After my first reading of a Chicago Tribune article about parents deciding what to do with leftover embryos following IVF treatment, I was so confused I had to consult my smart friend Laura. I IM'ed her the link and asked, "Am I crazy, or does this article totally take it on faith (ha!) that everyone deciding what to do with an embryo is religious?" Laura's verdict? "Man, those babies in the picture are cute. Especially the yawning one." Also, "You are definitely not crazy. This is an article about Christians struggling with this decision, which is very interesting, but nowhere in the article does the writer specify that."
Technically, that's not true -- 11 paragraphs into the article, the religions of the couple in question, Adrianna and Robert Potter, are mentioned (she's a lapsed Catholic, he's a Methodist). And after 10 paragraphs, the author, Manya A. Brachear, notes, "Such decisions, doctors say, are often informed and framed by faith" -- which is enough to justify focusing on that angle for one article. But it would be nice if said article either led with a clear indication that it was doing just that, or else acknowledged that "What would Jesus do?" is not the central question facing every couple with embryos in storage. Laura continues, "There is no one saying, 'Hey, guess what, embryos aren't people' -- whether that comes from a scientist, an atheist, or simply a different set of Christians. There's also no 'here are some of the things that stem cell research is used for' info. It's all, 'Your dead babies will go to Science, whatever that is.'"
That's an exaggeration, but not by all that much. Writes Brachear, "At this time last year, doctors say, the absence of government funds combined with the economic downturn stalled most meaningful embryonic science, making donations to research a riskier and more radical option. Some laboratories stopped accepting donations, forcing some fertility centers to hold on to embryos despite parents' preference to devote them to research." So, wait, deciding that you'd like your embryos to go to science somehow becomes "risky" and "radical" if there's a chance they might not be used for research? I guess that makes sense if, like Adrianna Potter, you only favor donating embryos to science to promote "the creation of new life" -- she notes that research led to their ability to conceive via IVF, and would like to help other couples. Her husband, Robert, either wants to keep them "to fulfill God's mandate to be fruitful and multiply" or donate them to another infertile couple. So for them, donating embryos to science with no guarantee that they'll be used might indeed seem risky and/or radical. But what about couples who make that choice simply because they'd rather see the embryos go to good use than discard them? Because they believe in the promise of stem cell research -- and at this time last year, were probably hoping that Obama would revoke the ban on federal funding for it, which he did? At this point in the article, there's still been no clear acknowledgment that this particular debate has a faith-specific context -- but any other context is completely ignored.
And that's the subtle part. Later, Brachear writes, "Robert doesn't trust that every embryo [donated to science] fulfills a greater purpose. He can't imagine sentencing two potential children to short lives that would end in a laboratory." I'm sorry, I can get on board with "potential children," emphasis on potential, but short lives? No. The idea that an embryo has a "life" that can be ended, even when it's never seen the inside of a woman's uterus, is a purely religious one; Robert seems to hold that belief as part of his faith, which is fine, but could we please get some quotation marks, or even a non-specific "he said" on that? Because otherwise, you're asking the reader to accept the concept of embryonic personhood as a given. And boy, this reader doesn't.
As Laura said, an article about Christians struggling with a decision that raises serious questions about their own faith versus science is a very interesting idea -- and if the headline or subhead or first nine and a half paragraphs indicated that that is, in fact, the subject here, I would have an entirely different take on the execution. Instead, a peculiarly religious dilemma is universalized -- "Families struggle with science, faith," reads the subhead -- and people who have no faith-based qualms about donating embryos to science (including many religious people, as well as those who don't have faith-basied qualms, period) are simply not acknowledged. Not to mention, "struggling with science" is presented as wondering whether your embryos' "lives" will have meaning in a lab -- which, call me crazy, still sounds more like struggling with faith. At a time when anti-choice groups are sincerely attempting to redefine personhood as "the beginning of biological development" -- raising the possibility of everything from miscarriages being investigated as potential homicides to pregnant women qualifying for the carpool lane -- blurring the line between religious beliefs and observable facts is what I would call "risky" and "radical."
In his story in today's New York Times about the three American winners of the Nobel Prize in Medicine, science reporter Nicholas Wade tells us a quite a bit about cell biology and the relevance of the discoveries made by Elizabeth H. Blackburn, Carol W. Greider and Jack W. Szostak for understanding cancer and the process of aging. We also learn some interesting tidbits about why female scientists are particularly prominent in the field of telomeres research.
But one piece of biographical information about Elizabeth Blackburn was left out -- her brave role in exposing the charade of George W. Bush's "President's Council on Bioethics."
Let's outsource the story to Nick Anthis, at the Scientific Activist.
From 2001 to 2004 [Blackburn] served as one of only three full-time biomedical researchers on the 17-to-18-member council. In 2004, she was fired from the council, along with another member who disagreed with the administration's position on some of the relevant issues.
Blackburn spoke out about the Council of Bioethics, demonstrating that despite its written mission to be a body that monitors research developments and recommends appropriate guidelines, it was really just a tool for parroting the Bush Administration's positions on certain hot-button issues -- particularly embryonic stem cell research. Thus, Blackburn played a central and important role in revealing the extent of the political interference in science that pervaded the Bush Administration.
After her firing, Blackburn published a strongly worded account of her experiences in the New England Journal of Medicine. Her closing paragraph definitely deserves a prize:
When prominent scientists must fear that descriptions of their research will be misrepresented and misused by their government to advance political ends, something is deeply wrong. Leading scientists are routinely called on to volunteer their expertise to the government, through study sections of the National Institutes of Health and advisory panels of the National Academy of Sciences and as advisers to departments ranging from health and human services to defense. It has been the unspoken attitude of the scientific community that it is our duty to serve our government in this manner, independent of our personal political affiliations and those of the administration in effect at the time. But something has changed. The healthy skepticism of scientists has turned to cynicism. There is a growing sense that scientific research -- which, after all, is defined by the quest for truth -- is being manipulated for political ends. There is evidence that such manipulation is being achieved through the stacking of the membership of advisory bodies and through the delay and misrepresentation of their reports. As a naturalized citizen of the United States, I have an immigrant's love for my country. But our country must not fail us. Scientific advice should and must be protected from the influence of politics. Will the President's Council on Bioethics be up to that challenge?
One-time Bush propagandist turned Obama-supporter Andrew Sullivan is in high dudgeon at reports that the new Republican Party platform will ban all public and private funding of embryonic stem cell research. The news comes from Stephen Spruiell, a contributor to the National Review's group blog the Corner, who offered an eyewitness description of back-and forth over an amendment to the existing platform earlier this week, and concluded, with an air of what Sullivan likes to call "Christianist" triumphalism, that:
"The 2008 Republican Platform calls for a ban on all embryonic stem-cell research, public or private."
Lefty bloggers have been quick to pounce on the news, as well they should, since, if true, it represent a remarkable extension of Republican big-government interference in the domain of science and medicine in the United States. Hillary supporters still looking longingly at John McCain should take note -- this is what today's GOP is all about, McCain's protestations otherwise notwithstanding.
I'm a little bit confused, however. I can't find a copy of the final draft of the 2008 Republican Platform online, but in another post to the Corner, Spruiell provided what he says is the full text of the stem cell plank (italics are mine):
Taxpayer-funded medical research must be based on sound science, with a focus on both prevention and treatment, and in accordance with the humane ethics of the Hippocratic Oath. In that regard, we call for a major expansion of support for the stem-cell research that now shows amazing promise and offers the greatest hope for scores of diseases -- with adult stem cells, umbilical cord blood, and cells reprogrammed into pluripotent stem cells -- without the unethical destruction of embryonic human life. We call for a ban on human cloning and a ban on the creation of or experimentation on human embryos for research purposes.
Do you see any reference to private funding in that paragraph? I don't, unless you take the last sentence to be an all-inclusive ban that is not connected in any way to the original reference to "taxpayer-funded medical research." And as far as I can tell, the back-and- forth that occurred between Republican delegates who were debating changes in the language of that plank focused on only one word in the last sentence, which originally called for "a ban on the creation of and experimentation on human embryos." That and has now been changed to or. The significance of that change, I guess, is that it extends the proposed ban to experimentation on embryos that already exist, such as those currently frozen in IVF clinics.
Maybe I'm making too much of an obscure point, although it would be ironic if the lefty blogosphere was accidentally propagating a mistaken interpretation of the Republican Party platform perpetrated by Republican Party zealots. Because whatever the truth is about the platform as it stands now, there is little doubt that the religious right wing of the GOP desperately wants to be able to tell everyone in the United States what they can or cannot do, according to the precepts of their own theology, whether they are publicly or privately-funded. I just wonder why the Republicans just don't come clean, à la Ann Coulter, in the platform, and call for the forcible conversion to Christianity of all American unbelievers. It would simplify politics in the country greatly.
Of course, we have, in the United States, no monopoly on fundamentalist idiocy, although it certainly seems like most other advanced countries are doing a better job of drawing lines between science and religion. But to return once again to one of my favorite examples, India, I ran into a strange bit of synchronicity this morning while reading a decent summary of the archaeological and scientific evidence as to whether an underwater rock formation between southern India and Sri Lanka is actually the remains of a bridge built by Lord Rama in the ancient, ancient past.
(If you are unfamiliar with the details of this fight between fundamentalist Hindu politicians and supporters of a dredging project to widen navigable shipping lanes in the region, I refer readers to my posts from last year, "Don't Mess With Lord Rama (Or His Bridge)" and "Bring Me the Head of the Chief Minister of Tamil Nadu.")
Suraj Bhan closes his review of the evidence, "Ram Setu: Separating a Myth from Reality," with the following paragraphs -- (italics mine):
The literary, archaeological and geological investigations have demonstrated beyond doubt that the Ram Setu or Adam's Bridge is not a man made structure. Propaganda being indulged in by the right wing political parties and their ideologues is totally unscientific.
Scientific knowledge is essential to understand the historical context. It helps people to organize to build a knowledge-based society and to look forward to create a genuine democratic political and social culture ensuring equity and justice.
You would almost think Mr. Bhan was addressing the Republican Party Platform Committee directly, and not his own country's batch of power-hungry sectarian evangelicals.
In federal court tomorrow, trial lawyer Martin Palmer will, as he sees it, defend Mary Scott Doe from enslavement. There's just one teeny-tiny, microscopic problem: Mary is an embryo. Palmer is the founder of the National Association for the Advancement of Preborn Children (in other words, the NAAPC -- what a comedian) and is deeply troubled by the state-run California Institute of Regenerative Medicine (CIRM), which funds stem cell research. So, naturally, he's suing.
In 2005, Palmer filed a lawsuit in Riverside, Calif., representing the so-called Mary Scott Doe -- again, a frozen embryo -- against Robert Klein, chairman of CIRM, arguing that embryos deserve equal protection under the law and that stem cell research amounts to slavery. At the time, Palmer told LifeNews.com that he chose "Scott" as the embryo's middle name because it is "reminiscent of the Dred Scott case in which the US Supreme Court decided that the black man was not person but property."
A federal judge ruled not that the lawsuit was utterly bonkers, but that it should be tried in either the state's capital or CIRM's hometown of San Francisco; Wired's science blog reports that Palmer will appeal that decision tomorrow in the U.S. Court of Appeals for the Ninth Circuit in Pasadena. Here's hoping the lawsuit does eventually get time in court and a judge clarifies, as judges have in the past, that a frozen embryo is unequal to a human being -- not to mention that using embryos to potentially treat diseases and save lives is incomparable to enslaving fully realized human beings.
George W. Bush this morning quietly vetoed legislation that would have expanded health coverage for children by increasing the federal tax on cigarettes. The bill passed with large bipartisan majorities in both the House and the Senate. The president vetoed it today behind closed doors, with no ceremony and no press present.
It was only the fourth time the man who ran as a "compassionate conservative" has exercised his veto power.
The other three:
July 19, 2006: Bush vetoes a bill that would have lifted restriction on the use of federal funds for research on stem-cell lines derived from embryos that would otherwise be destroyed by fertility clinics.
May 1, 2007: Bush vetoes a bill that would have tied continuing funding for the war in Iraq to a timetable for ending it.
June 20, 2007: Bush once again vetoes a bill that would have allowed federally funded research on stem-cell lines derived from embryos that would otherwise be destroyed by fertility clinics.
Supporters of the child healthcare bill Bush vetoed this morning seem to have enough votes to overcome his veto in the Senate but not in the House.
After a year of trying to get pregnant in the time-tested manner (intercourse with mate, slow jams and cocktails optional), Beth Kohl discovered that, like 6.1 million of her fellow Americans, she was clinically infertile. So she and her husband, Gary, then 29 and 32 years old, respectively, embarked on a different, but increasingly common, baby-making journey -- one using assisted reproductive technology (ART) to conceive.
But along with prenatal vitamins and baby-name books, Kohl found a mess of ethical questions. Why spend so much time and money conceiving bio-kids when many already-born babies could benefit from the same resources? How many embryos is it OK to transfer, given that later a mother might be faced with the decision to selectively reduce (read: abort) one or more of her fetuses? Are IVF kids the same -- healthwise, soulwise -- as naturally conceived children? What about the risk of pregnancy complications, premature birth, and the host of long-term problems that come along with them? Can "man-made" babies ever be reconciled with religious faith? And the biggie: What should would-be parents do with their leftover embryos?
Kohl, who grew up in a conservative Jewish household in suburban Milwaukee, tackled her ethical and reproductive journey with a typically Midwestern work ethic, digging for answers in sources ranging from the Bible to congressional testimonies about forced abortion in China. Now she chronicles her struggle, both with fertility and morality, in a new book, "Embryo Culture: Making Babies in the Twenty-First Century." The bones of "Embryo Culture" is Kohl's own story of two IVF-assisted pregnancies, but she beefs it up with an impressive amount of research on the technical matters and moral questions facing would-be parents, clinicians and the government.
While the subject is serious, her touch is light. Trying to find a metaphor for their infertility, her husband suggests "botanists in the Arctic Circle" -- and Kohl replies: "That is better. Not only does it suggest that my uterus is inhospitable to life, it also manages to hint of my frigidity." She's compassionate, but unsentimental (especially when you compare "Embryo Culture's" language to the banter in infertility chat rooms and blogs. Kohl reports that some women refer to their frozen embryos as "embies" and nickname the eight-cell clusters "Frosty" and "Snow White"). And she never claims to have all the answers.
In late July, while her three daughters were at summer camp, Kohl spoke to Salon from her home in Chicago about reproductive rights, "test tube babies" and the unexpected impact IVF has had on her.
When you began IVF treatment 10 years ago, were there any books about infertility treatment available?
I think there was a "Fertility for Dummies" book. I didn't buy it for myself because of the title, but somebody who was also going through IVF gave it to me. It was very nuts and bolts -- basically it explained the procedures and the bazillion acronyms.
When I poked around on the Internet, I found that there were some clinics that were starting to advertise, but back in those days there weren't any overriding organizations. You could just see the little seedlings of what have now become the American Society for Reproductive Medicine and support organizations like Resolve starting to spring up.
Without a network, was it difficult to find a doctor you trusted?
I think that, as with any kind of doctor, you click with certain people and not with others. Some doctors are interested in manipulating tiny cells and all of the research that's going on (certainly not federally funded). There are some that want to help otherwise infertile people have children.
But you also have people -- like my second doctor, actually -- who feel like a lot of the problem is that woman have been so go-getting that they have changed their cellular structures and have what they see as hysterical infertility. So on one hand, it's nice to have a place where you're not just this number, but on the other hand, you want to feel like you have someone...
...who isn't going to blame you.
Exactly! Polycystic ovarian disorder is genetic. You cannot blame women for their infertility.
Now, IVF is at the point where certain clinics are rising to the top. A lot of insurance doesn't pay for fertility treatments in this country, and people think, "I don't want to mess around." They just want to be somewhere where they think doctors are making good choices, that doctors give them all of the information they need, that they're not going to end up in a position where a doctor lowballs their chances of conceiving and convinces them to put three, four, five embryos in and they end up severely pregnant.
In trying to figure out what choices you could live with, you consulted a lot of clergy -- some of them pretty hard-line. What was your religious background?
I grew up in a conservative Jewish house in a town where we were the only Jewish people. We kept a kosher house and we were observant. So I had this weird, sheltered upbringing in many ways -- I didn't know how different religions viewed any of this stuff. And I think if you're raised ultra-conservative, you really do have a reckoning. It requires a more flexible way of thinking. I don't think you can call yourself a Catholic and just make up a bunch of rules, or a conservative Jew and then make up a bunch of rules. So you either have to redefine yourself or quit defining yourself.
When I started looking at the IVF issue, I started with my old rabbi, who is very conservative. He pulled out some books that definitely predated 1978 and pointed to this rabbi and that rabbi who had so clearly spoken about these issues -- and I thought, "What are you talking about? IVF wasn't even around then!" He said, "Well, don't underestimate what people envision." And I just thought, Well, that's it for me. If this is the person I'm going to have to talk to when I'm faced with having to reduce a quadruplet pregnancy, he's not my guy. Later, to research the book and for my own edification, I called the Archdiocese of Chicago and spoke to a woman in their Respect Life office who made it very clear that it was sinful, very sinful.
A lot of people have been disappointed in their spiritual leaders' response to their questions, but luckily, recently there's been a surge in the other direction. Most religions, if they're not orthodox or not fundamental in the way that Orthodox Judaism is or Catholicism can be, are willing to admit that this is all fairly new and open to debate. They're holding conferences and trying to come up with a thoughtful approach.
Did you find any camaraderie from women or couples who were also going through fertility treatment?
My husband and I were on our own a lot largely because a lot of support groups were just starting to form and solidify. But we were fortunate in that two of my very best friends were also going through IVF at different clinics -- though I think it was a good thing that my friends were at different clinics. You can't help but look around at your clinic, and knowing your statistics, start doing the math. If it's the woman to my right and the woman to the left who are going to get pregnant, then maybe it's not going to be me. As much as you smile at everyone and think good thoughts, you're aware of that.
What effect did IVF have on your marriage?
There's no gauging how hard this is going to be on any individual or couple. Gary's a really reasonable guy and he talked me down quite a few times -- I was really lucky that he was my partner in all of this.
But I do know several people who did not survive IVF as a couple; often it's the thing that ends up being the couple's death. Some women want to be really aggressive, some men don't; some men like a certain doctor for his own reasons and a woman doesn't. I know other couples who decided to give up on IVF after one round, two rounds, five rounds because they realized it was not worth sacrificing their marriage to have a biological child.
What was the hardest decision you had to make?
I had the hardest time deciding what to do with the embryos. We didn't want to transfer them all, even if our doctor would have let us. But we were never at the place where we thought, "OK, let's just get rid of them." We chose to freeze our embryos because we still wanted to have a choice. So here we are, all these years later. We have seven embryos and I go back and forth every day. I'm not sure what the right thing to do is, if there is a right thing.
I have a gay cousin who's trying desperately to have a child. There's a part of me that thinks, maybe he'd like some of our embryos! I love him and at least we'd know the kid that way. Then I come to my senses and I think that it'd be terrible -- what would happen if I regretted it and I wanted the kid back, or I disagreed with how he was parenting?
I also think it would be a fine and wonderful and blessed thing to donate them to science, but I can't help but picture them disassembling these embryos and pulling apart the cells, and saying, "Aw, know what? This one wasn't really what we were looking for!" and tossing them all.
Did that change your stance on abortion?
Until I discovered that I was infertile, my belief that abortion was a purely political matter went unexamined. I looked at abortion as men trying to control what women do with their bodies. I was an activist and I supported every reproductive rights group there was. I marched and I wrote letters and all of that.
Then I started trying to get pregnant and found out that it was much harder for me (and a lot of people) to get pregnant than I had once believed, and I started thinking that I could no longer take for granted -- I don't want to call it the "switching on of life," but that life was miraculous. And believe me, to talk in those terms makes me really uncomfortable, because it sounds like I'm "pro-life" and I'm not. I'm pro-"the right for a woman to choose just what she does with her body," including whether or not she gets pregnant. In fact, I'm probably one of the few people who wouldn't criticize the 60-year-old woman who ended up going to South Africa and having IVF and having twins recently.
My husband and I very consciously chose to create embryos, and for me, those seven embryos were a struggle to achieve. I really didn't want to face selective reduction, particularly because it's quite arbitrary; the fetus that they reduce just happens to be one that's easier for the doctor to reach.
So I can't help but see those embryos in that same universe of choice. I know that none of them is implanted, and there's no proof that any one of them will ever develop into a baby, but having said that, there is the potential there.
Do you think it is possible to reconcile reproductive technology with faith?
That's a hard question. Gary's convinced that people just believe different things and there's no way of knowing what's right and what's wrong. For me, it was a struggle between what I had really absorbed as a kid as the truth -- that life is God-given and spontaneous, provided one "engages in the marital act," right? So it was a big shock, seeing the other ways to make it happen. IVF was something that was developed when I was growing up. I was 10 when Louise Brown, the first IVF baby, was born, so I had an awareness of it. Do you remember that?
Yes! The "test-tube baby"!
I used to picture a big, chubby baby, smushed into a test tube.
Maybe because I grew up conservative, I did want to come up with some way to explain it all. If you believe that God is the source of everything, then you may believe that man's intellect and man's scientific ability stem from the God-given, and it's then blessed and holy and all that. Or, you could believe that it's all evolutionary and that maybe the very beginning is God-given, but it's up to us to evolve and develop and progress.
I have personally drifted further away from the God-given model and more toward the science model, but I don't feel like it's one or the other. I'm not sure. I think if you're comfortable with that state of not knowing, it's OK to say I'm not sure what the source is, but I'm thankful that it exists.
What do you think will be the next big debate about assisted reproduction?
Who knows what the next thing will be? Now we're at the point where the technology is fairly refined and the doctors are better able to control outcomes to some extent -- although there's still a huge amount of mystery. They're not sure why some embryos end up thriving and others don't, but they're better at evaluating things in the dish.
We're also at the point where there are tens of thousands of leftover embryos and people are faced with what they're going to do with them. Nobody can stand the idea that they're going to be the one who decides to get rid of embryos. They're afraid of being sued or that someday parents are going to resurface.
We're also getting into areas that are kind of scary for prognosticators and bioethicists. For example, we can grow embryos in an artificial womb. Researchers say, "We got this far and we're not ready to go any further." We know how to do it; the question is: Do we do it?
Nova scienceNOW: Stem cells breakthrough
Three separate teams overcome a biomedical hurdle—creating stem cells without the use of human embryos.
Rethink stem cells? Science already has
President Obama lifts restrictions on stem cell research, earning praise from the scienfitic community.
By Nicholas Wade, The New York Times
Stem cell division
The growing blue state-red state gap over this research shows that science has serious economic and political muscle in America today.
By Peter Dizikes, Salon
Everything you always wanted to know about the stem cell debate
George Bush's opposition to stem cell research is intellectually and morally incoherent. Here's why.
By Farhad Manjoo, Salon
National Institude of Health: Stem Cell Information Page
A comprehensive database of information on stem cells from the NIH, including everything from FAQs on the science and policy surrounding stem cells to recent news articles on the subject.
How I Spent My Summer Vacation: Family Dinner
Plagiarism and the scientific paper
unpacking my life