Читать книгу Bioethics - Группа авторов - Страница 52

In some quarters of bioethics, homosexual men and women do not enjoy a strong presumption of equality in regard to social goods and relationships. Some commentators presuppose this inequality in the questions they raise about the prospect of synthetic gametes and the children of same‐sex couples, questions that imply burdens of proof that do not apply to others. Other commentators express this view directly in claims that gay and lesbian parenthood compromises the rights and welfare of children, so much so that gay men and lesbians should refrain from having children altogether (according to the more stringent arguments) or should avoid using certain methods to have children (according to the less stringent arguments).

To be fair, some commentators have expressed strong support for the use of synthetic gametes as a way for same‐sex couples to have children with shared genetics. Testa and Harris have defended this use on four main fronts: (1) that the idea of ‘nature’ cannot sustain an argument against it because the ‘whole practice of medicine is a comprehensive attempt to frustrate the course of nature’, (2) that claims that children are harmed by coming into existence this way cannot be sustained because existence is preferable to non‐existence in terms of the value of children’s lives to themselves, (3) that ARTs are currently available to homosexual men and women in a way that would make it idiosyncratic to forbid synthetic gametes and (4) that, in any case, the evidence is lacking that children of gay and lesbian parents fare worse than the children of others.¹⁸ Not only do they criticise objections to the use of synthetic gametes as unfounded, but Testa and Harris offer positive arguments in favour of synthetic gametes for gay and lesbian people, for example, by arguing that synthetic gametes would help ‘democratise reproduction’. Yet, even here, the defence of gay men and lesbians as parents comes as the conclusion to a long and involved argument, which Testa and Harris concede could have gone on to even greater lengths!

In the early days of bioethics, some commentators analysed homosexuality relative to various theories of disease and health.^19–21 Ironically, many of those early discussions occurred after the interpretation of homosexuality as pathological had already faded in credibility and significance. The UK Wolfenden Report repudiated the view of homosexuality as pathological in 1957, and the American Psychiatric Association followed suit in 1973.^22,23 Bioethics busied itself with this question for some time afterward. Since those discussions, however, most analysts have moved on from questions about the ‘pathology’ of homosexuality, and focused on questions of healthcare access and equity for gay men and lesbians. Yet some commentators have used synthetic gametes to throw the integrity of homosexual men and women into question again, at least as far as parenthood is concerned. In different ways, Somerville, Velleman and Callahan treat the legitimacy of gay and lesbian parenthood as objectionable. As I have tried to show, however, their very objections can sometimes work in favour of synthetic gametes for same‐sex couples, especially by rendering moot worries about the relationships between parents and children.

At this stage of bioethics, though, why should we not assume in an axiomatic way that gay men and lesbians should be respected in their sexual identities, in their relationships in general, and in relationships with their children in particular? How many times must bioethics relitigate parenthood for gay men and lesbians? Questions of ethics do arise in the use of synthetic gametes by same‐sex couples, but the most important questions are not about the suitability of same‐sex couples as parents or even the welfare of their children. The most important questions involve access and equity. Are prevailing clinical standards – with their framing of infertility in terms of anatomical or physiological deficits involving opposite‐sex partners – a hindrance in any way to fertility medicine for same‐sex partners? If insurance companies in the USA cover infertility treatments for straight couples, is there any morally compelling reason they should not extend the same benefits to opposite‐sex couples, some of whom will be in lawful marriages? Given the historical arc of homosexuality in bioethics, the field may eventually move to embrace these kinds of questions fully, after the novelty of synthetic gametes wears off, and bioethics may yet embrace homosexual men and women as the presumptive equals of everyone else in regard to fitness as parents. The sooner, the better.