The political crackdown on IVF embryo screening.
Remember that bill in Georgia to restrict in vitro fertilization? The Associated Press thought it was dead. Surprise! The Georgia Senate revised it and passed it a week ago. But don't worry, says the senator who rewrote the bill. In its revised form, all the bill says is that "when you create a fertilized embryo, that's for the purpose of creating children." He adds: "The only thing you can't do is form the embryo for the purpose of scientific research." The Atlanta Journal-Constitution agrees that the bill just "mandates that all embryos be created for the purpose of making babies. All mention of in vitro fertilization was removed."
No, no, no. I'll say it again: Read the bill, not the spin. The legislation, Senate Bill 169, has indeed been stripped of several controversial provisions. But look closely at the operative text of the adopted version:
(a) It shall be unlawful for any person or entity to intentionally or knowingly create or attempt to create an in vitro human embryo by any means other than fertilization or intracytoplasmic sperm injection of a human egg by a human sperm.
(b) The creation of an in vitro human embryo shall be solely for the purposes of initiating a human pregnancy by means of transfer to the uterus of a human female for the treatment of human infertility or cryopreservation for such treatment in the future.
The first paragraph bans the cloning of embryos for any purpose. But the second paragraph does not, as advertised, require that IVF be "for the purpose of creating children." It requires that IVF be "for the treatment of human infertility." The two phrases are not equivalent. Sometimes IVF is done to create children for couples who are technically or even clearly fertile. The bill, as written, would prohibit this.
Much of the muscle against the Georgia bill came from Resolve, a group whose mission is "to ensure equal access to all family building options for men and women experiencing infertility." Resolve claims to have pumped thousands of e-mails and letters into Georgia to stop the bill. It purportedly helped opponents "pack" the hearing that deep-sixed the original version. Jim Galloway, the Journal-Constitution's statehouse reporter, says this constituency was pivotal in forcing senators to rewrite the bill: "Religious conservatives underestimated the reaction of couples who have had to cope with infertility."
Resolve remains unhappy that the bill doesn't clearly permit IVF for "women who have medical conditions like kidney disease that prevent them from carrying a pregnancy, but who are not usually considered to have 'infertility.' " But that language can be resolved easily in Georgia's House of Representatives. The more interesting question is what will happen to the use of IVF for creating children when there's no question of infertility at all. That use is the screening of embryos for unwanted genes: preimplantation genetic diagnosis.
PGD began with screening for fatal childhood diseases but has gradually expanded to flaws that are less lethal, less harmful, less likely to cause disease, and less likely to strike early in life. Two years ago, British regulators approved its use to get rid of embryos that might become grotesquely cross-eyed. PGD is now frequently used to weed out boys or girls. One clinic temporarily advertised it for selecting hair, eye, and skin color.
From this unsettling progression, it's tempting to conclude that we should wall off the slippery slope of PGD. That's what the Georgia bill, as written, would do. The pro-lifers behind the bill have already conceded the IVF provisions necessary to get it through the Senate. They might appease the infertility lobby further by explicitly permitting IVF for pregnancy-related diseases. That would leave one constituency isolated: couples and doctors who want to use PGD not to overcome fertility problems but to screen out embryos that have unwanted genes or are of the wrong sex.
Is that constituency strong enough to get its own exception added to the Georgia bill? Will pro-lifers tolerate this use of IVF? My bet on both questions is no.
I don't know whether the bill will pass the Georgia House. But this is just the beginning. The bill is part of a nationwide project to regulate the emerging industry of embryo production. In one state or another—and then another and another—legislation will be filed to restrict IVF. Based on the Georgia experiment, these bills will probably make exceptions for infertility but not PGD. The battles, then, will be fought over which uses of PGD are acceptable. And these fights will be every bit as ugly as the preceding fights over abortion.
This column is dedicated to making us look at ugly facts and moral problems we don't want to see. For several years, one of these problems has been the slippery slope of PGD. Now we'll have to face, in all its ugliness, the slippery slope of regulating it.
Will Saletan covers science, technology, and politics for Slate and says a lot of things that get him in trouble.