Bob Edwards created IVF. Was he a hero or a villain?

The creator of the first IVF baby, 2010 Nobel Laureate Robert Edwards, died last week. Obituaries and eulogies by colleagues, friends and admirers spoke of a passionate man with boundless energy, driven by a desire to bring happiness to infertile couples. Since he is directly responsible for the birth of some five million children since the first IVF baby in 1978, his legacy is worth pondering.

Like Margaret Thatcher, who was born in the same year and died two days before him, Edwards reshaped the world we live in. And as with Thatcher, we ought to ask whether it has been for the better. 

Edwards was born in 1925 in Yorkshire. After a slow start in his research career, he began working in human reproduction in the mid-1950s.

He teamed up with Dr Patrick Steptoe, an expert in the new field of laparoscopy in 1968. By 1969 they had provided the first compelling evidence that fertilisation could take place outside the human body. Characteristically, this development was announced on Valentine’s Day.

At the time, the scientific establishment – to say nothing of the churches -- was strongly opposed. The reaction of the British Medical Association was so extreme that Edwards twice sued it for defamation. Eminent scientists described his work as immoral and criticised him as a self-publicist. James Watson, the Nobel laureate who discovered how DNA works, sneered at him. He lost government funding for his project.

Even the leading journal Nature, which backed his work, expressed some reservations. What was the point of bringing new children into an already over-populated world?

Fully aware that he was smashing as many idols as Thatcher did in political life, Edwards started to cobble together an ethical justification for his controversial research. In 1971 he wrote a paper (in conjunction with an American lawyer) for Nature on the ethics of IVF which anticipated many later developments.

Edwards was extremely adept at public relations. He knew exactly what would happen once human reproduction became possible in laboratories and he tried to smooth a path for it. On the medical side he predicted sex selection, embryonic stem cell research, children for lesbians and single women, posthumous reproduction and genetic engineering. On the legal side he foresaw debates about over-population, gender imbalance, the personal identity of clones, and the need for government regulation. 

When Louise Brown, a healthy 5 pounds, 12 ounces baby, was born on July 25, 1978, criticism stopped. As Edwards triumphantly put it, “Most ethical disagreements have been vaporized” by the existence of millions of IVF babies.

 

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What were the ethical principles which inspired him?

First, there should be no limits on scientific research as long as it does no harm. Science could not and should not be limited by ethics. As he told a journalist for the magazine Living Marxism, “I cannot accept this hyper-emotional stuff that says that some areas are out of bounds and cannot be touched.”

In his hands, science was an attack upon the Christian world view. In 2003 he told the London Times: "[IVF] was a fantastic achievement, but it was about more than infertility. It was also about issues like stem cells and the ethics of human conception. I wanted to find out exactly who was in charge, whether it was God himself or whether it was scientists in the laboratory."

And what he discovered was that "It was us."

In principle nothing was out of bounds for scientists. His 1999 remarks backing eugenics are widely quoted: “Soon it will be a sin for parents 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 was actually in favour of human reproductive cloning, provided that the procedure was safe.

Second, the ethical norm for medicine (he was not a medical doctor) was the “clinical imperative”. Whatever satisfies a patient’s desires must be done. In 2004 he wrote: “Clinical imperative is a powerful doctrine, immediately accepted by many patients and professionals alike. A strong argument offered by many clinicians insists that any unwarranted restriction of scientific and clinical research must be rejected if it restricts the access of their patients to the most recent scientific advances.”

This, obviously, can justify almost any medical procedure.

Third, human identity is proportionate to consciousness – which means that embryos, which have none, are just disposable organic material.

Edwards was a fan of “practical ethics” – pragmatic justifications for his research. He wasted little time in debating issues like personhood. Why should he? They might have hampered his research.

As long as it undermined the humanity of the embryo, any reason, however specious, seems to have been good enough. One of his papers contains a bizarre passage drawn from evolutionary pantheism. “The broad evolutionary outlook [is] that life began only once and is continued as its spark is transmitted through successive generations via the gametes. Any decisions about the beginnings of human life will therefore be arbitrary and involve selecting a point where human life and dignity become paramount.”

This is so silly that only an intellectual who has lost all faculty for self-criticism could propose it. If the beginning of human life is arbitrary, why not the end? Could we decree that life should end at 30, as in the film Logan’s Run?

As with Mrs Thatcher – who, by the way, presided over the passage of the world’s most liberal experimentation law in 1990 -- the fulsome praise heaped upon Edwards skips over some sticky questions, even for those who are not opposed to IVF.  

Edwards’s patients were not properly informed about the dangers of the procedure. (There were no animal trials for IVF (or for its successor, ICSI). Edwards did not seem to worry about the higher rate of birth defects among IVF children. They were just collateral damage of the “clinical imperative”.

Feminists criticised Edwards for commodifying the female body. The magazine Living Marxism reminded Edwards of objections by the Feminist International Network of Resistance to Reproductive and Genetic Engineering. These women were arguing that IVF was “not invented to serve women’s interests, but the needs and desires of medical scientists, and the state, to further technological progress and to aid population-control aims”.

Edwards’s response was apoplectic. “Look at the happiness of those women [his patients],” he said. “They wanted this treatment. I am fighting for these women. Feminists should be arguing for more of this kind of help for women, not less of it.”

Similarly, there is little discussion in Edwards’s papers about the psychological welfare of the children created through IVF. What about the genetic orphans created through anonymous sperm donation? What about children of gay parents who will grow up without a mother or a father? More sad, but necessary, collateral damage.

The artificial reproduction created and defended by Edwards may someday be viewed as a technology more powerful than the atomic bomb.

And perhaps like Edward Teller, the father of the bomb, another scientist without self-doubt, he believed that “There is no case where ignorance should be preferred to knowledge — especially if the knowledge is terrible”. His blithe indifference to the social consequences of IVF is staggering.

In 2013 an Australian bioethicist, Robert Sparrow, set out a blueprint for “in vitro eugenics” in the Journal of Medical Ethics.

Generations of people can be created in Petri dishes, eliminating unsatisfactory genes in the quest for better human beings. Dr Sparrow calculates that two to three generations of human beings could be produced in a single year – rather than the 60 or so years that the pace of natural reproduction requires. “In effect,” he writes, “scientists will be able to breed human beings with the same (or greater) degree of sophistication with which we currently breed plants and animals.”

Is this chilling scenario the fault of the genial, baby-kissing professor who was Robert G. Edwards? It certainly is. There have been few scientists who envisaged the future more clearly and worked harder for it. "After such knowledge, what forgiveness?" 


Michael Cook is editor of Mercator. 

Image credit: Pexels 


 

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