Monday, September 08, 2008

PGD Paper (Update)

Back in January of 2007 I posted this while on the train from Exeter to Oxford. A revised version of that paper has been accepted for publication in The Journal of Medicine and Philosophy. My earlier post outlines the central details of the arguments I advance in the paper. But here is an excerpt from the final paper:

What should the scope and limits of reproductive freedom be for citizens that live in pluralistic liberal democratic societies? And how can a philosopher help enhance our deliberations concerning what would constitute a fair and reasonable answer to such a contentious social question? These are the two general questions that motivate the analysis and arguments developed in this paper. But in order to make some progress towards answering these more general questions I will need to narrow the focus of this paper quite this paper I will focus on a much more controversial range of issues, those which arise when considering permitting non-medical uses of PGD, such as gender selection. Gender selection (for non-medical purposes) is currently prohibited in both the United Kingdom and Canada.

....In this paper I will examine the appeal of these distinctive features of deliberative democracy (DD) by applying the theory to the issue of regulating the non-medical uses of PGD. PGD is perhaps an ideal issue to consider as it brings to the fore the two distinctive features of DD which Gutmann and Thompson (2004)emphasize. Firstly, it is a policy issue that raises distinct and conflicting values that need to be fairly accommodated. Permitting gender selection, for example, raises fundamental questions about the scope and limits of reproductive freedom and the importance of equality. And secondly, PGD is a novel technology that requires law-makers to adopt a provisionalist attitude. The stakes at risk in screening for gender, sexual orientation or a child’s propensity for certain behavioural characteristics can vary widely depending on the background features of the society in question (e.g. how pervasive patriarchy is) and the specifics of the intervention in question (e.g. costs of the procedure, etc.). Thus law-makers need to consider these different stakes and be prepared to revise policy in light of new moral insights and empirical discoveries.

By applying DD to the issue of regulating non-medical uses of PGD we see that the real challenge for liberal democracies, in terms of regulating these new technologies, is not to determine which first-order substantive or procedural values should be given primary importance. Rather the central issue is the different means by which we can best achieve a fair accommodation of the distinct values that arise in the context of regulating non-medical uses of PGD. So an examination of how DD can be applied to these issues illustrates how the theory can enhance public deliberation about legitimate public policy in a morally pluralistic liberal democracy. Rather than trying to win a philosophical debate among rival first-order theories, the prescriptions of DD will lead us to seriously entertain a certain range of policies over a different range of policies.

Drawing from the insights of DD, I argue that a just regulation of the non-medical uses of PGD is one that seeks to reasonably balance both substantive (e.g. liberty, equality) and procedural (e.g. democracy) values. Furthermore, it will seek to do so in a way that takes seriously what Gutmann and Thompson call “provisionality”. In order to take seriously the requirements of provisionality, as well as conflicting substantive and procedural principles, I argue that liberal societies should seek to satisfy what I call the Reasonable Genetic Intervention Model (hereafter referred to simply as the Model). The Model does not give an absolute priority to any one substantive or procedural principle; it adopts a cost-benefit analysis that permits liberal societies to consider the fuller range of values (e.g. ends) and issues (e.g. means) that must be addressed if we hope to justly regulate non-medical uses of PGD.

While I do not intend to utilize the Model for the purposes of pre-empting actual public debate on what constitutes a just regulation of PGD, I do conclude that outright bans or even severe restrictions on non-medical uses of PGD will likely fail the test prescribed by the Model. The general prescription of DD, as it applies to the issue of regulating PGD, is that justice requires that we pursue responsible legislative activism. Such activism does not give an absolute priority to considerations of liberty or equality, but it does require liberty-restricting provisions to be premised on grounds more defensible than mere speculations concerning the potential negative effects non-medical uses of PGD might have on society.