Do Same Sex couples have a greater right to Fertility Treatment?

Emily McTernan “argues that states have greater reason to provide fertility treatment for same sex couples than for heterosexual couples” (1). She bases her argument on the premise that greater access to fertility treatment for same sex couples will encourage a diversity in of ways of life and that this diversity is a social good. In this posting I will argue that she is mistaken and that same sex couples do not have a greater right to fertility treatment.

In what follows I will restrict my discussion of fertility treatment to IVF. McTernan argues that IVF cannot be justified as an element of general healthcare. Healthcare she assumes should be concerned with disease and infertility is not normally a disease. She defines disease as an adverse deviation from normal species functioning and this deviation is a deviation from what is statistically normal given someone’s age and sex. Of course there are exceptions.  A women with a specific problem such as blocked fallopian tubes has a disease and using the above definition has a right to fertility treatment, has a right to IVF. However for most couples, especially if the women is older, infertility is not a deviation from what is statistically normal, and as a result most couples do not have a right to IVF based on a right to healthcare. I agree with McTernan.

Accepting the above of course doesn’t automatically mean people don’t have some right to IVF or that the state shouldn’t provide IVF. After all the state provides such things as libraries, parks and sports fields. Accepting the above only means that the states provision of IVF should compete with the states’ provision of libraries, parks and other things which help its citizens flourish. Let us accept that the state should provide some funding for IVF commensurate with other requirements it has. McTernan argues that within this provision same sex couples should be prioritised in order to encourage a diversity in ways of life.

I now want to argue that McTernan’s argument is unsound and that in allocating IVF we shouldn’t prioritise same sex couples. Firstly I will argue McTernan’s reason for such prioritisation is unsound and secondly present an argument against any such prioritisation. McTernan believes that we should encourage diversity in ways of life. Offering priority in access to IVF to gay couples might increase diversity in child rearing. However if diversity in ways of life is an unqualified good then perhaps the state should reform the law on bigamy and even encourage polygamous marriage as by doing so it would encourage different sorts of relationships. Few people would support such a reform but even if such a reform could be justified other examples could be imagined to show that not all diversity in ways of life are good. Nonetheless let us accept that diversity is sometimes desirable, is a qualified good. It follows diversity in child rearing might be such a qualified good and hence should be encouraged. What exactly does McTernan want to increase diversity in? Does she want to increase diversity in child rearing or simply diversity in relationships? Child rearing involves loving, safe guarding, nurturing and guidance. I don’t believe McTernan wants to change these basics. It follows she wants to increase a diversity in relationships. However the state could also encourage a gay lifestyle, in order to increase a diversity in relationships, by tax incentives. Few would support such a proposal. Such a proposal seems to be mistaken for surely the amount of diversity in sexual orientation in a society should be determined by people’s natural inclinations rather than by government policy. Accepting the above means of course if sexual orientation in a society should be determined by people’s natural inclinations rather than by the state that the state has reason to permit gay marriage. Accepting the above also means the state has no reason to prioritise access to IVF for gay couples.

Gay couples cannot have children unaided by anyone else. It might be suggested that this fact means gay couples should be prioritised in accessing IVF. However even if gay couples cannot have children unaided by others IVF is not the only option open to them if they want to have children. Both male and female same sex couples might be able to adopt a child. Male couples might also use surrogacy and this need not involve IVF. Female couples can use AID. It seems to me the fact that gay couples cannot have children unaided does not mean they should be prioritised in accessing IVF.

I now want to argue there is a second reason as to why gay couples should not be given greater priority in accessing IVF. My argument is based on fairness. Let us assume that gay couples are given greater priority in accessing IVF. It might then be objected such prioritisation is unfair. Fairness requires that everybody’s needs are considered. It does not follow of course that everybody’s needs should be satisfied equally. However it does require that if some peoples’ needs aren’t satisfied equally that some reason can be given for this. Let us assume that people have a need to have children who are genetically related to them. Let us consider a gay and a heterosexual couple both of whom are unable to conceive children without IVF. Both couples have the same need. Fairness requires that if the needs of these couples are satisfied unequally that there that some reason can be given for this unequal satisfaction. The need of both couples are identical, to have children they are genetically related to. If the needs of both couples are the same then any reason given for unequal treatment must depend on the outcomes for any children so conceived or some benefit to society. The outcomes for any children depends on the parenting skills of the couples involved. Perhaps for instance either gay or heterosexual couples make better parents. However there seems no evidence to support such a reason. Perhaps then society might benefit from unequal satisfaction. It is difficult to see how society might benefit except for promotion of greater diversity, but I have argued above that whilst society must permit greater diversity it should not try to alter the natural diversity occurring within it. In conclusion it would seem that the encouragement of a diversity in ways of life does not give us a reason to prioritise IVF for gay couples over heterosexual couples. It further seems that fairness requires that all couples are given equal priority.

1. Emily McTernan, 2015, Should Fertility Treatment be State Funded? Journal of Applied Philosophy, 32,3. Page 237

The Philosophy of Rudeness

 

In this posting I want examine rudeness. It might be thought that rudeness is of minor concern to society and hence not of any great philosophical interest. In the age of Trump and Brexit I believe rudeness should be of far greater concern to society. For instance, consider the former Chief Constable of Northumbria Police who resigned over alleged rudeness to senior colleagues, see the guardian . It also seems possible that rude and aggressive behaviour, for rudeness and aggression seem to be linked, might make teaching more difficult. Lastly it appears that someone’s creativity and willingness to help others might be damaged by rudeness, see the psychologist . It follows there are some reasons as to why rudeness should be of concern to society. I would suggest that any civilised society must pay attention to the views of all members of that society. Rudeness involves an inattention to the views of others and as a result damages discussion by shifting the focus of our attention from the issues involved to the tone of the discussion. Rudeness means we talk at each other rather than engage in a meaningful discussion. In the light of the above I would suggest that any society which accepts a high degree of rudeness is not a civilised society even if it possesses advanced technology. In this posting I want to consider a different aspect of rudeness, is rudeness linked to immorality? Is rudeness a vice?

What do we mean by rudeness? Rudeness might be defined as a lack of manners or being discourteous. In what follows I won’t deal with etiquette and mainly focus on someone being discourteous. What then do we mean when we say someone acts discourteously? One can’t be discourteous to oneself, discourteousness applies to relationships. Someone acts discourteously in his relationships if he focusses solely on his needs and wishes without considering the needs, views and wishes of others. Such a definition of discourteousness seems to be too broad. For instance someone might not consider the needs, views and wishes of others due to ignorance. Rudeness, acting discourteously, might be better defined as knowingly not considering the needs, views and wishes of others. It might be objected this definition remains too broad as there is a difference between acting selfishly and acting rudely. My objector might then proceed to suggest that real rudeness means someone not only not considering the needs, views and wishes of others but also making explicit his lack of consideration and perhaps even his contempt for them. In response to my objector in what follows I will argue that knowing selfishness is a form of rudeness. I would further respond that my objector is really pointing to more extreme form rudeness which might be better defined as a type of arrogance rather than proposing a different concept. Of course it is possible that a more basic form of rudeness might foster arrogance.

Before proceeding let us be clear what the above definition entails. It must include a lack of consideration for the views and wishes of another and not just his needs. If only needs were involved I could be rude to my dog by not considering his need for exercise. However the above definition remains inadequate. For instance I could ignore my sleeping partner’s needs, views and wishes but my lack of consideration would not be a case of rudeness. Let us modify our definition of rudeness; rudeness might be defined as someone knowingly not considering the needs, views and wishes of another and at the time of this inconsideration the other is aware of this inconsideration.

Accepting the above definition means having a joke at someone else’s expense is not being rude for the joke to be effective one must be consider the views of another, More importantly accepting the above means that rudeness and morality are linked. Rudeness need not be linked to consequentialism or deontology but there seems to be a link with virtue ethics. However differences remain between acting rudely and acting immorally. Morality very roughly consists of someone considering the needs of others and acting to meet these needs provided he judges or feels action is appropriate. Acting rudely only involves a lack of consideration. It follows rude behaviour need not necessary be immoral behaviour but that rudeness is on the road to immoral behaviour and might be regarded as a minor vice. Let us consider an example. Suppose I knowingly fail to consider ways to get my partner to work, when her car has broken down and that she is aware of my lack of consideration. Clearly I have acted rudely. However whether I have also acted immorally depend on the circumstances. If I had an important doctor’s appointment then I have acted rudely but not acted in an immoral manner. However if I only want to sleep a bit longer and a little less sleep would not harm me and I fail to run my partner to work then I have acted both rudely and acted in a slightly immoral way. It is also true that behaving in an immoral way towards someone need not be rude behaviour. I can behave in an immoral way when the subject of my bad behaviour is unaware of my behaviour. For instance if a charming sociopath might use his charm to further his own ends without consideration of someone’s needs then he may be acting immorally but he is not acting rudely.

I now want examine the causes of the lack of consideration which seems to be an essential element of rudeness. Firstly someone might attach great importance to his self. Secondly he may lack empathy. This second reason might explain why it appears that on average men display greater rudeness than women. In what follows a lack of consideration refers to a knowing lack of consideration when those who are not considered are aware of this lack. Someone’s needs will refer to his needs, views and wishes.

The first cause I wish to examine is when someone overvalues his self-importance. Some of the endemic rudeness on twitter might be partly due to this overvaluation. Such a person when deciding on how to act focusses solely on his own needs. If someone focusses on his own needs and these needs don’t affect others then he is acting prudently rather than rudely. However if someone focusses on his own needs without any consideration of the needs of others and he makes others aware of his inconsideration then he acts rudely. If someone always bases his actions on his own self-importance then I would suggest he fails to see others of equal importance. But his failure has an additional element he fails to recognise something essential about his own nature, he fails to recognise his nature as a social animal. Such a failure damages both the relationships which help foster society and him personally. Such a failure also damages discourse which fosters society. Rudeness means people talk at each other rather than to each other as exemplified by many of the replies on twitter.

The second important cause of rudeness is that someone lacks empathy. I must make it clear by empathy I mean associative rather than projective empathy. A sociopath can project himself into the minds of others and understand the feelings of others. He might use this understanding to experience pleasure in the pain of others. Associative empathy means someone experiences the feelings of others. It seems to me a rude person might have projective empathy but that he does not have associative empathy. I should make it clear at this point that I don’t believe only having projective empathy necessarily makes someone into a sociopath. It makes him indifferent. It also gives him one of the tools a sociopath needs. I would suggest a lack of associative empathy damages someone as a person as he lacks an essential element needed in the makeup of social animals.

I have argued that whilst even if rudeness is not always immoral it is on the road to immorality. I further argued that rudeness damages a rude person’s status as a social animal. I would suggest that for the most people being a social animal is a good. It follows rudeness damages most people and should regarded as a vice. Rudeness might also be regarded as an epistemic vice, a way of behaving which makes the acquisition of knowledge difficult, due to its close relationship with arrogance. At the beginning of this posting I gave three examples which pointed to rudeness damaging society. What then can be done to combat rudeness? One thing that might be done is that society should become less accepting towards rudeness. What is entailed in being less accepting? Less acceptance means not being indifferent to rudeness but pointing out to rude people that their rudeness damages them as social animals. However, less acceptance should simply mean less acceptance and not slip into aggressively challenging rudeness which might itself might become a form of rudeness. Perhaps we should ask someone who is rude to us whether they really meant to be rude. Ask if his sexist remark was really intended or simply bullshit. If such a strategy fails we should ask why he holds such beliefs, try and make him justify them, rather than trying to directly confront his beliefs. Secondly we must become more prepared to accept that other people are the same sort of creatures as ourselves. We must respect the autonomy of others. This means we must give priority to respecting someone’s autonomy before acting beneficently towards him. Indeed acting to satisfy our perception of someone’s needs instead of attempting to satisfy his expressed needs might be seen as a form of rudeness, see woolerscottus . Respecting autonomy means we must be tolerant of persons and their views. However this toleration should not extend to their attitude towards others if this attitude is a rude one. Sometimes we must be prepared to simply accept that our views and those of others differ and do no more, see practicalethics . Thirdly I have argued that a lack of associative empathy is one of the root causes of rudeness. It follows we might combat rudeness by addressing this lack. Unfortunately doing so is not easy, it can’t be done by simply increasing awareness or cognition. Michael Slote argues that parental love helps a child develop associative empathy (1) but even if combatting rudeness by increasing parental love is possible it will be a slow process. 

1. Michael Slote, 2014, A Sentimentalist Theory of the Mind, Oxford, pages 128-134.  

Afterthoughts

In the above I have considered rudeness against a Confucian background but I could have done so against one based on Erasmus views and arguments of others damages us by denying us potential knowledge. Being rude damages us and increases the polarisation of society.