A rational cure for prereproductive stress syndrome.

M any women and men, usually in the 20–50 age cohort, suffer from a condition that can be called prereproductive stress syndrome. The primary symptom is that these individuals have an urge to have children. Secondary symptoms, which are many and varied, can include a conviction that this urge is self evidently reasonable, and an illusion that others should help them in satisfying it. The syndrome typically disappears, at least for the time being, when the urge is met, and the standard treatment is, accordingly, pronatal counselling. In cases where the sufferers cannot have children of their own on their own, further approved treatments include artificial insemination, in vitro fertilisation, surrogate pregnancies, prenatal selection, and, in some jurisdictions, attempts to clone individuals. While pronatal counselling is widely seen as unproblematic, all the other alternatives are associated with difficult questions of ethics and health policy. In professional discussions concerning assisted reproduction and genetic selection, scientists and ethicists alike have, however, overlooked one fundamental question, namely, is it rational to have children in the first place. If it is not, then the use of advanced technologies in this context should be reassessed, and recommendations to possible parents reformulated. The least controversial intervention would be to let possible parents know that their urge is not necessarily rational. This view can be based on the following considerations.