esearch and program implementation which might urther population-related objectives. Harm to Innocent Children. For an incentive cheme to be ethically acceptable it would have to meet several conditions: (1) The incentive, fee, or penalty would have to have only indirect effects on the children (effects mediated, for instance, by parental decisions not to spend limited resources on children rather than penalties which directly affect innocent children by preventing them from obtaining needed medical or educational services); (2) emergency remedial measures would have to be available to any children indirectly harmed; (3) a plausible case would have to be made that the children themselves are better off, or at least not harmed, in the long run because of the incentive to the parental generation; (4) psychological and social, as well as physical, harm to children would have to be taken. into consideration. The Genetic Effects. Incentive schemes might delay childbearing to a period where there are greater genetic risks. The Universal or the Average N-Child Family. Many incentive schemes are designed to take effect after the Nth child in the family is born. This would be the case if payments were made for sterilization or contraception after the Nth child or if social services were limited to N children. These proposals are based on the ethical judgment that every family should be entitled to a certain minimal number of children. A policy alternative is that the average family size should be N. Against the ethical claim that every family should be entitled to a certain minimal number of children, there are several arguments for the goal of an average N-child family: First, the policy objective should not be to affect decisions about children after the Nth no matter what the sacrifice called for; rather, it should affect those decisions in which not having the child would call for the minimal sacrifice. Second, establishing the norm of the universal N-child family could unjustly create serious hardship for children born after the Nth. Even if their material welfare is cared for, there may be an implied psychological burden of blame attributed to these children and their parents. Third, establishing the norm of the universal N-child family implies that a particular family size, whatever it may be, is socially preferable, when, in fact, evidence for such a claim is hard to come by. Fourth, from the genetic point of view, a universal N-child family would contribute to stagnation of the gene pool. Efficacy. Incentive programs raise many of the same questions of efficacy which apply to voluntarist programs and the programs which shift socio-cultural institutions to be discussed below. This is, first of all, a practical political problem. But it is also an ethical problem. If money is being paid and the primary purpose of that payment is to bring about a desired change in social conditions, but these changes are not, in fact, brought about, this is an ethical problem. It constitutes irresponsible use of resources and infringement on individual freedom. This would be particularly noticeable with positive incentives. Government funds would be spent perhaps in large quantities, without improving the general welfare. But a negative incentive program which was not successful would also raise serious ethical questions even if it cost the government nothing, or, in fact, produced some income for population-related government programs. There would still be costs to the individual citizen-sacrifices made in the form of penalties and fees or sacrifices made in childbearing decisions. Legal Acceptability. Although there can be no question of government's broad power to initiate incentive programs of various sorts as an aspect of the spending power, that power, like all government action, will be limited by the constitutional protection of individual rights. The hardest problem with any popula tion control program relying on monetary incentives is whether it can possibly meet the law's increasing concern for equality. Whether an incentive is looked upon as a welcome inducement, or covert coercion, may be a matter of individual perception; on the face of it, many monetary incentives would seem to place a burden upon the poor, who have greater need of the money or goods offered. However, there are imaginable circumstances in which this would not necessarily be the case (e.g., if there existed a guaranteed income and welfare program, if there were exemptions for the poor, or if the plan worked with a sliding scale). Negative incentives, particularly flat taxes on childbearing, would probably be unconstitutional to the extent that the poor were completely unable to afford the price. Moreover, any program which placed burdens on some children by disqualifying them from receipt of benefits, would be unacceptable, as a denial of equal protection. Acceptability to Interest and Professional Groups. Many positive and negative incentives would be particularly unacceptable and abhorrent to racial minority groups. Because of the poverty in these groups, they would see such incentives and penalties as directed at them, harmful to them, and confirming their suspicions of the motives behind population control policies. With the exception of some ecologists, physicians, and family planning groups, such programs would not commend themselves to the values of most groups in America. Specific Incentive Programs24 One possible incentive program to reduce fertility would be to establish a sliding-scale tax or tax adjustment as a fee for childbearing. Arguments for: Such a program would minimize the individual sacrifices arising from the control of population growth and distribute them equally if the basis of the scale is equitable.25 It is reversible and flexible. Arguments against: Such programs violate freedom to have as many children as one wants. Childbearing would become monetized. A second program could be to give Social Security bonuses to people with few or no children. Arguments for: The incentive is positive rather than negative. Deferred payment minimizes disadvantages to children. There is no effect on spacing. Arguments against: The economic impact of a flat rate is greater on the poorer. This creates a norm of universal N-child family rather than average. The right to bear children rather than the amount of sacrifice becomes equally distributed. Children after the Nth may be blamed by parents or older siblings for increased responsibility for care of parents in old age. Special problems of enforcement and efficacy are created. Third, the government could give direct financial rewards for periods of not giving birth. Arguments for: The incentive is positive rather than negative. It does not set an "ideal" number of children per family. Arguments against: The impact of a flat rate is greater on the poor. Payments are required for those not planning children anyway. If only married women are paid, there are questions of justice and possibly even pressures for marriage. If unmarrieds are paid, the program is inefficient and "rewards" ethically and legally expected behavior. Fourth, the government could levy a flat tax on childbearing. The direct economic costs of the program are small, even if it fails (though social costs may be high). However, it distributes the right to bear children according to ability of parents to afford the tax, placing greater burden on the poor. Finally, maternity benefits, free education, welfare, medical coverage, and so forth, could be restricted to N children. Arguments for: This can be defended only on principles of justice that cannot be accepted, i.e., that the right to bear children should go to those who have economic ability, are "useful to society," etc. Arguments against: The impact is greater (i.e., almost totally) on the poor. It creates a norm of the universal N-child family and potential blame and guilt for children above the Nth. Suffering of innocent children becomes even more Shifts in Socio-Cultural Conditions for General Considerations Ethical Acceptability. A third group of policies depends upon a much broader, more indirect approach. By exerting governmental pressures to modify sociocultural conditions (such as education, family structure, and income), changes in demographic patterns might be anticipated. From the ethical point of view, evaluation of such policies depends largely on what conditions are changed and how. They would tend to be ethically acceptable if the socio-cultural changes in themselves promote the general welfare in a just way, and unacceptable if they do not. Three general ethical objections to such policies can be noted. First, on the surface they appear to maintain a semblance of freedom for the individual. Yet in a more subtle, psychological way, changes of basic values and conditions of life which would essentially force demographically preferred family planning decisions can be seen as coercive. This could be seen as placing the government in the role of a manipulator. Second, broad-scale efforts to change socio-cultural patterns are probably the least reversible of any population policy. Third, if such policies were developed without making clear to all the demographic motivations, they would violate the ethical principle of truth telling; they would be deceptive. Such efforts might arise in areas where there is resistance to other, more direct population policies. Legal Acceptability. Government frequently intrudes on social and economic institutions to further the general welfare; the principle itself is long-established. Problems would arise, however, if education programs aimed at promoting a small family norm were compulsory and propagandistic in nature and if the motives behind programs were hidden from public view. On the whole, government promotion of the correlates of small family size would be acceptable, particularly if the correlate (e.g., greater female employment opportunities) was a good in itself. Even if the correlates were promoted for population purposes only, they would probably be acceptable. Acceptability to Interest and Professional Groups. Population programs based on shifts in socio-cultural conditions for population purposes would probably be acceptable to most groups if (1) the purposes behind the shifts were clearly made known, (2) the shifts did not place excessive pressures on people, and (3) the ends served were, in addition to population goals, valuable in themselves. They would particularly arouse suspicion in racial and ethnic groups if they seemed, in any radical way, to downgrade the value of children and childbearing. Specific Policy Proposals Three types of policies, effecting changes in sociocultural conditions, can affect population growth. First, population "education" can be designed in such a way as to promote the small family ideal. Arguments for: A semblance of individual freedom of choice is preserved. The program could be accommodated to ongoing citizenship education. It can be consistent with the principles of justice. It could be carried out with a minimum of "felt harm." Arguments against: The government is placed more consciously in role of manipulator. In more subtle forms, it would violate the principle of freedom taken in the psychological sense, limiting the alternative values and life styles available. Its reversibility is questionable. (For arguments against limiting policy to education promoting the small family ideal, see the general discussion of voluntarist policies.) The government could also promote anti-natalist social conditions which have inherent value independent of population factors, such as education, overcoming poverty, and liberation of women. (This is discussed above in the section on voluntarist policies.) Finally, the government could promote sociological correlates of the small family which are anti-natalist, but do not warrant government promotion on nondemographic grounds (for example, urbanization, breakdown of the nuclear family, trial marriages, and participation of women in the labor force beyond what would result from the Women's Liberation Movement). Arguments for: A semblance of freedom is preserved. Some correlates may be consistent with the principle of justice. Arguments against: Government is placed in the role of manipulator. Such a program violates the principle of truthtelling if motivation for policy is not disclosed. It probably is not reversible. It would violate the principle of justice if benefits and harms are not distributed equitably. The efficacy and economic efficiency of such a program are questionable. Security/survival may be jeopardized (for example, breakdown of the family). Teachings of certain religious groups may be violated. Governmental Involuntary Controls General Considerations Ethical Acceptability. Among the most dramatic proposals for regulating population size and growth are those which are clearly compulsory (for example, reduction in immigration, fertility control agents in the water supply, marketable licenses for babies, compulsory sterilization, and compulsory abortion). They are direct means and probably could effectively reduce growth rates. Yet they are, by their very nature, gross violations of individual freedom in all of the senses discussed in this study. Such a violation of freedom could be justified, if at all, only in extreme circumstances where individual and social welfare, security, or survival are at stake. After emphasizing the more obvious ethical claims against such policies, it is important to realize that the motive behind some such proposals is an attempt to intervene into population-related behavior in a way not directly linked to financial incentives (which often treat certain groups such as the poor unjustly) or psychological manipulation (which is a more subtle violation of freedom). Many of these policies are demographically (though not necessarily individually) readily reversible. Legal Acceptability. These programs most seriously strain the legal tradition of freedom. Since the Constitution contains no explicit protection of the right to bear children, however, it is most likely that if Congress really determined at some future point that drastic compulsory measures were necessary, they would be accepted as constitutional. That is a major stipulation, presuming exceptionally grave, generally recognized dangers. Compulsory measures are enough at odds with basic values in the legal tradition that they would (and should) be employed only as a desperate last resort. They would be objectionable to all persons who simply think the freedom eliminated is a basic social right. They would be even worse to those who considered the controls to conflict with their fervently held religious or moral beliefs. There would be ample grounds for constitutional objection. For a government based on consent of free men, compulsions against the conscience of a substantial minority is fraught with dangers; that much the legal tradition makes clear. Acceptability to Interest and Professional Groups. With the exception, perhaps, of some biologists, ecologists, and medical professionals, compulsory programs would be acceptable to most groups in America, if at all, only as a last desperate resort. The minority groups would find their basic values violated, as would most of the religious groups. It is doubtful that, for some groups (such as racial minorities and some religious groups) compulsory programs would be acceptable even as a last resort. Specific Policy Proposals There are five basic involuntary controls by which the government can effect reduced population growth. The first would be radically reducing immigration.26 Arguments for: Reduced immigration imposes relatively few hardships on the present population. Arguments against: It violates the tradition of freedom of movement and the image of the country as a haven for the "tired, the poor, the huddled masses. . . ." (This is also an ethical argument for permitting increased immigration.) It may imply that the United States is rejecting responsibility for more global population-related problems. The harm done by such action must be compared to the harm of reducing the domestic growth rate enough to produce a comparable effect on total population growth (between 0.2 and 0.3 children per family at present immigration and birth rates). It would be unjust to families wanting relatives to immigrate (if reductions are made in all quota categories). It would also be unjust to groups which cannot fit special quota categories if reductions are limited to these groups. A second type of involuntary control could be to require people to have licenses to have children.27 Arguments for: Such a program would be flexible and reversible. Parents would be able to choose between children and other goods, minimizing individual sacrifices made. Arguments against: The right to have children is distributed according to the economic resources of the parents (if licenses are openly marketed) or according to society's evaluation of individuals without regard to parental desire (if some other basis of distributing licenses is used). It represents a gross violation of freedom of choice in family planning. A nonmarketable license eliminates economic injustices but increases ethical questions related to enforcement. Childbearing would become monetized. Serious ethical questions would arise if the original distribution was on any basis other than the same number to each individual. (Giving people the same number raises serious questions also.) Remarriage creates problems. Thirdly, fertility control agents could be dissolved in the Nation's water supply. Arguments for: This would eliminate factors such as economic resources (subject to qualification), or governmental evaluations of quality or usefulness for the giving of the right to bear children. Arguments against: This grossly violates individual freedom. Unless corrective therapy to control effects of the anti-fertility agent were available, it would discriminate against the marginally fertile. Those with resources to purchase means of avoiding the agent (e.g., bottled water) would be unjustly exempted. Moral approval would be dependent upon a technically feasible method with assurance of safety. This currently seems unlikely using hormonal fertility control agents. The agents used may be intrinsically morally reprehensible to some (e.g., those opposed to chemical means of contraception). A fourth alternative is compulsory sterilization. This could require sterilization in all cases after N children or by lottery after two children. Arguments for: It would be reversible in its demographic impact (though probably not for individual couples). It would eliminate factors such as economic resources (subject to qualification) or governmental evaluations of quality from the right to bear children. Arguments against: This grossly violates individual freedom. It also violates the right to bear any (future) children. A norm of the universal N-child family would be established. If women were sterilized, it would discriminate against them and would involve more medical risk than if done on men; if men were sterilized, it would discriminate against them and would potentially violate their right to have any children, including those already born under present childcustody laws. The psychic costs vary for different individuals. Sterilization is abhorrent to racial minorities. Enforcement and surveillance might violate privacy. Unless there was a conscientious objection clause, it would require an intrinsically immoral act for some. It would lead to evasion and resentment of government. Difficulties would arise in cases of remarriage and where children are lost through natural deaths or accidents. Finally, abortion could be made compulsory after N children. The arguments for and against this policy are similar to that of compulsory sterilization except that (1) abortion is seen as a grosser ethical offense and intrinsically immoral by a larger number of people, and (2) the policy would be carried out against women and thus would discriminate against them specifically. Population Distribution Policies General Discussion Ethical Acceptability. The objective of population distribution policies is different than that of the above policies. Freedom of movement has long been an important part of the American tradition. A program which facilitated movement by making funds or other incentives (e.g., jobs) available for movement not otherwise possible could enhance freedom. Policies which sought to break up urban ghettoes and the entrapment they represent for many of their inhabitants could promote justice; the present de facto denial to ghetto residents of ready access to open space could also be facilitated. If concern for overcrowding in high-density areas is part of a definition of the population problem, then redistribution might promote the general welfare. A goal of regionally balanced distribution, combining a mixture of urban, town, rural, and primitive-area availability and recreation could, optimally, offer people a diversity of options. The potential ethical objections to a distribution policy fall into two groups. Involuntary or coercive distribution policies, which would either force people to move or deny them the opportunity of moving, would directly contradict the tradition of freedom of movement and the right to choose one's place of residence; not only would freedom be denied, but justice would be threatened as well. Voluntary distribution programs would raise many of the same problems inherent in any "voluntary" governmental programs. If there were any sense on the part of those supposed to benefit from the programs that their choices were, in fact, restricted by psychological, economic, or other pressures, then the policy could infringe upon their freedom. Moreover, unless exceeding care was taken in the devising of a distribution plan, the options left open for future generations could be endangered, for example, by failure to preserve open space and forest land. Many distribution policies would appeal primarily to those least well off in their present condition, perhaps unjustly placing the burden of any policy primarily on them. On the other hand, it may be ethically acceptable |