A Child by IVF vs Adoption:: Ethical Defining of "Want" vs "Need"
The issue is simply or perhaps not so simply the addition of a member to the family where there is an infertility problem of the couple. Should the couple "want their own kid", a child of their own genetic background, to carry on the family's genes by attempting an expensive and with some risk the invitro fertilization (IVF) and implantation of the embryo into the mother? Or would it be less expensive and more ethical in a societal sense to adopt a child who needs parents and a home? What is the ethical difference between need and want?
Physician-ethicist Erich Loewy wrote a response about "need" and "want" to a bioethics listserv dealing with this issue about the "wants" of infertile couples. He has given me permission to reproduce his comments here.
"Want their own kids" or want their own anything is the disease we in
Capitalist societies have, the "I need" is equated with I want. I
need food, water, shelter, the opportunity to get educated (no
comment please---I know it is too late!!) and to have health care. I
want is substantially different. I want to see the Great Chinese Wall
but if I don't, so what. I (actually) wanted to become a conductor
but lack perfect pitch which a first rate conductor needs. So, I
changed my want to something else. If I am terribly thirsty I need
water (same for hunger--and I do not mean appetite) and if I do not
get it I will die.
Having your own child may be a want but it surely is not a need. We
have (and I will not cite statistics once again) myriads of children
that need a home. Yes---they need it because there is more to a
child's surviving than what I have called "first order needs" (see
above). The problem is that many children who are homeless in today's
splendid Capitalist society happen to be Afro-American and (horor of
horrors!, I should have a Black, Jewish or Hispanic child!!!). So
instead of the needy glut we spend perhaps billions to artifically
satisfy somebodies want and let the need of others slide. Further,
this society is as full of racism (although the fraud of PC covers it
with a veneer of probity) as Austria, Germany and, yes, the US had of
anti-Semitism after the first war and, alas has today but again
hidden by a veneer of PC.
If a person is sterile (and I remember several classmates who would
have liked to be!!) that is unfortunate. If I lack perfect
pitch--that is unfortunate. Engelhardt woud claim that if I am ill,
that is unfortunate or unlucky. It however puts no obligation on
anyone to help me. But you see that is an entirely different one. My
"wanting" medical care is not a want---it is a need and it is
therefore that a decent society would provide single tiered
(everybody gets the same and no one can buy more of those things that
are "wants"---private rooms, TV in the room, nicer curtains, etc.
which do not affect outcome, However, the same physicians, staffing
with nurses, diagnostic or therapeutic means, waiting time, etc which
do affect outcome.
Being unable to have my own child is no more a "need" than is my
having perfect pitch is. It seems perverse to me that a society and a
world which already have more than it can take care of (or is willing
to take of!!!) goes out and with great effort and the use of many
resources tries to make more of what we already have but neglect severely.
Dr Erich H. Loewy
Professor of Medicine and Founding Chair of Bioethics (emeritus)
Associate in Philosophy
University of California, Davis
How do you look at this "want" vs "need" decision of infertile couples? ..Maurice.