Wrongful Life: Paradoxes in the Morality of Causing People to Exist  pp. 208-248

Wrongful Life: Paradoxes in the Morality of Causing People to Exist

By Jeff McMahan

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Harm and Identity

The issue I will discuss can best be introduced by sketching a range of cases involving a character I will call the Negligent Physician.

The First Preconception Variant

A man and a woman are considering having a child but suspect that one of them may be the carrier of a genetic defect that causes moderately severe mental retardation or cognitive disability. They therefore seek to be screened for the defect. The physician who performs the screening is negligent, however, and assures the couple that there is no risk, although in fact the man is a carrier of the defect. As a result, the woman conceives a child with moderately severe cognitive impairments.

Had the screening been performed properly, a single sperm from the man would have been isolated and genetically altered to correct the defect. The altered sperm would then have been combined in vitro with an egg drawn from the woman, and the resulting zygote would have been implanted in the woman's womb, with the consequence that she would later have given birth to a normal child.

Notice, however, that the probability is vanishingly small that the sperm that would have been isolated and altered would have been the very same sperm that in fact fertilized the egg during natural conception. And let us suppose that the egg that would have been extracted for in vitro fertilization would also have been different from the one that was fertilized during natural conception.