From Yuck to Yippee!

What this year's Nobel Prize for a test tube baby pioneer tells us about the moral endorsement of technology.

At long last, in vitro fertilization pioneer Robert Edwards has been awarded a Nobel Prize. Back in 1978, his research with his colleague Patrick Steptoe led to the birth of the world’s first test tube baby, Louise Joy Brown. The public (and makers of public policy) initially reacted to Edwards’ research with moral horror. However, once he and Steptoe had succeeded in producing a healthy baby girl, revulsion swiftly turned into wide approval and ethical acceptance.

In 2001, when Roberts was given the prestigious Lasker Award for medical research, biochemist Joseph Goldstein quipped, "We know that IVF was a great leap because Edwards and Steptoe were immediately attacked by an unlikely trinity—the press, the pope, and prominent Nobel laureates." Edwards’ scientific career traces out the ethical arc that characterizes reaction to much technological progress during the last century—initial fear and loathing followed by a warm embrace. Yuck followed quickly by yippee.

In 1969, a Harris poll found that a majority of Americans believed that producing test-tube babies was "against God's will." In 1970s, the federal government imposed a moratorium on federal funding of in vitro fertilization research and legislation that would have outlawed IVF was considered by Congress. Yet just one month after the birth of Louise Brown, the Gallup poll reported that 60 percent of Americans approved of in vitro fertilization and more than half would consider using it if they were infertile.

Advances in biomedicine—especially those that touch most closely on birth and death—have been the most ethically fraught. A lot of moral struggles have centered on control over reproduction. Let’s set aside the long fight over abortion and look chiefly at a couple of the other moral struggles over fertility control, contraception and artificial insemination, as examples of this process of progressive moral endorsement.

Contraception was essentially outlawed in the United States by the passage of An Act for the Suppression of Trade in, and Circulation of, Obscene Literature and Articles of Immoral Use in 1873. Championed by moral crusader Anthony Comstock, this act outlawed, among many other things, the sale of “any article or medicine for the prevention of conception.” Violators could be “imprisoned at hard labor in the Penitentiary for not less than six months nor more than five years each offense, or fined not less than $100 nor more than $2,000, with costs of court.” Anthony Comstock was immediately made a special agent of the Post Office, and he spent the next 42 years vigorously enforcing the new law.

By the beginning of the 20th century, agitation for birth control information was increasing—as well as official pushback. In 1915, The New York Times reported on the trial of William Sanger, husband of birth control pioneer Margaret Sanger, for handing over a copy of his wife’s pamphlet, Family Limitation, to a Comstock agent. According to the Times, Margaret Sanger had earlier fled to Holland after being “indicted by the Federal authorities for sending through the mail Woman Rebel, a monthly paper which she edited and published.”

During Sanger’s one day trial, the three justices each examined the pamphlet and then immediately convicted and fined Sanger $150. When Sanger refused to pay, the justices ordered him hauled off to jail for 30 days. The Times quotes Chief Justice McInerney’s reproof of Sanger: “Such persons as you who circulate such pamphlets are a menace to society. There are too many now who believe it is a crime to have children. If some of the women who are going around and advocating equal suffrage would advocate women having children they would do greater service.” The Times disapprovingly reported that the courtroom was crowded with a bunch of unruly socialists and anarchists.

A year later the Times reported that the New York Medical Society was divided on birth control. In New York state, the penal code made it a criminal offense for a physician to give any advice to a patient concerning birth control. “At present any physician who gives information on this subject is liable to go to jail,’ noted the vice president of the society, Dr. J. Bentley Squier. “At the same, however, it must be remembered that if the Penal Code on the subject were altered, it would be possible for unprincipled persons to do a great deal of damage.” On the other hand, Dr. Abraham Jacobi favored changing the law “to allow every licensed physician to give advice to married people on the question of birth control.”

During most of the 20th century, the public, the press, and policy makers turned to religious leaders for guidance on the ethics of various biomedical issues. The Roman Catholic Church has had a long tradition of reflecting on the moral consequences of reproductive technologies. A November 3, 1930, article in the Times headlined “Sees Birth Control As Road to Atheism,” reports a lecture by Rev. Ignatius W. Cox, Professor of Ethics at Fordham University. Rev. Cox denounces various Protestant denominations for caving into acceptance of modern contraception as being moral. He specifically noted that the Lambeth Conference, the worldwide gathering of Anglican bishops, had 10 years before declared that birth control “errs against purity,” but now had “allied themselves, partially at least, with modern pagans on marriage.” 

“The modern doctrines on sex and morals are the logical conclusion of an atheistic philosophy of life, and their practice logically leads to atheism,” argued Cox. “Why? Because modern doctrines on sex and morals are the declaration of physical and moral independence of God. They serve notice that man does not come from God, that man, and man alone, is man’s chief concern.”

Artificial insemination was becoming a more common procedure to overcome infertility in the 1950s. The Times reported in 1956, that “Pope Pius XII again condemned artificial insemination today as a means of helping childless couples to have offspring.” In 1958, 20 years before the birth of the world’s first test tube baby, the Times reported that Geoffrey Fisher, the Archbishop of Canterbury, “condemned artificial insemination by donors today as ‘an offense against the social and legal implications of marriage.’” The archbishop urged that artificial insemination “be made a criminal offense altogether” or “if that cannot be, then the law should require that every case of artificial insemination by donor be registered and the register should be available for inspection under safeguards.” The archbishop was not alone in Britain. Also in 1958, the Methodist Conference of Great Britain, according to the Times, “condemned artificial insemination because it invaded the essence of Christian marriage and deceived both the child and society.” Despite these denunciations, The New York Times reported that by 1976 as many as 500,000 children had been born by means of artificial insemination.

In 1960, one of most consequential technological introductions in the 20th century occurred—the Food and Drug Administration approved the new birth control pill. “Approval was based on the question of safety,” said FDA associate commissioner John L. Harvey to the Times. “We had no choice as to the morality that might be involved.” The Catholic Church ended up maintaining its opposition to artificial methods of contraception. The pill had a wider approval among Protestant denominations, but that acceptance went only so far. For example, Bishop Fred Pierce, president of the World Methodist Council, argued in 1966 that “morally and religiously, birth control methods should be prescribed only for married couples after consultation with their religious advisors, if they are associated with a religious body.” Bishop Pierce added, “Making it easy to secure an over-the-counter product will create an evil brood of moral deterioration as well as economic and social problems.”

In a 1965 New York Times magazine article, Cornell government professor Andrew Hacker wrote to reassure the public that stories about college health clinics giving out prescriptions for birth control pills to unmarried female students were “overrated, and certainly over-reported.” In fact, he could find no college clinics that were prescribing the pills to unmarried students. Hacker reported that he had surveyed his 200 freshmen students about whether the university clinic should be willing to prescribe the pills to undergraduate girls who request them. “It is hardly necessary to say that a good majority of the boys thought this was a splendid idea,” reported Hacker. “But what surprised me was that most of the girls also agreed with this proposal.” He was particularly startled to find that the steady churchgoers were almost as strongly in favor of dispensing the pill as were his non-religious students.

What Hacker’s little survey discovered was that the sexual revolution had already taken off despite the handwringing of religious and political authorities. Hacker, however, was prescient when he concluded, “Just as we have adjusted our lives to the television set and the automobile, so—in 20 years’ time—we shall take the pill for granted, and wonder how we ever lived without it.” Yes, indeed. In April of this year, the Harris poll reported that 86 percent of Americans believe that having the birth control pill available is good for society.

In a 1972 New York Times magazine article, William Gaylin, a practitioner the nascent field of bioethics, was already wringing his hands over the possibility of using in vitro fertilization not only to produce babies for the infertile but also applying it to selecting the sex of embryos or diagnosing disease in embryos before implanting them in a womb. Gaylin also warned that some women might one day implant in herself donor eggs fertilized with her husband’s sperm or conversely pay another woman for the use of her uterus to carry her embryos to term. In addition, Gaylin feared that humanity’s growing reprogenetic powers would result in cloned people.

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  • mb||

    I suppose its not really possible in a short article such as this, but I would like to have seen you make the moral case for OCPs and in vitro. Instead the article reads like a "this is what those foolish naysayers said was morally wrong, but look, now its commonplace." That doesn't really prove the morality of it in my mind.

  • Thomas O.||

    I think the moral here is that most of the time the positive moral aspects of emerging procreative technology (infertile couples being able to conceive a child) outweigh any negatives (licentiousness, promiscuity, eugenic implications, etc.)

  • The Man||

    What are you saying? There isn't even a point to argue here. Yeah, it's true, most of the time some good things are better than some other bad things but can this kind of statement guide any sort of policy (public or private) or ethical judgment? Do you have something more specific to say?

  • Phanatic||

    Why is "infertile couples being able to conceive a child" something that has a positive moral aspect? Infertile couples could otherwise adopt one of the countless thousands of abandoned or orphaned children in the world and enjoy all of the benefits of parenthood other than actually procreating. Why is the choice to spend thousands and thousands of dollars to conceive via procreative technology rather than adopting a child any more of a "positive moral aspect" than a couple's decision to spend lots of money on a purebred show poodle rather than adopt a mutt at the local shelter? If it's their personal preference to do so, fine, it's their money, but I don't see anything particularly morally positive about it.

  • ||

    The human condition is summed up by three needs. Food sustenance, shelter from the elements, or protection from predators (including other humans) and procreation. Any technology that enhances or in some way provides options to those people seeking these basic things is morally positive because it is a benefit to these people.

  • Ron L||

    mb|10.5.10 @ 5:35PM|#
    "I suppose its not really possible in a short article such as this, but I would like to have seen you make the moral case for OCPs and in vitro."

    Uh, it doesn't work like that. Humans are free to do as they please unless there's a compelling reason to do otherwise.
    Got one? I somehow doubt it.

  • mb||

    ?

  • Ron L||

    You are looking for 'moral justification' for his efforts, are you not? None required.
    If you wish to contest the point, let's hear some opposing argument.

  • scineram||

    Congess can ban contraception unless there is a compelling reason to do otherwise.

  • ||

    There is a compelling reason to do otherwise: most Americans would not approve of it.

  • ||

    Rule number one: Never interfere with a people's desire to fuck.

  • ||

    That's because the opponents haven't made a moral argument against these technologies. They've made a moral non sequitir which can be simplified as "yuck".

    If bioconservatives "argue" that eating ice cream is immoral (as Leon Kass has done); how exactly does one "respond" to this non sequitor.

  • ||

    Citation needed.

  • ||

    The stages of a scientific advance:

    1) Some dreamer considers the possibility.
    2) Someone writes a “gee whiz” science fiction story about it, usually with really bad science.
    3) Someone else writes a “ohmygod” science fiction horror story about it, invariably using really bad science.
    4) Someone makes a movie of the book in item #3, with added explosions.
    5) A lab develops a process that opens the possibility.
    6) Congress holds hearings with NIMBYs regurgitating the story from #3.
    7) Another lab moves the process forward to a viable stage.
    8) Public outrage against the new process from NIMBYs, luddites and most preachers. Also from the left because it is “for the rich.”
    9) It becomes routine and people stop worrying about it. Awards are given to the developers.
    10) The left demands that governments make it available to everyone as a “basic right” at no charge.

  • ||

    Aresen: :-)

  • ||

    hahaha

  • Banjos Kick Ass!||

    That was pure awesome Aresen.

  • CBBTOO||

    Seems like there's a period of several decades between the first and second sentences of stage 9.

    And these religious arseholes are against contraception because it allows people not to have children when they other would and artificial insemination because it allows people to have children when they otherwise couldn't? I wish these morally perfect absolute thuthers would make up their mind.

  • El Duderino||

    LOL. Can someone please show this to the people who are:

    Anti-nuclear power
    Anti-biotech
    Anti-chemistry (still cant believe they exist)
    Anti-stem cell research
    Anti-cloning
    Anti-genetic modification
    Pro-government controlled internet
    Pro-government supervised medicine (FDA fucktards)

    Did I miss any?

  • Thomas O.||

    I wouldn't be surprised if one of these days "human incubators" become viable and commonplace. I did a little "gee whiz science fiction story" on this speculation in my webcomic. The storyline starts here:

    http://www.timeslikethis.com/index.php?id=279

    And if you want to cut to the chase:
    http://www.timeslikethis.com/index.php?id=283

    (A couple notes: Cassie is a time traveler and Nicki is a robot that she purchased from the future.)

  • ||

    Re: "yuck will turn as quickly to yippee"

    There should be a libertarian economic yuck though. Because now the life-ain't-fair condition of infertility has morphed into another "right" to treatment. I.e., a couple can't get pregnant, so it's required that insurance companies and implicitly their policy holders subsidize IVF treatments for infertile couples costing up to a hundred grand.

    I'm sorry, infertility may be tough luck, but it's not an illness. Let couples pay for their own IVF treatments, or even heaven forbid, adopt...

  • El Duderino||

    I dont see why anyone should be forced to cover any illness. If people want to help other people cover the cost of costly medical procedures, then they are free to go ahead and do it, but somebody's illnesses are not the insurance companies responsibility. The insurance company sells a specific product to specific people as INSURANCE in case they get sick. Insurance isn't for people who are already sick, that is what CHARITY is for.

    The only technology liberals are for are the ones that rub conservative Christians the wrong way (stem cell research) or the ones that seem natural, but dont work particularly well (solar and wind energy) and to call these last two "breakthroughs" is akin to calling cow shit a breakthrough in fertilizer.

  • MJ||

    Because a practice is accepted, that makes it morally good?

    That does not follow. Particularly with the shotgun approach to conception and pregnancy that IVF practioners take is, at best, ethically questionable.

  • Ron L||

    MJ|10.5.10 @ 8:25PM|#
    "Particularly with the shotgun approach to conception and pregnancy that IVF practioners take is, at best, ethically questionable."

    Uh, care to back that statement with something that makes sense?

  • mb||

    i think he is referring to the multiple embryos (i.e. tiny developing human beings) that get discarded with each IVF attempt.

  • Ron L||

    So?

  • Ron L||

    And "tiny developing human beings" needs some real support, or it's just one more appeal to emotion.

  • ||

    Easy, Octomom.

  • El Duderino||

    Octomom is not an ethical issue. Her CHOICES may be questionable considering the burden these children will be to her and her community, but there is no ethical issue here. And if you think her children being a burden to the community is unethical, let me just point out that there are only two ways the community can take care of her children. The first way is through charity. Since charity is voluntary, there is no ethical concern. The other is through government intervention. Since government intervention is the government FORCING citizens to pay for octomom's decision, this is an ethical issue, but not because of the procedures octomom underwent, but because of the government policies that require everyone to pay for the results of the procedure.

  • GRRRR||

    I was hoping that this article was going to give me some information on how I can go about getting a perfect little Gattaca baby of my own...
    Disappointment.

  • ||

    I was a test tube baby.

  • Ragnar||

    Why did the Nobel committee take so damn long to give the guy the prize? They lose the paperwork for 30 years or something?

  • DK||

    Happens all the time. The usual reasons for a Nobel taking a long time to be granted is that there is some controversy over who deserves credit, the discovery takes awhile to prove how valuable it is, or there is some ethical/scientific controversy surrounding the discovery.

    Here are a few other cases. MRI wasn't recognized until 2003 even though the initial work was carried out in the 1970s. This was mainly due to a dispute about who published what and when. It took something like 40 years for the discovery of genetic transposition (a huge current research topic) to be recognized. And then there are cases like that of Albert Einstein, who was never recognized for his seminal contribution to physics, the special and general theories of relativity, owing mainly to a lack of experimental verification of these theories until after his death.

  • Brian ||

    Einstein's general theory of relativity was proven in his lifetime - in 1922 in fact. He was given the Nobel for his paper on the photo electric effect.

  • Ron L||

    Naah. He didn't qualify for the 'hate Bush' Nobel, so it took a while.

  • El Duderino||

    They were all waiting in line to blow Barack Obama.

    ...Its a very long line.

  • Kelly||

    The long-term consequences of artificial birth control for women aren't fully known. We do know that women on the pill are attracted to men who are more similar genetically to them than women who aren't using chemical contraceptives. A recent study reported in Scientific American finds that BCP hormones are affecting the structure and activity of the human brain. Asthe SA authors state, "The possibility that an accepted form of chemical contraception has the ability to alter the gross structure of the human brain is a cause for concern, even if the changes seem benign -- for the moment." All is not sweetness and light with the BCP. Our culture decries parts per trillion levels of chemicals in our rivers and lakes, but is largely unconcerned with part per billion levels of articial hormones circulating in the bloodstream of our females. Bit of a disconnect, no?

  • DK||

    Such is the nature of progress. This is not a new phenomenon in the history of science. History is replete with the development of methodologies which worked for a time and were then recognized to have negative consequences. A direct comparison to your issue might be found in DDT, a pesticide that was used for many years until it was found to have negative effects on the environment.

    Of course, history is also replete with negative consequences of ceasing the utilization of a methodology that carries negative effects. Since the ban of DDT, the number of malaria cases in areas in which the chemical's use has been banned has skyrocketed.

    The point here is that new technologies take time to assess. Any benefits will certainly be accompanied by some negative repercussions. The question is whether the positives outweigh the negatives, which can decades of research to determine.

    I agree with your sentiment about the disconnect between what we do to our environment and what we do to our bodies. I can think of no compelling reason why such a disconnect exists. Perhaps it has something to do with the time periods associated with each? One often hears the cry that we need to save the environment for future generations. Individuals don't last that long. Maybe this has something to do with it? It's not compelling, but these types of appeal to emotion never are.

  • Douglas Gray||

    Quantitatively speaking, one of the greatest impacts of modern medical technology is the destruction of millions of female fetuses in India & China, resulting in millions of guys being unable to get wives when they are of age. It's hard to find much that is morally positive there.

    A technology that enables a few infertile couples here and there to conceive? So what? They could easily have adopted.

  • Ron L||

    Douglas Gray|10.6.10 @ 4:54PM|#
    "A technology that enables a few infertile couples here and there to conceive? So what? They could easily have adopted."
    Very kind of you, as a third party ignoramus, to offer your BS.
    Stuff it.

  • ||

    Ron L is a creep who uses personal invective to shut down speech and thought

  • ||

    A baby is a baby regardless of how it is made.

    Look I am all for making babies the old fashioned way (ladies feel free to email me if you are interested in this process), but why would you find IVF to be useless? People want to make babies, it is a genetic predisposition. I am not opposed to adoption, as I am adopted myself, but IVF is easier and less socially complicated than adoption. Unless of course, you think that all babies given up for adoption were given up without some sense of loss by the natural parents.

  • ||

    CORRECTION: Based on M.E.'s comment below, I will amend my comment to say that IVF may not necessarily be easier than adoption, but that said, it is easier than making babies the old fashioned way if it is a physical impossibility for the couple and having it available as an option is important.

  • M.E.||

    It's about time he got the Nobel Prize! IVF gives hope to couples like my husband and I who have medical issues that prevent us from having a child the traditional way.

    To those of you who think infertility is not an illness, you are sadly mistaken. Cancer treatments can cause infertility as can gynecological issues.

    Also, going through IVF is no walk in the park. Neither is the adoption process. It's not like you can walk into the baby store and choose one. People have a right to choose which way they want to go.

  • ||

    M.E. Well said. And good luck!

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