Human Nature: Science, Technology, and Life.

Lady Parts

Yesterday I wrote about an awful story in California. A number of couples hired gestational surrogates through a fertility brokerage. They were directed to put money in trust accounts to pay the surrogates throughout their pregnancies. Now the money is gone. Andy Vorzimer, an attorney involved in the case, told the New York Times, "We've got couples in the midst of pregnancies with no ability to pay the surrogate." I ended the piece this way:

I hope the women carrying these pregnancies will see them through, even if the company that hired them doesn't. But that financial burden shouldn't fall on them alone. Here's the contact page for an attorney working the case. If you'd like to prevent abortions, help pregnant women, and facilitate reproductive choice at the same time, now's your chance.

Yesterday evening, Vorzimer sent me an e-mail to clarify the situation:

The article has obviously resonated with your readers as my inbox has been flooded with concerned people offering to donate funds so as to avoid possible abortions. I am happy to inform you that there are no situations in which a surrogate has elected to abort because of this financial scandal. While many of the surrogates will not be reimbursed for their out-of-pocket expenses lost wages or even have their medical bills paid, every single one of them has committed to moving forward.

That's great news. I'm impressed with the surrogates. I'm also impressed with all of you who contacted Vorzimer and offered your support so they wouldn't have to end their pregnancies. Pro-lifers are often accused of moralizing and interfering but not helping. You disproved the caricature. And I hope you'll stand by your offers even if no abortions are at stake.

In recent days, I've had a few curious exchanges with friends, readers, and bloggers who wonder why I keep writing about this stuff: abortions, pregnancies, IVF, surrogates—what some of my critics jokingly call "lady parts." What's my agenda? Do I have a problem with women controlling their bodies? Am I a frontman for the religious right, a useful idiot who pretends that compromise on these issues is possible when, in fact, it isn't? Even Vorzimer, in a tweet posted on his blog, initially responded to my article by remarking, "The lengths (or depths) abortion foes will go to make a point."

Vorzimer and I have had some back and forth since then, so we've come to understand each other better. But the misunderstanding was my fault, not his. I need to do a better job of explaining myself.

This may sound strange, but I don't consider myself a real abortion foe. I have friends and sparring partners who think abortions should be illegal or at least heavily restricted. To me, that's the chief dividing line in the debate. I don't feel comfortable crossing that line. I don't think a regime of abortion restrictions enacted in the name of life would make this world a better place. I think it would cause a mess—hypocrisy, deceit, interrogations, amateur home surgery, moral crudity backed by the force of law—as ugly as any war fought in the name of peace.

I don't equate abortion with murder. I don't even think it's the worst option available to a woman facing unintended pregnancy. Every abortion dilemma is different, because every situation is different. The person best situated to make the right decision is the pregnant woman. A few years ago, I wrote a whole book on this point.

So why do I keep bringing up abortion as a moral problem? Because it is a moral problem. It's the destruction of a developing human being. For that reason, the less we do it, the better. When I say abortion is bad, I'm not saying it's necessarily worse than bringing a child into the world in lousy circumstances. I'm saying it's worse than avoiding unintended pregnancy in the first place. That's why I keep pushing contraception. If you cause an unintended pregnancy and an abortion because you didn't want to wear a condom, you should be ashamed.

But that's the conventional life/choice debate. The reason I keep you posted on developments in IVF, surrogates, and embryo screening is that they're transforming the debate. They're changing the conditions on which our moral positions rely. Were you pro-choice because the embryo was in a woman? Now we have embryos in dishes. Did you support embryo screening for fatal diseases? Now we're talking about screening embryos for eye color. Does the value of an embryo depend on what its mother thinks? Now we have embryos with two mothers: a genetic one and a gestational one. Should they at least consult each other?

I got into this field because the moral questions are enduring but the facts are always changing. Technology is transforming culture. And I write about the value of unborn life because that's the problem my fellow pro-choicers don't like to talk about. I want to challenge you. Keeping the government out of these sticky moral questions doesn't make them go away. It just puts the burden on you to face them responsibly.

Defaulting on a Surrogate Pregnancy

What if you delivered the money to a broker, and the broker lost, stole, or squandered it? You did your part, but the surrogate is no longer being paid. And she has every legal right to end the pregnancy.

That's the scenario unfolding in California.

More here.

The Crackdown on 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.

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. The battles will be fought over which uses of preimplantation genetic diagnosis are acceptable. And these fights will be every bit as ugly as the preceding fights over abortion.

More here.

IVF, Switched Embryos, and Abortion

Would you abort a fetus just because it wasn't yours?

The scary scenario is the one you never expect: going through IVF and discovering, weeks into your pregnancy, that your doctor put the wrong embryo in your womb.

If you think this can't happen, I have bad news: It just did.

More here.

The IVF Battlefield

Thanks to the octuplets mom and legislative attempts to harness the backlash against her, a political framework for fighting about in vitro fertilization is beginning to take shape. This is a new issue for most of us. Here's an attempt to start making sense of who's proposing what.

You don't often get to see a new issue form before your eyes. It's kind of like the formation of a constellation. There's a big explosion, stuff flies in all directions, and gradually the pieces begin to align in relation to one another. That's what the biotech explosion is doing to politics right now. IVF regulation is one of the constellations taking shape. Let's take a look at who the players are and what they're after.

The initial battle that has brought them together is the fight over Georgia Senate Bill 169, which I wrote about Wednesday ("Crocktuplets"). On Thursday, the bill was sent to a subcommittee. The Associated Press says the bill is dead. The Los Angeles Times says it could survive in some form if a compromise is worked out by Monday.

The bill's sponsor, state Sen. Ralph Hudgens, professes shock that it has become a flashpoint for abortion politics. "There is nothing in this law to limit abortions. I can't believe that people are reading that into it," he told the Times.

Please. We're not stupid. The bill says:

A living in vitro human embryo is a biological human being who is not the property of any person or entity. The fertility physician and the medical facility that employs the physician owe a high duty of care to the living in vitro human embryo.

And:

Nothing in this article shall be construed to affect conduct relating to abortion as provided in Chapter 12 of Title 16; provided, however, that nothing in this article shall be construed or implied to recognize any independent right to abortion under the laws of this state.

In other words, lawyers have inserted a "this doesn't affect abortion" clause so that Hudgens can claim the bill doesn't affect abortions. And we're supposed to take this seriously, even though the bill makes every embryo a human patient and stipulates that if Roe v. Wade falls, this bill can't be construed to keep abortion legal.

Did I mention that Georgia Right to Life helped Hudgens draft this supposedly abortion-neutral bill? Actually, I did. But I missed the bill's more important source: the Bioethics Defense Fund. BDF, whose self-proclaimed mission is to "address the human rights violations involved in human cloning and embryo research, abortion, and end-of-life," says two of its lawyers flat-out wrote the Georgia bill. The group adds:

BDF is grateful for the consultation and analysis provided by the National Catholic Bioethics Center, who opined that with added conscience protections and with public education on how this legislation limits violations against vulnerable human life, the Georgia bill "could be supported consistent with John Paul II's position on incremental legislation contained in his encyclical Evangelium Vitae."

A statement by Fr. Thomas Berg, L.C., Ph.D., of the Westchester Institute for Ethics and the Human Person concluded that the BDF drafted bill is "an incremental approach aimed at minimizing the harm done [and] is an essential tool for undermining the greater evils in our culture."

I know these people. I spent several days with them at the Vatican four years ago. They're as pro-life as you can get. When they call the Georgia bill an "incremental" approach toward the pope's vision, I assure you that abortion is in the crosshairs.

By the way, BDF proudly quotes a supporter's description of the Georgia bill as "model language" for legislation in other states. So you can expect more Georgia-style bills elsewhere.

That's the pro-life camp. At the other end of the spectrum, we have the American Society for Reproductive Medicine. Sean Tipton, the ASRM's public affairs director, told the Atlanta Journal-Constitution that the Georgia bill "says that decisions about how to treat [infertility] patients will not be made by patients in consultation with their physicians, but by politicians." That line comes straight out of the pro-choice playbook on abortion. It's a categorical indictment of government interference. And politically, it's highly effective.

Much of the muscle against the Georgia bill seems to have come from Resolve, a group whose mission is "to ensure equal access to all family building options for men and women experiencing infertility." Resolve may be emerging as the NARAL of IVF regulation. It says its members pumped thousands of e-mails and letters into Georgia to stop the bill and helped opponents "pack" Thursday's hearing.

In addition to the pro-life and pro-choice camps, at least two hybrid positions are taking shape. One is to broadly regulate the fertility industry, preferably under federal control. This is the agenda of the Center for Genetics and Society. CGS has a complex philosophy that could roughly be described as leftist. Here's its mission statement:

The center supports benign and beneficent medical applications of the new human genetic and reproductive technologies, and opposes those applications that objectify and commodify human life and threaten to divide human society.

The Center works in a context of support for the equitable provision of health technologies domestically and internationally; for women's health and reproductive rights; for the protection of our children; for the rights of the disabled; and for precaution in the use of technologies that could alter the fundamental processes of the natural world.

Basically, CGS is a home for people who don't trust private industry and prefer to regulate it, but from the standpoint of environmentalism, equal access, and women's rights. It's for pro-choicers who are more socialist than libertarian.

CGS wants congressional hearings and federal regulation to address the octuplets case and the fertility industry's lack of oversight. Its agenda is ambitious but unclear in its details. If you have the time, check out its proposal for "Responsible Federal Oversight of the New Human Biotechnologies."

A fourth position is to embrace government intervention but much more modestly. This is the idea behind legislation recently filed in Missouri, which would put some of the fertility industry's voluntary guidelines into law. The ASRM says self-regulation is already preventing octuplets-type abuses. But Missouri state Rep. Rob Schaaf has filed legislation to enforce these limits. Unlike the Georgia bill, Schaaf's bill is short and direct. Its operational text consists of one sentence:

When treating infertility, physicians within the state of Missouri shall not implant more embryos into a human than the current recommendations set forth by the American Society for Reproductive Medicine, or its successor.

Schaaf argues that "it is within the realm of the state to make sure that doctors don't participate in things that are harmful to people." So if you don't trust complex regulatory schemes like the Georgia bill but aren't afraid of government intervention in the fertility industry per se, piecemeal measures like this one may be the way to go.

Octuplets and Opportunism

Under a Georgia bill, if you're 39, your doctor is forbidden to fertilize more than two of your eggs per treatment cycle. Take all the hormones you can stand, make all the eggs you want, but you get two shots at creating a viable embryo, and that's it.

How does this restriction "protect the mother" and "reduce the risk of complications" for her? It doesn't. ... So why limit the number of embryos created per cycle? Because the bill's chief purpose isn't really to help women. It's to establish legal rights for embryos.

More here.

Big Sperm Families

Eight hundred years ago, if you wanted to father a swarm of children, you had to seize power, kill men, and collect a harem of women. That's what Genghis Khan did. "An astonishing 8% of males throughout the former lands of the Mongol empire carry the Y chromosome of Genghis Khan," Nicholas Wade reports in his excellent book Before the Dawn. "This amounts to a total of 16 million men, or about 0.5% of the world's total."

Today, if you want to spread your seed around, it's a lot easier. Just make a deposit at a sperm bank.

Thanks to the Donor Sibling Registry, a nine-year-old organization that helps genetic siblings find one another, it's increasingly possible to find out who's been fathering whom in the world of egg and sperm donation. And even when you can't find out who, you can often find out how many. Human Reproduction has just published a survey of parents connected to the registry. The parents had sought out their kids' donor siblings, i.e., kids conceived from the same donor. And guess what? "In several cases, a considerable number of donor siblings had been traced, with 11% (55) of parents who had found their child's donor siblings finding 10 or more, reaching 55 siblings in one instance."

Fifty-five kids from a single donor. Think about that: You have 54 siblings and don't even know who they are. In a town of 5,000 people, what are the chances that somebody close to you—neighbor, mail carrier, waitress, wife—is secretly a relative? And while that's the extreme case, donor reuse seems to be quite common. If 11 percent of donors are being reused 10 or more times, that's a lot of Genghis Khan action. Think of what that's doing to communities, kids' identities, and even biodiversity.

Tabitha Freeman, one of the study's authors, blames lax regulation:

More than 90 percent of parents included in the study came from the United States, where guidelines regulating the use of sperm or eggs are looser than in Britain, she added. "The study is exposing that some clinics are using the same donor for a lot of families," Freeman said. ... "Guidelines suggest this should not be the case but they are not strictly enforced" in the United States, she added.

Maybe while we're beating up on Nadya Suleman, the octuplets' mom, for bearing 14 children, we should stop to think about all the men who have been fathering carloads of kids without even knowing about it. Apparently, the clinic that impregnated Suleman used her to inflate its IVF success rate because she was a reliable producer. That's the same reason a lot of sperm donors get reused. Even if all these kids can be cared for, is there something unhealthy about pumping out child after child from the DNA of one person? Have we had enough of Genghis Khan?

The Deserted World of Frozen Embryos

I remember the day my first child was born. He lay sleeping, swaddled, in a plastic bin at the hospital. That's when I finally understood what it meant to be a parent. "If we leave this hospital without this baby," I told my wife, "we'll be arrested."

It was a joke, but it was also true. You arrive at the hospital as two people, and you leave as three. You can't just make a baby and walk away. It's yours forever.

Unless, that is, you make a baby through in vitro fertilization. In that case, you can put the embryo away in a freezer and decide what to do about it later. Or never. ...

More here.

Marrow With Children

If you're tired of reading about how dead Hillary Clinton is or how long it'll take her to admit it, fly with me across the Atlantic for a couple of minutes. A monumental debate is going on in the British House of Commons over the Human Fertilisation and Embryology Bill, which will influence how governments around the world regulate family and reproductive issues in the next century.

Everything's on the table in this free-for-all: late-term abortions, human-animal hybrids, and IVF for lesbians and unmarried women.

The liberals are steamrolling the conservatives. None of the proposed restrictions has passed. But what's really intriguing is the difference in vote counts among the various issues. It tells us something about which values people care about most. Is it life? Sex? Human dignity?

Here's how many members of Parliament voted for each proposed restriction:

A. Ban abortions after 22 weeks instead of the current 24 weeks: 233.

B. Require clinics to consider the "need for a father" in approving women for IVF: 217.

C. Ban abortions after 20 weeks: 190.

D. Ban the use of gutted animal eggs to make human embryos for research: 176.

E. Ban genetic testing of embryos to choose (for implantation and birth) those that could grow tissue for transplant to an already-born sibling: 163.

F. Ban abortions after 16 weeks: 84.

So the most popular restriction was on late-term abortions. Chalk one up for life.

But wait: The number of votes to prevent lesbian parenthood beat out the number of votes to prevent abortions after 20 weeks. From this, you could make a pretty good argument that feminists are right: Some supporters of abortion restrictions care more about regulating sex and family structure than about protecting life.

Personally, I'm sure of this. The proof is that most people who support abortion bans also support exceptions for rape and incest, where the life considerations are the same, but the sex and family-structure considerations are different.

Now look at the vote count on banning human-animal hybrids. The hybrids in question aren't equal mixtures of human and animal. They're fully human cell nuclei cloned inside eviscerated animal eggs, for lack of available human eggs. In other words, the animal contribution is minimal, almost inconsequential. Furthermore, the embryos are just for research and cell derivation, not for procreation. I'm not saying this is unobjectionable. I'm just pointing out that the degree of mixture is trivial.

Nevertheless, the number of votes to ban it is more than double the number of votes to ban abortions after 16 weeks. To that extent, "human dignity" beats out life. It seems that keeping our DNA separate from that of animals is more important than saving those second-trimester babies.

But that's still not the headline, in my book. The headline is that restrictions on lesbian IVF and trivial species mixture outpolled restriction of genetic testing to choose embryos for tissue harvesting. The common term for this practice is "savior siblings." Here's the prototypical situation: Your daughter has a serious disease. She needs compatible bone marrow. The best way to get it is for you and your spouse to make another baby and transplant its bone marrow to her. But not all your offspring will have tissue that matches hers. To guarantee a match, you need to make a batch of embryos, implant one that matches, and forget about the rest.

The happy ending is that your daughter is saved, and you've made another child to love. But you've also crossed a line. You've made a bunch of human embryos and then flushed them not because of anything wrong with them, but because they weren't useful. And if there's no tissue match, you've crossed that line for nothing.

In my view, the rise of this mentality -- the reconceptualization of human beings as medical tools and resources -- is way more dangerous than gender upheaval, species-mixing, or even abortion. Abortions, no matter what you think of them, are defensive. Tissue harvesting, on the other hand, carries an affirmative mandate. It entitles you, and arguably obliges you, to deliberately create new human life, which will then live or die based on its utility to others.

Contrary to pro-life rhetoric, there's no broad incentive to increase the number of abortions. But there's plenty of incentive to increase the number of sibling saviors. That's why sibling saviors scored so well in the House of Commons. This is one thing I've learned from covering biotechnology: Bad things don't happen because they're bad. They happen because they're good.

Keep an eye on this utilitarian mindset as we continue to take ourselves apart. As the British debate illustrates, it'll be hard to stop.