Writing in the Wall Street Journal in March, Jerome Groopman discussed the recent case of the thirty-year-old woman who screened her IVF embryos for the early-onset Alzheimer's gene that she herself carries. Although the woman will likely succumb to Alzheimer's disease before her daughter reaches her tenth birthday, the girl at least will presumably be free of this disease. Groopman had little patience with the reservations raised about this case by physicians and ethicists. Those who oppose preimplantation genetic diagnosis (PGD) to screen for genetic disease, he wrote derisively, so primarily because of religious beliefs. To the concern that this girl would grow up in a household where her mother would soon be neurologically compromised and incapable of caring for her, Groopman simply affirmed the judgment of the physician who performed the PGD that such decisions be left to the parents. I begin with this op-ed piece because it illustrates the sort of narrow, individualistic model of moral reflection that often passes for serious analysis of reproductive medicine. Groopman would do well to read both of the books under review, for both Shanley and Ryan--albeit in very different ways--make the case that it is not enough simply to attend to the desires of prospective parents. Indeed, both Shanley and Ryan argue that we need to reconceptualize debates about reproductive medicine in order to discharge the grave responsibility we have in bringing children into the world. Shanley examines this responsibility to children through the lens of family law. As we have responded to the challenges posed to traditional definitions of parenthood and family by reproductive technology, there has been a tendency to rely, as apparently Groopman does, on the principle of the primacy of individual liberty. The problem with this, says Shanley, is that we live in a society structured by sexual, racial, and economic inequality and governed by market mechanisms. In such a society, unregulated procreative liberty is not likely to safeguard the welfare of children. In order to articulate an alternative to an atomistic, individualistic approach to family law, Shanley undertakes a child-centered analysis of various ways of creating families, including adoption, sperm and egg donation, and surrogate motherhood. Although she continues to use the language of rights, her nuanced analysis of parenthood demonstrates that parental rights should not be viewed as pertaining to an individual per se, but only to an individual-in-relationship with a dependent child (p. 63). For this reason, parental rights are grounded on more than genetic connection; they rest on a foundation of concrete acts of care and commitment to children. This analysis of parenting and parental rights grounds most of the normative claims Shanley makes. She argues, for example, that unwed biological fathers may have parental rights, but not simply on the basis of genetic connection. Because parental rights are based on both genetic connection and concrete care, unwed fathers cannot seek custody merely by asserting genetic paternity and meeting a minimal fitness test. Instead, a genetic relationship, writes Shanley, becomes a reason to look to see if he has attempted to assume responsibility for the child, and has done so without interfering with the mother's well-being (p. 62). Her reasoning about the system of gamete transfer in the United States is similarly shaped by a child-centered perspective. According to Shanley, the current policies and practices governing gamete transfer are designed to serve the interests of adults rather than of children. For example, the practice of secrecy and anonymity fails to recognize that children may have interests in knowing the identity of their genetic forebears (p. 90). So, too, does a market in gametes create the possibility that children may come to see themselves as worth less, if the gametes used in their conception were not highly valued. …