The film Gattaca is a 1997 science fiction thriller about a world where the genetically engineered elite have exclusive rights to space travel, while the In-Valids, who are “naturally conceived,” perform routine, menial tasks to serve and pamper the elite. Vincent, conceived the old-fashioned way in the back of a Chevy, was short and had astigmatism and a weak heart. So his parents, Marie and Antonio, determined not to repeat that mistake, instead opting to give their next child every possible advantage. They also reserved Antonio’s name for their nearly perfect son.
Their in vitro fertilization procedure (IVF) yielded four healthy embryos, two boys and two girls. The scene at the Eighth Day Center, where they were presented with their options, hints at the mingled anticipation and distress that is not too far removed from what some real-life parents experience today.
Marie and Antonio are informed that all four embryos are healthy, with no predisposition for major diseases, such as the heart disease that threatened to end Vincent’s life by the age of 30. They encountered several decision points:
First, they chose the gender, a boy, so that Vincent could have a brother. They asked for specific hair, eye, and skin color. They also wanted him to be heterosexual so they could have grandchildren.
Next, when the doctor offered options for mathematic or musical enhancement, Marie jumped at the thought: “Oh, Anton. Choir!” With reluctance they admitted they could not afford the enhancement. Once they started down the path of their assisted reproduction project, the only barrier restraining them was financial. Despite their desire to keep some semblance of natural conception by leaving a few traits to chance, the doctor genetically engineered the embryos to pick “simply the best of you.”
Before they knew it, they were complicit in the destruction of 75 percent of the embryos they commissioned. Marie’s final question—What will happen to the others?—highlights the reality of IVF and the moral status of the embryo. Although perfectly healthy, they were, after all, as the technician smugly phrased it, “merely human possibilities.” We are left with the implication that the embryos will be destroyed.
Guaranteed Perfection
Gattaca is simply a futuristic and sophisticated refinement, based on advances in technology, of the reproductive model we find in Aldous Huxley’s 1931 novel, Brave New World. Both works highlight the stark realities of a world of controlled reproduction.
In the world of Huxley’s novel, there is guaranteed perfection. There are “no mistakes.” As the various characters explain the Bokanovsky Process, we learn that women “voluntarily” offer their ovaries for egg harvesting, “for the good of society.” They are compensated with a six-month bonus.
The process proceeds along alternate pathways, with several steps:
- There is the one-of-a-kind embryo produced for the highest castes, the Alphas and Betas.
- The lower castes are mass-produced through the Bokanovsky Process. Huxley suggests a kind of “super cloning” process, where as many as 96 identical embryos are produced.
- All the embryos, and later fetuses, are bathed in chemicals designed to bring out the correct traits.
- The conditioning done with chemicals before “decanting” (the word “birth” is an obscenity) continues afterwards through Hypnopaedia. Continual repetition, beginning at the toddler stage, reinforces each child’s desire to conform precisely to the role appointed for his or her caste.
- Only 30 percent of the females are allowed to develop normally. The rest are sterilized. Their infertile state reflects the “progress” that “has brought us out of the realm of slavery to nature,” Huxley’s Director proudly proclaims.
In Huxley’s novel, sex is completely severed from procreation. Sex is for pleasure. Sex is for everyone, and with everyone. Promiscuous sex is for social stability, ensuring that no one becomes uniquely attached to someone else.
Today, in the real world, we have also severed sex from marriage, and marriage from procreation. Sex is an expression of personal preference, power, or pleasure. The procreation of children the “natural way” is still the ideal for some. But for those who have spent their fertile years on non-procreative pleasure, and then later decide that they want to have a child, reproduction is still possible through Assisted Reproductive Technology (ART), that is, through “baby-making.”
A Tour of ART
The oldest ART method is also the lowest-tech one. Artificial insemination by husband, or AIH, involves collecting a man’s sperm and transferring it to his wife’s uterus for fertilization and implantation. AIH was based on methods of artificial insemination first developed for cattle in the U.S. in the late 1930s, and later adopted by many other countries.
A line could have been drawn at AIH, that is, at limiting the practice to the use of a husband’s sperm and his wife’s womb to assist a married couple in the conception of their biological child. But the practice soon expanded to include AID, or artificial insemination by donor, using sperm donated by someone other than the woman’s husband. Furthermore, the donor (the biological “father”) could be either known to the woman or anonymous.
Female infertility itself can be treated in several ways. One way is to use medication. There are a variety of drugs that have different mechanisms that induce the female to produce eggs. Surgery is another way. Surgical procedures may be used to remove obstructing tissue, reverse a prior sterilization, or open a blocked Fallopian tube. If medication or surgery is successful, no assisted reproductive technology may be required.
But if drugs and surgery do not work, the couple may attempt in vitro fertilization (IVF). In this procedure, the woman must take chemical hormones to cause her ovaries to release many more eggs than normal. The mature eggs are harvested through a laparoscopic procedure. Then, the male’s sperm must be retrieved. The sperm are mixed with the eggs in a Petri dish, and the hope is that several eggs will be fertilized. If they are, then one to six days later, one or more of the embryos are transferred to the woman’s uterus, where implantation may occur. If the sperm do not successfully penetrate and fertilize the eggs, then they can be injected directly into the eggs via ICSI, or intracytoplasmic sperm injection.
If a couple desires a child but the woman is not able to bear one herself, the couple may seek the services of a gestational surrogate. This is a woman who agrees to be inseminated with the commissioning man’s sperm, or to be implanted with an embryo created by others. Her primary function is to go through pregnancy and childbirth on behalf of another woman. A surrogate can be altruistic, that is, someone who does not receive money for carrying the child but simply desires to help a family member or friend. One vivid recent example is Jaci Dalenberg, who gave birth to her triplet granddaughters in 2008.
Surrogates can also be commercial, that is, women who receive compensation for carrying a child for someone else. Because of legal and cultural barriers against baby selling, such arrangements are usually structured as payments for the surrogate’s medical care and delivery, plus compensation for her time and suffering.
In both altruistic and commercial gestational surrogacy, the woman is the biological mother of the baby or babies she gestates. In some cases, she may be the genetic mother as well, that is, someone who agrees to have her own eggs inseminated with the sperm of the contracting male. This is becoming less and less common, however, as women tend to get attached to babies who share 50 percent of their DNA.
Baby-making used to involve only one man and one woman. All of these ART methods involve at least one “third party,” such as a doctor, and some of them inevitably involve third-party gametes from donors as well. We’ve been told it takes a village to raise a child—but to make one, too?
This should prompt us to take the time to stop and reflect on where we are and what we’re doing. The competing drives to both end and initiate pregnancy at will, assisted by rapidly developing technologies, have blunted our moral awareness of the transcendent issues in baby-making. Our cultural myopia was foreshadowed by Huxley’s character, . Mustapha Mond, the Resident World Controller in Brave New World, when he proudly announced, “Mindless pleasure, love without emotion, supreme serenity . . . and best of all . . . there is no time to think!”
Fractured Bonds
The story of ART in law and policy begins with two Supreme Court cases, Griswold v. Connecticut (1965) and Eisenstadt v. Baird (1972). In Griswold, the Supreme Court struck down a never-enforced Connecticut law prohibiting the distribution or use of contraceptives, even by married couples. The Court questioned whether we would “allow the police to search the sacred precincts of marital bedrooms for telltale signs of the use of contraceptives?”1 It concluded that the law violated the right of marital privacy.
A line could have been drawn there, but it did not hold. This was, after all, the era of hippies, “free love,” and the birth control pill. In 1972, the Court did an about-face on its statement about marital privacy. It ruled that “if the right of privacy means anything, it is the right of the individual, married or single, to be free from unwarranted governmental intrusion into matters so fundamentally affecting a person as the decision whether to bear or beget a child.”2
It was but a short step from the right to use birth control to prevent a pregnancy to the right to have an abortion to end a pregnancy. Just one year later, in Roe v. Wade, the Supreme Court ruled that a woman has a constitutional right of privacy that includes the right to choose to terminate her unwanted pregnancy. When Roe is read together with its companion case Doe v. Bolton, as the Court explicitly directed it to be, the “privacy right” is exposed as essentially a right to abortion throughout pregnancy for virtually any reason.
The right not to continue a pregnancy implies a right to control, not just the spacing and timing, but also the fate of one’s own offspring. Through the invention of this “right,” an important feature of the parent-child bond was fractured.
The New Babies
Just five years after Roe, the first “test-tube baby” was born. Louise Brown, born in 1978, was produced from her mother’s and father’s gametes, mixed via in vitro fertilization. The embryo was placed in Lesley Brown’s uterus, below her blocked fallopian tube. The world celebrated Louise’s seemingly miraculous birth.
What was perhaps less well known was the price of her birth. Before Lesley Brown’s successful IVF pregnancy, researchers had created over 80 embryos and transferred them into women’s wombs, and all of these embryos died. “Happiness must be paid for,” says Mustapha Mond near the conclusion of Brave New World. Lesley and John Brown’s happiness was paid for with research that did no good for at least 80 unborn children. Good and noble goals sometimes have a high price. The question we should ask is whether that price was worth paying.
In another significant development, researchers figured out how to cryopreserve, or freeze, human embryos. This meant that when IVF produced an abundance of embryos, the “excess” embryos could be frozen for future use—another technological hurdle overcome, another line crossed. The first birth from a frozen embryo occurred in 1983.
By this time, “baby making” also involved anonymous men to donate sperm, technicians to harvest, inspect, and fertilize eggs and to inspect embryos, and doctors to transfer embryos into women’s wombs. And still society did not draw the line at providing such material or technical assistance. After all, the reasoning went, women who are infertile due to blocked tubes can have their tubes unblocked or bypassed. But what about the woman with an inhospitable womb? Should she, because of ethical scruple, be barred from parenthood?
Worst-Case Scenarios
Enter the case of Baby M, born in 1986 to Mary Beth Whitehead. Mrs. Whitehead was inseminated with sperm from William Stern. Stern’s wife, Elizabeth, was not infertile. She had multiple sclerosis and did not want to incur any health risk from pregnancy. So the Sterns commissioned Mary Beth Whitehead to be their gestational surrogate. But problems arose when Mary Beth became attached to her baby and refused to give up the child. A legal battle ensued. Just who was Baby M’s “real” mother, anyhow?
In a Solomonic decision, the New Jersey Supreme Court declared “payment of money to a surrogate mother illegal, perhaps criminal, and potentially degrading to women.”3 The court awarded custody to Mr. Stern and visitation rights to Mrs. Whitehead. When Baby M turned 18, she terminated Mary Beth Whitehead’s parental rights, and Elizabeth Stern adopted her.
The Baby M case was an illustration of “too many parents.” The next legal battle was over “not enough.” The first courtroom battle over frozen embryos was fought in 1992 in Davis v. Davis.4 Mary Sue and Junior Davis tried to have children via IVF, without success. Before the final attempt, Mary Sue’s doctor became aware of cryopreservation and froze the embryos that were not transferred to her womb. The attempt failed, and so did the marriage. Mary Sue couldn’t save her marriage, but she wanted to save her children by donating the frozen embryos to someone else. Junior opposed the idea. They went to court, and Junior Davis won.
In weighing Mary Sue’s interest in donation against Junior’s interest in avoiding parenthood, the Tennessee Supreme Court reasoned thusly:
Refusal to permit donation of the preembryos would impose on her the burden of knowing that the lengthy IVF procedures she underwent were futile, and that the preembryos to which she contributed genetic material would never become children. . . . [But] If she were allowed to donate these preembryos, he would face a lifetime of either wondering about his parental status or knowing about his parental status but having no control over it. . . . Donation, if a child came of it, would rob him twice—his procreational autonomy would be defeated and his relationship with his offspring would be prohibited.5
Note that the court decided that the embryos were actually “preembryos.” As such, according to the court, they were entitled to “special respect,” a legal status that placed them above human tissue but below human persons. And because the Davises did not have a prior agreement about their “preembryos,” the court ruled that Junior Davis’s wishes should prevail.
In spite of all the thorny problems it exposed, Davis v. Davis did not lead to a cessation or even a slow-down in the freezing of embryos. No one has kept good track, but fifteen years after Davis, it was estimated that half a million embryos resided in liquid nitrogen tanks at various clinics around the U.S.
Children Without Sex
From diaphragms for married couples to paid surrogates to frozen embryos, no legal lines held. In less than two generations, we moved from demanding “sex without children” to producing “children without sex.”
In 1972, six years before IVF succeeded for the first time, Christian ethicist Dr. Paul Ramsey predicted the trajectory that assisted reproduction would take. Nearly thirty years later, Gilbert Meilaender noted the fulfillment of Ramsey’s prophetic insight that ART would be “less likely to treat and remedy a medical problem than to provide the desired product by other means.”6
Those “other means” have come to include the use of donor sperm, creating a curious kind of social myopia. Meilaender has written poignantly about this twist of events:
When we turn procreation into reproduction, disaggregating its parts, we create difficulties for ourselves that we do not always want to acknowledge. . . . The man who fathers a child because of a one-night stand will be held legally responsible to support that child throughout his minority. “But if a college student visits the local sperm bank twice a week for a year, produces a dozen children, and pockets thousands of dollars, he can whistle his way back to econ class, no cares, no worries.” Thus, Kay Hymowitz notes, “by going to a sperm bank, women are unwittingly paying men to be exactly what they object to.”7 (emphasis mine)
The irony here would be funny if it did not reflect our serious moral predicament. On the surface, it appears that modern reproductive technology allows us to realize our deepest desires and wants without any moral strings attached. Of course, we are deceiving ourselves, but does anyone even care? Again, Meilaender reflects on the insight of Ramsey, who wondered, if the practice of medicine makes this turn to “doctoring desires,” then
is there any reason for doctors to be reluctant to accede to parents’ desire to have a girl rather than a boy, blond hair rather than brown, a genius rather than a lout, a Horowitz in the family rather than a tone-deaf child, or alternatively, a child who because of his idiosyncrasies would have a good career as a freak in the circus?8
This sounds a lot like the scenario at the Eighth Day Center in Gattaca, where Anton and Marie select various characteristics for their future child. Is this the brave new world we really want?
This article is excerpted and adapted from a lecture originally presented at Trinity International University, Deerfield, Illinois, and was published in the Spring 2011 issue of Dignitas, the quarterly publication of The Center for Bioethics & Human Dignity.
The original lecture is available at www.cbhd.org.
Endnotes
[1] Griswold v. Connecticut, 381 U.S. 479, 485 (1965).
[2] Eisenstadt v. Baird, 405 U.S. 438, 453 (1972)(emphasis in original).
[3] In re Baby M, 537 A.2d 1227, 109 N.J. 396 (N.J. 1988).
[4] Davis v. Davis, 842 S.W.2d 588 (Tenn. 1992).
[5] Id. at 604.
[6] Gilbert Meilaender, Neither Beast Nor God: The Dignity of the Human Person (Encounter Books, 2009), 35.
[7] Ibid., 32. See also Kay S. Hymowitz, “The Incredible Shrinking Father,” City Journal, 17, no. 2 (Spring 2007), https://www.city-journal.org/html/incredible-shrinking-father-13009.html.
[8] Paul Ramsey, “Shall We ‘Reproduce?’” The Journal of the American Medical Association 220, no. 1 (1972), https://jamanetwork.com/journals/jama/article-abstract/342813, quoted in Meilaender, id., 35–36.