Embryo Politics

Ethics and Policy in Atlantic Democracies

Thomas Banchoff

• Publisher: Cornell University Press
• Year: 2011
• ISBN:
  9780801461071
• Topic: Politics & International Relations
• Subtopic: Public Policy
• Index: Politics & International Relations

Since the first fertilization of a human egg in the laboratory in 1968, scientific and technological breakthroughs have raised ethical dilemmas and generated policy controversies on both sides of the Atlantic. Embryo, stem cell, and cloning research have provoked impassioned political debate about their religious, moral, legal, and practical implications. National governments make rules that govern the creation, destruction, and use of embryos in the laboratory—but they do so in profoundly different ways.

In Embryo Politics, Thomas Banchoff provides a comprehensive overview of political struggles aboutembryo research during four decades in four countries—the United States, the United Kingdom, Germany, and France. Banchoff's book, the first of its kind, demonstrates the impact of particular national histories and institutions on very different patterns of national governance. Over time, he argues, partisan debate and religious-secular polarization have come to overshadow ethical reflection and political deliberation on the moral status of the embryo and the promise of biomedical research. Only by recovering a robust and public ethical debate will we be able to govern revolutionary life-science technologies effectively and responsibly into the future.

CHAPTER 1

The Emergence of Ethical Controversy

The human embryo only slowly emerged as an object of ethical controversy. A first alleged account of human in vitro fertilization, reported by the New York Times in 1944, occasioned little public reaction. News stories about work with embryos appeared intermittently during the early 1960s but, in the absence of scientific confirmation, generated very little notice. Even after the first confirmed fertilization of a human egg in the laboratory in Cambridge, England, in 1968, questions surrounding the moral status of the embryo and the promise of biomedical research sparked little public controversy. Groups later embroiled in embryo politics, including scientific associations, patient-advocacy organizations, and even the Catholic Church, took up the moral quandaries of embryo research only slowly.

An important catalyst was a series of national ethics committees convened on both sides of the Atlantic to advise governments on how to govern IVF and embryo research. Reports by the Ethics Advisory Board (1979) and the Human Embryo Research Panel (1994) in the United States, the Warnock committee (1984) in the United Kingdom, the Benda Commission in Germany (1985), and the National Consultative Ethics Committee (1986) in France translated rapid scientific developments for a wider audience, identified some of the key moral dilemmas, and made a set of convergent policy recommendations.

The relatively slow emergence of controversy was due in part to the pace of scientific and technological development. Before the February 1969 publication of Robert Edwards’s breakthrough the previous year, experiments with human fertilization were rare and poorly documented. Even after the breakthrough, Le Monde could comment, nonchalantly, that it was “still too early to see anything in this experiment beyond an interesting technological prowess now only of interest to scientists.”1 In the years after 1969 only a handful of teams were active in the IVF field worldwide, mainly in the United Kingdom, the United States, and Australia. Through the late 1970s, estimates of the number of eggs fertilized, observed, or manipulated, and then discarded in the laboratory, ran into the hundreds rather than the thousands.2 With the birth of the first “test-tube” baby, Louise Brown, in 1978, this picture changed. Work with embryos in the laboratory spread as IVF treatments moved around the world. Embryo freezing techniques introduced in 1983–84 made a growing number of surplus IVF embryos available for experiments. Scientists gradually turned greater attention to research questions beyond infertility.

It was not just the pace of technology but the existence of other, competing ethical concerns that crowded out concern with the moral status of the embryo early on. Anxiety about a eugenic “brave new world”—an allusion to the dystopian future evoked by Aldous Huxley’s 1932 novel—dominated early media coverage of IVF research. The Catholic Church focused its ire on IVF as an unnatural form of artificial reproduction. Governments approached IVF primarily as a safety issue for both mothers and children. Gradually, however, the new discipline of bioethics did take up the issue of the moral status of the embryo and when it might be used up in research. As national ethics committees joined the debate, other social actors, including scientific organizations and churches, entered the fray. During the 1980s, Catholic and evangelical leaders discovered links between the abortion issue and embryo protection, while scientists and their allies in the bioethics field emphasized, not respect for the embryo, but the promise of research to address infertility and, potentially, other medical conditions. By the time governments moved to legislate embryo research regimes, from the late 1980s through the mid-1990s, terms of debate centered on the moral status of the embryo and the imperative of biomedical research were in place.

The Trajectory of Embryo Research

The late emergence of embryo debates during the final decades of the twentieth century was largely a function of the slow growth of scientific understanding. Through the nineteenth century, knowledge about human embryos and embryonic development was extraordinarily fragmentary. Long-running scientific, philosophical, and theological debates pitted two irreconcilable positions against each other: preformation and epigenesis. Without much evidence to go on, one side argued that the human being was preformed at the embryonic stage, while the other insisted that it gradually took shape in utero. During the late nineteenth and early twentieth centuries scientific discoveries gave a partial vindication to each side. The microscopic analysis of embryonic tissue revealed successive developmental stages, while advances in cell biology and genetics pointed to the existence of a hereditary program from fertilization onward. Embryologists turned increasingly to experiments with animal embryos kept alive in the laboratory to deepen their understanding. In 1935 Hans Spemann received the Nobel Prize for his work with amphibian embryos. A year later Gregory Pincus claimed to have achieved the first “test-tube” birth of a mammal—a rabbit.3

Initial efforts to culture human embryos in the laboratory date from this era. John Rock, a Harvard gynecologist with research support from the National Research Council and the Carnegie Foundation, began a series of human IVF experiments during the late 1930s. Over several years, he and his lab assistant, Miriam Menkin, exposed eggs removed from hysterectomy patients to sperm. In February 1944 they apparently achieved a breakthrough: fertilization and cleavage to the two- and three-cell stage. “We believe we have succeeded in these experiments,” they wrote, somewhat tentatively, in the leading U.S. research journal, Science. Subsequent experts have argued that fertilization probably did not take place; the cells observed and photographed may have been the result of parthenogenesis, or egg division. At the time, the Science article and purported breakthrough drew only moderate media attention. In its end-of-year review of major scientific events of 1944, the New York Times reported the feat as fact but gave it only passing mention, noting simply that Rock and Menkin had “succeeded in fertilizing a human ovum (egg) in a glass flask for the first time in history.”4 There was no public outcry.

Human embryo experimentation did not make headlines again until the 1960s. Daniele Petrucci, an Italian gynecologist, claimed in 1961 to have successfully cultivated human embryos in the laboratory for twenty-nine days. He provided no evidence for his assertion but still garnered attention in the international press. While Petrucci made further fantastic claims—he alleged in 1964 that twenty-eight children had been born through IVF—a number of researchers in the United States and United Kingdom were pressing ahead with difficult and painstaking research designed to overcome two main obstacles: the extraction of eggs from infertility patients, and an effective culture medium for their union with sperm in the laboratory.5 Among the researchers was Dr. Landrum Shettles of Columbia University, who claimed to have fertilized embryos that survived for up to six days during the 1950s and to have tried to initiate a pregnancy in the early 1960s. Shettles never published these early results and admitted years later that “fertilization was as rare as hen’s teeth.”6 His self-description as a first IVF pioneer has never been convincingly corroborated.

By the mid-1960s, the U.K.-U.S. team of Robert Edwards of Cambridge University and Georgeanna and Howard Jones of Johns Hopkins University in the United States had made the most progress in overcoming the technological obstacles. Howard Jones maintains that their research led to the fertilization of at least one egg in Baltimore in the summer of 1965. Edwards dates the breakthrough later, after his subsequent return to the United Kingdom. In early 1968 he began to work with Patrick Steptoe, a gynecologist based in Oldham who had developed a successful laparoscopic technique for extracting eggs from patients.7 With support from the Ford Foundation, a supply of eggs, and a newly developed culture solution, the Cambridge team achieved the first documented success of in vitro fertilization in March 1968. Edwards and Steptoe published their results in Nature, the leading British scientific journal, in February 1969. In a classic understatement, the article abstract referred to “certain clinical and scientific uses for human eggs fertilised by this procedure.”8

The avowed goal of Edwards and Steptoe was the alleviation of infertility: the transfer of an embryo into a woman’s uterus and the birth of a child. By 1970 they routinely succeeded in culturing embryos to the blastocyst stage—the phase several days after fertilization when implantation can take place—but they did not make their first, unsuccessful transfer attempts until the following year. Other international fertility specialists in pursuit of the same goal included the Joneses and Shettles in the United States and an Australian team under Carl Wood and John Leeton based in Melbourne. Two German teams working on infertility problems reportedly cultured early human embryos in Kiel and Hamburg in the mid-1970s, and a French team around Jacques Testart and René Frydman took up IVF work in 1977. While embryo transfer and the birth of healthy children was the primary goal of this research, Edwards and many of his colleagues also viewed work with embryos as a means to increase basic knowledge about infertility, human genetics, and congenital disease. Whatever the ultimate goal—infertility treatment, scientific knowledge, or some combination—this work involved the creation, observation, and subsequent discarding of embryos in the laboratory.9

The race to produce the world’s first “test-tube baby” garnered world media attention intermittently during the decade after 1969. A 1970 series of news reports left the impression that Edwards and Steptoe were on the verge of a successful embryo transfer. In fact, they only began their transfer efforts in 1972. In 1973 reports of first, failed pregnancies surfaced in Australia and then the United Kingdom. In 1974 a British gynecologist, Douglas Bevis, claimed—falsely, as it turned out—to have facilitated the birth of twenty children by in vitro fertilization. It was not until July 1978, after years of effort and a series of failures, that Edwards and Steptoe first reached the goal. One of Steptoe’s patients, Lesley Brown, gave birth to a child conceived in the laboratory, Louise. Her arrival sparked a global media sensation. Joy at the arrival of a healthy baby was joined with an initial surge of apprehension about the new technology’s implications for “designer babies” and a eugenic future. Only with the rapid and successful march of IVF procedures around the world—first births in Australia in 1980, the United States in 1981, and France and Germany in 1982—and an awareness that genetic engineering was a far-off prospect did eugenic fears begin to fade.10

As the techniques spread, so did research with human embryos designed to improve the efficiency of IVF. The work was slow and painstaking, and limited by the short life span of embryos outside the uterus. Clinicians tended to transfer viable embryos to the patient, leaving mostly defective ones and perhaps some healthy ones for experimentation, with only a short window for research before they should perish. In this context embryo freezing techniques proved a revolutionary breakthrough. In the early 1980s, an Australia-based research team successfully applied cryopreservation methods recently developed with livestock to human embryos. By retrieving and fertilizing more eggs than were to be transferred to infertility patients, and freezing the remainder, doctors created a store of embryos for future treatments. The March 1984 birth of Zoe Leyland in Melbourne, the first child from a frozen and thawed embryo, generated worldwide attention.11 Less remarked on at...

Table of contents

• Preface
• Introduction
• 1 The Emergence of Ethical Controversy
• 2 First Embryo Research Regimes
• 3 The Ethics of Embryonic Stem Cell Research
• 4 Stem Cell and Cloning Politics
• Conclusion
• Bibliography