This, according to the survey, is exactly what's not being done. The authors find that "fertility patients are likely to face an unanticipated conundrum when they have completed treatment: a choice among unappealing disposition options." Unanticipated? Come on. IVF isn't a night of passion. It's an elaborate plan. How can you go into it without thinking through the eventualities?
The answer, the authors explain, is that "when embryos are initially cryopreserved, patients are focused on having a child and may not be prepared to consider fully their views about embryo destruction or donation." Furthermore, they report, "Our review of consent documents indicates that patients are often not asked their preference regarding disposition of excess embryos at the time of freezing. … Discussion of disposition options is not mandated by professional guidelines."
In other words, nobody focuses on the extra embryos. The patients and doctors are preoccupied with making a baby. If you get one, congratulations. Anything extra is an afterthought. We treat the leftovers as raw material, available to be used or thrown away. But they aren't raw material. Eggs and sperm are raw material. Embryos are what we make with that material. They're us.
So the leftovers sit in freezers, like souls in limbo. In this survey, nearly half the people with embryos on ice said they didn't want to have more kids. Yet among this group, the authors report that 40 percent "have yet to select a preferred disposition option, and nearly a fifth indicate they are likely to freeze their embryos indefinitely."
Compared with this, the abortion debate is almost quaint. There, the pro-choice slogan is: Who decides? And the scripted answer is: The woman does. But in the world of IVF, the answer, too often, is that nobody does.
What does it mean to be pro-choice in a world without time or fetal development? A world so frozen that no choice is required? Is it possible to respect each couple's choice but to demand that they choose one way or the other? Does the ethic of free choice require at least that much?
I'm a pro-choice moralist. I don't want the government telling people what to do with their pregnancies or their spare embryos. But that freedom doesn't eliminate moral obligation; it intensifies it. Each of us has to decide how to respect life in all its complexity. To me, embryos aren't people, but they're the beginnings of people. They aren't to be created, killed, or frozen lightly.
That means, among other things, that they should never be an afterthought. Don't have sex, at least not the procreative kind, without discussing what you'll do in the event of pregnancy. Don't make or freeze embryos without thinking through what you'll do with them. And if, after talking it over, you can't stomach the options ahead, maybe you should reconsider whether you're ready for this. That's a lot to ask, I know. But nobody said choosing would be easy.