- Report of the Committee of Inquiry into Human Fertilisation and Embryology
HMSO, 103 pp, £6.40
- Human Procreation: Ethical Aspects of the New Techniques
Oxford, 91 pp, £3.95, December 1984, ISBN 0 19 857608 0
- The Redundant Male by Jeremy Cherfas and John Gribbin
Bodley Head, 197 pp, £9.95, May 1984, ISBN 0 370 30523 X
- Begotten of Made?: Human Procreation and Medical Technique by Oliver O’Donovan
Oxford, 88 pp, £2.50, June 1984, ISBN 0 19 826678 2
God began to leave the world in 1543. That was the year when modern science is deemed to have begun; when the appearance of Copernicus’s De Revolutionibus and Vesalius’s Anatomy marked the end of scholastic reliance on authority, and the beginning of the scientific method based on observation, hypothesis and experiment. I do not mean that God literally gathered together his possessions and moved back to Heaven: rather, that the mid-16th century marked the death of pre-scientific man, who had reasonably assumed that since God was in everything, he made everything work. It therefore made sense to believe that if the effective cause of any event from mental disease to crop growth is known, there can be no room for God as effective agent. God can exist only in the ever-decreasing gaps in our knowledge. And by simple extrapolation, there must come a time when there will be no space for him – except above the bright blue sky.
Now all this makes sense, until we come down to ourselves. After all, cogito ergo sum. It is all very well to talk about the evolution of consciousness, of neural potentials and feedback mechanisms, but most of us have more than a sneaking suspicion that there is more to being human than merely being an affluent ape. Which is why the unravelling of the causal chain from copulation to childhood via cell biology, DNA chemistry, gene action, epigenetic switching, and so on, is vaguely disturbing. And why it is more difficult to adjust to the possibility of reproduction in a test-tube than it was to adjust to the clinical and pharmaceutical niceties of a well-planned family. In other words, we are scared by the prospect of genetic determinism and all its implications.
Just over half a century ago, Aldous Huxley introduced us to a Brave New World:
On a very slowly moving band a rack-full of test-tubes was entering a large metal box, and another rack-full was emerging. Machinery firmly purred. It took eight minutes for the tubes to go through, he told them. Eight minutes of hard X-rays being about as much as an egg can stand. A few died, of the rest the least susceptible divided into two; most put out four buds; some eight; all were returned to the incubators, where the buds began to develop; then, after two days, were suddenly chilled, chilled and checked. Two, four, eight, the buds in their turn budded; and having budded were dosed almost to death with alcohol; consequently burgeoned again and having budded – bud out of bud out of bud were thereafter – further arrest being generally fatal – left to develop in peace. By which time the original egg was in a fair way to becoming anything from eight to 96 embryos – a prodigious improvement, you will agree, on nature. Identical twins – but not in piddling twos and threes as in the old viviparous days, when an egg could sometimes accidentally divide; actually by dozens, by scores at a time.
‘Scores,’ the Director repeated and flung out his arms, as though he were distributing largesse. ‘Scores.’
But one of the students was fool enough to ask where the advantage lay.
‘My good boy!’ The Director wheeled sharply round on him. ‘Can’t you see? Can’t you see?’ He raised a hand; his expression was solemn. ‘Bokansky’s Process is one of the major instruments of social stability!’
The voice was almost tremulous with enthusiasm. ‘You really know where you are. For the first time in history.’ He quoted the planetary motto. ‘Community, Identity, Stability.’ Grand words.
Twenty-six years ago Huxley revisited his dream. He wrote:
I forget the exact date of the events recorded in Brave New World; but it was somewhere in the sixth or seventh century AF (After Ford). We who were living in the second quarter of the 20th century AD were the inhabitants, admittedly, of a gruesome kind of universe; but the nightmare of those depression years was radically different from the nightmare of the future described in Brave New World .... The prophecies made in 1931 are coming true much sooner than I thought they would. The blessed interval between too little order and the nightmare of too much has not begun and shows no sign of beginning.
George Orwell gave us a similar vision of an unyielding pathway in 1984. The inability to affect our fate is the bogey of the 20th century. The technological triumphs of the 19th century have become our machine-models of behaviour and human potential. We are surreptitiously relieved when we are told that our behaviour is inherited, so that we cannot be blamed for our unsocialities, but upset if we think our IQ is fixed by the fusion of a sperm and an egg nine months before we are born. Are we really free? Or is free-will and responsibility an illusion?
In July 1978, Louise Brown precipitated and focused some of these concerns. She was born after an entirely normal pregnancy, but from a conception that took place in a laboratory dish. Moral or not? Legal or not? Playing God? Her existence was made possible by the work of Patrick Steptoe, a North Country obstetrician, and Bob Edwards, a Cambridge physiologist. In his 1983 Horizon Lecture on BBC Television, Edwards described their search for moral guidelines:
We have looked for inspiration to philosophers, theologians, lawyers, for their wisdom gained over centuries of debate about ethics, about human standards, in relation to the implications of new work. This search for advice, for leadership, for clarity from the traditional purveyors of moral standards, usually ends in confusion. There is confusion between the great religions of the world ... It is the same, with philosophers ... Nor do the lawyers give us any help.
It was therefore a relief when in 1982 the Government established a Committee of Inquiry into Human Fertilisation and Embryology under the chairmanship of Mary Warnock, ‘to consider recent and potential developments in medicine and science related to human fertilisation and embryology; and to consider what policies and safeguards should be applied, including consideration of the social, ethical and legal implications of these developments’.
The Warnock Committee reported in July this year. The Report consists of 50 pages of discussion about procedures concerned with helping individuals to overcome infertility, 17 pages devoted to the more general question of research on human embryos, and eight pages containing three separate notes of dissent to specific recommendations (involving between them eight out of the 14 members of the Committee). It is a thoroughly workmanlike and commonsensical document, and does not demonstrate the impossible splits that some newspapers had promised. The notes of dissent are about whether surrogate mothers, bearing a child to be handed over to someone else after birth, should be outlawed or merely discouraged; and, more important, whether any research on human embryos should be permitted. The central premise of the Report is that ‘the embryo of the human species ought to have a special status.’ If this had not been agreed, there would, of course, have been little to discuss. What the Report lacks is any attempt to justify this statement: the Committee merely asserts that its members were ‘agreed’. Now there are two possible reasons for claiming special status for human embryos. It could be that human beings are intrinsically superior to other species, a not unrealistic claim to make for one’s own species, despite the objection that it is akin to sexism, racism, and other heinousness. Or humans may be qualitatively distinct, a belief shared by Christianity and Islam on the basis that we are ‘made in God’s image’.
A book which appeared just before the Warnock Report, and which complements and expands on the ‘Warnock topics’, is Human Procreation. This is the report of another working party, in this case set up by the Council for Science and Society, and chaired by Gordon Dunstan, until recently Professor of Moral and Social Philosophy at King’s College London. It is a more reflective and inclusive document than the Warnock Report, and an excellent introduction to the issues involved. Human Procreation deals obliquely with the ‘special status’ of the human embryo (‘The ethical dilemma about the degree and respect which should be accorded to the embryo is certainly one of the most important issues which has to be faced in this whole field of human reproduction’). It points out that biology does not give a clear-cut answer to the question ‘When does life begin?’:
Life does not begin at conception since the spermatozoa and oocytes are already alive in advance of fertilisation; they are living cells and the spermatozoa in particular display great activity. All that can be said is that a genetically novel kind of cell comes into existence at fertilisation and that this cell has the potentiality, if it is successfully implanted into the womb, for becoming a human individual. It does not have the potentiality if it is not implanted. Furthermore, fertilisation of an oocyte by a spermatozoon is not absolutely essential to the formation of an embryo which might develop into a foetus ... Fertilisation is not a satisfactory criterion of the beginning of ‘life’.
Two other ways of approaching the ‘special status’ problem are to ask either at what stage the embryo or foetus becomes a person (which is rather like asking ‘when does middle age begin?’) or whether there is a stage at which the embryo or foetus should be ‘saved’ by all methods available to medical science. The answer to this last question has in effect already been given by Parliament and society by allowing abortion under certain circumstances, and thus implicitly accepting that the life of an embryo or foetus should not necessarily be protected at all costs.
Arguing about the status of fertilised eggs (two or three out of each four of which will not survive) is like counting angels on pin-heads, yet attitudes to it can stir emotions and give rise to very tangible problems. The press exploded with excitement when a baby was born to a mother who had been paid by an agency to bear it for an infertile couple. The local authority took action to prevent the child being removed from the hospital where it was born; the child was made a ward of court, and then entrusted to the care of the couple who had ‘commissioned’ it in the first place. The Minister of Health promised a ‘fair wind’ for any Private Member’s Bill that would ban surrogate motherhood. As Nature (10 January 1985) commented, ‘the danger is that the Minister will be diverted from paying proper attention to the urgent need for action on the other questions Warnock has dumped on his desk.’ Mary Warnock herself made exactly the same point:
Surrogacy is never going to be common ... The question whether or not to permit research using early embryos, on the other hand, can affect countless people, both now and in the future. It can affect not only infertile men and women, but children who, as a result of such research, might be saved from profoundly handicapping disorders. We should forget the fuss about surrogacy as soon as possible, and turn our minds to the rational consideration of establishing a permanent body to license and control research.
It is the groups opposed to abortion which have produced the most strident condemnations of the Warnock Report. Their complaint is threefold: that abortion, and the Warnock proposals, are symptoms of a wasteful, ‘throw-away society’; that sacred ‘life’ is wantonly destroyed (an accusation which is debatable, as we have just seen, since ‘life’ here really means ‘special status’); and that abortion and related techniques are unnatural and treat humans as mere machines, bringing us back to the fears articulated in Brave New World.
This last viewpoint is argued lucidly and forcibly by Oliver O’Donovan, Regius Professor of Moral Theology at Oxford, in Begotten or Made?, originally given as the 1983 London Lectures in Contemporary Christianity. O’Donovan’s main theme is that there are limits to the proper use and function of the human body, just as there are to any well-designed piece of machinery. His argument, however, is much better than the argument from crude mechanism (for example, he rejects the artificiality of traditional ‘strict act-analysis’, used by, among others, the authors of Humanae Vitae): he is concerned with persons, their properties and relationships, rather than simply with the preservation of human bodies or biological life. But it is at the very point of the connection between the physical and the personal which he is seeking to emphasise that he is at his weakest. He insists on the traditional inseparability of the unitive and procreative aspects of marriage rather than seeking to prove it, and appears to regard the transmission of genetic traits to a child as determinative of the proper acceptance of that child into a family. In theory, however, a woman could be implanted with an ovum fertilised by sperm from a man who is not her husband; the child would have two ‘social parents’ who are not its genetic parents, but would be born to a woman who has nurtured it for nine months in her womb – is the child less a member of its ‘social’ family than one conceived by AID or a donated ovum fertilised by the husband’s sperm, given that a couple who commit themselves to all the manipulations necessary to produce a ‘test-tube baby’ are more likely to want and care for it than couples who conceive more normally, and casually? We are so ready to assume that we are really more animal than human that O’Donovan’s emphasis needs to be heard; he is much more persuasive and less polemical than others who come to the same conclusions. But the root question is still the status to be accorded to the human embryo: if we agree with Warnock and Dunstan that the early embryo has a different status from an older embryo (even one only a few days old), much of the O’Donovan case (and even more of that of the dogmatic life-begins-at-conception school) falls to the ground.
A very different approach to sex is taken by Jeremy Cherfas and John Gribbin in The Redundant Male. Theirs is good scientific journalism, marred by snide asides. One could – snidely – say that cloning is the goal of Women’s Lib, because embryos could be developed and implanted using adult cell nuclei, and without needing a male at all – or even his sperm. Technically this is not yet possible in humans (it is in amphibians), but it is probably not far off. Such asexual reproduction is much more energy-conserving than our normal practice, in which we are lumbered with approximately equal numbers of males and females. Honey bees have an excellent system whereby they produce exactly the number of males they need, with the majority of individuals developing as productive (female) workers; many aphid species only produce males when conditions become harsh – the rest of the time females give birth only to females by parthenogenesis. Both bees and aphids thus combine rapid adaptation and exploitation of resources with longer-term evolutionary flexibility through genetic recombination in sexual reproduction. Why are we (and the majority of animals) so inefficient in our sex? This is a serious question which has occupied some very good scientists. Drs Cherfas and Gribbin expound the issues and suggested answers, very clearly; they don’t quote people such as Dunstan and O’Donovan who claim to believe that for Homo sapiens individual male-female links are more significant than a simple invitation to copulate.
Cloning and sex-ratio regulation are a long way from the frustration of the estimated one-in-ten couples who desperately want children, but who cannot have them. Children born by AID are technically illegitimate. Almost always they are illegally registered, with the wife’s husband recorded as the father. The Warnock Committee makes recommendations which would resolve these anomalies. It seems likely that the Government will legislate on them fairly soon. On the central issues, experts and society are as divided as ever. These books are useful contributions to the debate. But we have to go further: we must agree about the factors relating zygote to person, embryo to neonate, genetics to responsibility, and only then will we be near to resolving the real problem: who am I, who are you? Some of the questions are scientific, some ethical, some – dangerous thought – theological.