No stranger to controversial choices, the Nobel Committee has awarded its 2010 Prize in Physiology or Medicine to Robert Edwards of Cambridge University, who, along with the late Australian Dr. Patrick Steptoe, developed in vitro fertilization.
In terms of impact, the award is fitting. In vitro fertilization techniques isolated the earliest stages of embryonic human life from the female body and, since 1978, allowed for the conception and birth of more than 4 million children to infertile couples.
The Nobel Committee chose to focus, understandably, on these results. But other aims and consequences of Edwards’s techniques have created severe ethical dilemmas. As Edwards worked to develop procedures and culture media that could sustain human life, many of his research subjects died, including embryos conceived using his own sperm. In addition to refining the success rate and safety of his techniques, Edwards developed techniques for pre-implantation genetic diagnosis that would allow parents to identify genetic diseases before taking the developing human being from the petri dish to the womb. The same techniques increasingly allow scientists to select embryos on the basis of their sex or other desired physical characteristics, practices that remain controversial.
“Soon it will be a sin of parents,” Edwards reportedly said in 1999, “to have a child that carries the heavy burden of genetic disease. We are entering a world where we have to consider the quality of our children.”
Edwards’s basic science was also instrumental, as the Nobel Committee reported, in studies involving human embryonic stem cells. Congress and successive Administrations have continued to debate public funding for research involving these cells, whose harvesting requires destruction of the human embryo. Recent advances in developing alternatives—including new work on non-embryonic cells called induced pluripotent stem cells—have raised hopes that consensus can form around ethical techniques that are already yielding effective treatments. One Pandora’s Box that Edwards helped to open may be closing.
The contents of other boxes, however, will need much more study. Many advocates of in vitro and other assisted reproduction technologies (ART) celebrate the impact they have had in redefining parenting and the family. Separating sex from reproduction, these techniques have encouraged the formation of single-parent and two-parent households where one or both of the biological parents are deliberately excluded at the time the child is conceived. Adults have gained options from these new techniques, while 32 years after the birth of the first in vitro baby, Louise Brown, the impact on the generation of children born by them is just beginning to receive attention.
The Institute for American Values released a study earlier this year that underscores how many children conceived via ART desire knowledge of and contact with their biological parent or parents. The desire for connection with natural parents, for knowledge of one’s personal heritage and history, includes many practical and emotional considerations that social scientists and public policymakers have scarcely begun to explore. Like the sexual revolution, the reproductive revolution has largely featured the spread of industries that cater to adult desires. Meeting the needs of the children of ART will require a much more comprehensive reflection.