The concept of prenatal screening as an enforceable parental duty

  • Constantinos Kanaris

Student thesis: Phd


he question of whether parents-to-be have a moral obligation to maximize the welfare of their future children before they are born has fuelled considerable debate and a multitude of contrasting opinions from within the philosophical, legal and medical academic literature over the last three decades. It is unsurprising that this burst of activity in the field has coincided with continuous and significant advances in the field of reproductive, perinatal and neonatal medicine. These advances perpetually re-set the bar as to what screening processes and therapies can be offered before birth to ensure that infants are born in the healthiest possible state. By extension, I argue, that our obligations towards the unborn should also change.Within this thesis I explore philosophical and legal theories relating to responsibilities held to the unborn child by those wishing to be parents but also the State. In doing so, I approach the available literature from a more clinical viewpoint. I argue that in future, when screening processes and in utero therapies are likely to be safer and more effective, the duty of future parents to bring to life the healthiest child possible will become more compelling.In my articles I employ a personhood view of the foetus and argue that eventual children can be harmed in the pre-personal stage. I carefully analyze what it means to be harmed and apply a comparative account of harm through the thesis in trying to answer the five main questions that permeate through the articles.I question whether parents-to-be have a moral obligation to engage with antenatal screening services, I do not limit the screening processes to genetics alone but include foetal anomaly and microbiological information acquired antenatally in the process. I also explore what the obligations of parents-to-be are, once a screening process reveals a certain problem or risk. I elaborate on what circumstances they may be obliged to act upon, in a way that treats or minimizes the risks posed to the foetus. I argue that even in the absence of a cure, antenatally acquired information can be vital for the welfare of the child and this should compel parents to engage with the services on offer. I also purport that if there is a cure the parents are obliged to uptake it, provided it is safe and with good clinical outcomes.Finally I question whether the State has a moral duty to increase uptake of such antenatal health programs and if so to what extent should it attempt to do so. By analyzing the moral limits of law I argue that impositions on individual liberties in the interest of the unborn may only be reasonable if our reproductive choices stand to significantly harm others. I argue that recent amendments in English and Welsh Law that prohibit the application of advanced reproductive technologies to select for disabled foetuses signify an important change in the way the State values the welfare of future children. I explore international legal cases that suggest that the foetus is increasingly afforded more legal protections and investigate possible ways in which we could objectively quantify harm caused antenatally in a manner that would help us decide if and when the State should intervene with reproductive choices of parents- to-be. Finally, I elaborate on the how State led medical paternalism can be stratified and what each stratum involves in terms of intervention. I put forth that the State ought to explore avenues of soft and moderate paternalism first but should stop short of hard paternalism for a number of reasons.
Date of Award31 Dec 2016
Original languageEnglish
Awarding Institution
  • The University of Manchester
SupervisorRebecca Bennett (Supervisor) & Alexandra Mullock (Supervisor)


  • Moral Status of the Foetus
  • Pregnancy Ethics
  • Advanced Reproductive Technologies
  • Parental responsibility

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