health care professionals who assist intimates”, I don’t mean their own intimates, so the theoretical price is not that high: only health care professionals working in fertility clinics that accept anonymous gamete donation and anonymous surrogacy are doing something morally regrettable (because prospective procreators are not in an epistemic position to assess each other’s parental competency prior to procreation). Now, regarding the miscarriage question: once pregnancy is confirmed, there is a prima facie duty on the part of health care workers to prevent a miscarriage (at any stage in the pregnancy) if the woman consents to that intervention.
Oh, then I’ve misunderstood your first reply – sorry. I don’t see why it matters that people who need help with procreation are intimate with each other – can’t two awful prospective parents be intimate with each other?
Sorry Anca, I should have made things clearer before. The argument in the paper is just about the obligation of procreators (gamete donors and surrogates) not to go ahead with procreation when they cannot assess the parental competency of social parents (and when social parents are incompetent). Now, I assumed throughout the discussion that there is a causal account that picks out gamete donors and surrogates as procreators, but not health care professionals. (So I have been assuming that the correct account of parental rights/obligations is able to draw such a line but I have not argued for this position). Now you asked me if I think that health care professionals have the same obligations as procreators, and the answer to that is no. But I do think than when health care professionals working in IVF/surrogacy clinics accept anonymous gamete donation/surrogacy, they do something morally regrettable – after all they are enabling procreation under non-ideal epistemic conditions. But note, I have not said that health care professionals who work in such clinics are violating a stringent moral obligation because I have assumed that they do not count as procreators proper. To be sure, all of that is parasitic on a causal account of procreation that can single out donors and surrogates as procreators, and not health care professionals. If that account is mistaken, then my claims over-generalize to health care workers, which certainly give rise to counter-intuitive results. (Although I would still prefer a scenario where we have too many parties with parental responsibilities, then one where persons can procreate willy-nilly). But yes, if this narrow causal account fails, I will be forced to bite some of your bullets.
Hi Luara! Thanks for your thought-provoking post. My question is this: Wouldn’t you have to show that people who have intimacy (such as future co-procreators) are on average better able to assess each other’s parenting competence than a psychologist (who does not necessarily have to be employed by the fertility clinic itself btw, so s/he could be impartial)? I think you might both be overestimating people’s ability to judge (for example) their partner’s fitness to parent and underestimating a psychologist’s capability. To consider another context: For example, psychologists or psychiatrists are able to assess whether a person who committed a crime is likely to do it again even though the criminal who believes of himself that he would do it again clearly has an interest not to be open with them. There are also really good questionnaires used on people who don’t observe traffic rules that can detect who is likely to do this again. So I think psychologist might be quite good at detecting whether someone’s a good enough parent or not. I’d also say that maybe people who are in a romantic relationship with each other are not always great at judging parenting abilities in each other (rose-coloured glasses etc.). What do you think?
Hi Sabine, these are great questions. So I spent a whole section of the paper engaging with the empirical literature on so-called positive illusion, precisely because there is evidence that satisfying romantic relationships, including marriages, can involve mutual idealisations (when each party in the relationship sees the other person in a more positive light than they see themselves). And if that is correct, it may seem that prospective procreators who are also part of satisfying romantic relationships are not actually in a position to assess the parental competency of their romantic partners. Interestingly, there is also strong evidence that people are more accurate or realistic about their partner’s qualities when they find themselves in deliberative mode than when they are simply dealing with their daily routine. So in day-to-day life, individuals may exaggerate how attractive or funny their partners are, but when they are making important life decisions, they will become sufficiently realistic about their partners characteristics and competencies. So yes, intimates are in an adequate epistemic position to assess each others’s parental competency.
Now, let me turn to the question of whether psychologists outside of a fertility clinic could be in a position to make this sort of assessment. Let me first say that I certainly think this is true of psychologists who have been supporting their clients to acquire self-knowledge for quite some time. There is very good reason to think that these psychologists are in an adequate epistemic position to assess the parental competency of their clients because the confidentiality that comes with the relationship gives the psychologist a lot of insight into the client’s inner life. But of course, once confidentiality goes away, this becomes less plausible. As for an impartial psychologist, who neither works in a fertility clinic nor has an on-going confidential relationship with the patient, I think we need more empirical evidence that they could properly assess the competency of prospective social parents through tests, etc. If we were reasonably confident that they could, then I would be very happy with such a scheme. But until we have such evidence, we should continue to rely on intimacy for the permissible transferal of parental rights and responsibilities.