Human Reproduction vol.15 no.3 pp.502–504, 2000 DEBATE continued The welfare of the child to those cases which maximize the welfare of the child. At Problems of indeterminacy and the same time this fact explains why the standard for medically- deontology assisted reproduction must and can be higher than for natural reproduction’ (Pennings, 1999, p.1146, my italics). Darren Langdridge Whilst this proposition appears, upon first inspection, to be Department of Behavioural Sciences, School of Human sensible, the conclusion does not, necessarily, follow from the and Health Sciences, University of Huddersfield, premise. Assisted conception techniques are indeed under the Queensgate, Huddersfield HD1 3DH, UK control of service providers, and this offers the opportunity for only providing the service where we can maximize the This debate was previously published on Webtrack 97, December 3, 1999 welfare of the child. However, this only explains why the standard can be higher and not why it must be higher. There Recent literature has addressed arguments about the importance are, arguably, potential explanations for why the standard of of the ‘welfare of the child’ principle (Blyth and Cameron, care should be higher where we exert some control over the 1998; Golombok, 1998) in the assessment of the provision of event, but this is by no means an issue beyond debate. Whilst assisted conception services. Two broad positions have emerged service providers have a duty of care to their patients, whether concerning the application of this principle: (i) the minimum this must extend to assessing the welfare of a child conceived welfare principle, and (ii) the maximum welfare principle. through assisted conception is still open to question despite Pennings (1999) attempts to provide a commonsense resolution being enshrined in UK legislation [Human Fertilisation and to this debate by proposing a ‘reasonable welfare principle’ Embryology Act, 1990; section 13(5)]. For the purpose of this for the welfare of the child. Whilst, the attempt to move paper however we shall set this argument aside and move on beyond the two present positions is welcomed, there are a to the most significant immediate criticisms of Pennings’ number of significant problems with the arguments presented (1999) position. by Pennings (1999). Pennings (1999) correctly outlines the two most widely recognized positions (maximum and minimum welfare The indeterminacy of the welfare of the child principles) concerning the welfare of the child and the Pennings (1999) clearly presents the case for consequentialist provision of assisted conception services. Whilst we are arguments about the welfare of the child and argues that broadly in agreement with the arguments and criticisms greater follow-up research on children in ‘alternative’ families presented for the maximum welfare principle, there are a (e.g. lesbian households) will provide the answers about who number of significant problems with his presentation of the should and who should not be allowed access to assisted minimum welfare principle. The most notable problems with conception services (at least according to this particular ethical Pennings’ (1999) argument concern, firstly, his inadequate criterion). This position presents an unproblematic case for account of how to determine welfare and, secondly, his what constitutes adequate welfare of a child. However, debates unproblematic presentation of deontological arguments about about child welfare in the adoption and child protection the provision of assisted conception services. Furthermore, it literature have been concerned with what exactly constitutes can be argued that these criticisms, once again lead to a ‘the best interests of the child’ or welfare of the child for minimum welfare criterion and that this is the only principle some considerable time and have yet to reach any degree of which is beyond individual moralizing, self-interest and consensus (for a summary, see Fernandez, 1996). In fact, there prejudice. is increasing agreement about the great difficulties involved There is, however, a more minor (though potentially signi- in assessing the welfare of a child due to the open-endedness ficant), problem highlighted by Pennings (1999), when he and indeterminacy of the concept. discusses the maximum welfare principle, that we shall briefly The indeterminacy of the ‘welfare of the child’ principle address (though by no means answer) before tackling the stems from the potentially insoluble difficulties entailed in major problems as we see them. In an attempt to frame the identifying possible outcomes for a child, assigning probabilit- argument for and against the respective positions on the ies and attaching values to these outcomes. How can we make welfare of the child, Pennings (1999) reiterates an important a judgement at the very beginning of a child’s life about what assumption (which was made originally by the editors of the level of satisfaction, happiness and so on that they will achieve Lancet) on medically-assisted procreation, which requires as they develop into an adult? Not only is it difficult to state further examination: ‘Since we can control (at least to some the criteria with which to judge welfare but it becomes extent) the circumstances in which a child is made when the candidates are infertile, we ought to restrict our co-operation impossible to assign values to these criteria and make projective 502 © European Society of Human Reproduction and Embryology