Hard Cases and Parental Choices in Biomedicine

Parental decisions in biomedicine shape every aspect of children’s lives, from birth to death, from illness to health. This article examines three distinct fields of parental decision: reproduction, genetics and the end of life. With the development of new reproductive technologies, the range of parental choices has significantly widened: healthy gametes may be used from donors, or embryos may be screened and selected before the implantation. The growing availability of various genetic technologies, such as genetic testing and screening, prenatal and preimplantation diagnostics, also create opportunities for parents to make decisions with important and lasting consequences on their child’s life. When parents are confronted with an incurable disease in their child, they are forced to make end-of-life decisions and may seek extraordinary remedies. Any new technology that offers hope in such a desperate situation may be regarded as lifesaving or at least capable of prolonging life or making unavoidable death more dignified. In all three biomedical cases parents literally make life and death decisions which are informed by their visions of a good life for their children. The author argues for the assessment of the best interest of the child in the light of the new technologies, and to provide assistance to parents in this hard decision making.