recognized the special values of racial, religious, and ethnic groups which are a cherished part of their traditions (the values, for example, of children, kinship ties, styles of living, and cultural continuity and preservation). A population program would reduce respect for other important values present in American society if it: evaluated programs in a way which did not give full consideration to minority values and interests. took no account of the legacy of evils inflicted upon racial and other minority groups. A population program would show positive disrespect for other important values in American society if it: excluded minority values and interests in evaluating programs. presumed that the traditional, historical values of different groups were of no consequence or importance in contemporary society. Conflict and Resolution of Values Clearly, the foregoing list of population-related ethical propositions raises a number of problems. First, it is evident that many of the propositions will, in practice and application, be incompatible; only in the best of all possible worlds (which ours is not) would it be possible to realize all values simultaneously. Second, a listing of central ethical propositions does not, by itself, provide any guidance to their application. Third, the variety of different factual situations, the wide range of possibilities for joining a number of population programs together as part of one overall policy, and the different interpretations of the nature of the population problem, all conspire to render any simple ethical formulas for resolving value conflicts useless or misleading. The history of Western ethics, not to mention the history of American jurisprudence, has seen any number of theoretical attempts to formulate methods of resolving conflicts among values. Single principle theories, for example, propose that it is possible to combine a number of values into one general ethical proposition, which can then be used to test proposed ethical judgments. An example would be that the ethically right policy is always the one which maximized the good. Rank order value theories, by contrast, presume that it is possible to specify the relative importance, in a rank order, of a variety of important values. The attraction of rank order theories is that they respond to the main problem of single principle theories: How does one decide, when the single principle theory actually suggests a number of claims, which of the claims is to be given a greater or lesser weight when all cannot be realized fully at the same time? A rank order theory requires that, in the end, one be willing to give primacy to one value (e.g., freedom) even if this is achieved at the expense of others. Balance of value theories, in contrast to both of the preceding kinds, assert that it is not possible to frame a single principle value statement which can take account of all important values, nor that it is possible to specify a rank ordering of values without eventually encountering insuperable conflicts and dilemmas. The list of values in the Preamble to the Constitution is an example. Thus it would say that, even a full statement of the single principle leaves many important (to some) values to one side. And it would say that, if one tried to give a rank order of a fixed kind to a list of values such as that found in the Preamble, irreconcilable conflicts would soon appear. (For example, if freedom is given an absolute primacy, then what does one do when the cumulative effect of the freedom ends by being a threat to freedom itself?) Balance of value theories propose to meet these difficulties by asserting that, in the end, the best one can do is to take account of all the important values in a relatively informal way-by drawing on accumulated experience and wisdom, by general sensibilities, or by relying, when possible, on tested (and proven) traditional strategies for weighing and balancing values. We do not propose-for we are not able-to tell either the Commission on Population Growth and the American Future, or the American people, which theory is right or best. The history of Western philosophy itself, not to mention the American ethical tradition(s), cannot do that. At this point, we reach the limit of our own research and thought; like everyone else in society, we are divided among ourselves on that issue-just as most of us are divided within on such large and perhaps ultimately unresolvable problems. Moreover, for the purposes of the making of public policy, it is the policy-maker and the legislator who, in our society, take the final steps in that chain of research, thinking, and discussion which precede action. They are the ones who will have to decide these matters, hopefully in a wise and sensitive way, fully aware that they are representatives of the people, custodians of the tradition, and responsible for their own moral and political conduct. If we cannot, then, pretend to provide any simple test of ethical correctness and rectitude, or provide any final word of sage advice, we can offer an evaluation of a variety of different population proposals. These evaluations, put in brief, summary form, represent an attempt to apply the values we have discussed and analyzed to concrete policy alternatives. They are meant to provide a range of value-based analyses of the implications for American ethical values and principles of possible policy directions. Application of Criteria to Policy Alternatives20 A number of population proposals have been put forward in recent years, proposals designed to solve or ameliorate population pressures. The 24 proposals listed below represent the most prominent of these. Our analysis, necessarily in summary form, is based upon the ethical and legal criteria just presented, together with considerations drawn from earlier sections of this report. The policies have been arranged into five general categories: (1) voluntarist policies of inherent value unrelated to population considerations, (2) incentive and welfare programs, (3) policies shifting social conditions for population purposes, (4) involuntary governmental controls, and (5) policies affecting distribution. Where appropriate, policies bearing on immigration will be treated under these headings. The five general groups of policies are designed to deal with somewhat different conditions. Yet, in general and with important qualifications, the policies in the earlier groups are ethically more acceptable than those in the later groups. The groups are constructed here along the dimension of freedom and coercion, though, of course, justice, general welfare, and security/survival continuums might also be devised. There is a continuum between freedom and coercionranging from promotion of education through policies of persuasion, to policies of control through incentives and penalties, and finally to outright physical or psychological control which can be called coercion in the fullest sense. While freedom is one of the fundamental values of the American tradition, certain policies which would promote freedom of the individual under certain empirical conditions and with certain notions of freedom can still be far from acceptable as population policies for the society. Some policies toward the coercion end of this spectrum may be more acceptable than some which are less coercive because of claims of values other than freedom or other claims of freedom itself. Thus, the list should not be viewed as a ranking of total ethical acceptability. Each of these five general policy categories can be evaluated from the three perspectives which have been treated as interrelated in this report: (1) ethical acceptability, (2) legal acceptability, and (3) acceptability to interest and professional groups. After discussing the general policy groups from each of these perspectives, specific policy proposals within each group will be examined. The technical feasibility of effectiveness of these proposals is beyond the scope of this report. Voluntarist Policies General Discussion of Voluntarist Policies Ethical Acceptability. The group of policies which will generally be most acceptable as first efforts are those which are often called "voluntarist." Working on the basis of the concept of freedom employed in this report, we would conclude that a population policy would contribute to or at least be consonant with freedom in its fullest sense when it assures that every individual has the capacity, opportunity, and incentive for making choices in the planning of his or her own family. This could be advanced by providing (1) the access to information and materials, (2) the knowledge and motivation to use that information and materials without fear or anxiety, and (3) the removal of constraints from, and the providing of resources for, making those choices. This suggests that there are at least three disputes about how freedom should be furthered in a voluntarist policy. Should such a policy make available materials as well as information? Must it provide knowledge about this information and materials in such a way that there is sufficient motivation to make use of the knowledge? Is it necessary to provide resources (money and materials) for exercising choices when they are not otherwise available? If a policy is designed solely to promote freedom in all its senses, then the answers would be yes. The policy question which must be resolved is whether the objective is to promote all of these senses of freedom, and how the claims of freedom to plan one's family are to be weighed against the claims of other values (e.g., well-being, justice, security, aesthetics), and against the other claims of freedom itself. The principle of freedom of choice obviously holds a crucial place in the American tradition. The arguments against freedom will take longer to describe, but this does not mean they are necessarily stronger argumentsones which can override the principle of liberty. They fall into four main groups. First, there are some policies which might be called freedom-enhancing, but which still should be opposed as public policies because they encourage or permit acts which are themselves morally unacceptable. Some would argue that chemical and mechanical contraception, sterilization, and early abortion fall into this category. Even those who do not agree that these practices themselves are immoral, might agree that they are when dealing with late-term abortions, infanticide, and illegitimate births. Second, promoting freedom of choice in the area of family planning may, under certain empirical, social conditions, jeopardize the promotion of the general welfare, security, and survival. This is the position that voluntarism may not "be enough." Third, voluntarist policies may regulate population size, growth, and distribution but only at the expense of serious violation of justice. Three examples will illustrate. (1) If the poor, suffering under financial hardships, are manipulated "voluntarily" to curb their childbearing, then it could be preferable to provide means for this disadvantaged group to have the children they want. Social changes providing educational and career opportunities to improve their lot may be ethically right-even if it means they will have more children and, because of this, require the taking of policy steps "beyond voluntarism" for the entire population. In short, justice might require more freedom for some at the cost of less for others. A policy which maintains population growth rates by forcing the poor to have small families is one which is in violation of the principle of justice. (2) The principle of justice could be violated by voluntarist policies which preserved present population rates by maintaining present levels of infertility (by refusing, for instance, to support research for, or permit the practice of, means for overcoming infertility). (3) A third case is summarized in the guideline: No population policy should reduce or control Fourth, a policy promoting full freedom of choice in the planning of one's family may violate other implications of the principle of freedom itself. It might violate the freedom to use national forest land undisturbed by crowded conditions. It might violate the freedom of future generations to make the choices they might desire. In the eyes of those who consider the unborn child the possessor of human rights, it might violate his freedom in a very fundamental way. Legal Acceptability.22 Voluntarist policies have the advantage of maximizing freedom now, patently a highly important value in the American legal system. Indeed, it may fairly be argued that government provision of information relevant to family planning, which surely relates to health and welfare, is mandated by an evolving society's goal to ensure the same basic rights to adequate health to all. Moreover, if voluntaristic policies result in acceptable population size, then the "problem" is resolved at substantially no cost to others in terms of values of security, freedom, general welfare, and justice. Acceptability to Interest and Professional Groups.23 Voluntarist policies would be most acceptable to traditional family planning organizations, religious groups, most social scientists and demographers, politically radical ecologists and environmentalists and, in general, most other major groups in the population. If controlled by minority group members and made a patently clear part of more general welfare programs directed at minority groups, they would be acceptable to all but the most militant members of racial minority groups. A failure to meet those conditions, however, would make them the subject of continuing suspicion on their part. Taken alone, voluntarist policies would be most unacceptable to radical ecologists. Specific Voluntarist Policies There are four basic types of voluntarist population growth policies. First of these would be the provision of free and readily accessible birth control information and materials to all. Arguments for: Freedom is enhanced. The general welfare is enhanced. Arguments against: Some forms of birth control are seen by some as intrinsically wrong for all, for unmarrieds, or for unmarried teenagers. Provision of birth control materials may be seen by some as having lower acceptability than merely providing knowledge. Providing financing (resources for exercising freedom) may not be included in some conceptions of freedom. For some, the obligation of the government to promote freedom by providing resources necessary to act upon choices should be limited to those who would otherwise be unable to act on those choices. Arguments against limiting policy to free information and materials: The general welfare and eventually even the security Such limitation may be unjust to the sub-fecund. It may be unjust to those of good will who sacrifice The freedom to make other choices may be violated. The freedom of future generations may be violated. A second voluntarist approach would be the development of an education campaign limited to distributing information about the demographic and ecological facts of population growth; birth control information would also be distributed, without promoting anti-natalist ideals. Arguments for: Knowledge is intrinsically valuable. Information is essential for reflective freedom of choice. Arguments against: Selection of materials and biases of teachers and curriculum planners mean that values will necessarily be incorporated into the teaching of "just the facts." Education within school curricula may mean that students are not free to refuse information. (Does one have the right to ignorance in these areas?) Some may see provision of information as necessarily leading to use of that information in intrinsically immoral ways. This could lead to objection to teaching about the use of contraceptives while still endorsing the teaching of demographic and ecological facts. Arguments against limiting policy to education: See first policy above. The government could facilitate a third approach by promoting antinatalist social conditions which have inherent value independent of population factors, such as education, overcoming poverty, and liberation of women. Arguments for: Government has an obligation to promote the general welfare. Justice requires such promotion. Freedom is enhanced in the larger sense (greater options for choice; better ability to act on them). Arguments against: For both political and ethical reasons, changes might not be reversible. If some social changes are empirically found to be pronatalist, they might be opposed by some on the grounds that demographic considerations are crucial. Such policies will be coercive and deceptive (and thus violate freedom and truth) unless the motivation for the policies are made clear. Arguments against limiting policy to antinatalist social changes: See first policy above. Finally, early abortion on request could be available, with government financing when necessary. The debate on abortion on request is a familiar and complex one. Government policy must be based primarily upon a social judgment about the ethical significance of the human life in the fetal stage. This is a social judgment which cannot be avoided by public policy makers. While medical evidence might provide data about certain biological processes, it cannot answer the important question about what it is in a life which invests it with dignity, "humanity," and the fundamental inalienable rights guaranteed by the American tradition. These questions must be resolved individually by one's theological and philosophical understanding of the nature of man and collectively by the policymaking process which decides fundamental questions of this nature. There are many alternatives proposed as the point at which the essential characteristics of significant human life are acquired. These emphasize in various degrees man's biological, psychological, social, and cultural nature. Among them are fertilization, fixation of genetic information (soon after fertilization), implantation (about one week), central nervous system activity (detectable EEG at about eighth week), spontaneous movement (tenth week), brain structure completion (twelfth week), quickening (thirteenth to sixteenth week), viability at present point in technology (24 to 28 weeks, normally; 20 to 28 weeks, occasionally), birth, breath, consciousness, and social interaction. Some different groupings of ethical judgment can be distinguished. Many would hold that abortion prior to the acquisition of those characteristics thought essential to the meaning of "human" is ethically acceptable, posing no moral dilemmas. Then there are those who would agree that, while it might be possible to stipulate a point at which the conceptus acquires essential "human" characteristics, an abortion prior to that time is still an ethically serious act; even life which is, after conception, still only potential human life requires ethical respect, though abortion would be acceptable in some circumstances. Still others would hold that all the essential characteristics of the "human" are present from the time of conception or very shortly thereafter and that abortion would always be wrong (save in very rare medical circumstances). These general characterizations do not, of course, bring out the variety of nuances which different adherents of the positions bring to bear in support of, or emendation of, their arguments. Moreover, to disputes on the purely ethical issues must be added a variety of positions concerning the relationship between law and ethics in the abortion area. Here distinctions can be made among (1) those who believe abortion wrong and appropriately subject to legal prohibitions and regulations; (2) those who believe abortion wrong but not a matter appropriate for governmental prohibition; and (3) those who believe abortion not necessarily wrong in all circumstances, nor necessarily to be prohibited, but nonetheless best carried out in an atmosphere which sees abortion as ethically undesirable and, at best, as a last resort method of birth limitation. Many variant positions could be described as well. The following ethical considerations also enter the abortion debate. These are considerations primarily relevant to abortion decisions at the point in life prior to the time when the state should provide full protection to the individual just as it would to any other human being. Arguments for: The freedom and well-being of the parents must be protected. The welfare of the family should be considered. Women have the right to control their bodies. Religious freedom for those religious traditions which sanction abortion is protected. Arguments against: Lack of respect for all human life resulting from destruction of the potentially human may develop. A physician may be forced to violate his personal conscience unless a conscientious objection clause is written into abortion legislation. In a condition of ethical uncertainty (about the status of a fetus), some claim it is ethically preferable to take the "safer" course. If abortion is financed under government health insurance programs, it might imply that abortion decisions should be based on medical factors alone, rather than in conjunction with ethical factors. A policy of (voluntary) abortion for demographic purposes undermines the position that abortion is solely a matter of individual free choice. Arguments against limiting a policy to abortion on request: See first policy above. Positive and Negative Incentive Programs General Considerations Moving beyond policies which are primarily oriented to the promotion of individual freedom in areas which have anti-natalist implications, a second group of policies would attempt to change behavior in the direction of population-related objectives by providing positive incentives to encourage limiting births or by instituting either fees or penalties (negative incentives) for behavior which is inconsistent with demographic objectives. Ethical Acceptability more Positive and Negative Incentives. The ordinary use of our language reflects a distinction maintained by some, but not all, scholars that positive incentives are palatable than penalties (negative incentives): Positive incentives enhance or are, at least, consistent with freedom while penalties are more coercive. Quite apart from any economic difference, which may be minimal, there are important subjective differences in perception of the significance of the type of incentive. Fees and Penalties. Ethically speaking, virtually all would agree that childbearing per se is not bad, but only too much or too rapid childbearing on a societal level. For such situations, fees are often more appropriate than penalties. They are designed to reduce activity which is not intrinsically bad to a point where the aggregate effect of the activity is also not bad. Penalties, on the other hand, at least imply blame on the part of the parents or perhaps even on children. Monetizing Childbearing. A more insidious general ethical problem with all incentive schemes is that it monetizes childbearing, reducing choices about the creation of life to economic calculations. Further, different groups might be affected differently because of varying attitudes toward monetizing childbearing. Costs of Failure. Policy-makers are ethically and politically obligated to be responsible in their choices in spending the common resources. If positive incentives fail, substantial sums of money may be spent without producing significant demographic effects; but if negative incentives fail to produce the desired demographic effects, at least funds have been accumulated for |