Last week, British scientist Robert Edwards, the man who devised the fertility treatment IVF, on which we have been finding trouble to settle legislation locally, was awarded the Nobel Prize. Two years ago, the first baby born of IVF, Louis Brown, became 30 and at the time she had an interview on BBC saying that she lived a perfectly normal life.
People would not shun her or anything; but when told that since then three million people had been born through IVF, she did say it felt nice to be the first of those. Since that time another million has been added to the figure. Certainly, as the Swedish organisers said, the method has brought happiness to many couples who could not have children.There is no doubt that IVF has brought with it considerable moral dilemmas. At the time, the two scientists (the other was Patrick Steptoe, who died in 1988) found considerable opposition from governments and Churches and indeed had to fund their research through private means and benefactors. Today the method remains somewhat controversial on religious grounds, and perhaps is the main stumbling block for Maltese legislation to regulate this field, to go forward. Nevertheless Maltese society, a largely Catholic society, continues to accept that IVF can be used for couples who are infertile and even at a pastoral level they find the necessary support.
However it is worth reflecting on Monsignor’s Carrasco’s reaction to the Nobel prize. Carrasco is the Vatican’s spokesman on bioethics, but he said that he was speaking on a personal level and not officially. He condemned the award saying that it did not reflect on the damage the method has brought about. Through IVF we have had many fertilised eggs abandoned; millions frozen, and of those who are actually put inside the mother, many are naturally aborted. He claimed that Professor Edwards had been ‘completely out of order’ with this invention as without it, this damage would not have been done.
While the Vatican maintains its position on IVF as being illicit, the reasons documents give, usually base themselves on the fact that the conjugal act is bypassed and couples have to resort to a laboratory. Whilst it is true that many fertilised eggs have been frozen, and many others lost, one can hardly blame the inventor of the method for the abuse. Now, years later, many countries have recognised the faults and made the necessary amendment. In the UK you can only fertilise one egg at a time and use it. We often fail to distinguish between the moral issue we are discussing and the other moral consequential issues it raises, which in time can be resolved. Thus we do not blame the discoverers or nuclear physicists, including Einstein himself, for the ‘damage’ that their physics brought to the world. We tend to look at the good. If it were not for Einstein the nuclear bomb would not have been invented. He himself spoke out on this issue and felt a sense of guilt. But nevertheless we honoured him and no one today can put even a tinge of blame for someone who abused his theory and science.
If Professor Brown had been the one to promote the freezing of embryos; or rather, had the prize been given for this as well, then clearly Monsignor’s Carrasco’s words will be upheld. Perhaps it is a little unjust to blame the scientist for his achievement. That someone else decided to freeze embryos; that someone else decided to select the best embryos; that nature continues to follow its course, impregnating only 15% or so of eggs that enter the uterus, whether they come from the fallopian tubes or via a pipette, surely cannot be blamed on the scientist. Carrasco could have commented on the unfortunate consequences without putting blame on a scientist who brought happiness and life to the world. Are we saying these four million should never have been born? Had countries not decided to over-react and regulated IVF immediately, then the freezing and selection would not have occurred. This is what we risk in Malta. For over here there is nothing to stop laboratories from freezing embryos until such time as a law comes around to save the day. The same happened 30 years ago in other countries – but these countries did not have the moral structure we perhaps have, to stop freezing etc.
By legislating and regulating IVF, while protecting embryos and the family structure (offering the service only to infertile couples) we will be giving happiness to people who are not as fortunate as others to have children by natural methods. These couples go through a lot of pain and suffering. They have not bypassed the conjugal act; they have tried and continue to try and love one another. The question is, once the technology is available, and once we can deal with the consequential and pragmatic issues, ought we or ought we not to offer theses couples the chances of children. There is always the noble act of the couple to accept their fate. But I think that justice has it that the question is self-answering. We cannot withhold a technology which has eliminated the need for killing of embryos. That miscarried embryos still exist is only natural for this happens to more than 80% of naturally fertilised eggs. The chances of IVF couples having children are now just the same as that for normal couples – 20%.
Certainly Ms Brown, who as a child played with the children of a surgeon colleague of mine, certainly believes that the award to Prof. Edwards was ‘fantastic news’ and that he is being given the recognition he deserves. Her mother thinks so as well. It is a pity that not all of us share the joy of four million children and their parents. It came at a heavy price, true, but so did the advances of nuclear physics. Both cost lives and we are deeply sorry for those who abuse science – it is these people who are ‘out of line’. Science is not the enemy.
Pierre Mallia is Associate Professor in Family Medicine, Patients’ Rights and Bioethics at the University of Malta; he is also Ethics Advisor to the Medical Council of Malta. He is also former president of the Malta College of Family Doctors.