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The Monash University team at the Queen Victoria Hospital in Melbourne has achieved great success in its endeavours to relieve infertility by the production of ‘test-tube babies’. This collection explains what goes on, discusses moral and legal problems relating to the programme, and gives a preview of what might lie ahead. The contributors include members of the medical team, their clients, and moral philosophers and theologians.
- Book 1 Title: Test-Tube Babies
- Book 1 Biblio: OUP, $17. 95, 165 pp, 0 19 554342 4
The medical procedure adopted is to secure a number of eggs from the woman’s ovaries by means of an instrument inserted through an incision in the patient’s abdomen (laparoscopy). These are then fertilised in a dish by sperm from the woman’s husband (in vitro fertilisation, IVF). When the resultant embryo has reached a suitable stage of development it is placed in the woman’s uterus (embryo transfer, ET), where, it is hoped, it will attach itself and develop in the normal way. The success rate between June and December 1980 was twelve pregnancies and ten babies from 112 laparoscopies.
The moral responses to this procedure range from enthusiastic acceptance to unqualified rejection. Sir Frank Little, Catholic Archbishop of Melbourne, rejects the program as involving an illicit substitute for sexual intercourse. Pope Pius XII is quoted as taking a similar line. Against this view the theologian Fr William Daniel, in what I think is the best contribution to the book, argues that the procedure is morally acceptable as a last resort in order to satisfy a childless couple’s reasonable desire to have a child.
But some of those who approve the program in principle are still worried. One of their concerns is the thin edge of the wedge argument: let them get away with IVF and ET and the way is clear to, ultimately, cloning, ectogenesis and hybridisation. This argument is given a great deal of support by the contribution of one of the editors, William Walters, Associate Professor of Obstetrics and Gynaecology at Monash. Walters draws the line at hybridisation but produces remarkably feeble arguments in favour of many of the others. If we wanted to send large numbers of embryos into space, he says, we would need to go in for ectogenesis because ‘it would be mandatory to have an environment in which to mature the embryos’. In support of cloning he offers this gem: it will be necessary to produce cloned people for special tasks, for example little people for space flight. To be fair to Walters, he does present contrary views but it is all set out uncritically as though anything that might be offered as an argument is worthy of consideration. A particularly striking example is his po-faced support of ‘a feminist view’ that childbirth is barbaric because it causes temporary deformation of the body, pain and discomfort.
Another contributor who, no doubt unwittingly, supports the thin edge of the wedge argument is Alan Rassaby of the Centre for Human Bioethics at Monash. It is his view that surrogate motherhood should be available to busy female executives and models who want offspring without the inconvenience of pregnancy. Among the serious dilemmas he considers are whether a surrogate mother should be forced to give up smoking and whether she should be forced to have an abortion if the ‘parents’ decide against having a child.
Another matter which concerns many of those who have moral scruples about the programme is the fate of the unwanted embryos. The usual procedure is to collect a number of eggs, fertilize them, implant two and freeze the remainder. If the surplus embryos, are not wanted is it all right to destroy them? The philosophers Helga Kuhse and Peter Singer argue that they should not be. I do not know whether they are right or wrong but their arguments do nothing to inspire confidence. This is their favourite argument:
Everything that can be said about the potential of the embryo can also be said about the potential of the egg and sperm. (The egg and sperm, if united, also have the potential to develop into a normal human being, with a high degree of rationality, self-consciousness, autonomy and so on.) On the basis of our premise that the egg and sperm separately have no special moral status, it seems impossible to use the potential of the embryo as a ground for giving it special moral status.
If we ignore the bracketed section, we have an argument which is worthless except for one purpose: to illustrate the fallacy known as the Fallacy of Composition. Another argument of the same form is the following: I am an aggregate of my constituent cells; none of these cells has any moral status; so I have no moral status.
What happens if we take the bracketed section into account? It amounts to the innocent claim that the union of egg and sperm – i.e. the embryo – has the potential to develop into an adult human being. What is this truism doing in the argument? The only way I can see it doing any useful work is if it could be used to support the claim that there is no difference in potential between the embryo and the separate sperm and egg. It does not, of course, support that claim. A suitable analogue here would be to argue that water has the potential to be an adhesive paste because the mixture of flour and water has that potential.
After all, the arguments one might well ask: why go in for IVF anyway? The answers offered in this book rely essentially on the fact that people want babies. How much they want them is demonstrated by a remarkably frank piece of testimony from Isobel Bainbridge, a participant in the program, who admits to having had a fantasy child, Stephen, quite determinate in appearance (and obviously sex) since she was fourteen. What if the technique fails? Then, says Mrs Bainbridge, she will have to face up to her infertility. This will inevitably be the outcome for most of the customers, and for them it may well have been better to have done so a lot earlier. It is disturbing to realise that one of the things that makes this difficult for them is the thought that to be infertile is to be less than a complete person. The IVF program can do nothing about that way of thinking, which is perhaps the fundamental problem. This explains the value of the theologians’ contributions to this volume: it is they who emerge as profoundly and intelligently concerned with human nature.
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