Saturday, April 01, 2006

Eugenics analogy used inaccurately and selectively in The Times

I was struck by the science correspondent, Mark Henderson's comment piece in the Times today "We should all boo that weaselly phrase 'the welfare of the child'. Apart from the fact that Mark Henderson has a platform to dismiss this clause and there is no counterpoint put forward by anyone arguing in favour of the "welfare of the child", it also struck me that it was rather clever how he raised the spectre of eugenics to tarnish any state restriction on fertility treatment. He says that:

"The [welfare of the child] provision enshrines a concept in law that was last popular in the heyday of eugenics: that the State has a right to decide who should and should not become parents. Civilised societies no longer forcibly sterilise the mentally ill or disabled, and constrain the reproductive rights of convicted criminals only for as long as they are locked up. We do not vet fertile men and women before allowing them to have sex, even when they have a history of violence or drug abuse. Expectant mothers are free to smoke and drink during pregnancy, regardless of the risk to the foetus. Yet as soon as people need medical help to conceive, an entirely different standard is applied.

Is anyone taken in by the idea that state restrictions in the interests of safeguarding children, which simply attempts to consider the child as well as but not instead of the infertile couple, on immensely expensive, experimental and often ineffective fertility treatment is an abuse of human rights, when it simply refuses a not medically essential treatment on serious welfare grounds, has anything in common with the universally condemned forced sterilisation programmes on a whole population of women in Peru or China motived by blanket racism which maims women? Surely there is a vast difference between the violence of forced sterilisation and voluntary and often ineffective IVF procedures?

Is it not in fact entirely justifiable to consider the welfare of the child when the state has a hand in fertility, and therefore a responsibility for the child, in a way that is not justifiable when no lab techniques are involved? How is it eugenics to ensure that non-essential medical techniques are only applied when it is obvious there is no harm to those involved?

Isn't eugenics much more applicable to many IVF procedures including pre-implantation genetic diagnosis (PGD) which seeks to test and destroy embryos for being "defective"? Why use the eugenics argument to attack the welfare of the child clause and say nothing about the eugenic principles underlying PGD, where embryos can be discarded because they might have a late onset condition? or the trend towards designer babies when parents could design a supposedly "perfect" child (surely a good birth and inescapably eugenics) they want down to blue eyes as a parental right without state interference?

Who will fill the decision-making gap if the state leaves it up to whatever couples want and whatever IVF clinics (motivated by money as Deborah Spar points out in her book on the IVF industry) want to give them? How is it better for the state to wipe its hands of any responsibility and for the IVF clinics and infertile couples to make eugenic choices themselves?


Blogger Laban said...

Hi Fiona - did you hear "pro-choice" Stuart Derbyshire argue this morning thet babies don't feel pain until SEVERAL MONTHS after birth ?

12:40 PM  
Blogger Bea said...

Creating designer babies? IVF does what now?

Designer babies would never be "commissioned" by infertile people who ache for a child - any child - for years without success. Infertile couples just can't afford to throw away their chances like that (by selectively discarding embryos).

In fact, whilst fertile couples "try for a boy this time", "try for a spring baby" or arrange to "space siblings by two years", infertile couples take what they can get, and are grateful.

I want to be crystal clear on the reality of the situation here.

Even using IVF, infertile couples have less control over their reproductive outcomes than fertile couples conceiving via natural methods.

The simple solution to your "designer babies" problem is to restrict IVF services to infertile couples who cannot produce a healthy baby on their own.

On the other hand, denying fertility treatment to a couple who are unable to conceive on their own is exactly like forced sterilisation. Same ends, different means. Now that sounds like eugenics to me.

3:04 AM  
Blogger Fiona said...

hey Laban thanks for pointing that out. Just posted on your blog. hope you've had a good Easter weekend.

Bea, thanks for dropping by. My post wasn't about infertile couples who ache for a child, any child and wouldn't opt for PGD or wish to design their child. I have the utmost sympathy for any infertile couple and think that a) they have a right to proper information about techniques like PGD rather than just accepting the pro-PGD spin, and b) that there are ethical boundaries in IVF.

As you rightly point out designing their child is desired by some infertile couples and insofar as you suggest that there could be restrictions on IVF treatment to infertile couples who want any child, we are in agreement.

Would you agree with me that PGD should be banned then as it is unnecesssary procedure that is not required if the only aim is to assist a woman to have a child?

My broader point was that there is a trend towards all sorts of techniques - like sex selection, selection for various traits by carrying out PGD and then discarding embryos that don't meet up to certain criteria - and it is this that I am objecting to. Partly because it is unnecessary to assisting an infertile couple to have a child, and because the wrongs of sex selection (population imbalance, encouraging sexist stereotyping and the destruction of the embryo on such superficial grounds) and designer babies and PGD (which involve destroying embryos that don't match the criteria) cannot be justified on the basis of choice. These trends are being driven by the IVF industry that stand to gain a lot of money from these techniques, and people who see designing children as a right.

Whatever the rights of the couple, they are adults who can make choices and protect themselves, the vulnerable party that stands to lose the most and doesn't have a voice is the embryo and child - I do not believe that destroying embryos is justifiable ever, and IVF can be carried out without destroying embryos - and that's why it's legitimate to regulate IVF to ensure the child is protected and not just another part of what Deborah Spar calls the baby business (though she herself sees no problem with this).

I don't believe that these trends are in the real interest of IVF couples or children. One of the UK's leading IVF practitioners (Professor Winston) said that many IVF techniques should not be in general use until there is more safety testing because they are experimental and the harmful impact on women and IVF children is unknown.

In answer to your point about withholding infertility treatment as the same as forced sterilisation, I disagree. I see forced sterilisation as akin to assault - like hitting someone - where there is no physical impact, there is no assault, withholding treatment is analogous to not hitting someone, it isn't an assualt. The history of eugenics is that eugenics was driven by good noble intentions - the eradication of disease, but it involved the destruction of those who were considered not worthy of life. PGD is exactly this, it is destroying embryos that are defective.

thanks again for posting.
best wishes

5:12 AM  
Blogger Fiona said...

correction: there should have been a "not" in the following sentence so it read:

"As you rightly point out designing their child is not desired by infertile couples"

6:49 AM  
Blogger Bea said...

PGD is used by some infertile couples to avoid transfer of embryos which carry chromosomal abnormalities which are incompatable with life.

Using PGD to identify unaffected embryos is far superior when the other option is a pregnancy which is dangerous to the mother, and which will inevitably result in the death of an unborn or newborn child.

We'll have to agree to disagree on the active vs passive sterilisation issue.

We'll also have to agree to disagree on some other issues - it's one thing to argue, for example, that termination of a pregnancy is only justified when the life of the mother is at stake, but I think in the case of 2 day embryos, only the health of the mother need be at stake. And I'm willing to give that a lot of leeway. I just don't think they're important enough for anything more. Sorry.

11:46 PM  
Blogger Fiona said...

You say:

"I think in the case of 2 day embryos, only the health of the mother need be at stake. And I'm willing to give that a lot of leeway. I just don't think they're important enough for anything more."

but the mother's health is not at stake if she has a 2 day old embryo.

in fact creating more embryos so there will be some that can be discarded, ovarian hyperstimulation syndrome etc is bad for women's health.

I agree that it is a big jump for society to understand that the early embryo is as precious as you or I, but it is logically the case. Human rights are intrinsic to every human being. The small embryo is as much a human being as the later foetus or newborn. It's just a bit smaller.

Thanks again for posting.

11:27 PM  
Blogger Holopupenko said...

     Great blog... although I hope you post more often. I'm an American hailing from Kyiv, Ukraine. While I'm not directly involved in the pro-life movement here, there is definitely a great need for it. Could I e-speak to you in an off-line e-mail about this? You can leave a message at my blog on how to reach you.

5:50 AM  
Anonymous Anonymous said...

Its a joke to call this "eugenics". In the first place, there is no such thing as "master race". If someone believes in master race, that means they are racist.

People (like me) who use PGD are just trying to ensure the embryo they get will grow to full term and not have some horrible hereditary disease. Defective embryos likely will result in a miscarriage anyway. If your spending a lot of money on IVF, you can't risk having a miscarriage.

5:27 PM  

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