Preserving children’s fertility: two tales about children’s right to an open future and the margins of parental obligations
The sources, extent and margins of parental obligations in taking decisions regarding their children’s medical care are subjects of ongoing debates. Balancing children’s immediate welfare with keeping their future open is a delicate task. In this paper, we briefly present two examples of situations in which parents may be confronted with the choice of whether to authorise or demand non-therapeutic interventions on their children for the purpose of fertility preservation. The first example is that of children facing cancer treatment, and the second of children with Klinefelter syndrome. We argue that, whereas decisions of whether to preserve fertility may be prima facie within the limits of parental discretion, the right to an open future does not straightforwardly put parents under an obligation to take actions that would detect or relieve future infertility in their children—and indeed in some cases taking such actions is problematic.
KeywordsFertility Klinefelter syndrome Cancer Right to an open future Right to genetic privacy Screening Fertility preservation
- BBC News, Ovarian transplant first welcomed. August 2, 2007. http://news.bbc.co.uk/2/hi/health/6924014.stm. Last accessed August 2014.
- Borry, P., et al. 2014. Is there a right time to know? The right not to know and genetic testing in children. Journal of Law, Medicine & Ethics 42(1): 19–27.Google Scholar
- Bourke, E., et al. 2014. A qualitative exploration of mothers’ and fathers’ experiences of having a child with Klinefelter syndrome and the process of reaching this diagnosis. European Journal of Human Genetics 22(18): 24.Google Scholar
- Davis, D.S. 2010. Genetic dilemmas: Reproductive technology, parental choices, and children’s futures. Oxford: Oxford University Press.Google Scholar
- Donnez, J., et al. 2011. Pregnancy and live birth after autotransplantation of frozen-thawed ovarian tissue in a patient with metastatic disease undergoing chemotherapy and hematopoietic stem cell transplantation. Fertility and Sterility 95(5): 1787 e1781–1784.Google Scholar
- Feinberg, J. 1980. The child’s right to an open future. In Whose Child? Children’s rights, parental authority, and state power, ed. W. Aiken, and H. LaFollette. Totowa, NJ: Rowman and Littlefield.Google Scholar
- Feinberg, J. 1992. Freedom and fulfilment: Philosophical essays. Princeton: Princeton University Press.Google Scholar
- Jonas, H. 1997. Tecnica, medicina ed etica. Prassi del principio responsabilita. Torino: Einaudi.Google Scholar
- Laurie, G. 2014. Recognizing the right not to know: Conceptual, professional, and legal implications. Journal of Law, Medicine & Ethics 42(1): 53–63.Google Scholar
- Poirot, C., and B. Schubert. 2011. Fertility preservation in prepubertal children. Bulletin du Cancer 98(5): 489–499.Google Scholar
- Rieker, P.P., et al. 1990. Adaptive behavioral responses to potential infertility among survivors of testis cancer. Journal of Clinical Oncology 8(2): 347–355.Google Scholar
- Rochman, B. 2011. Even as babies, cancer patients strive to preserve fertility. http://healthland.time.com/2011/03/22/children-having-children-when-a-kids-got-cancer-fertility-preservation-can-help/ (last accessed August 2014).
- Sanchez-Serrano, M., et al. 2010. Twins born after transplantation of ovarian cortical tissue and oocyte vitrification. Fertility and Sterility 93(1): 268 e211–263.Google Scholar
- Simon, B., et al. 2005. Preserving fertility after cancer. CA: A Cancer Journal for Clinicians 55(4): 211–228.Google Scholar