As members of a "progress" oriented society, we are increasingly faced with choices about our children. No longer are our options limited to simply whether or when to have children; in this era of biotechnology, discerning would-be parents may now make decisions about what kinds of children we will and won't have. In a slim volume that condenses a series of his lectures at the Oxford Uehiro Centre for Practical Ethics, renowned moral philosopher Jonathan Glover tackles the complicated subject of the rights and responsibilities that attach to this capacity for decision-making. Choosing Children: Genes, Disability, and Design attempts to adhere to academic standards while remaining accessible, while simultaneously making life better. This review focuses in particular on this last standard — whether the moral reasoning advanced by Glover in fact makes life better, and for people with disabilities in particular.
Choosing Children poses an important question at its core. Given advances in genetics and reproductive technologies, we now have the power to reduce the incidence of disabilities. Should we embrace this power, or run from it, screaming? One particular merit of Choosing Children is Glover's apparent initial neutrality. Rather than having made up his mind in advance and dedicating the book to a defense of that position, Glover circles around the issue, exposing readers to the many facets of the difficult decisions that technology makes possible. To his credit, it is possible to come away from Glover's book without a clear, easy answer — instead, with a stronger grasp of the complexities he details.
On the pro-genetic-choice side, Glover argues that in many cases, having a disability means that people have "less good" lives than they would or could have had — lives streaked with more pain and more brushes with problematic institutions, lives marked by greater challenges and disadvantages, and that these injustices might be understood as a warrant for the removal of disability. (What exactly constitutes "removal of disability" remains murky at many points in the volume, and there is a big difference between gene therapy that might remove a disability and elective pregnancy termination, which removes not only the disability but the possibility of life.) He also recognizes the existence of a technophilic argument that sees the mere elimination of disabilities as a prerequisite to the most exciting possible ends of genetic choices — "designer babies" to whom genetic choices have promised life's most enriching qualities and abilities.
On the other, more-wary-of-genetic-choices side, Glover details the echoes of eugenics heard by those who see the elimination of disability via prenatal screening or pre-implantation genetic diagnosis as, in fact, the prevention of the birth of people with disabilities. Glover notes that these choices make life more difficult for people who do live with disabilities. In addition, he notes the problems inherent in allowing the state, or even individual sets of parents, to play god with the genetic makeup of their children, which may have disastrous consequences for society as a whole.
Choosing Children is divided into three chapters, the first of which will be of greatest interest to readers in Disability Studies. Glover begins by discussing genetic choices linked to disability in the first section, then moves on to considering potential conflicts between parental freedom of choice and the child's interests in the second. In the third section, he concludes by reviewing the case of "designer babies" whose genes are not selected simply on a medical basis but for more broad notions of enhancement. The comments that follow describe primarily the first section, as this is most relevant to readers of DSQ.
Glover outlines medical and social models of disability, and defines disability as a limitation of functioning that either on its own or in combination with social disadvantage impairs capacities for human flourishing. This pushes him along to a consideration of what constitutes normal human functioning (which he admits is a messy business), as well as a review of moral objections to the contrast with normality, which leads him to integrate the perspectives of people living with disabilities who do not see their flourishing as impaired on account of their disability. Alas, Glover quickly notes that "disadvantage can itself shape people's preferences" (p. 18) before dismissing "the satisfaction of scaled-down preferences" (as in the case of women in India or China who proclaim satisfaction with their restricted access to education and medical care) as a form of false consciousness. In this move, Glover calls into question the entire enterprise of self-determination for people with disabilities. He eventually settles on the idea that evidence of impaired flourishing can best be judged by interpreting the preferences of competent judges who have experienced both states, giving back some of that power. Glover's final move in this disability-focused chapter is to argue that comparisons between present genetic choices and Nazi eugenic campaigns are overwrought, as parents pursuing screening today feel compassion for the potential child or their other children, rather than acting out of a desire for racial cleansing or gene pool-strengthening. He does recognize that such parental choices may be borne out of ugly attitudes towards people with disabilities, but feels that not all decisions not to have a child with a disability may be an expression of these ugly attitudes. Glover carefully states that "It is important to show that what we care about is our children's flourishing: that this, and not shrinking from certain kinds of people, or some horrible project of cleansing the world of them, is what motivates us. To think that a particular disability makes someone's life less good is not one of the ugly attitudes. It does not mean that the person who has it is of any less value, or is less deserving of respect, than anyone else" (p. 35). While his intentions are clearly good, Glover comes off as somewhat naïve in his estimation of how ugly attitudes about disability play out in the real world.
As Choosing Children winds down, Glover speculates about the yet-not-fully-realized potential for designer genes — say, choosing a gene for "patriotism" or "generosity" for one's child. While fascinating, there are important differences between moral reasoning about such speculative choices and about physical and mental forms of difference for which we can already test. It is the latter case that is of greatest importance to scholars of Disability Studies. Thus, DSQ readers interested in philosophical perspectives on our capacity to design children without disabilities will find the first third of Glover's book illuminating yet sometimes challenging.
