Wow! What a remarkable response to my reflections in my paper “Do all ways lead to Rome?”! In this paper, I have reflected on the potential tensions between parental expectations and children’s developmental needs. I have discussed the possible impacts of modern reproductive technologies and diverse cultural beliefs on child-rearing practices. Steier, Lim, Zeanah, Zeanah & Korfmacher have drawn upon a substantial corpus of bioethics literature and scientific studies to illustrate that my reflections may lack sufficient vigilance with respect to the potential dangers of discriminatory attitudes towards homosexual parents and the possible detrimental impact of authoritarian state interventions. They even suggest parallels between my reflections and the eugenics movement that emerged during the late 19th and early 20th centuries, as well as Ceaușescu’s population policy.
I do not wish to reiterate my arguments. This response gives rise to a number of significant questions that warrant further consideration:
1. Is it not within the remit of the infant mental health community to discuss the potential consequences of modern reproductive medicine on child development without becoming mired in the issue of political correctness?
Even Steier et al. posit that there are ethical boundaries to the ways in which parents in Western industrial societies can fulfil their desire for children, namely by “exploiting desperately poor women” as surrogates for their own offspring. It is my contention that this discussion is of critical importance and we should conduct it with the utmost rigor from the vantage point of the child and his/her right to a healthy development.
2. As infant mental health specialists, should we really waive our claim to provide young children with best possible care?
This is a challenging standard to meet. Of course, it is important to consider the social circumstances in which parents raise their children when assessing the “best possible” outcome. For example, families in countries facing poverty and war have different challenges than those in affluent and peaceful communities, which can afford a range of new medical treatments. However, even in difficult social conditions, it is essential to advocate for the improvement of young children’s developmental situations to the greatest extent possible.
3. Is there really always a consistent alignment between the aspirations of adults for access to parenthood and the children’s access to positive development?
Of course, both the wishes of the parents and the needs of the children fortunately evolve towards each other most of the time. But this correspondence has to evolve over time, from the infant in the parents’ minds to the real child and his/her demands. As we clinicians know, harmony in the parent-child relationship is not always a given and can be fraught with conflict. It requires a constant negotiation of mutual needs and it requires a balancing of both, the rights of the parents and the rights of the child. And yes, society has a responsibility to carefully negotiate the terms and limits of how children should be brought up. In my country, for example, corporal punishment was outlawed about 50 years ago. This was preceded by an intensive social debate. Against this background, it is for example not so easy to decide how we as clinicians and our child protection services should deal with families in which corporal punishment is part of the traditional parental means of ensuring children’s respect for the older generation. Moreover, is it really acceptable to allow a market in surrogate motherhood in order to enable parenthood at any price, apart from the fact that only the rich and privileged can afford such measures?
Who, if not we as child mental health professionals, should be involved in this debate? In our liberal Western societies, the freedom and self-realisation of individuals are considered to be of great value. In light of the fact that different individuals have different interests we should be less concerned with political correctness but rather we should take a clear and unequivocal stance with regard to safeguarding the child’s well-being. My paper was intended as a stimulus for this discussion and I look forward to further debate.
Authors
Kai von Klitzing,
Germany
