Are Some Parents Too Old?

Age Restrictions in Postmenopausal Pregnancies and Adoptions

Lawrence M. Hinman

Department of Philosophy

University of San Diego

5998 Alcalá Park

San Diego, CA 92110-2492

Voice: 619-260-4787

Fax: 619-260-4227

E-mail: hinman@sandiego.edu

For a discussion of this paper,

go to the Ethics Forums

Introduction

Shortly after a fifty-nine year old British woman, Jennifer F., gave birth to twins at Dr. Severino Antinori’s fertility clinic in Rome and–six months later–Rosanna Della Corte gave birth at the age of 62 to a baby boy at the same clinic, the French government introduced a bill to prohibit post-menopausal pregnancies. The French Health Minister, Dr. Philippe Douste-Blazy, argued that "artificial late pregnancies were immoral as well as dangerous to the health of mother and child … [and] urged women not to be ‘egoistic’ by trying to become pregnant after menopause." Dr. John Marks, former chairman of the British Medical Association Council, said the woman's case "bordered on the Frankenstein syndrome." Virginia Bottomley, Britain's secretary of state for health, said, "Women do not have the right to have a child; the child has a right to a suitable home." Similar restrictions were introduced in the Italian legislature in the wake of a papal encyclical, Evangelium Vitae, condemning in vitro fertilization and many of other high-tech fertility procedures. Italy's Association of Medical Practitioners and Dentists barred their members from administering fertility treatment to women over fifty. Italy’s National Council of the Federation of Doctors barred artificial inseminations for all but child-bearing age heterosexual married couples. Indeed, this and other similar cases have given rise to considerable controversy about what the contours of procreative liberty ought to be in regard to age.

Age restrictions on potential parents have not been limited to the high tech world of postmenopausal pregnancies. They are common and usually quite explicit in the world of adoptions, especially international adoptions. Some countries have strict and equal age limits for both parents—e.g., neither parent may be over thirty. Some have sex-based differential age limits, requiring that the prospective mother be no older than, say, thirty and allowing the father to be as much as five years older. Some have formulas tied to the age of the child being adopted. For example, the sum of the ages of both parents cannot be more than sixty-five years older than the age of the child being adopted. A couple, both of whom were thirty-five, could not adopt a child less than five years old.

The opposition to older parents seems to stem from several sources. The opposition to postmenopausal pregnancies, as Bonnie Steinbock and Ron McClamrock have pointed out in a 1994 article in The Hastings Center Report, probably "expresses a prejudice against what is new or unconventional, rather than a position that can be rationally justified." Yet age-based restrictions on adoptions, which are neither new nor unconventional, have been the norm. Age-bias against older adoptive parents exists despite the fact that in many countries it is quite common for children to be raised by grandparents while the parents are working. The opposition is, in this country I suspect, also a symptom of a youth culture that values youth and energy over age and experience. In some countries where life expectancy is low, it may also stem from an understandable experience of the local life span of parents.

The interesting philosophical issue here is whether such age restrictions on parenting have a rational foundation. Several arguments can be advanced in support of such restrictions. All of these arguments appeal in some way to the best interests of the child. Each has some merit, and each points to a genuine moral concern. However, none of these arguments is sufficient to establish a strong restriction on age per se, and indeed, none of these arguments proves to be genuinely age-based. Each of these argument points to factors that, while associated with age, are not tied to it in a direct and univocal way. Let’s examine each of these arguments.

The Best Interests of the Child Arguments

One of the most common arguments against postmenopausal pregnancies and adoptions later in life is that they are unfair to the child, that they harm the children in some way. Indeed, there is widespread agreement in both the world of in vitro fertilization and the adoption world that the welfare of the child should be the principal–perhaps the sole–concern in making these decisions. It is not in the best interest of the child, this argument implies, to have older parents.

What would be needed to support age restrictions in postmenopausal pregnancies and adoptions? Typically, such arguments must have at least three elements. First, there must be a sufficiently determinate notion of "the best interests of the child." Second, it must be shown that the possession of a specific characteristic on the part of the parent(s) is detrimental tothe best interests of the child. Third, it must be shown that this specific characteristic is tightly linked to age. Typically we get something like the following:

Age à Characteristic à Detrimental to best interest of child

As we shall see below, the characteristic may be earlier death, lack of energy, or some such similar attribute.

There are three principal junctures at which this type of argument is open to attack. The first is establishing that age entails the characteristic in question. The second crucial point is showing that this characteristic is entailed only by age or that it is a consequence of other factors which are as objectionable as age. The final, and perhaps most difficult point, is to provide a sufficiently determinate notion of the best interests of the child. This notion in fact has to be determinate enough to show (a) that age-based characteristics are in fact detrimental to the best interest of the child and (b) that there are no other age-based characteristics that are in the best interests of the child and which thereby outweigh the negative factors.

There are obstacles at each juncture of this argument. Before considering these difficulties, however, let’s pause to consider one of the conceptual differences between cases of postmenopausal pregnancy and cases of adoption by older parents.

Potential Children vs. Real Children. It should be noted, by way of preface, that the postmenopausal pregnancy cases differ from the adoption cases in several important respects. One of these is particularly relevant to the issue of the best interests of the child. In the case of postmenopausal pregnancies, if the woman does not conceive, no child comes into existence whose interests can be harmed. This raises interesting conceptual issues that Parfit, Feinberg and others have explored. In the possible pregnancy cases, the stakes are also raised, as it were, in regard to the level of harm, apparently requiring that the harms be worse than not having been born at all. Yet in adoption some of the intricate questions of counterfactual interests and harms disappear. We are dealing with an actually existing child. The choice is usually between several different sets of possible parents or even no parents at all in cases where the child will be raised in an institution or in a series of foster care homes. Thus the possible harm of having older parents is best weighed against the possible harms attached to other prospective sets of adoptive parents or to no family life at all.

What are the harms that we are talking about here? Presumably these are harms that result from the age of the parents, especially of the mother. (I’ll consider the issue of gender equity below.) The case against older parents has two aspects: the age of the parent’s death relative to the age of the child, and the parent’s age and associated energy level relative to the child’s. Let’s consider each of these.

The Death of the Parent. The thrust of this objection is that older parents are more likely than parents who are younger to die when their children are still young. In the British case of the woman who had twins at the age of fifty-nine, she is much more likely to die while the children are still growing up than if she had had children when she was in her twenties or thirties.

Yet for this argument to be sound, it would have to include more cases than just postmenopausal women. The underlying principle is presumably something like this:

• Individuals should not have children when there is a higher than normal chance that they will die before the children have reached adulthood.

There are several difficulties with this principle.

First, it makes a major life decision dependent on a highly fallible judgment. Our ability to predict life span in any individual case is far from reliable, and we may well be ill advised to place so much weight on such a judgment. The weightier the decision, the more we justifiably expect certitude.

Second, this principle would be more restrictive than most of us would like. It would limit not only people with a potentially lethal disease, but also anyone who has an above average susceptibility to such diseases. At a time in our history when we are trying to affirm the rights of persons with disabilities of various kinds, a principle such as this one threatens to restrict persons with disabilities in one of the most important areas of human life. This concern is further exacerbated by continuing developments in genetic screening and our consequent ability to foresee possible illnesses.

Third, it treats the death of a parent as a supreme evil. Yet the issue is more complex. The harm of the death of a parent is certainly a sad and sometimes even tragic event, but the harm associated with it has to be seen in conjunction with the goods attendant upon having had that particular person as a parent. All of this, at least from a consequentialist point of view, has to be balanced against the possible goods and harms associated with either (in the postmenopausal pregnancy case) not having been born at all or (in the case of adoption) having other parents, foster care, or life in an orphanage (or "receiving home").

Finally, we can legitimately question whether the only interest that counts in this equation is the interest of the child. An interesting form of consequential reasoning takes place here. Such decisions should be guided, it is implied, solely by a consideration for the best interests of the child. The implication is that other interests do not count. This is not ethical egoism, at least in any standard form, since it is done by proxy. Neither is it a straightforward version of utilitarianism, since it does not take the interests of everyone into account.

In what ways, if any, should the interests of potential parents enter into this equation? It seem reasonable that they should in principle be given at least some weight. We will return to this issue below, when we consider motives for postmenopausal pregnancies and adoptions later in life.

The Parenting Capabilities Argument. The second principal concern that gives rise to age restrictions relates to the physical capabilities of the parents. Because of their age, this argument states, older parents will be less able to do many of the things that contribute to the well-being of the child than younger parents can do.

What are these things? Typically, proponents of this argument point to physical activities such as playing baseball and soccer with children. The person who becomes a parent at fifty-nine will begin playing soccer with his or her children in the early to mid-sixties. Most of us peak well before this age in terms of our athletic abilities. Advocates of these age restrictions may also point to social limitations. It is difficult for the child, they maintain, when the child’s parents are the only ones at a child’s school gathering with gray, or perhaps even white, hair. Finally, some advocates of age restrictions may even maintain that older parents, on the whole, are less physically energetic than their younger counterparts. Therefore, such parents have less energy for their children.

One of the difficulties with this argument is that it goes too far in its restrictions. Think of the cases which such a restriction might cover.

• The Bookworm Case. If physical capabilities, especially in area such as sports, are required for parenthood, many of us who are not so inclined or gifted might well be restricted from becoming parents.
• Persons with Disabilities. Similar issues arise in regard to persons with disabilities, whether these be purely physical or are also social. Should someone in a wheelchair be refused the opportunity for parenthood solely on the basis of that condition?
• The Prematurely Gray. Finally, there are people who simply look much older than they actually are. Sometimes this is due to premature grayness of the hair, sometimes to premature wrinkles, etc.

Thus we begin to see that these attempts to restrict parenthood on the basis of age fall short of the mark. They fail to establish that age necessarily entails characteristics detrimental to the best interests of the child; furthermore, they fail to show that only age is associated with those characteristics. Finally, they fail to show that those characteristics are necessarily detrimental to the best interests of the child.

Drawing the Line at Restrictions. Should age restrictions apply to very young parents as well as very old ones? We can argue that we have no chance for social intervention in most cases. Having a family is a function of the private sphere of activity, and except in extreme cases of abuse we hesitate to monitor and to intervene in family life. We could argue that not only should we place legal restrictions on older parents, but that we also should restrict parenting throughout the population generally. However, our social policy is not to intervene by placing restrictions on family life. This is an equity question. If we do not intervene in the general population, ought we to intervene upper age brackets simply because intervention in this case is more feasible.

Do Older Parents Have Advantages Over Their Younger Counterparts? The other question to ask here is whether older parents bring to parenting any special characteristics not usually found in younger parents.

Generalizations about the differences between older and younger parents are notoriously difficult, and any claims about them are best couched in hypothetical terms. That said, we can see some possible advantages. Older parents are more likely to be financially secure than their younger counterparts. Second, they are more likely be under less pressure in their chosen profession than those who are just beginning and must continually prove themselves. Presumably this means that they will be more able, all other things being equal, to have disposal time that they can spend with their children. Finally, many older parents would claim that they have much more emotional maturity than they had twenty or even ten years earlier. That emotional maturity, they claim, allows them to raise their children in a more sensitive manner than they would otherwise be able to do.

The Gender-Bias Argument

There is obviously another major argument against restricting postmenopausal pregnancies: these restrictions fall solely on women. They do not limit men in the same way, at least in part because it is difficult to regulate or limit the reproductive activities of men. Yet it is simply a fact of nature that women, once they have gone through menopause, cannot conceive without technological assistance. Men, even in advanced age, can father children without necessarily needing technological assistance. Thus women are more vulnerable to controls on their reproductive freedoms than men are. I would certainly want to reject any proposed restriction that singled out women alone in this fashion.

It is striking, in this context, to look at the new paper reports of the birth of Rosanna Della Corte’s son Ricardo. Great outrage was expressed over the fact that she was sixty-two; hardly a mention was made over the fact that her husband was in his sixties.

Indeed, it is helpful in this context to see the issue of age restrictions, whether in postmenopausal pregnancies or in adoptions, as a choice issue. Defenders of reproductive freedom have long emphasized a woman’s right not to have a child, but the other side of a pro-choice position is presumably the right to have a child. Opposing age restrictions is, I think, part of being pro-choice.

Male Infertility. It is worth noting that men sometimes do need technological assistance as well, including medications and surgery. Should they too be subject to restrictions about probable life span, energy level, and the like before they are given access to such assistance? Should older men be restricted from surgical procedures such as varacocile that are intended to increase fertility?

Gender Bias in Adoptions. Interestingly, some of this gender bias is even found in age-based adoption restrictions. Some countries and agencies have more stringent requirements about the age of the prospective mother than they do about the age of the prospective father. The gap may be five years or even more. The assumption here is that an age differential between spouses is acceptable as long as an older man has married a younger woman.

Should There Be Stronger Restrictions on Men? The most peculiar thing about this gender-bias in age restrictions is that, at least in the case of adoption, it would appear to be more justified if it were slanted in the opposite direction. Since women have a longer life expectancy on the average than men, the death of parent argument would seem to imply stronger restrictions on men’s age than on women’s.

Who Has Control? One of the principal underlying issues here is the question of who has control over a person’s reproductive life. Individuals should, I have argued, have the maximal degree of control over their own individual reproductive life.

The issue of control also is relevant to the question of whether postmenopausal pregnancy might bring with it undue medical liabilities for the pregnant woman. There may well be increased risks, and women should be clearly advised of those risks. However, the final choice of whether those risks are worth the possible gains should be left up to the woman herself, except in those cases where physicians feel that they would be medically irresponsible to participate in such a pregnancy.

Conclusion: Wise Choices

To argue that individuals should have the maximal degree of liberty in making reproductive choices obviously does not mean that all such choices are wise ones. Let me conclude with several remarks on what we could call the contours of reproductive wisdom.

The Motivation Issue. Stories of postmenopausal pregnancy are often greeted with incredulity about why someone would want to have a child (much less twins) at such a late time in life. Why do older persons have, or want to have, children beyond the usual childbearing age?

The answers to this question are, in large measure, the same answers we find in parents of a younger age. The relevant question is perhaps why they didn’t act on those reasons earlier in their life. As we shall see, in at least some of these cases, they did act on those reasons earlier in life.

We can imagine several common scenarios. First, a child might have died, and the person might want to have another child in its place, as it were. There are certainly serious dangers with any attempt to have one child "replace" another, but there is nothing about these dangers that is confined to older age. This indeed was the principal motivation in the case of Rosanna Della Corte, whose sixteen year old son Ricardo had died in an automobile accident three years earlier. The baby she had at sixty-two was also named Ricardo.

Second, a woman might have been infertile–either all her life or during the period when she wanted to have children–and only with the development of new technologies is she at last able to conceive. Her reasons for having children may be no different than anyone else’s. However, the technology necessary to allow her to conceive may have only been developed when she was postmenopausal.

Third, we can imagine a person wanting to have children with a new spouse after getting married later in life. (This in fact has been the motivation in several cases.) This seems to be a thoroughly reasonable motivation. There may be a variety of factors that make it an unwise choice, and the likelihood of these factors may increase with age, but it hardly seems that age alone should be an impediment here.

The Seasons of Life Issue. A final argument here is worthy of consideration, although it is hard to state it with precision. Isn’t it the case that life has, as it were, its seasons and that having children late in life–whether for males or females–is to ignore those seasons?

There is, I think, merit in this argument, but it is hardly strong enough to justify restriction on having children later in life. The seasons certainly are there, but it is also true that we live increasingly in an age of choice, one where we may construct lives that do not follow traditional patterns. It is important, I think, to continue to preserve this as an option.

Footnotes

1Alan Riding, "French Government Proposes Ban On Pregnancies After Menopause," The New York Times, January 5, 1994, Section A; Page 6; Column 1.

² Louis J. Salome, "59-year-old Mother Sparks Fierce Debate in Britain," The Times-Picayune, January 10, 1994, Pg. A23.

³ Ibid.

⁴ Bruce Johnston, "Mother who gave birth at 62 plans new baby," The Daily Telegraph, July 19, 1995, p. 10.

⁵ William D. Montalbano, "Physicians Ban Controversial Biogenetics," Los Angeles Times, April 15, 1995, Part A, page 2.

⁶ Bonnie Steinbock and Ron McClamrock, "When is birth unfair to the child?", The Hastings Center Report, Vol. 24 ; No. 6 ; (November, 1994), pp. 15 ff.

⁷ The Human Fertilisation and Embryology Authority, which regulates fertility treatment in Britain, does not stipulate an age limit, saying: "In our guidelines to clinics, the paramount concern is the welfare of a child. The age of the mother would be one of the considerations for a clinic before agreeing to treatment." Quoted in Celia Hall, "Woman has test-tube baby at the age of 51," The Independent, April 14, 1995, Section: Home, page 9.

⁸ See, for example, Derek Parfit, Reasons and Persons (Oxford: Clarendon Press, 1984), chap. 16, "The Non-Identity Problem," pp. 357-61.

Are Some Parents Too Old?

Age Restrictions in Postmenopausal Pregnancies and Adoptions

Lawrence M. Hinman

Department of Philosophy

University of San Diego

5998 Alcalá Park

San Diego, CA 92110-2492

Voice: 619-260-4787

Fax: 619-260-4227

E-mail: hinman@sandiego.edu

For a discussion of this paper,

go to the Ethics Forums

Introduction

Shortly after a fifty-nine year old British woman, Jennifer F., gave birth to twins at Dr. Severino Antinori’s fertility clinic in Rome and–six months later–Rosanna Della Corte gave birth at the age of 62 to a baby boy at the same clinic, the French government introduced a bill to prohibit post-menopausal pregnancies. The French Health Minister, Dr. Philippe Douste-Blazy, argued that "artificial late pregnancies were immoral as well as dangerous to the health of mother and child … [and] urged women not to be ‘egoistic’ by trying to become pregnant after menopause." Dr. John Marks, former chairman of the British Medical Association Council, said the woman's case "bordered on the Frankenstein syndrome." Virginia Bottomley, Britain's secretary of state for health, said, "Women do not have the right to have a child; the child has a right to a suitable home." Similar restrictions were introduced in the Italian legislature in the wake of a papal encyclical, Evangelium Vitae, condemning in vitro fertilization and many of other high-tech fertility procedures. Italy's Association of Medical Practitioners and Dentists barred their members from administering fertility treatment to women over fifty. Italy’s National Council of the Federation of Doctors barred artificial inseminations for all but child-bearing age heterosexual married couples. Indeed, this and other similar cases have given rise to considerable controversy about what the contours of procreative liberty ought to be in regard to age.

Age restrictions on potential parents have not been limited to the high tech world of postmenopausal pregnancies. They are common and usually quite explicit in the world of adoptions, especially international adoptions. Some countries have strict and equal age limits for both parents—e.g., neither parent may be over thirty. Some have sex-based differential age limits, requiring that the prospective mother be no older than, say, thirty and allowing the father to be as much as five years older. Some have formulas tied to the age of the child being adopted. For example, the sum of the ages of both parents cannot be more than sixty-five years older than the age of the child being adopted. A couple, both of whom were thirty-five, could not adopt a child less than five years old.

The opposition to older parents seems to stem from several sources. The opposition to postmenopausal pregnancies, as Bonnie Steinbock and Ron McClamrock have pointed out in a 1994 article in The Hastings Center Report, probably "expresses a prejudice against what is new or unconventional, rather than a position that can be rationally justified." Yet age-based restrictions on adoptions, which are neither new nor unconventional, have been the norm. Age-bias against older adoptive parents exists despite the fact that in many countries it is quite common for children to be raised by grandparents while the parents are working. The opposition is, in this country I suspect, also a symptom of a youth culture that values youth and energy over age and experience. In some countries where life expectancy is low, it may also stem from an understandable experience of the local life span of parents.

The interesting philosophical issue here is whether such age restrictions on parenting have a rational foundation. Several arguments can be advanced in support of such restrictions. All of these arguments appeal in some way to the best interests of the child. Each has some merit, and each points to a genuine moral concern. However, none of these arguments is sufficient to establish a strong restriction on age per se, and indeed, none of these arguments proves to be genuinely age-based. Each of these argument points to factors that, while associated with age, are not tied to it in a direct and univocal way. Let’s examine each of these arguments.

The Best Interests of the Child Arguments

One of the most common arguments against postmenopausal pregnancies and adoptions later in life is that they are unfair to the child, that they harm the children in some way. Indeed, there is widespread agreement in both the world of in vitro fertilization and the adoption world that the welfare of the child should be the principal–perhaps the sole–concern in making these decisions. It is not in the best interest of the child, this argument implies, to have older parents.

What would be needed to support age restrictions in postmenopausal pregnancies and adoptions? Typically, such arguments must have at least three elements. First, there must be a sufficiently determinate notion of "the best interests of the child." Second, it must be shown that the possession of a specific characteristic on the part of the parent(s) is detrimental tothe best interests of the child. Third, it must be shown that this specific characteristic is tightly linked to age. Typically we get something like the following:

Age à Characteristic à Detrimental to best interest of child

As we shall see below, the characteristic may be earlier death, lack of energy, or some such similar attribute.

There are three principal junctures at which this type of argument is open to attack. The first is establishing that age entails the characteristic in question. The second crucial point is showing that this characteristic is entailed only by age or that it is a consequence of other factors which are as objectionable as age. The final, and perhaps most difficult point, is to provide a sufficiently determinate notion of the best interests of the child. This notion in fact has to be determinate enough to show (a) that age-based characteristics are in fact detrimental to the best interest of the child and (b) that there are no other age-based characteristics that are in the best interests of the child and which thereby outweigh the negative factors.

There are obstacles at each juncture of this argument. Before considering these difficulties, however, let’s pause to consider one of the conceptual differences between cases of postmenopausal pregnancy and cases of adoption by older parents.

Potential Children vs. Real Children. It should be noted, by way of preface, that the postmenopausal pregnancy cases differ from the adoption cases in several important respects. One of these is particularly relevant to the issue of the best interests of the child. In the case of postmenopausal pregnancies, if the woman does not conceive, no child comes into existence whose interests can be harmed. This raises interesting conceptual issues that Parfit, Feinberg and others have explored. In the possible pregnancy cases, the stakes are also raised, as it were, in regard to the level of harm, apparently requiring that the harms be worse than not having been born at all. Yet in adoption some of the intricate questions of counterfactual interests and harms disappear. We are dealing with an actually existing child. The choice is usually between several different sets of possible parents or even no parents at all in cases where the child will be raised in an institution or in a series of foster care homes. Thus the possible harm of having older parents is best weighed against the possible harms attached to other prospective sets of adoptive parents or to no family life at all.

What are the harms that we are talking about here? Presumably these are harms that result from the age of the parents, especially of the mother. (I’ll consider the issue of gender equity below.) The case against older parents has two aspects: the age of the parent’s death relative to the age of the child, and the parent’s age and associated energy level relative to the child’s. Let’s consider each of these.

The Death of the Parent. The thrust of this objection is that older parents are more likely than parents who are younger to die when their children are still young. In the British case of the woman who had twins at the age of fifty-nine, she is much more likely to die while the children are still growing up than if she had had children when she was in her twenties or thirties.

Yet for this argument to be sound, it would have to include more cases than just postmenopausal women. The underlying principle is presumably something like this:

• Individuals should not have children when there is a higher than normal chance that they will die before the children have reached adulthood.

There are several difficulties with this principle.

First, it makes a major life decision dependent on a highly fallible judgment. Our ability to predict life span in any individual case is far from reliable, and we may well be ill advised to place so much weight on such a judgment. The weightier the decision, the more we justifiably expect certitude.

Second, this principle would be more restrictive than most of us would like. It would limit not only people with a potentially lethal disease, but also anyone who has an above average susceptibility to such diseases. At a time in our history when we are trying to affirm the rights of persons with disabilities of various kinds, a principle such as this one threatens to restrict persons with disabilities in one of the most important areas of human life. This concern is further exacerbated by continuing developments in genetic screening and our consequent ability to foresee possible illnesses.

Third, it treats the death of a parent as a supreme evil. Yet the issue is more complex. The harm of the death of a parent is certainly a sad and sometimes even tragic event, but the harm associated with it has to be seen in conjunction with the goods attendant upon having had that particular person as a parent. All of this, at least from a consequentialist point of view, has to be balanced against the possible goods and harms associated with either (in the postmenopausal pregnancy case) not having been born at all or (in the case of adoption) having other parents, foster care, or life in an orphanage (or "receiving home").

Finally, we can legitimately question whether the only interest that counts in this equation is the interest of the child. An interesting form of consequential reasoning takes place here. Such decisions should be guided, it is implied, solely by a consideration for the best interests of the child. The implication is that other interests do not count. This is not ethical egoism, at least in any standard form, since it is done by proxy. Neither is it a straightforward version of utilitarianism, since it does not take the interests of everyone into account.

In what ways, if any, should the interests of potential parents enter into this equation? It seem reasonable that they should in principle be given at least some weight. We will return to this issue below, when we consider motives for postmenopausal pregnancies and adoptions later in life.

The Parenting Capabilities Argument. The second principal concern that gives rise to age restrictions relates to the physical capabilities of the parents. Because of their age, this argument states, older parents will be less able to do many of the things that contribute to the well-being of the child than younger parents can do.

What are these things? Typically, proponents of this argument point to physical activities such as playing baseball and soccer with children. The person who becomes a parent at fifty-nine will begin playing soccer with his or her children in the early to mid-sixties. Most of us peak well before this age in terms of our athletic abilities. Advocates of these age restrictions may also point to social limitations. It is difficult for the child, they maintain, when the child’s parents are the only ones at a child’s school gathering with gray, or perhaps even white, hair. Finally, some advocates of age restrictions may even maintain that older parents, on the whole, are less physically energetic than their younger counterparts. Therefore, such parents have less energy for their children.

One of the difficulties with this argument is that it goes too far in its restrictions. Think of the cases which such a restriction might cover.

• The Bookworm Case. If physical capabilities, especially in area such as sports, are required for parenthood, many of us who are not so inclined or gifted might well be restricted from becoming parents.
• Persons with Disabilities. Similar issues arise in regard to persons with disabilities, whether these be purely physical or are also social. Should someone in a wheelchair be refused the opportunity for parenthood solely on the basis of that condition?
• The Prematurely Gray. Finally, there are people who simply look much older than they actually are. Sometimes this is due to premature grayness of the hair, sometimes to premature wrinkles, etc.

Thus we begin to see that these attempts to restrict parenthood on the basis of age fall short of the mark. They fail to establish that age necessarily entails characteristics detrimental to the best interests of the child; furthermore, they fail to show that only age is associated with those characteristics. Finally, they fail to show that those characteristics are necessarily detrimental to the best interests of the child.

Drawing the Line at Restrictions. Should age restrictions apply to very young parents as well as very old ones? We can argue that we have no chance for social intervention in most cases. Having a family is a function of the private sphere of activity, and except in extreme cases of abuse we hesitate to monitor and to intervene in family life. We could argue that not only should we place legal restrictions on older parents, but that we also should restrict parenting throughout the population generally. However, our social policy is not to intervene by placing restrictions on family life. This is an equity question. If we do not intervene in the general population, ought we to intervene upper age brackets simply because intervention in this case is more feasible.

Do Older Parents Have Advantages Over Their Younger Counterparts? The other question to ask here is whether older parents bring to parenting any special characteristics not usually found in younger parents.

Generalizations about the differences between older and younger parents are notoriously difficult, and any claims about them are best couched in hypothetical terms. That said, we can see some possible advantages. Older parents are more likely to be financially secure than their younger counterparts. Second, they are more likely be under less pressure in their chosen profession than those who are just beginning and must continually prove themselves. Presumably this means that they will be more able, all other things being equal, to have disposal time that they can spend with their children. Finally, many older parents would claim that they have much more emotional maturity than they had twenty or even ten years earlier. That emotional maturity, they claim, allows them to raise their children in a more sensitive manner than they would otherwise be able to do.

The Gender-Bias Argument

There is obviously another major argument against restricting postmenopausal pregnancies: these restrictions fall solely on women. They do not limit men in the same way, at least in part because it is difficult to regulate or limit the reproductive activities of men. Yet it is simply a fact of nature that women, once they have gone through menopause, cannot conceive without technological assistance. Men, even in advanced age, can father children without necessarily needing technological assistance. Thus women are more vulnerable to controls on their reproductive freedoms than men are. I would certainly want to reject any proposed restriction that singled out women alone in this fashion.

It is striking, in this context, to look at the new paper reports of the birth of Rosanna Della Corte’s son Ricardo. Great outrage was expressed over the fact that she was sixty-two; hardly a mention was made over the fact that her husband was in his sixties.

Indeed, it is helpful in this context to see the issue of age restrictions, whether in postmenopausal pregnancies or in adoptions, as a choice issue. Defenders of reproductive freedom have long emphasized a woman’s right not to have a child, but the other side of a pro-choice position is presumably the right to have a child. Opposing age restrictions is, I think, part of being pro-choice.

Male Infertility. It is worth noting that men sometimes do need technological assistance as well, including medications and surgery. Should they too be subject to restrictions about probable life span, energy level, and the like before they are given access to such assistance? Should older men be restricted from surgical procedures such as varacocile that are intended to increase fertility?

Gender Bias in Adoptions. Interestingly, some of this gender bias is even found in age-based adoption restrictions. Some countries and agencies have more stringent requirements about the age of the prospective mother than they do about the age of the prospective father. The gap may be five years or even more. The assumption here is that an age differential between spouses is acceptable as long as an older man has married a younger woman.

Should There Be Stronger Restrictions on Men? The most peculiar thing about this gender-bias in age restrictions is that, at least in the case of adoption, it would appear to be more justified if it were slanted in the opposite direction. Since women have a longer life expectancy on the average than men, the death of parent argument would seem to imply stronger restrictions on men’s age than on women’s.

Who Has Control? One of the principal underlying issues here is the question of who has control over a person’s reproductive life. Individuals should, I have argued, have the maximal degree of control over their own individual reproductive life.

The issue of control also is relevant to the question of whether postmenopausal pregnancy might bring with it undue medical liabilities for the pregnant woman. There may well be increased risks, and women should be clearly advised of those risks. However, the final choice of whether those risks are worth the possible gains should be left up to the woman herself, except in those cases where physicians feel that they would be medically irresponsible to participate in such a pregnancy.

Conclusion: Wise Choices

To argue that individuals should have the maximal degree of liberty in making reproductive choices obviously does not mean that all such choices are wise ones. Let me conclude with several remarks on what we could call the contours of reproductive wisdom.

The Motivation Issue. Stories of postmenopausal pregnancy are often greeted with incredulity about why someone would want to have a child (much less twins) at such a late time in life. Why do older persons have, or want to have, children beyond the usual childbearing age?

The answers to this question are, in large measure, the same answers we find in parents of a younger age. The relevant question is perhaps why they didn’t act on those reasons earlier in their life. As we shall see, in at least some of these cases, they did act on those reasons earlier in life.

We can imagine several common scenarios. First, a child might have died, and the person might want to have another child in its place, as it were. There are certainly serious dangers with any attempt to have one child "replace" another, but there is nothing about these dangers that is confined to older age. This indeed was the principal motivation in the case of Rosanna Della Corte, whose sixteen year old son Ricardo had died in an automobile accident three years earlier. The baby she had at sixty-two was also named Ricardo.

Second, a woman might have been infertile–either all her life or during the period when she wanted to have children–and only with the development of new technologies is she at last able to conceive. Her reasons for having children may be no different than anyone else’s. However, the technology necessary to allow her to conceive may have only been developed when she was postmenopausal.

Third, we can imagine a person wanting to have children with a new spouse after getting married later in life. (This in fact has been the motivation in several cases.) This seems to be a thoroughly reasonable motivation. There may be a variety of factors that make it an unwise choice, and the likelihood of these factors may increase with age, but it hardly seems that age alone should be an impediment here.

The Seasons of Life Issue. A final argument here is worthy of consideration, although it is hard to state it with precision. Isn’t it the case that life has, as it were, its seasons and that having children late in life–whether for males or females–is to ignore those seasons?

There is, I think, merit in this argument, but it is hardly strong enough to justify restriction on having children later in life. The seasons certainly are there, but it is also true that we live increasingly in an age of choice, one where we may construct lives that do not follow traditional patterns. It is important, I think, to continue to preserve this as an option.

Footnotes

1Alan Riding, "French Government Proposes Ban On Pregnancies After Menopause," The New York Times, January 5, 1994, Section A; Page 6; Column 1.

² Louis J. Salome, "59-year-old Mother Sparks Fierce Debate in Britain," The Times-Picayune, January 10, 1994, Pg. A23.

³ Ibid.

⁴ Bruce Johnston, "Mother who gave birth at 62 plans new baby," The Daily Telegraph, July 19, 1995, p. 10.

⁵ William D. Montalbano, "Physicians Ban Controversial Biogenetics," Los Angeles Times, April 15, 1995, Part A, page 2.

⁶ Bonnie Steinbock and Ron McClamrock, "When is birth unfair to the child?", The Hastings Center Report, Vol. 24 ; No. 6 ; (November, 1994), pp. 15 ff.

⁷ The Human Fertilisation and Embryology Authority, which regulates fertility treatment in Britain, does not stipulate an age limit, saying: "In our guidelines to clinics, the paramount concern is the welfare of a child. The age of the mother would be one of the considerations for a clinic before agreeing to treatment." Quoted in Celia Hall, "Woman has test-tube baby at the age of 51," The Independent, April 14, 1995, Section: Home, page 9.

⁸ See, for example, Derek Parfit, Reasons and Persons (Oxford: Clarendon Press, 1984), chap. 16, "The Non-Identity Problem," pp. 357-61.

Are Some Parents Too Old?

Age Restrictions in Postmenopausal Pregnancies and Adoptions

Lawrence M. Hinman

Department of Philosophy

University of San Diego

5998 Alcalá Park

San Diego, CA 92110-2492

Voice: 619-260-4787

Fax: 619-260-4227

E-mail: hinman@sandiego.edu

For a discussion of this paper,

go to the Ethics Forums

Introduction

Shortly after a fifty-nine year old British woman, Jennifer F., gave birth to twins at Dr. Severino Antinori’s fertility clinic in Rome and–six months later–Rosanna Della Corte gave birth at the age of 62 to a baby boy at the same clinic, the French government introduced a bill to prohibit post-menopausal pregnancies. The French Health Minister, Dr. Philippe Douste-Blazy, argued that "artificial late pregnancies were immoral as well as dangerous to the health of mother and child … [and] urged women not to be ‘egoistic’ by trying to become pregnant after menopause." Dr. John Marks, former chairman of the British Medical Association Council, said the woman's case "bordered on the Frankenstein syndrome." Virginia Bottomley, Britain's secretary of state for health, said, "Women do not have the right to have a child; the child has a right to a suitable home." Similar restrictions were introduced in the Italian legislature in the wake of a papal encyclical, Evangelium Vitae, condemning in vitro fertilization and many of other high-tech fertility procedures. Italy's Association of Medical Practitioners and Dentists barred their members from administering fertility treatment to women over fifty. Italy’s National Council of the Federation of Doctors barred artificial inseminations for all but child-bearing age heterosexual married couples. Indeed, this and other similar cases have given rise to considerable controversy about what the contours of procreative liberty ought to be in regard to age.

Age restrictions on potential parents have not been limited to the high tech world of postmenopausal pregnancies. They are common and usually quite explicit in the world of adoptions, especially international adoptions. Some countries have strict and equal age limits for both parents—e.g., neither parent may be over thirty. Some have sex-based differential age limits, requiring that the prospective mother be no older than, say, thirty and allowing the father to be as much as five years older. Some have formulas tied to the age of the child being adopted. For example, the sum of the ages of both parents cannot be more than sixty-five years older than the age of the child being adopted. A couple, both of whom were thirty-five, could not adopt a child less than five years old.

The opposition to older parents seems to stem from several sources. The opposition to postmenopausal pregnancies, as Bonnie Steinbock and Ron McClamrock have pointed out in a 1994 article in The Hastings Center Report, probably "expresses a prejudice against what is new or unconventional, rather than a position that can be rationally justified." Yet age-based restrictions on adoptions, which are neither new nor unconventional, have been the norm. Age-bias against older adoptive parents exists despite the fact that in many countries it is quite common for children to be raised by grandparents while the parents are working. The opposition is, in this country I suspect, also a symptom of a youth culture that values youth and energy over age and experience. In some countries where life expectancy is low, it may also stem from an understandable experience of the local life span of parents.

The interesting philosophical issue here is whether such age restrictions on parenting have a rational foundation. Several arguments can be advanced in support of such restrictions. All of these arguments appeal in some way to the best interests of the child. Each has some merit, and each points to a genuine moral concern. However, none of these arguments is sufficient to establish a strong restriction on age per se, and indeed, none of these arguments proves to be genuinely age-based. Each of these argument points to factors that, while associated with age, are not tied to it in a direct and univocal way. Let’s examine each of these arguments.

The Best Interests of the Child Arguments

One of the most common arguments against postmenopausal pregnancies and adoptions later in life is that they are unfair to the child, that they harm the children in some way. Indeed, there is widespread agreement in both the world of in vitro fertilization and the adoption world that the welfare of the child should be the principal–perhaps the sole–concern in making these decisions. It is not in the best interest of the child, this argument implies, to have older parents.

What would be needed to support age restrictions in postmenopausal pregnancies and adoptions? Typically, such arguments must have at least three elements. First, there must be a sufficiently determinate notion of "the best interests of the child." Second, it must be shown that the possession of a specific characteristic on the part of the parent(s) is detrimental tothe best interests of the child. Third, it must be shown that this specific characteristic is tightly linked to age. Typically we get something like the following:

Age à Characteristic à Detrimental to best interest of child

As we shall see below, the characteristic may be earlier death, lack of energy, or some such similar attribute.

There are three principal junctures at which this type of argument is open to attack. The first is establishing that age entails the characteristic in question. The second crucial point is showing that this characteristic is entailed only by age or that it is a consequence of other factors which are as objectionable as age. The final, and perhaps most difficult point, is to provide a sufficiently determinate notion of the best interests of the child. This notion in fact has to be determinate enough to show (a) that age-based characteristics are in fact detrimental to the best interest of the child and (b) that there are no other age-based characteristics that are in the best interests of the child and which thereby outweigh the negative factors.

There are obstacles at each juncture of this argument. Before considering these difficulties, however, let’s pause to consider one of the conceptual differences between cases of postmenopausal pregnancy and cases of adoption by older parents.

Potential Children vs. Real Children. It should be noted, by way of preface, that the postmenopausal pregnancy cases differ from the adoption cases in several important respects. One of these is particularly relevant to the issue of the best interests of the child. In the case of postmenopausal pregnancies, if the woman does not conceive, no child comes into existence whose interests can be harmed. This raises interesting conceptual issues that Parfit, Feinberg and others have explored. In the possible pregnancy cases, the stakes are also raised, as it were, in regard to the level of harm, apparently requiring that the harms be worse than not having been born at all. Yet in adoption some of the intricate questions of counterfactual interests and harms disappear. We are dealing with an actually existing child. The choice is usually between several different sets of possible parents or even no parents at all in cases where the child will be raised in an institution or in a series of foster care homes. Thus the possible harm of having older parents is best weighed against the possible harms attached to other prospective sets of adoptive parents or to no family life at all.

What are the harms that we are talking about here? Presumably these are harms that result from the age of the parents, especially of the mother. (I’ll consider the issue of gender equity below.) The case against older parents has two aspects: the age of the parent’s death relative to the age of the child, and the parent’s age and associated energy level relative to the child’s. Let’s consider each of these.

The Death of the Parent. The thrust of this objection is that older parents are more likely than parents who are younger to die when their children are still young. In the British case of the woman who had twins at the age of fifty-nine, she is much more likely to die while the children are still growing up than if she had had children when she was in her twenties or thirties.

Yet for this argument to be sound, it would have to include more cases than just postmenopausal women. The underlying principle is presumably something like this:

• Individuals should not have children when there is a higher than normal chance that they will die before the children have reached adulthood.

There are several difficulties with this principle.

First, it makes a major life decision dependent on a highly fallible judgment. Our ability to predict life span in any individual case is far from reliable, and we may well be ill advised to place so much weight on such a judgment. The weightier the decision, the more we justifiably expect certitude.

Second, this principle would be more restrictive than most of us would like. It would limit not only people with a potentially lethal disease, but also anyone who has an above average susceptibility to such diseases. At a time in our history when we are trying to affirm the rights of persons with disabilities of various kinds, a principle such as this one threatens to restrict persons with disabilities in one of the most important areas of human life. This concern is further exacerbated by continuing developments in genetic screening and our consequent ability to foresee possible illnesses.

Third, it treats the death of a parent as a supreme evil. Yet the issue is more complex. The harm of the death of a parent is certainly a sad and sometimes even tragic event, but the harm associated with it has to be seen in conjunction with the goods attendant upon having had that particular person as a parent. All of this, at least from a consequentialist point of view, has to be balanced against the possible goods and harms associated with either (in the postmenopausal pregnancy case) not having been born at all or (in the case of adoption) having other parents, foster care, or life in an orphanage (or "receiving home").

Finally, we can legitimately question whether the only interest that counts in this equation is the interest of the child. An interesting form of consequential reasoning takes place here. Such decisions should be guided, it is implied, solely by a consideration for the best interests of the child. The implication is that other interests do not count. This is not ethical egoism, at least in any standard form, since it is done by proxy. Neither is it a straightforward version of utilitarianism, since it does not take the interests of everyone into account.

In what ways, if any, should the interests of potential parents enter into this equation? It seem reasonable that they should in principle be given at least some weight. We will return to this issue below, when we consider motives for postmenopausal pregnancies and adoptions later in life.

The Parenting Capabilities Argument. The second principal concern that gives rise to age restrictions relates to the physical capabilities of the parents. Because of their age, this argument states, older parents will be less able to do many of the things that contribute to the well-being of the child than younger parents can do.

What are these things? Typically, proponents of this argument point to physical activities such as playing baseball and soccer with children. The person who becomes a parent at fifty-nine will begin playing soccer with his or her children in the early to mid-sixties. Most of us peak well before this age in terms of our athletic abilities. Advocates of these age restrictions may also point to social limitations. It is difficult for the child, they maintain, when the child’s parents are the only ones at a child’s school gathering with gray, or perhaps even white, hair. Finally, some advocates of age restrictions may even maintain that older parents, on the whole, are less physically energetic than their younger counterparts. Therefore, such parents have less energy for their children.

One of the difficulties with this argument is that it goes too far in its restrictions. Think of the cases which such a restriction might cover.

• The Bookworm Case. If physical capabilities, especially in area such as sports, are required for parenthood, many of us who are not so inclined or gifted might well be restricted from becoming parents.
• Persons with Disabilities. Similar issues arise in regard to persons with disabilities, whether these be purely physical or are also social. Should someone in a wheelchair be refused the opportunity for parenthood solely on the basis of that condition?
• The Prematurely Gray. Finally, there are people who simply look much older than they actually are. Sometimes this is due to premature grayness of the hair, sometimes to premature wrinkles, etc.

Thus we begin to see that these attempts to restrict parenthood on the basis of age fall short of the mark. They fail to establish that age necessarily entails characteristics detrimental to the best interests of the child; furthermore, they fail to show that only age is associated with those characteristics. Finally, they fail to show that those characteristics are necessarily detrimental to the best interests of the child.

Drawing the Line at Restrictions. Should age restrictions apply to very young parents as well as very old ones? We can argue that we have no chance for social intervention in most cases. Having a family is a function of the private sphere of activity, and except in extreme cases of abuse we hesitate to monitor and to intervene in family life. We could argue that not only should we place legal restrictions on older parents, but that we also should restrict parenting throughout the population generally. However, our social policy is not to intervene by placing restrictions on family life. This is an equity question. If we do not intervene in the general population, ought we to intervene upper age brackets simply because intervention in this case is more feasible.

Do Older Parents Have Advantages Over Their Younger Counterparts? The other question to ask here is whether older parents bring to parenting any special characteristics not usually found in younger parents.

Generalizations about the differences between older and younger parents are notoriously difficult, and any claims about them are best couched in hypothetical terms. That said, we can see some possible advantages. Older parents are more likely to be financially secure than their younger counterparts. Second, they are more likely be under less pressure in their chosen profession than those who are just beginning and must continually prove themselves. Presumably this means that they will be more able, all other things being equal, to have disposal time that they can spend with their children. Finally, many older parents would claim that they have much more emotional maturity than they had twenty or even ten years earlier. That emotional maturity, they claim, allows them to raise their children in a more sensitive manner than they would otherwise be able to do.

The Gender-Bias Argument

There is obviously another major argument against restricting postmenopausal pregnancies: these restrictions fall solely on women. They do not limit men in the same way, at least in part because it is difficult to regulate or limit the reproductive activities of men. Yet it is simply a fact of nature that women, once they have gone through menopause, cannot conceive without technological assistance. Men, even in advanced age, can father children without necessarily needing technological assistance. Thus women are more vulnerable to controls on their reproductive freedoms than men are. I would certainly want to reject any proposed restriction that singled out women alone in this fashion.

It is striking, in this context, to look at the new paper reports of the birth of Rosanna Della Corte’s son Ricardo. Great outrage was expressed over the fact that she was sixty-two; hardly a mention was made over the fact that her husband was in his sixties.

Indeed, it is helpful in this context to see the issue of age restrictions, whether in postmenopausal pregnancies or in adoptions, as a choice issue. Defenders of reproductive freedom have long emphasized a woman’s right not to have a child, but the other side of a pro-choice position is presumably the right to have a child. Opposing age restrictions is, I think, part of being pro-choice.

Male Infertility. It is worth noting that men sometimes do need technological assistance as well, including medications and surgery. Should they too be subject to restrictions about probable life span, energy level, and the like before they are given access to such assistance? Should older men be restricted from surgical procedures such as varacocile that are intended to increase fertility?

Gender Bias in Adoptions. Interestingly, some of this gender bias is even found in age-based adoption restrictions. Some countries and agencies have more stringent requirements about the age of the prospective mother than they do about the age of the prospective father. The gap may be five years or even more. The assumption here is that an age differential between spouses is acceptable as long as an older man has married a younger woman.

Should There Be Stronger Restrictions on Men? The most peculiar thing about this gender-bias in age restrictions is that, at least in the case of adoption, it would appear to be more justified if it were slanted in the opposite direction. Since women have a longer life expectancy on the average than men, the death of parent argument would seem to imply stronger restrictions on men’s age than on women’s.

Who Has Control? One of the principal underlying issues here is the question of who has control over a person’s reproductive life. Individuals should, I have argued, have the maximal degree of control over their own individual reproductive life.

The issue of control also is relevant to the question of whether postmenopausal pregnancy might bring with it undue medical liabilities for the pregnant woman. There may well be increased risks, and women should be clearly advised of those risks. However, the final choice of whether those risks are worth the possible gains should be left up to the woman herself, except in those cases where physicians feel that they would be medically irresponsible to participate in such a pregnancy.

Conclusion: Wise Choices

To argue that individuals should have the maximal degree of liberty in making reproductive choices obviously does not mean that all such choices are wise ones. Let me conclude with several remarks on what we could call the contours of reproductive wisdom.

The Motivation Issue. Stories of postmenopausal pregnancy are often greeted with incredulity about why someone would want to have a child (much less twins) at such a late time in life. Why do older persons have, or want to have, children beyond the usual childbearing age?

The answers to this question are, in large measure, the same answers we find in parents of a younger age. The relevant question is perhaps why they didn’t act on those reasons earlier in their life. As we shall see, in at least some of these cases, they did act on those reasons earlier in life.

We can imagine several common scenarios. First, a child might have died, and the person might want to have another child in its place, as it were. There are certainly serious dangers with any attempt to have one child "replace" another, but there is nothing about these dangers that is confined to older age. This indeed was the principal motivation in the case of Rosanna Della Corte, whose sixteen year old son Ricardo had died in an automobile accident three years earlier. The baby she had at sixty-two was also named Ricardo.

Second, a woman might have been infertile–either all her life or during the period when she wanted to have children–and only with the development of new technologies is she at last able to conceive. Her reasons for having children may be no different than anyone else’s. However, the technology necessary to allow her to conceive may have only been developed when she was postmenopausal.

Third, we can imagine a person wanting to have children with a new spouse after getting married later in life. (This in fact has been the motivation in several cases.) This seems to be a thoroughly reasonable motivation. There may be a variety of factors that make it an unwise choice, and the likelihood of these factors may increase with age, but it hardly seems that age alone should be an impediment here.

The Seasons of Life Issue. A final argument here is worthy of consideration, although it is hard to state it with precision. Isn’t it the case that life has, as it were, its seasons and that having children late in life–whether for males or females–is to ignore those seasons?

There is, I think, merit in this argument, but it is hardly strong enough to justify restriction on having children later in life. The seasons certainly are there, but it is also true that we live increasingly in an age of choice, one where we may construct lives that do not follow traditional patterns. It is important, I think, to continue to preserve this as an option.

Footnotes

1Alan Riding, "French Government Proposes Ban On Pregnancies After Menopause," The New York Times, January 5, 1994, Section A; Page 6; Column 1.

² Louis J. Salome, "59-year-old Mother Sparks Fierce Debate in Britain," The Times-Picayune, January 10, 1994, Pg. A23.

³ Ibid.

⁴ Bruce Johnston, "Mother who gave birth at 62 plans new baby," The Daily Telegraph, July 19, 1995, p. 10.

⁵ William D. Montalbano, "Physicians Ban Controversial Biogenetics," Los Angeles Times, April 15, 1995, Part A, page 2.

⁶ Bonnie Steinbock and Ron McClamrock, "When is birth unfair to the child?", The Hastings Center Report, Vol. 24 ; No. 6 ; (November, 1994), pp. 15 ff.

⁷ The Human Fertilisation and Embryology Authority, which regulates fertility treatment in Britain, does not stipulate an age limit, saying: "In our guidelines to clinics, the paramount concern is the welfare of a child. The age of the mother would be one of the considerations for a clinic before agreeing to treatment." Quoted in Celia Hall, "Woman has test-tube baby at the age of 51," The Independent, April 14, 1995, Section: Home, page 9.

⁸ See, for example, Derek Parfit, Reasons and Persons (Oxford: Clarendon Press, 1984), chap. 16, "The Non-Identity Problem," pp. 357-61.