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Tuesday, February 24, 2004

Postrel postscript

I am not making this up:  within 15 minutes of my putting up the previous posting, someone wrote to me to ask me for the details about my exchange with Postrel two years ago.  I tell you, this Internet, it’s almost like conversing sometimes.  OK, here goes.

The context was Postrel’s critique of Francis Fukayama’s Wall Street Journal essay on libertarianism and biotechnology, originally posted here (some scrolling required).  Postrel argued on libertarian grounds against all restrictions on cloning-- that is, she favored both therapeutic cloning (or what the Kass Report called “cloning-for-biomedical-research"), as do most people who aren’t guided by fundamentalist beliefs about the ensoulment of nine-day-old embryos, and the cloning of humans (what the Kass Report called “cloning-to-produce-children"), which is far more controversial.  (I myself support the former and not the latter.) But what was amazing about her “it’s all good” approach to cloning was that she drew the line at the birth of children who . . . well, you know, who might be social inconveniences, drains on the public till, that kind of thing:

As it happens, in various interviews over the years, I have specifically raised the problem of deaf parents who want to have deaf children as a potential example of the abusive use of genetic technology. Given attitudes in some quarters of the deaf community, that desire was predictable. I agree that genetic intervention to create a deaf child would constitutes a form of child abuse that would in theory justify state action to protect the child. . . .

So what to do about deaf parents who want deaf kids? I’m not sure. It’s extremely dangerous to give state authorities power over reproductive decisions, and prohibiting parents from introducing genetically abusive traits in their children would require prenatal screening that could easily lead to mandatory eugenics. Ample historical experience, the kind conservatives generally value, tells us that it’s wise to err on the side of preserving familial autonomy rather than looking for reasons to expand government regulation of family life. Respecting the family is a good general principle, even if in some cases (e.g., Andrea Yates) that respect has awful results.

The best approach is probably an indirect one, such as some sort of liability for the doctors and others who perform prenatal genetic alterations. If the doctor who deliberately creates a deaf child has to pay for the youngster’s special education, I don’t think we’ll see a lot of medically assisted child abuse. It would also help in the long run (though at the cost of considerable pain in the short run) to eliminate the many protections and privileges accorded disabled individuals.

So I wrote to Ms. Postrel to say, basically (and politely), just what “protections and privileges” are you talking about?

Her reply, in part:

The privileges include such things as open-ended payment for private-school education through public funds and state provision for medical care that is not provided for non-disabled children. I’m not saying that these children have privileged lives-- certainly they don’t-- but they have access to resources that even poor children without disabilities do not have.

The point about the long run is that, in a world where genetic intervention is possible both to cure and cause disabilities, the lack of state provision for, say, special education would create incentives for curing and disincentives for causing disabilities via genetic intervention. It wasn’t a point about the world we live in today (the occasional deaf lesbian couple aside) but the world Fukuyama is arguing we should never reach.

My response:

First paragraph:  There are two problems here.  One: since the Individuals with Disabilities Education Act (written and passed by Republicans who rightly saw it as a means of decreasing the dependence of the disabled on public assistance, just as C. Boyden Gray supported the ADA 15 years later) mandates only a “free and appropriate public education in the least restrictive environment,” it is hard to grant you your first point absent further evidence.  Two: it is sometimes the case that children with disabilities have access to resources that poor children with disabilities do not have.  But these would be, of course, resources that poor children without disabilities do not need, like physical therapy.  Now, if you want to argue that poor children without disabilities should have access to resources that enable them to make the most of what they were born with, great.  We welfare-state progressives would love to sign you up.

Second paragraph:  Fair enough, but the lack of state provision for special ed would create incentives for curing and disincentives for causing disabilities via genetic intervention only in a rational-choice Utopia in which (a) people knew in advance what disabilities their offspring might bear, (b) infallible treatments in utero and in the germline would prevent “anomalies” like Down syndrome within hours of fertilization, (c) cerebral palsy, autism, pervasive developmental delay, and catastrophic illnesses could be predicted with reasonable assurance the moment fertilization happens, and (d) everyone was completely rational (in a sense that you’d approve of) about (a), (b), and (c), and made their reproductive choices accordingly. 

--OK, so you see what I mean?  You’d think, from reading Postrel on “disincentives,” that there are plenty of libertarian couples out there who consult the tax code before they hop in the sack.

“Honey, when the government takes one-third of our money to prop up its outmoded welfare-state apparatus, does it give us any reason to try to have a child with disabilities?”

“You bet, snookums!  Look here-- it’s all paid for in advance, except for medical costs and child care!  All we have to do is have a child with cerebral palsy or autism, and finally the government will be working for us!”

Posted by Michael on 02/24 at 07:43 AM
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