{"id":4612,"date":"2024-12-12T06:18:17","date_gmt":"2024-12-12T05:18:17","guid":{"rendered":"https:\/\/blogs.bmj.com\/medical-ethics\/?p=4612"},"modified":"2025-02-18T16:11:03","modified_gmt":"2025-02-18T15:11:03","slug":"ethics-is-the-key-to-demographic-change","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/medical-ethics\/2024\/12\/12\/ethics-is-the-key-to-demographic-change\/","title":{"rendered":"Ethics is the key to demographic change"},"content":{"rendered":"<p>By J.Y. Lee<\/p>\n<p>In the Global North, the fact that aging populations are <em>increasing<\/em> while birth rates are <em>decreasing<\/em> has become a point of great alarm in recent years. The average total fertility rate (TFR) across the globe stands at <a href=\"https:\/\/www.statista.com\/statistics\/1034075\/fertility-rate-world-continents-1950-2020\/\">2.3 births per woman today, compared to 4.9 back in 1950<\/a>. However, some countries are well below the so-called replacement number of 2.1 births per woman. South Korea for instance currently has the lowest TFR in the world, at just <a href=\"https:\/\/www.scmp.com\/news\/asia\/east-asia\/article\/3253465\/south-korea-sets-new-record-worlds-lowest-fertility-rate-despite-spending-billions-stem-population\">0.72 births per woman<\/a>. As a result, catastrophized claims about population and welfare \u2018collapse\u2019 have dominated headlines about such countries, with <a href=\"https:\/\/eastasiaforum.org\/2024\/02\/16\/south-koreans-blame-feminism-for-demographic-collapse\/\"><em>women<\/em> and <em>feminism<\/em><\/a> in particular being commonly (but mistakenly) cited as the primary causes of this demographic \u2018problem\u2019.<\/p>\n<p>While declining birth rates may evoke legitimate existential concerns about the future of various nation states, <a href=\"https:\/\/jme.bmj.com\/content\/early\/2024\/11\/27\/jme-2024-110001\">my latest JME paper<\/a> critiques the kinds of pronatalist logics and policies which have been implemented in countries like South Korea as a response to demographic change. Increasing birth rates have been framed as a political priority, yet even non-coercive and family-friendly policies like child benefits or generous parental leaves have been ineffective at reversing declining birth rates. This is because these so-called benefits do not actually resolve the existential challenges that both men and women face inside of a deeply competitive, overworked, and patriarchal society like South Korea: How should men provide for a household under the burden of economic insecurity? How might women balance returning to work when they are expected to become full time caregivers after childbirth? Do parents have enough resources to feel confident that they can provide their child(ren) with a good enough life? Is it even worth reproducing the current conditions of one\u2019s society?<\/p>\n<p>Without embedding a more holistic approach to these interconnected social issues, pronatalist policies that sound intuitively family-friendly in the abstract can fall short of providing real solutions for real people. While non-coercive interventions are perhaps not ethically problematic in and of themselves, a fatal flaw with deploying such methods to get people to have (more) children is that it simply fails to consider the actual interests (and concerns) of the target citizens, and the complex social (and national) context against which these policies would be weighed up. Mitigating childbearing hesitancy in the populace is surely not simply a matter of incentivizing people (especially women) to <em>value<\/em> children\/family\/marriage more than they do now. Perhaps it\u2019s partly true that the times have changed, and that people no longer want their lives to be defined by having babies. Be that as it may, pointing the blame mainly in this direction neglects other possible explanations. Perhaps some people are involuntarily childless. Perhaps it is precisely <em>because<\/em> people care profoundly about reproduction \u2013 and its attendant consequences and responsibilities \u2013 that decision-making around the matter of having children is so difficult.<\/p>\n<p>There remains much work to be done in unearthing and understanding the reasons for why people \u2013 in South Korea, to be sure, but also in many other countries \u2013 are having fewer and fewer children. It is important not to be reductive about individual wants and motivations around procreation, but to investigate how people of \u2018reproductive potential\u2019 might experience and navigate their social world and existence in diverse ways. In order for pronatalism to have any practical \u2013 and for that matter <em>ethical <\/em>\u2013 appeal, it must address the struggles and hopes of those being asked to bear the weight of reproduction.<\/p>\n<p>&nbsp;<\/p>\n<p><strong>Paper title: <\/strong><a href=\"https:\/\/jme.bmj.com\/content\/early\/2024\/11\/27\/jme-2024-110001\">Towards an ethics of pronatalism in South Korea (and beyond)<\/a><\/p>\n<p><strong>Author:<\/strong>\u00a0J. Y. Lee<\/p>\n<p><strong>Affiliations<\/strong>: University of Copenhagen<\/p>\n<p><strong>Competing interests<\/strong>: None declared<\/p>\n<p><strong>Social media accounts of post author:<\/strong><\/p>\n<p>Twitter \u2013\u00a0<a href=\"https:\/\/twitter.com\/jyleephilosophy\">https:\/\/twitter.com\/jyleephilosophy<\/a><\/p>\n<p>Webpage \u2013\u00a0<a href=\"https:\/\/jyleephilosophy.wordpress.com\/\">https:\/\/jyleephilosophy.wordpress.com\/<\/a><\/p>\n<p>&nbsp;<!--TrendMD v2.4.8--><\/p>\n","protected":false},"excerpt":{"rendered":"<p>By J.Y. Lee In the Global North, the fact that aging populations are increasing while birth rates are decreasing has become a point of great alarm in recent years. The average total fertility rate (TFR) across the globe stands at 2.3 births per woman today, compared to 4.9 back in 1950. However, some countries are [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/medical-ethics\/2024\/12\/12\/ethics-is-the-key-to-demographic-change\/\">Read More&#8230;<\/a><\/p>\n","protected":false},"author":503,"featured_media":4613,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[8130,2022],"tags":[],"class_list":["post-4612","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-ethics","category-reproduction"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.6 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Ethics is the key to demographic change - Journal of Medical Ethics blog<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/medical-ethics\/2024\/12\/12\/ethics-is-the-key-to-demographic-change\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Ethics is the key to demographic change - Journal of Medical Ethics blog\" \/>\n<meta property=\"og:description\" content=\"By J.Y. Lee In the Global North, the fact that aging populations are increasing while birth rates are decreasing has become a point of great alarm in recent years. The average total fertility rate (TFR) across the globe stands at 2.3 births per woman today, compared to 4.9 back in 1950. 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