title: Preconception care: a parenting protocol: a moral inquiry into the responsibilities of future parents towards their future children.
abstract: In the Netherlands fertility doctors increasingly formulate protocols, which oblige patients to quit their unhealthy lifestyle before they are admitted to IVF procedures. We argue that moral arguments could justify parenting protocols that concern all future parents. In the first part we argue that want-to-be parents have moral responsibilities towards their future children to prevent them from harm by diminishing or eliminating risk factors before as well as during the pregnancy. This is because of the future children's potential to become of a certain type, more specifically: a person that will be the want-to-be parents' child. Want-to-be parents intend to become pregnant and therefore have an additional moral reason to diminish the risks. Also, people who become pregnant unintentionally have the responsibility to prevent their children from harm, unless they become pregnant due to contraception failure. All people not wanting to become pregnant should use contraception methods carefully. In the second part of this paper we translate the want-to-be parents' responsibilities into practice. We distinguish four determinants of risk factors: modifiability, chance, severity and effort. We examine some evidence-based risk factors based on these variables and deduce levels of responsibility. In conclusion, formulating informal requirements for want-to-be parents is morally required and therefore also for want-to-be parents in need of medical assistance. The protocols developed by fertility doctors in the Netherlands could be seen as the precursor for a general, informal Parenting Protocol that could be developed on the basis of an extended and thoroughly debated risk-responsibility analysis.
authors.affiliation: Department of Medical Ethics and Philosophy of Medicine, Erasmus University Medical Centre, CA Rotterdam, The Netherlands. b.vanderzee@erasmusmc.nl
authors.forename: Boukje
authors.initials: B
authors.lastname: VAN DER Zee
authors.forename: Inez
authors.initials: I
authors.lastname: DE Beaufort
mesh_terms: D002985:Clinical Protocols; D000013:Congenital Abnormalities / Q000517:prevention & control*; D005260:Female; D006801:Humans; D008297:Male; D028681:Moral Obligations; D009426:Netherlands; D016487:Parenting; D016742:Preconception Care / Q000941:ethics* / Q000379:methods*; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000517:prevention & control*; D018456:Reproductive Medicine / Q000941:ethics; D018570:Risk Assessment