Wanted: Someone to Play God

By NANCY GIBBS

I understand why no politician wants to get between a childless couple and the doctors who offer an answer to their prayers. This is the longing that burns and scars so deeply that we don't know how to talk about it and so privately that we don't want to try. But as medicine redraws the map of what's possible when it comes to making children, we all have an interest in asking how far we should be allowed to go.

It's a good thing that most doctors are principled professionals, since there is nothing to stop them from implanting 10 embryos in a woman hoping to give birth to a softball team. Embryos can be bought and sold and cloned and even implanted in a monkey's womb because this is the most private of industries, a $4 billion business that largely polices itself. Liberals worry about egg selling and womb rental, about poor women being exploited to help rich women have children--but they don't want to push too hard, because reproductive freedom is a hallowed right. Conservatives struggle to explain why they oppose using leftover frozen embryos for stem-cell research but don't oppose their creation in the first place.

So credit two scrupulous professors for making the case that skittish politicians won't. In their new book, Embryo: A Defense of Human Life, Princeton's Robert George and the University of South Carolina's Christopher Tollefsen argue for treating the embryo as inviolable. Their defense, less theological than biological, is that the embryo is a whole, living member of the human species in its earliest stage of development, not just a potential one or a part of one--and if destroyed, that particular individual has perished. From that conviction arise their rules for both research and reproduction: Don't create more embryos than you will implant. No freezing, no choosing, no storing for future use and no experimenting on them.

Adopting these rules would mean that America is catching up with Europe, where governments subsidize more of the costs and so control some of the risks. Italy and Germany forbid embryo storage; England limits doctors to implanting two embryos, or three if a woman is over 40. Sweden and Belgium allow only one. Many lawmakers are driven less by moral than medical concerns, for the health of mother and baby and the costs associated with premature and multiple births. Professional associations in the U.S. also favor limits but stress the need to treat each case individually; they recommend a maximum of five embryos implanted in a woman over 40.

And what of the half a million leftover embryos, which now nestle in nitrogen? "What you do with the frozen embryos you don't use is your decision and yours alone," says the American Fertility Association. But it is not so simple. Are they people--or property? Stored embryos have been treated as part of an estate and the center of custody fights, like the Porsche or the puppy. Conservatives promote adoption as an answer, but some patients don't want their genetic offspring being raised by other people. Should they be required to keep them frozen indefinitely? Should governments pay for custody--and have the right to decide who gets them?

Markets have a way of meeting needs. Already, "reproductive tourists" travel to countries where looser rules might increase their odds of success. Could patients create as many embryos as they like and pick the best, as long as they line up couples to adopt the rest--or sell the extras to offset the costs? This is no wild plan; in the U.K. researchers offer women reduced rates on fertility treatment if they agree to donate half their harvested eggs for research.

Each new adult-stem-cell breakthrough makes the research easier by offering scientists more options, but advances in genetics make the issue of reproduction harder. Couples can screen out embryos for cystic fibrosis and cancer risk. Should they also be allowed to screen for blond, for smart, for straight or gay? We are on a road toward reproduction that doesn't require eggs and sperm at all. This is a moral wilderness, full of hope and traps. I don't expect aspiring parents to bring order to it when all they want is to survive the journey and make a family. That job is surely one for policymakers, to monitor the immense social and scientific experiment we've been conducting in private and make sure that we weigh the risks before we embrace the promise.