A little while back I wrote about counselling and screening in the context of surrogacy. At the time some of the closing lines from the film “Casablanca” came to mind. Those are the one’s where Rick (Humphrey Bogart) is trying to persuade Ilsa (Ingrid Bergman) to leave Casablanca with her husband, Victor Lazlo. Rick says
If that plane leaves the ground and you’re not with him, you’ll regret it. Maybe not today. Maybe not tomorrow, but soon and for the rest of your life.
The argument works. Ilsa leaves with Lazlo.
There’s another quote I could have used and it’s the one I’ve put in the header here–it’s from a song, perhaps most famously sung by Edith Piaf. It means “I regret nothing.” And I’m sure there are many others I could invoke, because I’m inclined to think that regret, and avoidance of regret, is one of the universals of human existence. We’ve all done things we regret. Equally important I strongly suspect we’ve all harbor regrets over things we failed to do when we had the chance. Indeed, I think the Piaf quote reflects an impossible stance–I regret nothing? I am inclined to think I would look askance at anyone who would make that claim.
I’ve been thinking about regret particularly because it plays a role in debates/discussions about counselling with regard to ART. Thus, one of the things one might consider before deciding to participate in ART (as a gamete provider or as a purchaser or whatever) is whether one might come to regret one’s decision to participate. Or perhaps not to participate. I don’t see any reason why regret is generally more likely to attach to action than inaction. After all, regret is really about ruing the choices one makes and inaction is typically a choice just as action is.
To my mind, there’s no denying that anyone travelling this road (ART) ought to think about how they will feel about their choices ten years from now (or twenty or thirty or whatever.) That said, perhaps I should note that I’d say the same thing about any major life choice. And I’m not sure any particular conclusion follows from this beyond the minimal “people should really think about this” point.
And truly, I worry a good deal about the way in which potential regret is deployed as a tactic of persuasion/coercion. Think about Rick and Ilsa. He got her to leave by presenting her with the prospect that she’d come to regret a decision to stay. Now she might also come to regret the decision to go, but Rick doesn’t point that out to her because he’s not really interesting in promoting careful consideration on her part. He’s seeking a specific end–to get her to leave with Lazlo.
I worry generally that people with a particular end in mind will deploy regret strategically in order to better the chances a person will make the right choice, just as Rick does. I think you see this happening in the debates over abortion. “Counselling” (and I put it in quotes deliberately) that focusses only on the potential of regret at electing to have an abortion is designed to prevent women from choosing abortion while appearing to leave the matter to individual choice.
I see suggestions of the same dynamic with the calls for counselling of egg providers. (There’s a side point here–the whole regret thing seems to play much more when the decision maker is a woman (abortion/egg provider) than a man (sperm provider). Perhaps that’s another topic.) If the people insisting on counselling are in fact seeking a particular result (ending the use of third-party gametes) then any counselling they design/provide is likely to over-emphasize the regret on one side of the equation. (I don’t mean to suggest that all those who support counselling seek this result, but some do.)
I also wonder about how we measure the efficacy of this kind of counselling. Surely not by women who make one particular choice or the other–that presupposes that there is a “right” choice here.
It seems to me that the possibility of regret and even the reality of regret is just something we have to live with. It’s a part of being human. When we face hard choices we may regret the road we take just as we regret the road not taken. Sometimes there just aren’t any “no regrets” paths available to us and we probably regret that, too.