In contemporary Western society, people are more often called upon to justify the choice not to have children than they are to supply reasons for having them. In this book, Christine Overall maintains that the burden of proof should be reversed: that the choice to have children calls for more careful justification and reasoning than the choice not to. Arguing that the choice to have children is not just a prudential or pragmatic decision but one with ethical repercussions, Overall offers a wide-ranging exploration of how we might think systematically and deeply about this fundamental aspect of human life. Reviewed by Deborah Lupton. 

Why Have Children? The Ethical Debate. Christine Overall. MIT Press. January 2012.

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This book addresses an ethical issue that has rarely been examined in depth. The assumption that having children is a right and proper – and indeed ‘natural — thing to do is rarely questioned. People who want children but are unable to bear them are the target of pity: people who choose to remain childless are often subject to suspicion and accusations of selfishness or egotism. The decision to procreate, in contrast, is generally assumed to be ‘what one does’.

If examined closely, however, there are a number of caveats to this assumption. Gays or lesbians, unmarried couples or people not in a partnership, people with disabilities, people who are considered ‘too old’ or ‘too young’ or parents who are viewed as already having too many children are often not considered suitable candidates for giving life to children. Further, while in earlier eras married couples were expected as a matter of course to produce children, this expectation is no longer as strong. Increasing numbers of couples are choosing to remain childless and couples with children are having fewer of them, accounting for a significant fall in birth-rates in developed countries over the past generation.

Christine Overall is a philosopher at Queen’s University, Canada. She is interested in bioethical issues, and has previously published on other philosophical aspects of human reproduction as well as on ageing and death. This book extends her interest in the ethics of reproduction in addressing itself to moral issues around procreative choices, and by doing so uncovers their complexities.

As one might expect from a philosophical enquiry, this book adopts a highly rational, considered argument. Overall’s central tenet is that the ‘naturalness’ of making the choice to procreate should be questioned for its ethical dimensions. In a clearly written and rigorously defended analysis, she sets forward a detailed exegesis of the various positions and perspectives one can take on this topic from a philosophical perspective.

In order to contain the focus somewhat, Overall directs her attention at contemporary North American society and on heterosexual procreation. She reviews the concepts of reproductive freedom and reproductive rights, the question of whether individuals are harmed, benefited or neither by coming into existence and whether there is a moral argument that can reasonably made for the obligation to have children. Overall also considers the ethical conundrums faced in situations such as when two prospective parents disagree about whether or not to have a child, they wish to conceive a saviour sibling to help an ill pre-existing child or when one or both prospective parents or the foetus has a serious illness or disability.

Overall distinguishes between deontological and consequentialist reasons for having or not having children. The former relates to conforming to moral rules: what is generally considered to be the ‘right’ thing to do. The latter is based on a consideration of the possible outcomes of decisions. Thus, from a deontological perspective choosing to have children may be founded on the acceptance that to procreate is morally right, based on the intrinsic values of childbearing. These values may include passing on one’s genetic inheritance, name or property, fulfilling the expectations of others, keeping a promise or discharging a religious duty or a duty to family members or the state. From the consequentialist position, whether or not procreating harms or benefits parents or their offspring is weighed up.

Having reviewed each of these positions in detail and examined the strength of their logic, Overall finds that neither of them presents a compelling moral reason to procreate. Her final argument is, therefore, that the burden of justification rests on those who choose to have children.

As a sociologist who researches the topics of pregnancy, childbirth and parenting cultures, I enjoyed the opportunity to consider a different perspective on reproduction. However, despite my admiration for the thoroughness and elegance of the philosophical argument Overall constructs, I found the discussions of these topics very disembodied and impersonal. This disappearance of the body is a feature that I have often noticed in the bioethical literature, in which highly contentious and emotional issues such late-term abortions or neonaticide are frequently considered in purely intellectual terms.

The fleshly body, with all its yearnings, inchoate longings, intense emotions, sensuality, desire for touch and love, its blood, sweat and tears – and yes, its irrationalities — tends to disappear from view in the midst of such dry reasoned argument. Nor do the sociocultural meanings around the unborn, infants and children which shape so many of the debates and choices concerning procreation tend to be acknowledged in any great detail. The kind of argument presented in the book cannot account for the desperate actions of some couples experiencing infertility: their willingness to undergo repeated expensive, emotionally stressful and invasive IVF treatments or travel overseas to employ a surrogate mother in the hope of having a child of their own.

This book is a useful addition to the bioethical literature on reproduction. Anyone who has an intellectual curiosity in the way such issues as procreative choice are examined and weighed up by philosophers will enjoy following the detailed arguments Overall puts forward. Those who might be seeking some support for their decision to go ahead and procreate or who wish to find arguments to defend their choice to remain childless might find the book rather too academically bloodless. So too may readers from outside bioethics who are interested in the lived experience of making reproductive choices and living with their consequences.

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Deborah Lupton is a sociologist in the Department of Sociology and Social Policy at the University of Sydney. She is the author of 12 books, the latest of which are Medicine as Culture (2012, 3^rd edition, Sage), Fat (2012, Routledge) and Risk (2^nd edition, in press, Routledge). Her current research interests are parenting cultures; unborn and infant embodiment; fat bodies and obesity politics; the ethics of public health campaigns; and the use of digital technologies in health and medicine. Deborah blogs at This Sociological Life. Read more reviews by Deborah.