Terrifying moral dilemmas

A regular interlocutor and occasional sparring partner over at MercatorNet asked for my opinion as an ethicist on a difficult moral dilemma: should couples who are, or suspect they are, genetically predisposed to terminal illness or other serious disease avoid having children?

For me these questions hit close to home. It is not difficult to imagine having children with serious illnesses or disabilities, though it is undoubtedly more salient for people who have witnessed and experienced the same in their families for generations.

Difficult cases such as these seem overwhelming when considered in isolation. It does indeed appear prudent and reasonable to avoid having children in order to avoid certain or highly probable disease.

However, ethics forces us to think not only of the outcomes, but of the principles behind an action. This is reasonable in part because our ability to assess outcomes is heavily constrained. For example, how do we correctly weigh the value of a life lived for thirty years, cut short by illness?
Even in a strictly consequentialist sense, we are not equipped to predict what medical advances or discoveries may come in the future.

In terms of the principles behind the action: at first glance, simply avoiding having children does not appear to be as bad as, say, actively killing people in order to root out genetic faults or variables either in utero or in vitro. The harm done is not to the non-existent offspring (assuming non-abortifacient contraceptive methods or alternatively NFP methods).

The harm done is to the marriage, and to the otherwise-would-be parents themselves. The nature of the harm or error is multifaceted and not obvious. It ranges from the simple harm of missing out on the fulfillment and enrichment that offspring provide, to the perhaps more ‘existential’ harm of adopting a worldview in which one is able and morally required to act with certitude and control in regard to circumstances and outcomes that are generally speaking beyond both our knowledge and our true control.

However, this last point broaches on terrain typically regarded as ‘religious’ and not encouraged in public debate. But I would say nonetheless that if the purpose of life is to avoid suffering and delay death, then perhaps such actions are a noble sacrifice. But if the purpose of our life is more than that, or better yet, the context of our life is broader than suffering and death, then we may have hope that such painful moral dilemmas are not as closed and complete as they appear.

I think the melancholic temperament is well-suited to ethics because it searches always for the principle or ideal behind an action. Melancholics are not good with ‘exceptional circumstances’ or arbitrary redrawing of boundaries. If we decide as a society that it would be wrong for children with certain disabilities to not be born, then an ethicist should (quite rightly) start to look for the operative principle behind such a conclusion.

The melancholics are, I think, merely more sensitive than most to the principles that exert constant albeit imperfect influence on all humans. That is why the eugenic fantasies may begin on ‘safe’ territory with the killing of severely disabled infants or the execution of the very worst serial criminals, but they tend to end with the elimination of those unlikely to achieve good university GPAs, and the culling of people with minor impulses toward rebellion or unconventional behaviour.