frontline: making babies

see below for text navigation
interview: Lee Silver
Lee Silver is a Professor of Genetics at Princeton University where his laboratory is attempting to identify genes that influence personality and behavior. He is the author of Remaking Eden : How Genetic Engineering and Cloning Will Transform the American Family(1998). You gave a lecture today on the supremacy of the market in the U.S. Tell me how that affects assisted reproductive technologies [ART], for instance?

American society, to a much greater extreme than any other Western country, has a sense that the marketplace is all important. Individual freedom is much more important than issues of society as a whole. So in my lecture today, I explained why there are absolutely no federal regulations guiding embryo research or even banning human cloning.

The reason is because on the one side you have religious conservatives who want to ban all sorts of embryo research as well as abortion. On the other hand, you have traditional conservatives who are very much against regulation of any kind. And then you have Democrats who are very much interested in keeping choice for a woman open. So you have all of these different forces competing with each other and in the end you end up with no laws at all.

Do you think that there should be laws?

Oh, I think that regulation is important to make sure that these technologies are used with informed consent and that people aren't harmed. And I would say that most people would be willing to accept regulations if the regulations were reasonable, the kind they have in the United Kingdom, for example. But what most people would say is that no regulation is better than a bad regulation--regulation that bans everything.

You're a mouse geneticist by training, but you seem to be fascinated by the assisted reproductive technologies. Why?

I'm fascinated by the way that science interacts with society and the way in which reproduction--reproductive science--interacts with the way people behave. [It] is very interesting, because there is a very powerful desire that most people have to have biological children. So you have this basic science of reproductive technology, which has been developed over the last 20 years, to help people who were previously infertile have babies. And you have this clash of ideas coming into the question of whether or not people should be able to manipulate embryos, whether or not you should be allowed to have in vitro fertilization [IVF], select embryos and all of these different kind of scientific abilities come into play with political concerns. I'm fascinated by that whole mix.

We've been to a cryobank in California, where we saw people picking sperm donors, and somebody on the phone describing what a particular person might look like and how it would match the husband. How do you feel about that?

Well, this is a very interesting case. The only people who are using sperm donors are people who, for whatever reason, can't have babies the old fashioned way, where the man cannot produce sperm, the man is sterile. So the sperm donor is a last result for this couple to have a child that is genetically related to the mother and not the father. So as a last resort they need to go to a sperm donor.

It gives us pause that we have taken control over our own evolution as a species. We have no idea of where we are going to end up. But we're going to control our evolution. Not nature.  Not the environment. What happened in the past, of course, is that the physician would decide who was the perfect sperm donor. But the American way is very consumer-based and people have realized that they have the ability to make the decision and that many people think that they should be the ones who make the decision, not the physician. Since they have to use a sperm donor, most people in America say, "Look, I have to use the sperm donor anyway, I might as well be allowed to choose who that sperm donor is, be allowed to determine the characteristics of the person ... "

They're choosing for things like height, the shape of the eyes, the color of the skin, but there are now many ads asking for people with a certain SAT score, asking for somebody with musical ability. What do you think about that as a geneticist?

I would say, first, what people want is to have babies that look like themselves. So most people are going to try to choose a sperm donor which has the same characteristics as the infertile male member or partner. If they try to choose other kinds of characteristics like enhanced intelligence and musical talents, they might be able to play games with probability, but they're not going to guarantee anything in their child. And I don't know if all people understand that. That there is no guarantee that the child will have any of the characteristics, the behavioral characteristics that are present in the sperm donor.

They're really seeking some kind of genetic determinism here, do you think that they are confused?

They're overestimating the role that genes play in who we become. It is perfectly clear that genes do influence what we are and what we become, but genes are not all that determining. You can be born with all of the musical talents in the world, but if you don't practice the piano, you're not going to be a great musician. We're not even at the point to where we can actually see what genes are going to determine musical talent or not. Most people don't understand that there is much, much more than genes that play a role in whether we are successful or whether we live up to our potential.

Why is it that there is such a seeking for this genetic counterpart, this child of my genetic heritage?

I'm a biologist and I actually believe very firmly that there is a kind of an instinct that people have to want to have biological children. I don't see any problem with that. Most people are able to have biological children without any intervention. And if all they're trying to do is use these technologies to enable them to have a child with a link, that is perfectly fine. I don't have a problem with that.

But it's going further than that now. We have sperm donors, we have egg donors, we have gestational surrogacy ... yet they're still trying to keep this tenuous, it seems to be, genetic link intact?

Well, actually, when we come to sperm donors and egg donors, they're breaking the genetic link. They're saying, "I can't have this genetic link. I really feel bad about that, so I'm going to get the best thing that I can." That is what is going through their minds. In the first instance, most normal people would prefer to have this genetic link over anything else. But then they feel kind of upset. "I can't have the genetic links, I'm going to get the best sperm donor I can or I'm going to get the best egg donor I can as a last resort, as a second best opportunity." That is what is happening with the sperm and egg donors.

Some people think there is a real problem mixing egg donors and sperm donors ... They would actually draw the line after IVF, and would not have donor sperm and donor eggs used. What do you think about that?

I don't have a problem with use of donor sperm or donor eggs if people want to have a baby. The most important thing that we have to ask is what is the intent of the parents? If the intent of the parents is to try to have a healthy child that they're going to give unconditional love to, then I don't think it matters where the child was conceived, where the child was gestated.

Also, the other important concern is whether the technology is safe. We want to make sure that no technology is used unless it's been demonstrated to be safe--to not cause birth defects, to not cause any harms to the child. But whatever the technology is, if it gives rise to a child that is loved by the parents, I think that is good.

There is a problem when you talk about surrogates, because now you're talking about a woman who is having a baby that she is going to give up whether it's related to her or not, she is going to give it up to another couple ... there are biological issues there that a woman feels a certain connection to the baby that she might not be aware of when she goes into the procedure.

A number of clinicians and some of the best labs in the country say that there will be pre-genetic diagnosis available and it's being done now. But they also say that coming along with that will be the iiability to enhance the genetics in the future. Do you think that is true?

I am absolutely convinced that we will have both an expansion of pre-embryo genetic diagnosis as well as genetic enhancement of embryos. The reason I'm sure it's going to happen is because we have already perfected this in animals. It's something that we do in mice in this building every day. We put new genes into mouse embryos and the mice grow up with these new genes. So yes, this is going to happen. It's going to be possible.

Do you have any concerns about that?

Well, my concern is that people are going to be thinking that they are getting something that they're not getting, perhaps. That is one problem when you're talking about genes that affect behavior, personality.

The other part of this technology, though, is that parents are going to want to give their children enhancements in health. That is the way the technology is going to be used first. For example, 1% of people are naturally resistant to infection with the virus that causes AIDS, HIV. They have a gene and we understand how this gene protects these people from being infected by this virus. So you can imagine prospective parents in the future saying, "I want my child to have this gene which will protect my child from getting AIDS."

Then it becomes very difficult to say that parents should not be allowed to do this, because they are giving their child something that some other children get naturally. And parents will say, "What is wrong with giving my child this enhancement ... We give all of our children a polio vaccine after birth. What is wrong with the genetic vaccine against AIDS?" When you are thinking about it from the individual level, it's very difficult to find something that is wrong with it.

I would say the difference between the polio vaccine and a genetic vaccine against AIDS or any other kind of disease is that the polio vaccine is given to all children in the country. There is no difference in accessibility. Whereas, this genetic enhancement technology may only be available to those who have money and so my concern is for those who are not able to receive this technology. They will be at a disadvantage.

If we enhance for something like the health issues, which surely may happen, we can then enhance for other issues as with the human genome project, and that is a great concern for people.

The interesting thing about genetic technology is that once the technology has been perfected, it's the same technology no matter what genes you want to put in. So if you develop the technology for putting in genes that enhance health characteristics, then that very same technology can be put in to give a child other kinds of non-health characteristics like increased talents, which we'll be able to figure out some day or increase memory abilities or cognitive skills.

Now, of course, we have to remember that none of these genetic enhancements of personality behavior or cognitive abilities are going to guarantee anything in the child. They are just going to increase probability that the child will have this talent or disability ... we also have to understand that the way this is going to work is that parents are going to give their children something that other children get naturally ... they're going to say to those who want to prevent them from getting this technology, "Why can't I give this to my child when other children get it naturally?" That is the argument that they're going to use and it's a very powerful argument in our society, where we basically allow parents with money to give their children environmental advantages that other children don't get.

We already have a group of people that are going through assisted reproductive technologies who are largely white, largely better off than other people and it already is a somewhat of a class system. You can see it in the waiting rooms. Is that one of your concerns as this marches on?

Yes, I think that this is basically unfair. But what I would like to point out is that it is completely analogous to what we already do. It costs $120,000 for parents to send their children to Princeton University. If a child comes from a middle class family they're not going to get a scholarship, they are not going to be able to afford to come to Princeton University.

Our society accepts this unfairness, and so what we're doing is we're taking this basic principle upon which our society operates, a basic marketplace mentality--if you have the money, you can do it. We're bringing this down to reproduction and we just keep pushing and pushing and pushing. I think that it's all unfair. It's going to make even worse the division between the have's and the have-not's in our society.

Some of the most cogent thinkers from the religious community will say, "to some extent, this creation of a child is a creation that we can't control. It is full of a kind of a mystery." What do you say to that?

Well, 200 years ago, most people thought that it was wrong and immoral to cheat death. The vast majority of people in Europe said, "If it's time to die, then God wants you to die, and you should die. You shouldn't do anything to stop that." That is not the way we think today. Every time we use medicine to cure a disease or prevent death, we are going against nature. And most people do it gladly because they want to live longer.

So yes, in the past we had to accept a random roulette of what genes went into our children, but that is not a valid reason to say that we shouldn't go and select genes. There are other reasons that we should be worried, but not the fact that because in the past it was random, we should continue to make it random.

Well, we're not talking only about randomness here and we're not talking, really, about disease, in the classical sense of disease. We're talking about the creation of life outside of the human body.

Yes.

... That kind of opinion needs to be respected to some extent.

Well, many different people have different religious points of view. There are some very religious people who are perfectly willing to accept in vitro fertilization and other technologies if it brings no harm to the prospective parents, and it brings no harm to the baby. Most Jewish groups are willing to accept that. They think it is good to assist people to have babies that are going to be loved. So there is not universal religious point of view on manipulating embryos ...

So you have really no concerns with that part of the argument?

My concern with the technology is not that it is unnatural or that we shouldn't be creating embryos in culture. My concern is that it's being done in a way where the parents are aware of the risks, where the physicians are only using technologies which have been proven to be safe through animal experimentation. My other concern is that technology is more freely available to more people in society.

Let's talk about one of the risks that most clinicians agree with--the risk of multiple births ... A clinician said to us, "I can talk about prematurity until I'm blue in the face." Indeed, most infertility clinics don't actually do that, but they talk about the risk of multiple births.

The reality to a patient who then has a multiple birth with children that are born, let's say, 25 or 26 weeks and they are struggling for life, is very, very different for them. For the doctor then to say, "Well, I gave them informed consent. I told them about multiple births." This is where one has to think really carefully about this informed consent issue, because people come with a certain sense of what information they take in and what information they don't.

With in vitro fertilization the doctor can determine how many embryos he's going to put back into the woman. There are some physicians who won't put back more than two embryos ... you can only get twins. There is more of a problem with multiple births when using fertility drugs, which is less of a high technology than in vitro fertilization.

With in vitro fertilization you can control the situation much better. So physicians might ethically decide that they're not going to put back two embryos. That is one way that you could go. The other way to go is to say, "I'll put back three embryos," which is really the most that physicians do right now and say to the couple, "I'm putting back three embryos as long as you will tell me that if all three take and there are three embryos in your uterus that you're willing to reduce. That you're willing to abort one of these or two of these embryos to insure that the one or two that are left are more likely to go full term."

I have no problem with an early abortion, and if people are willing to accept that, that is another way to get around this problem. But I agree that none of these are perfect solutions.

You predicted, I think two years ago, that human cloning would be here with us, within two years.

I don't think I said that ... I predicted that human cloning would be with us in 10 years and I still believe that is the case, because there is a demand among a small number of people for this technology to have babies. It's being driven by the marketplace. I think that, ethically, one should not use this technology until they are convinced that it is safe and efficient, shown with the use of animals. But I don't think that physicians around the world are going to wait for the confirmation that it's safe and efficient in animals.

The best example I can give you why physicians are not going to wait as they should is with ICSI, an intracytoplasmic sperm injection. This was a new technology developed in the early 1990s to overcome severe infertility and physicians did not wait to prove that it wasn't going to cause birth defects before they embraced it wholly across the country. We can use that history to understand how cloning is going to go. I'm not advocating the use of cloning in this way. I think it is wrong, but it's going to happen.

Can you explain simply what cloning is, because [some] people think that it's the creation of an adult copy.

When biologists use the term cloning, they mean something very different than what the public views cloning as. In the case of Dolly, what happened is the genetic material was taken from an adult cell and that genetic material was placed into an egg whose own genetic material had been removed. Under the right conditions, that egg with a complete set of genes, with a complete genomic material, could develop into an embryo. It would divide into multiple cells and that embryo could be placed back into a uterus to develop into a fetus and ultimately into a baby.

What would happen in those relationships?

Well, in purely genetic terms, if a woman used this procedure to have a baby, the child, the daughter would actually be the genetic sister of the mother. But I don't think that the mother would treat the child as a sister. The social situation would make the mother treat the child as a daughter ... we already have confused examples of heritage right now. If a person's father has an identical twin brother, then that person's uncle is also their genetic father in purely genetic terms. So we don't look at things in purely genetic terms. We look at things most often in social terms.

We have these confused identities and new forms of family, but we don't deliberately create them very often. In this instance, we are creating them and we are creating them within a private, market-driven industry.

When it comes to cloning, people are over emphasizing the genes ... the genes are being blown out of proportion. The reason is because every day somewhere in the world there are children born who look just like one parent and who grow up and behave just like one parent.

A clone will be no different than children who are already born today. It will pretty much look like one parent and it will have many of the same behavior predispositions as the one parent. But that already happens, so nobody is going got be able to distinguish a cloned child from a child who happens to look and behave like one parent.

Do you think that the people who are proponents of using this new technology, that see some real excitement in it, and see some possibilities in it, will actually develop a new language for it?

... ultimately, when children are born with the use of this technology they will not be called clones. There is a technology that scientists developed called nuclear magnetic resonance. When this was used in medical scenarios, people were resistant to it, because the word "nuclear" was there. So we changed the name of the technology to MRI [magnetic resonance imaging] and now everybody accepts it. The same thing is going to be happening with the so called cloning technology. It's going to be called single parent children or some other innocuous phrase that is going to be used.

...

[Do you think] there is something of a "yikes" factor?

We know from history that the "yikes" factor can often be misleading. In 1978, when the first baby was born by in vitro fertilization, most people were horrified. The vast majority of Americans, when asked, said that they would never consider the use of in vitro fertilization even if they were infertile, because they didn't understand what the technology did. It was an alien technology. It made them afraid. Today, of course, IVF is an acceptable practice across the country and most infertile people would consider trying to use IVF if they could.

Can you tell me where this new technology will emerge from?

Cloning is certainly going to emerge from the fertility clinics that exist in this country and elsewhere around the world, because it's only in the fertility clinics where the technology exists from taking eggs out of a woman's ovary, developing the eggs in a petri dish and putting the embryos back into a woman's uterus. That is done at fertility clinics. It is not done at biotech companies or anywhere else. So when cloning happens it's definitely going to happen within the context of a fertility clinic.

So even if 99% of them say no, all it takes is one clinic somewhere to not talk about it and just to use the technology to give rise to children who are going to be genetically identical to one parent.

Do you think that there is something coy or slightly political about them saying no?

Oh, it's absolutely political. Fertility treatments are highly controversial in this country. One of the things that president Harold Shapiro, president of this university, and who is also the head of the national bioethics advisory commission, told me is that when they had hearings on human cloning in the United States about a year or two ago, he invited a whole series of fertility doctors to come testify, and they all refused. They are a profit making business. They're in the business of trying to help infertile couples have babies, and they have no reason to publicize themselves.

You know what the critics say about children as commodities, as products, as designer babies. What do you say to this ...

I don't think that these people who claim that we are commodifying babies have ever actually talked to any couple who has had a child by one of these assisted reproductive technologies. The vast majority of these couples desperately want to have children and they treat their children as children.

This word cloning, indeed, the practice as you see it on the horizon, does not greatly dismay you?

I am not dismayed by cloning, because I don't think that it's going to be used in all of the outrageous kinds of ways that people have thought up, like the egomaniac, for example, that wants to have a replica of him. Cloning does not achieve immortality. What the ego maniac will end up with is a baby that will kind of looked like he looked like a baby that will grow up into a boy that won't listen to him. So he's not going to get what he expected. He's not going to achieve immortality. He's just going to have a son. He's not going to be able to control the life of that son. When people understand the little that cloning does, most of these kinds of people will lose interest in the technology. It's not going to accomplish what they think it's going to accomplish.

So you may ask me, "Then why would anybody use it if you're not going to be able to guarantee the child is going to turn out in a particular way?" My answer is that the only people who will end up really using this are people who can't have biological children another way and are going to be using this to have biologically children, because what most normal people want is unpredictable biological children. They want this genetic link to their children. And if that's why they're doing it, not expecting anything except to have a child that may not listen to them, that I don't have a problem with that use of the technology.

You have raised the issue before about creating Madonnas, Michael Jordans and the critics say that is indeed what will happen. At first, one can dismiss that argument very quickly. But when you see how market driven this culture is, how many groupies swarm around people like Madonna, clasping at her clothes, at her hair ... it gives you pause, really ...

Well, the question I have for people who worry about this star being cloned is to say to them, how often do you think a movie star has donated their sperm or eggs to a sperm bank today? I think the answer is none of them have put their sperm into a sperm bank. They're not interested in getting the $70 back to put their sperm or to donate their eggs, which is a serious protocol, into a bank ...

One of the issues that I raise in my book is that it might be done surreptitiously. That somebody will come up and take a scraping from Michael Jordan's skin and use that scraping to have a clone. I don't know how realistic that is. But I don't think it's very realistic, because the child that comes out of that cell, even though that child will be genetically identical to Michael Jordan, I can guarantee you that there is no way that child will ever make it into the NBA. Because Michael Jordan is more than his genes. Michael Jordan worked very, very hard and it was this hard work and this spirit that allowed him to reach the point that he reached. People forget that genes provide a framework and the potential, but unless you work very, very hard you're not going to get anywhere without it.

You talk in your book about an elite class of people called the "gen-rich" and then the other group of people that are called the "naturals." That is actually where you're thinking is leading, to some extent, and what gives you some concern.

My great concern is that genetic enhancements, although they don't guarantee anything, really will widen the gap between the have's and the have-not's. I put a very speculative argument into my book that said that people who have money in society will give genetic enhancements to their children. Their children will take those genetic enhancements and automatically give them to their children and add extra ones in. And that generation after generation after generation of accumulating these genetic enhancements could lead to a group of people who were genetically distinct from the naturals who are us.

That is the one point in my book that I've had serious argument from biologists, who say to me that it will never be. There will never be a point where humans actually don't have relationships with each other, and that because people who are genetically enhanced will always be having relationships with people who are not enhanced, that there will never be the separation of species. That, in fact, there will be an extension of the group who have genetic enhancements. We won't get these two species. I agree that that may be the case. I don't think that we can know without going into the future a thousand years ...

Can you describe where this technology could go that concerns you?

The most disturbing part of this technology is not the cloning, where you just have a child born who happens to be related to one parent instead of two. The most disturbing part of this technology is when parents are going to try to use genes to provide their children with serious advantages.

Now the problem is that all parents want to give their children advantages. In the United States, we have a market-based mentality, where we say that parents who have money can give their children more advantages than parents who don't have money. We all accept that. I think parents are going to keep going back to the genes and say, "I want to give my child every possible genetic advantage in the book."

That is troubling to me, for two reasons. One is that some of these genes really will provide advantages. Advantages of longevity, decreased risks of cancer and stroke and dementia, and so these children really will have health advantages, which means that the parents who are unable to afford this technology will have children who are disadvantaged. So I see this as greatly exacerbating the gap between have's and have-not's--much, much greater than it is today. That concerns me.

The other thing that concerns me is that parents will be giving their children genetic enhancements that they think are going to increase the behavioral, cognitive or talents of their children. And many times, they're going to be disappointed. It doesn't mean to say that the genes won't increase the probability that their child will have a particular talent, once we understand how genes affect talents, we don't yet. But I think that parents may be getting into this not realizing that all they're doing is increasing probabilities. You're not going to guarantee anything. So you worry about how parents are going to feel about children who don't express the genes that they got.

But isn't there something to be said for the position of people who say, "We do get, in some ways, the luck of the draw, we do get a surprise when we have a child? This is in the nature of something that we can't control very well and we want to take it into more of our control." There is a sense of determinism in this where you see people at computers picking the sperm donor.

I reject the luck of the draw argument against the use of the technology, because it was the same argument that people used against medicine 200 years ago. People said, "Well, some people get infected and die and other people don't and that is just the way it is. That is the way God intended it to be."

Now we reject that notion. We use medicine to overcome the unlucky draw. I don't understand why we should stop people from wanting to use medicine at an earlier time. In other words, I don't see why it is problematic for parents to want to give their children health advantages, because after birth they provide all sorts of advantages to their children. Before birth, they're going to want to do the same thing. The problem that I have is the access issue that some people are going to be able to give their children advantages that other children don't get. But I don't think the luck of the draw issue is going to ring true with people once this technology becomes available.

Well, maybe I didn't use the right phrase, but that sense of surprise, that sense of uncontrollable. There being some kind of romance or mystery about this?

There are two ways to answer this question about the luck of the draw. The first is that it's always going to be uncontrollable. The child's always going to be a surprise no matter what. No matter how much we know about the genes, the child is going to come out and be unpredictable. That is always going to be the case ... We don't ever get to the point where we're going to be able to control everything, because genes just provide the framework, not everything else.

Now, beyond that, the question is: Does this surprise? And it's good to have a surprise. I think that should be up to the parents. Some parents choose to know what the sex of their child is while the woman is pregnant and some parents choose not. The parents who choose not say they want to be surprised at birth. The parents who decide to find out the sex of their child, say, "I don't care about the surprise; I want to know." So we have to respect the individuals difference in the notion of whether surprise is good. Because, as I said, there is always going to be unpredictability in a child. So we don't have to worry about that.

What about the sense of a child's own lineage ... there isn't a clear genetic lineage for many of these children ...

I think that this notion of genetic lineage ... it's belied by what already happens in society today. Adoption is accepted. Children who are adopted treat their adoptive parents as a mother and father, there is no lineage there. Sometimes they do have the instinct to go back and look at their lineage. But cloned children could do the same things as well. When it comes to genetic engineering, the lineage is still going to exist. The social condition and the social relationships between children and parent are more important to the rearing process than the genetic relationships.

They may say that the social relationships are important too, but the genetic ones are also important. Surely, we see the adopted child searching out their birth parents. There are very few records of sperm donors and egg donors. In fact, in this area of the country, most of the donors are anonymous.

I don't think that this is a reason to stop people from using these technologies and having babies. I mean, we don't stop people from adopting children. We say, "Oh well, that's done for the good of the child." It is perfectly allowable for parents to use this technology because maybe the children will grow up and say, "Well, where did I come from?" Hopefully, we'll have regulations which will allow the child, when a child reaches a certain age, to go and look for the genetic parent that the child never knew. With cloning there is not an issue. With cloning it will be perfectly clear what the genetic lineage is. So I don't see why that is problematic.

As a scientist, is it possible that this generation of children, that have grown up since IVF was discovered in 1978, will have something wrong with their reproductive systems because of these kind of drugs that largely their mothers took?

What's going to happen, unfortunately, is that children who are conceived with advanced reproductive technology are going to have a higher probability of being infertile just because there is a genetic component to infertility. So the rate of infertility is certainly going to increase in the future. I can tell you that as the population geneticist from that kind of perspective. That is certainly problematic.

What effect the hormones will have, I don't know. We know that DES causes severe problems in the woman. The hormonal levels being used right now are much less than what was used with DES. But there will certainly be an increase in the rate of infertility among these children so that you're going to promulgate this technology, it's going to have to be used generation after generation. That is frightening.

Why is it frightening?

It's frightening because on the one hand, you're doing something good for people by allowing them to have children they're going to love. On the other hand you're increasing a kind of a disease, which is infertility, and so these children are going to be born with this new disease. So you have these tradeoffs. I find it very difficult to deal with these tradeoffs when they clash against each other like this.

We have a couple in this FRONTLINE report where the man has Kartagener's syndrome. It's not able to be tested for. They decided they would go ahead and have a child and they have a child who seems to be a healthy child, but they took a gamble. What do you think of that?

I believe that people should be able to reproduce. There are all sorts of people out there who have family histories of heart disease and family histories of cancer and we know that their children will have an increased risk of cancer or heart disease and we don't stop those people from reproducing. I don't see how we can stop people who have diseases from reproducing, especially when they're not sure what is going to happen to the child.

It would unethical to have a child who is going to have a serious disease knowing the child is going to have a serious disease. But in these situations, really there is no way of knowing what is going to be happening for the child and one just hopes the child will be normal and healthy and one hopes that if a child is not healthy that there'll be some kind of medicine that the child can use to become healthy.

... a bioethicist said to us today that nobody really is speaking about the child and the child's rights. They are talking always about the couple, the desperate couple's need for a child, but they are not talking about the children's rights ...

It is unethical to use the technology which has a high chance of causing harm to a child to be. I would agree that that would be unethical. But that is not what is happening in most of these cases. Most of these cases, it's not clear what the technology is doing and in most cases the technology is going to give rise to children who are healthy. You can't take a child's rights into consideration when the child doesn't exist.

I would say to these people who say, "We have to think about the child, not the infertile couple," that if these people were really being logical they would stop parents or prospective parents who have serious diseases which will definitely be transmitted to their children the old fashioned way. They need to stop those people from having babies, and nobody would do it.

So if we don't stop people from having babies the old fashioned way, no matter what, as well the parents are not criminals. I don't see how we can stop parents from using advanced reproductive technologies to have babies.

They would say that there can be a regulatory environment, because you're actually creating life, you're bypassing natural barriers. It's a completely different thing than natural or sexual reproduction in the general society.

I don't believe in the meaning of the word natural. I don't think that natural is good. Natural brings us AIDS, natural brings us polio. We go against nature all of the time. So I don't think we should put natural onto a pedestal and that is not the reason that we should regulate reproductive technologies different than we regulate whether or not fertile people can have babies.

We have to regulate the technologies so that no harm is caused, so that the technologies are not being used before they're shown to be as safe as natural childbirth. Which, by the way, is not very safe. It causes a lot of women who have natural childbirth have problems during childbirth and there is a rate of birth defects in the order of 2-5%. So doing it the old fashioned way is not so safe either. A new technology should be at least as safe as the old fashioned way, before it should be allowed to be used.

What sort of regulations do you see? Would you support certain regulations?

I would support the regulation basically saying that this technology, that new reproductive technologies must be treated the way all technologies are treated, all medical technologies are treated, which is it has to be validated in animals. There has to be some kind of scientific understanding that the technology is not going to bring harm to the child. That's the limit of the regulation that I would put onto it.

But that's not been the nature of how this has grown up?

Well, this is not going to happen, because what happens in the political arena of our country is that if you try to put what I consider to be sensible regulations on the use of this technology, those regulations get hijacked by people who want to ban the use of the technology and we fertility doctors know this. And what fertility doctors will say to you, is bad regulations are much worse than no regulations at all.

The human embryo research ban, has that been something that has really hurt?

I don't think the human embryo research ban has actually hurt anybody, because there is no ban on human embryo research in private clinics. The ban is on the use of federal funds to do human embryo research. The scientists who work in the federal laboratories, the federally funded laboratories, want to jump into this game and want to get this money to do their research. They are the only ones being harmed by this ban.

So it hasn't had the effect of no oversight because no National Institute of Health money involved?

That is exactly what has happened with the ban on the use of federal funds for embryo research. What has happened because of that ban is that all of the research gets pushed into private clinics and private laboratories where there is no regulation, and so the people are willing to take much more risks. They are willing to push the envelope much further in these private clinics. If we had some kind of regulation, the research would be going forward much more slowly.

What do you think of that?

Well, I don't have a problem with the research going more slowly. I really believe that we have to make sure that the research goes along in an ethical way. But I can tell you that because of the political situation in the United States, it seems clear to me that we cannot get sensible regulation. That there is a religious conservative group that will hijack that regulation and make it much more severe than most physicians want it to be.

Are there any other issues which we haven't covered?

The main issue in my mind--this is very powerful technology. For the most part, parents don't want to use this technology to harm anybody. This technology will be used by prospective parents who want to help their children. Help their children be more successful, help their children be healthier, healthier children perhaps be better to do things in the world. That is the way the technology is going to be used.

What I see is the problem is really conflict between liberty and justice. On the one hand, people should have the liberty, which we care a lot about in this country, to be able to do things to help their children. On the other hand, this technology is so powerful that if we leave it in the hands of the marketplace, the parents who don't get to use it will have their children at a disadvantage.

You talked about these as a very powerful technologies ... Does this give you cause for concern, the place we find ourselves in now, as our tools become so powerful?

I am always amazed and surprised by the power of biotechnology, especially as it is being applied to human beings, and how it will be applied in the future. This is a revolutionary, evolutionary point in our history as a species. I really believe, very strongly, that our species will change. If it doesn't happen in 10 years or 50 years, it will certainly happen within the next 100 or 1,000 years. So it gives us pause that we have taken control over our own evolution as a species. We have no idea of where we are going to end up. But we're going to control our evolution--not nature, not the environment. We are going to control the evolution of our species.

On one hand, that is just absolutely fantastic and amazing. On the other hand one really worries about our species dividing among classes and groups. So I'm very ambivalent about this technology. I'm excited about it on the one hand and I'm frightened to death on the other.

I would say not only that, but how dare we?

As I told my class, we've been practicing genetic engineering on animals for the last 10,000 years. Genetic engineering is the foundation of civilization. We have engineered pigs out of wild boars. Pigs are not natural. Cows are not natural. Corn was invented by the Indians. They engineered, the old fashioned way, a weed to become corn. So we have been taking control over nature for a very long time.

In the last 100 years, we have been taking control of our own bodies as we use medicines to overcome disease, as we use heart transplants to cheat death. So we are already doing it. It's just that this is an exponential process. And take everything that we've done already, which is really amazing, it's going to pale in comparison to what we can do in the future.

By that you mean the world of IVF and assisted reproductive technologies as well as cloning?

There are so many new ways in which we're able to manipulate reproduction that were unthinkable 20 years ago. We can already see ways in the future where we're going to be able to manipulate and control the genes that we give to our children. It's just over the horizon. So all of these new technologies are going to change humankind as we know it.

home + discussion + interviews + videos + cloning + quiz
links & readings + contacts + synopsis + glossary
press + tapes & transcripts + frontline + pbs online + wgbh

web site copyright 1995-2014 WGBH educational foundation

SUPPORT PROVIDED BY

NEXT ON FRONTLINE

Solitary NationApril 22nd

FRONTLINE on

ShopPBS
/frontline/ ../