In September 2003, a series of working papers were published by the council addressing 'biotechnologies that touch the beginnings of life'. Some of the papers have appeared relatively unaltered as chapters in 'Reproduction and responsibility'. Others have changed dramatically. For instance, most of the recommendations about professional oversight - such as more support for patient decision-making, improving adherence to guidelines or creating minimum standards - went unchanged from the draft to the final report. The council seems to have radically changed its approach, however, in recommendations for legislative control of particular technologies.
In draft form, the legislative proposals suggested prohibitions on a number of routine practices in assisted reproduction such as gamete donation on the grounds that children have the right to no more nor less than two human parents. The draft recommendations also talked of 'respect for early stages of nascent human life', of embryos as 'children to be' and raised the possibility of a ban on the use of human embryos for research. In their final form, the legislative proposals mention none of these issues, instead focusing upon a list of prohibitions not dissimilar from those in place in the UK, including reproductive cloning, the mixing of human and animal gametes and the use of embryos in research beyond 14 days of development. Council member, William Hurlbut, told the Scientist that members could not reach a consensus on the use of human embryos for research, so the final report detailed only those recommendations on which there was unanimity. The fact that a prohibition on embryo research was removed from the final version does not imply endorsement.
Given this silence on embryo research, 'Reproduction and responsibility' has come as a great relief to the pro-research community in the United States, particularly those seeking to prevent a federal ban on embryonic stem cell research. As Pamela Madsen, executive director of the American Infertility Association, says, much of the 'incendiary language' of the draft report has gone, providing some reassurance to practitioners and patients alike.
However, 'Reproduction and responsibility' should not be seen as an endorsement of reproductive medicine. Despite the removal of the embryos as children language, the report is shot through with more subtle disapproval of conception in the laboratory. In an attempt at balance, the opening chapter makes passing reference to the benefits that embryo research can bring to the lives of patients and their babies. But it is promptly eclipsed by an exploration of the council's concerns: 'The existence of the early embryo in the artificial setting of the laboratory... risks isolating and reifying the early stages of human development, thus making it easy to forget their natural place in a continuous, goal-directed, and humanly significant process of human procreation... Treating as 'normal' all the novel things we are learning to do with embryonic human life ex vivo might also desensitize us to still greater departures from the human way of procreating, putting us at risk of weakening, in thought as well as in deed, our regard for the meaning and worth of human procreation.'
This eulogy to natural conception, of which these quotes form just a small part, shows that the President's Council on Bioethics is in no way happy with its unnatural, laboratory-based counterpart. It is understandable that, in the politically charged atmosphere of the embryo research debate in the United States, this report has been seen as a welcome compromise. In the UK and other countries where the stakes aren't as high, we can perhaps be more critical.
Juliet Tizzard is the Founder of BioNews and was formerly Director of the charity that publishes it, the Progress Educational Trust (PET). She is coauthor of Key Issues in Bioethics (buy this book from Amazon UK) and Designer Babies: Where Should We Draw the Line? (buy this book from Amazon UK).