1. 29. In real life, providers do have more sway over what the patient decides, and more options, than b1 has with respect to b2. Suppose that the patient informs the provider that she will not undergo any treatment that includes any safeguard against supernumerary pregnancy. And suppose her reasons are religious, or “ethical,” in nature, and have nothing to do with costs: she just thinks that once those egg cells pop out and begin to drift downwards in the direction of the fallopian tube, ripe and ready for fertilization, the “be fertile and populate the earth” principle or perhaps the still more important and morally weighty “more the merrier” principle is triggered. The provider informs the patient, then, that that's not how he (suppose) or his clinic does business: no fertility treatment can be made available in the absence of precautions to avoid supernumerary pregnancy. And he explains to the patient, in the most graphic terms, why that is the case. Is this option – clearly available to the provider – one that really so obviously would have failed to create additional wellbeing for the disabled child? Isn't the woman highly committed to having a child just as likely to accede to the provider's terms? Perhaps, by taking a firm stand, the provider does reduce in some small way the child's chances of existence – but surely many supernumerary pregnancies themselves are spontaneously aborted and surely a more limited pregnancy has a greater likelihood of success, so there may be something of a wash here. Especially in the case where after the fact, in the context of a civil action, the woman then asserts that, had the provider made precautions against supernumerary pregnancy a condition of treatment, she would have acceded to that condition, despite her vague religious or moral protestations to the contrary, I am not sure that we would not or should not find her testimony credible.
2. Cycles and chaos in political party voting—a research note
3. 35. That we think probabilities have a role to play in determining whether harm has been imposed does not mean that actual wellbeing does not have a role to play in determining harm as well. Thus, we are free to say that an act that creates a less-than-maximal quantity of expected wellbeing for a given person p, but turns out, contrary to expectations, to be the objectively better-for-p act in light of how the future in fact unfolded, is an act that does not “harm” p. In the case at hand, however, this condition on harm would be satisfied given that the baby is in fact born damaged. Where this condition would come into play to avoid a.
4. 26. Parfit raised this question, though in a different context, in a recent talk entitled “What We Together Do: Questions About Collective Responsibility,” University Center for Human Values, DeCamp Lecture (Princeton University, October 10, 2005).
5. “Double Trouble: Legal Solutions to the Medical Problems of Unconsented Sperm Harvesting and Drug-Induced Multiple Pregnancies,”;Chester;St. Louis Law Journal,2000