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23 Med., Health Care & Phil. 1 (2020)

handle is hein.journals/medhcph23 and id is 1 raw text is: Medicine, Health Care and Philosophy (2020) 23:1-2 https://doi.org/1 0.1007/s 11019-020-09938-3 EDITORIAL All in the family Bert Gordijn' Henk ten Have2 Published online: 13 January 2020 © Springer Nature B.V. 2020 The Encyclopaedia Britannica defines the family as a group of persons united by the ties of marriage, blood, or adop- tion, constituting a single household and interacting with each other in their respective social positions, usually those of spouses, parents, children, and siblings. (Encyclopaedia Britannica 2019). Historically, the family-as a social unit- has undergone significant changes, for example as a result of technological innovations and associated societal transfor- mations such as those during the Neolitic or the Industrial revolution. These changes to the social structure of the fam- ily have continued to occur in modern times as is evidenced by the rise of single-parent families, reconstituted families, same sex couples, cohabiting couples, and voluntary child- less couples. Unsurprisingly, technological innovations and societal transformations have not only changed the social structure of the family. They have also altered its moral fab- ric and thus triggered new questions of family ethics. The first two papers in the issue at hand focus on two such ques- tions. The first involves parental responsibilities, the second filial obligations. Parental responsibilities New reproductive technologies have changed reproduc- tion-both when it comes to knowledge as well as in terms of control. Nowadays, prospective parents can access a lot more knowledge about what is going on at any given point in the reproductive process than has been possible at any ear- lier time in history. Pregnancies have become epistemically transparent. We can quite literally perceive the embryo in the womb, sequence its genome and observe its developing morphological characteristics. The amount of data and the quality of the information around reproductive trajectories, starting even before conception, has grown so much that it has triggered a discussion about the prospective parents' right not to know (cf. Sierawska 2015). Aspiring parents now have to decide to what extent the they wish to use avail- able knowledge about certain aspects of their reproductive journey. Together with improved knowledge, the possibilities to intervene in reproduction have developed immensely. Here also interventions are already possible before conception. Examples are contraceptive methods to prevent unintended pregnancies, and all kinds of assisted reproductive technolo- gies such as cryopreservation of sperm and oocytes, artificial insemination, in-vitro fertilisation and surrogacy. In addi- tion, there are lots of interventions-both before and dur- ing pregnancy-to lower the risks of neonatal and maternal mortality and morbidity (Lassi et al. 2014). Increased knowledge and control mean enhanced paren- tal responsibility. For example, it makes a difference when we know about certain negative effects of smoking dur- ing pregnancy in terms of sudden unexpected infant death cases (Anderson et al. 2019). The knowledge makes us more responsible, assuming we have some control over our smok- ing habit. Similarly, the availability of all kinds of prenatal and even preimplantation diagnostic interventions, enhances parental responsibility, presuming of course that parents know about these diagnostic possibilities. Against this backdrop, Wallis (2020) asks whether it is ethical when parents select for deafness in their child. As you can read in the current issue, the author concludes that it may sometimes be ethical for parents to do just that (Wallis 2020). The point of this editorial, however, is that Wallis' question is rather new. It results from improved knowledge and enhanced parental control over the reproduction process, which occasion enhanced parental responsibilities and new ethical challenges. Bert Gordijn bert.gordijn@dcu.ie Dublin City University, Dublin, Ireland 2 Duquesne University, Pittsburgh, USA 9 Springer