AIDS and Reproductive Decisions: Having Children in Fear and Trembling

The risks of perinatal HIV transmission do not currently constitute grounds for morally criticizing the reproductive choices of particular infected women. A contextualized assessment of morally relevant factors might in some cases, however, justify judgments of reproductive irresponsibility. Although no women should be subject to any form of coercive pressure when making the decision to initiate or continue pregnancy, a "moral-education" model of nondirective counseling may be appropriate for women carrying HIV. Not even highly desirable, concerted public efforts to foster social justice will eliminate the ethical questions of whether these women should have children and how to counsel them.