Thursday, October 13, 2011

Exposing Children to Risk: Why Do We Ignore Genetic Risk?

Reader Chuck G. proposes a thought experiment to examine our thinking on exposing children to different kinds of risk:
I was thinking about the moral problem of breeding couples with heritable diseases, specifically bipolar disorder (since I have it), and I came upon a nice little analogy that is pretty damning to those who think it's ever OK for two genetically-impaired parents to have a kid:

First of all (this isn't very well-researched, just Wiki, but it's a start), bipolar disorder has a 0.4% lifetime suicide rate among all patients, and a full third of them attempt suicide at some point. Those numbers compare well with the mortality rate and general seriousness of West Nile Virus. For those who don't know, West Nile Virus has to be handled in level 3 biosafety labs, right along with a bunch of shit the Pentagon tried to turn into biological weapons. You Do Not Want West Nile Virus.

So let's think of a couple where there is a decent chance of passing on bipolar disorder to their child. They have it, everyone comes to the baby shower, and they wish them well and give them lots of nice presents. It's a joyous occasion, and the parents may even be praised for their decision to reproduce. People might know about the parents' heritable genetic problem, but surely they would smile and nod anyway.

Now think of a genetic supercouple with no possibility of passing on a hereditary illness to their offspring. They go to the hospital, the child is delivered, and just as it comes out of the mother, the father sprays it in the face with a spray bottle full of West Nile Virus. Wanna know what happens?

Go to jail. Go directly to jail. Do not pass Go. Do not collect $200.

Oh, and also, you're going to be on the news for months, you will never live down your infamy, and you are never going to see your kid again, ever, regardless of whether or not it manifests symptoms.

I just don't see how willingly conceiving a child with a known risk of severe lifetime disease differs from willingly conceiving a child with no risk of severe disease, then willingly exposing it to such a risk later. You're deliberately gambling with someone's life in a way that goes far above and beyond the usual case for philanthropic antinatalism. I think this shows just how far toxic cheeriness infects our society. It warps all our perceptions and allows us to get away with assault/manslaughter/criminal negligence, as long as *our* genes do the hurting and not genes from some mosquito virus.

Intuitively, it does seem that we treat the risks inherent in the creation of a child differently from the risks we expose a child to after he has been created. This is true even though different prospective parents expose their children to different levels of genetic and early developmental risk.

The explanations I find most compelling for the double standard here are, first, an ill-thought-out, pluralistic/liberal distrust of eugenics, and, second, the very abstractness of the harm, compared to, say, kicking a baby like a ball or microwaving her.

And, of course, there's the idea that any existence is better than none, so that any risk necessarily engendered by bringing someone into existence is acceptable, whereas creating new risk after the fact is morally questionable.

What other reasons might there be for treating genetic and early developmental harm/risk differently from the harm/risk created later in a child's life? Is it so obvious that any existence is better than none? This seems like a dubious proposition upon which to base such a a serious action as childbearing.

Eugenics

On the Nazi/eugenics issue, I think it is highly relevant that many observant Ashkenazim participate in voluntary screening for Tay-Sachs disease. This, despite speculation that heterozygosity confers greater intelligence. As a culture, observant Ashkenazim have decided that the suffering of children born with Tay-Sachs is more important than concerns about "eugenics," and certainly more important than a speculated slight increase in intelligence for carriers.

9 comments:

  1. Oh two other comments here:

    1. The .4% rate is annual; I've heard as high as 10% suicide mortality, lifetime, for bipolar people.

    2. I think a death from suicide reflects worse on the parents than a death from other causes, because the suffering necessary to cause suicide is great. It reflects a judgment that this life was not worth living to its conclusion. If your child commits suicide, it's a better indication that you screwed up in your decision to procreate than if your child dies of e.g. leukemia.

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  2. Chip says:

    This might fall under the "abstractness" umbrella, but I suspect that procreative risks are more easily rationalized because people tend to be irrationally optimistic about their own future, and, by extension, about the future of their own children (and, by further extension, about the hypothetical children of others). People like to imagine that the future will provide a panacea for present ills.

    Anyone else unable to post comments? Please email me.

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  3. Is this irrational overoptimism about the future based on social programming or has a biologic component? If social programming was removed then would the situation change?

    B23

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  4. Sister Y, as quite often, I think you simply overestimate the intellectual capacity of the average person to think through moral problems with any degree of sophistication.

    People are programmed by memes, which in turn are fine-tuned to selection pressures with adaptation techniques such as "create a child and program it with a copy of me, even if it means accepting risks of suffering for the child" and, at the same time, "do not harm an existing child of yours, especially if it was or could still become programmed with me".

    And, at least here in Germany, "do exactly the opposite of what the Nazis did or else you will be socially and politically rejected".

    No one ever claimed that the result of this causality would in any way be rational or lead to consistent behaviors or value judgments.

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  5. Anonymous 7:33: I think that average person is perfectly capable of thinking through moral problems.They simply refuse to think the situation through because they know that they may not like the conclusion.

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  6. I see most of these things coming down to religious leftovers like self, intent, blame, and culpability. These notions do not exist in any relevant way. They are the roman numerals of ethics. You can justify almost anything if you work with such a complicated system of ill-defined concepts.

    Parents can justify having kids even if they know things like capitalism or robberies or oppression or torture will strike, because then the capitalists or the robbers or the oppressors or the torturers are fully responsible, and they themselves not at all. Hence we should fix reality such that these (possibly considered inherently evil) people are kept in check or removed. No attention is paid to the fact that reality almost certainly cannot be fixed in such a way; that is dealt with differently.

    If they know their kid will be subject to disease, famine, war, "natural disaster", i.e., things that "nobody can help", things that come with life, things that are "just the way things are", then you can't possibly hold the parents responsible either. They didn't cause the disease, nor did they cause the famine, nor did they cause the war, nor did they cause the natural disaster. These are things that "just happen", that we are trying our best to prevent and solve, or glorify (see: Steve Jobs on death, average joe on pain and suffering), or both.

    This is a blurry line, of course. For example, in the case of famine they might be able to find someone else to hold responsible (such as the goddamn government, or the goddamn capitalists, or the goddamn others-who-should-not-be-having-kids because their having kids costs resources). Maybe someone can be blamed, sued and devastated for being "negligent".

    A long time ago I used to justify eating meat just because I could, by pointing out that animals get killed in the harvest of plant-based food, that "plants have feelings too" (and they are much more densely kept than animals!), and by otherwise pointing out that we necessarily live at the expense of others. This is true, but the conclusion that making others pay is justified is false. (Incidentally, one of the rationalizations that I was aware of but never used because I found it too obviously stupid was that increasing meat consumption would enable more animals to exist, which was supposed to be a good thing. It still took me more than five years to get to antinatalism from there. :-))

    My relevant conclusion is that parents feel "they" can't be held responsible for the experiences that befall their kid due to the actions of "others". And if there are no "others", then it's just the way it is, so tough shit. Man up, kid!

    So this talk of responsibility is conflating things here, and we need to make some more distinctions between things, yea? While the parents don't necessarily help cause the diseases and famines that their kid happens to get caught up in, they do help cause the suffering their kid experiences. More precisely, the parents procreating is a necessary condition for the existence of that suffering. And in practice it is not only necessary but sufficient.

    (Sorry for the long comment... I am really too busy to make it short.)

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  7. I think the decision to breed when there's a family propensity to mental disease--particularly addictions, schizophrenia, autism, and especially mood disorders--is far crueler than when there's a propensity to deadly physical illness.

    After all, we're all toast at some point--which is why baby manslaughter (my pet name for childbirth) is cruel in any case, but to live one's life as a depressive alcoholic, or to be exposed to the side effects of antipsychotics, is a chronic hell all the way through. Not to mention the social stigma; I guess it's sort of OK to say you're depressed now, but alcoholics are still lepers. If people with a personal history addictions or mood disorders don't have the sense to know not to breed, I just don't know what you can say to them. "Really? You're miserable all the time, there's proof that it's genetic, and you're going to put that same gun to someone else's head? I guess in your case it might actually be valid to claim you stay depressed because you enjoy it!" If you pass on these genes you're not just making a miserable person, you're reducing the potential happiness of everyone they ever get close to.

    The law should not only be punitive but proactive: if I ran the world it would be illegal to sell cheap liquor or psychoactive medication without throwing in a free pack of condoms. Or, preferably, a tubal ligation, but then I'm the Nazi.

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  8. Akshully, make that all liquor. There are probably high-functioning bipoloar alcoholics out there who can still afford the good stuff but constantly think about jumping out the window and shouldn't be making babies.

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  9. Amen,Ann,amen! I'm a victim of heriditary anxiety and depression.

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