Take This Embryo and Shove It
Italy's mandatory pregnancy law.
Imagine lying on a table at a fertility clinic. Across the room are three Petri dishes containing embryos made from your eggs. Given your genetic history, at least one of the embryos probably has a fatal blood disease. You don't want to implant the sick embryo or embryos, but the law says you have to. On a judge's orders, every one of those embryos will be inserted through a catheter into your womb, whether you like it or not.
Is this Rosemary's Baby? The Handmaid's Tale? Nope. It happened last year to an Italian woman under that country's IVF law. Today, Italians held a referendum on whether to change the law. Thanks in part to vigorous opposition from the Catholic Church, the referendum failed.
This is a lesson in what can happen to the United States and other countries if religious conservatives get their way. Conservatives fear a slippery slope from IVF and pre-implantation genetic testing to eugenics and dehumanization. Their fears are well-founded. But they've overlooked a law of geology: Every slope has at least two sides. Legislation designed to stop us from sliding down one slope can push us down the other. That's what has happened to the Italians. And if we don't learn from their tragedy, it could happen to us.
Two years ago, Italy was the Las Vegas of biotechnology. A baby was born there to a 60-year-old mother and (thanks to frozen sperm) a father who had been dead for 10 years. A scientist claimed to have cloned babies. Italians were horrified. At the pope's urging, the parliament passed a law imposing numerous restrictions. You can't get IVF unless you're married. You can't use donated eggs or sperm. You can't employ a surrogate mother. You can't fertilize more than three eggs at a time, and you have to implant all of the resulting embryos simultaneously. A doctor who violates any part of the law can be jailed for up to three years.
It's easy to think that the people who wrote the law must have been crazy. Then you wouldn't have to worry about the same thing happening in your country. But the logic of the Italian law is eerily simple. It tries to make IVF as much like natural conception as possible. No surrogates or donated eggs, because a married man shouldn't have sex with another woman. No donated sperm, because a married woman shouldn't have sex with another man. No more than three embryos at a time, because nature almost never works that way, and every embryo you don't implant or carry to term is a forsaken human life. All embryos implanted quickly in your womb, even if they're doomed, because that's where they'd be if you'd made them the old-fashioned way, and you wouldn't even know—because you wouldn't be able to run all those fancy lab tests on them—that they were sick.
It's as though you weren't using IVF. But you are using IVF, and that's what causes the nightmare. As a practical matter, you could run the lab tests—so the law has to stop you from running them or from doing anything with the results. The embryos aren't inside you; they're in the dishes. To restore them to their "natural" place, the law has to move them through your vagina and into your uterus. The only thing standing in its way, potentially, is your refusal. Therefore, your refusal must be outlawed.
The ghoulish ironies don't end there. Last year, President Bush's council on bioethics, well-stocked with conservatives, strongly urged fertility clinics "to reduce the incidence of multiple embryo transfers and resulting multiple births, a known source of high risk and discernible harm to the resulting children." But the Italian law requires such multiple transfers, endangering healthy embryos in the name of protecting unhealthy ones. By limiting the number of embryos in each IVF round to three, the Italian law has doubled the average number of rounds necessary to get a successful pregnancy. This means more hormonally induced egg production and extraction, which, according to Bush's council, "carry significant medical risks to the women." To top off the absurdity, the law explicitly avoids any change in Italy's abortion regulations. So, if you don't want your embryos, you can't freeze them—but you can implant them, let them grow, and then kill them.
Or you could suffer the fate of the woman who was ordered to implant those high-risk embryos. Two of the embryos died before her case was resolved. The third was implanted. A month later, the woman ended up in a hospital with a gastric hemorrhage, apparently caused by stress. She lost the baby. Now that it was dead, the doctors could test it. The tests showed it was free of the dreaded blood disease.
This isn't what the Italians had in mind when they passed their law. They were just trying to stop the country from tumbling down a slippery slope. "Italy's grandmothers became mothers, and every uterus was for rent," an Italian politician explained. "We needed to take back control." Well, they've got control now. Just ask that woman.
Human Nature thanks Slate editorial intern Megan O'Connor for extensive research assistance on this article.
Will Saletan covers science, technology, and politics for Slate and says a lot of things that get him in trouble.