& infertility, IVF, surrogacy, cloning and other birth technologies.
This is a brief look at the various ways humans seek to propagate themselves, to pass on their genes, and how they seek to overcome obstacles such as infertility. It looks at the diverse and sometimes covert behaviour that has occurred and some of the possible solutions to the problems of infertility. It is an argument for responsible reproductive freedom, the freedom to have wanted children and the freedom to avoid them when they are not wanted, an argument in favour of the control of our own genes, and how they are used. We are the product of our genes, as Richard Dawkins suggests in The Selfish Gene 1976; gigantic lumbering robots that carry our genes, designed principally to ensure the survival and replication of those individual genes. This survival of the genes probably manifests itself in the human species by following not one but several strategies, sometimes simultaneously. The basic strategy is simple and is common to most animals. Simultaneous sexual attraction ultimately leads to coitus and pregnancy. The female animal finding herself with young must then ensure their survival until they can become independent. We must assume that there are two basic instincts, to mate and to care for the young. One follows the other but they can act independently. We can also argue that our genes program us to favour our own young over the young of more distant relatives of our species, or the young of other species.
The range of behaviour
In the human species, we find a range of sexual behaviour, of pairing or bonding behaviour, and a range of child rearing patterns. Here we look at some of that behaviour but reporting on the behaviour here does not necessarily imply agreement or endorsement of that behaviour.
In most traditional human societies, the female gained an advantage by attracting and keeping a male who would then assist her with the provision of the shelter and food so essential for the survival of her young. The modern trend to provide state funded welfare for single mothers and alimony or more equitable division of matrimonial property when relationships split, has provided an alternative that allows some women and some men to raise children alone. The best-known pattern is for the establishment of a family unit ? not necessarily a nuclear family but an extended family unit. Such families may include grandparents and uncles and aunts as well, all working toward the common economic goals of providing the shelter and food necessary for the survival of the family unit and the successful rearing of the young.1, In an extended family, Infertile people could bring economic advantage and help raise their nieces and nephews. Yet, even when such patterns are the norm we see alternative patterns of behaviour.
A common element in many societies is the marriage of close relatives, the marriage of cousins or second cousins1 mixed with a degree of intermarriage with more distantly related people. Such relationships have the advantage of ensuring compatible cultural behaviour for the couple, a high level of support from relatives, minimise the dilution of economic assets, and give promise to higher stability in the relationship. The risk of genetic problems in the offspring increases slightly but they tend to be self-eliminating. The alternative, outbreeding, a feature of many highly mobile modern societies where people are able to meet and marry people who are not close relatives, tends to mask undesirable genes allowing them to increase in frequency until a similar rate of genetic anomalies occurs. Cousin marriage, mixed with some outbreeding, may also provide the best evolutionary results.
Digressing for a moment we may find a look at the behaviour patterns ducks interesting. Three New Zealand Ducks are described by T. A. Caithness and Dr. M. J Williams of the New Zealand Wild Life Service in The Complete Book of New Zealand Birds, Readers Digest 1985. The New Zealand Gray duck and the closely related Mallard duck, introduced to New Zealand from America during the 1930s, are able to interbreed but do have some differences in behaviour and preferred habitats that have allowed them to continue as separate types. Gray ducks pair in winter, June, and spend all their time together, searching for a nest site and establishing a nest, until incubation begins from September onward. After a few days of incubation, the male loses interest in his companion who will now leave her nest for only two brief periods a day. He leaves and goes looking for another solitary female that he might establish a pair bond with. The behaviour of the Mallard is similar except that the males are more aggressive in their pursuit of females. When the Mallard drakes leave their incubating females they will form gangs that search for either Mallard or Gray solitary females, those not incubating, and forcibly mate with them. These gang rapes by big groups have been known to result in the exhausted female drowning when the attacks occur on the water. These rapes account for one fifth of all egg fertilisations. As a result of the more aggressive behaviour of the Mallard it has replaced the Gray over large parts of New Zealand and the Gray which formed 95% of the dabbling duck population in 1960 now comprises less than 20% and tends to be limited to areas remote from human habitation which the Mallard seems less inclined to exploit. The Paradise shelduck shows another variation in behaviour. Females nearing maturity incite males to fight one another and then choose mates from among the more successful. Pairs will then stay together for life but will mate again if their first mate dies.
These examples illustrate how different mating behaviour is genetically determined and is evoked at an appropriate time in response to environmental stimuli. With mammals, specific behaviours can be selected and deliberately bred into the offspring. Some readers may have already drawn parallels with human behaviour. It is possible that we have a range of genetically determined behaviours that can be evoked at an appropriate time and that some of us may have a greater genetic predisposition for some behaviours rather than for others. With a range of behaviours open to us we are also able to exercise choice.
Some men are content to put all their effort into the survival of the offspring from one partner, sometimes more than a dozen, or will seek a polygynous relationship with several wives. Other men are known for their serial polygyny, abandoning their partner before or after the birth of one or more children and then forming a new partnership with a second female to produce more offspring, repeating this pattern a number of times. Some men will wait until their first offspring are able to fend for themselves before seeking a younger wife to start a second family. Polyandry, where a woman has several husbands, has also played a part in some human societies ? societies where an economic benefit helps the survival of the young. We could debate the arguments for and against concurrent or serial polygyny and polyandry as a means of ensuring the survival of offspring. In the past, the early abandonment of a female and children reduced the chances that the offspring would survive. Serial polygamy seems to be a modern phenomenon brought about by Christian attitudes against concurrent polygamy, and is supported by welfare payments. To the male, welfare is a gift that frees him from the cost of child rearing enabling him to spread his genes with a series of other females without personal economic cost. Governments are now reacting to this and attempting to ensure that the father of a child pays a share of the costs of rearing his children.
Within seemingly stable partnerships, we also see other behaviour. Either partner may seek out a third party to mate with on a relatively short-term basis. For the male, we may say that he is attempting to find alternative means of ensuring that his genes survive and that he is maximising the number of his descendants. For the female who continues to hold her permanent partner while mating with other males we might say that she is perhaps trying to find alternative or superior genes with which to blend her own in order to ensure the survival of some of her own genes. In doing so she may need to convince her permanent partner that the young produced are all his so that he will continue to provide the support she seeks.
The sowing of wild oats is a well-recognised behaviour amongst some young males not yet ready to form a permanent partnership for child rearing. Basically it is a desire for a variety of sexual experience that is often attributed to young males but if we see it as only a male behaviour we overlook the cooperation of the young females involved and overlook the aspects of this behaviour that lead to so many unwanted pregnancies even when contraceptive knowledge is adequate. Many young males are known for using various forms of persuasion including deception, cunning, and emotional blackmail to convince young females that they should indulge in sexual behaviour and not adopt safe sex practices and some young woman are prepared to go along with this.
Now they swarm in huge colonies, safe inside gigantic lumbering robots ?
This purple passage (a rare?well, fairly rare?indulgence) has been quoted and requoted in gleeful evidence of my rabid ?genetic determinism?. Part of the problem lies with the popular, but erroneous, associations of the word ?robot?. We are in the golden age of electronics, and robots are no longer rigidly inflexible morons but are capable of learning intelligence, and creativity. Ironically, even as long ago as 1920 when Karel Capek coined the word, ?robots? were mechanical beings that ended up with human feelings, like falling in love. People who think that robots are by definition more ?deterministic? than human beings are muddled (unless they are religious, in which case they might consistently hold that humans have some divine gift of free will denied to mere machines). If, like most of the critics of my ?lumbering robot? passage, you are not religious, then face up to the following question. What on earth do you think you are, if not a robot, albeit a very complicated one? I have discussed all this in The Extended Phenotype, pp. 15-17.
The error has been compounded by yet another telling ?mutation?. Just as it seemed theologically necessary that Jesus should have been born a virgin, so it seems demonologically necessary that any ?genetic determinist? worth his salt must believe that genes control every aspect of our behaviour. I wrote of the genetic replicators: ?they created us, body and mind? (p.20). This has been duly misquoted (e.g. in Our Genes by Rose, Kamin, and Lewontin (p. 287), and previously in a scholarly paper by Lewontin) as ?[they] control us, body and mind? (emphasis mine). In the context of my chapter, I think it is obvious what I meant by ?created?, and it is very different from ?control?. Anybody can see that, as a matter of fact, genes do not control their creations in the strong sense criticised as ?determinism?. We effortlessly (well, fairly effortlessly) defy them every time we use contraception. q
(Richard Dawkins. The Selfish Gene 2nd edition 1989. pp 270-271.)
A female equivalent of the wild oat syndrome is the perhaps less common cuckoo syndrome, providing babies for other peoples nests. Often it is the grand parents or other members of the extended family group who take over the child rearing for a young female but some females are content to provide a series of offspring for other non-related people to adopt. Some intelligent and well-educated young women may produce several children, fathered by different males, and put them all up for adoption, despite the possibility of welfare support and proposals of marriage. With the more relaxed open adoption rules we now have they are able to meet the prospective parents and retain contact with the child.
With welfare help, other young women have deliberately started sole parent families with a series of selected but absent fathers. For other women, welfare payments are a means that allow them to shift from very unsatisfactory relationships to better ones but again it has allowed some women, like some men, to abandon relationships for almost trivial reasons and raise families as solo parents supported by the state.
While the wild oat and cuckoo syndromes may increase the number of offspring a person may produce, it would seem to be a less successful strategy for ensuring the survival of the offspring than permanent relationships and hence tends to be minority behaviour. An exception may be those communities where welfare payments have become a more reliable source of income for females than irregular male incomes and where we now find that single female parents have become the norm. Modern and state provided medicine also helps support the survival of such children.
It is possible that rape also has a genetic link as it does with Mallard ducks. Upbringing may influence the tendency to rape and counselling can be used to counter the behaviour but the initial tendency may be inherited. In some cases, male children produced by rape have in turn become rapists, either from a genetic tendency or because of their upbringing. It was once thought that rape was most often violent rape by a stranger, but it is now recognised that rape is more likely to be rape by a person known to the victim, perhaps date rape, or rape in circumstances where the victim may not be believed. A lot of male coercive or seductive sexual behaviour comes close to rape. In the past rape may have accounted for at least a percentage of human conceptions.
It seems that we have evolved a number of strategies for ensuring that it is our genes and not those of others that survive and we can postulate that human evolution is still proceeding. Researchers have discovered that less than 40% of people alive 10 generations ago (300 years) have living offspring. Killer sperm are a recent discovery. It seems that amongst the millions of genes that men produce, some do not race to fertilise the ovum but wait behind to block or strangle foreign sperm produced by other males. A male may leave his sperm behind in his partner when he departs in the morning protecting her from conception by other males, voluntary or otherwise.
In some social circumstances, we find that normally cooperative people can become competitive when sexual opportunity is perceived.
Disease and variations in human behaviour.
The evolution of sexually transmitted diseases has also resulted in limits to human behaviour. Some of these diseases can cause infertility and others death. Consequently people with a disposition toward short-term relationships with many partners may have become infertile or died, limiting the number of their offspring. People who restricted themselves to permanent partners with whom they produced offspring were able to raise large families.
Ethics, morality and religion.
With behaviour determined or influenced by our genes, our reason tends to follow our instincts rather than determining our behaviour. Thus a couple in a permanent relationship and raising children might feel that allowing extramarital sexual relationships is a threat to their relationship and the consequent well being of their young so they argue against such relationships. The children of abortionists finding themselves in a barren relationship and desperate to nurture children may reason against abortion ? it limits the supply of children for adoption. People use reason to justify their instinctively desired actions and to justify and support their past actions.
Looking at human behaviour and customs on a world scale reveals that morality is based on local circumstances. Polygyny (more than one wife) was formerly the excepted norm for human societies. If polygyny, rather than polyandry (more than one husband), provides the best economic answer for child rearing for the region then it is favoured and if the opposite is true then polyandry is favoured. Other regions fall in the middle.1 In general, polygyny has been favoured by those societies where the death rate is higher for men and where land is plentiful allowing women to create gardens to support the family, and polyandry has been favoured by a minority of societies where arable land is very restricted, such as some communities living in the high mountain valleys of the Himalayas.
Some polygynous families gained from the presence of an infertile woman. She was able to satisfy her need to nurture children by assisting in the raising of the family?s children and could bring economic advantage to the family by helping with the supply of food and shelter. Some women in these families prefer to deliberately remain without children of their own (Interviews of polygynous woman from Turkey to Pakistan, Iain Middleton and Kyle McCarthy, 1979).
Local custom, or culture, generally reflects the best economic answer for the area and religion reflects the local culture but religion may then impose the behaviour as an inflexible god given moral law. It is not always true that religion provides the best answers. Religion tends to pick up other aberrant ideas and beliefs to create a distorted morality and then to transplant those beliefs to other regions and future times where they may not be suited or are no longer relevant. Thus, Christianity has picked up the aberrant belief in the evil of sexual behaviour of any kind from a Persian distortion of Greek ideas and sought to limit sexual behaviour through the imposition of strict monogamy and has then taken this with it around the world.
During the last two hundred years, Western societies have, partly because of increased mobility, seen a trend toward the isolated nuclear family with all individuals expected to marry and form permanent monogamous relationships and to raise children. Improved record keeping, the reduction of geographic isolation and a tendency to strictly enforce permanent relationships have reduced options for infertile people and those who do not wish to follow normal patterns.
Infertility past and present.
While the majority of people have little difficulty with conception and need to limit the number of their offspring to give greater advantage to those they do produce, some people do have trouble. Most people have a desire to pass on their genetic material but infertility has always been a problem. It is a problem for about one out of six or 16% of couples and indications are that the rate of infertility is increasing. This increase can be attributed in part to the increase in the incidence of some sexually transmitted diseases following the greater sexual freedom after the introduction of contraceptive pills in the early 1960?s, and to other causes such as falling male sperm counts and reduced female fertility that may result from environmental pollution, overweight, and smoking.
In the past, societies developed strategies for dealing with infertility. In some traditional societies, including parts of rural England, marriage took place after the pregnancy of the female was confirmed. (Barbara Taylor Eve and the New Jerusalem: Socialism and Feminism in the Nineteenth Century, 1983). If pregnancy did not occur, the couple could split and find alternative partners in their quest for conception. But in other societies where religion was important and marriage was always supposed to precede conception, divorce was frowned upon and was generally prevented and this resulted in infertile couples with little chance of procreation.
In polygynous societies, if the first wife proved to be barren, a second wife, often selected by the first, could be invited to join the marriage. Turkish writer, Alev Lytle Croutier, in Harem: the World Behind the Veil 1989, tells of an example in Turkey from her own experiences. Likewise, polyandry would mask or overcome male infertility.
In other societies, particularly strictly monogamous Christian societies that did not allow pregnancy before marriage, when male infertility was suspected some females would establish an alternative and often-covert liaison in the hope of achieving pregnancy. But without her husbands? knowledge and cooperation a wife could risk destabilising their relationship or risk the husband rejecting the offspring he suspected were not his. Alternatively, another woman might act as a surrogate and surreptitiously give birth to the family?s children. In the past, the isolated nature of farms in some rural areas made it relatively easy to conceal a pregnant female and after birth another woman could claim to be the mother.
In New Zealand, the trend toward improved maternity care and hospitalisation for all mothers giving birth made it difficult to substitute mothers in this way, but "double standards" that often encouraged male promiscuity before marriage and discouraged contraceptive information ensured a supply of young unmarried pregnant women. These young women could be persuaded or coerced and sometimes tricked into giving up their babies for adoption. Some were told, immediately after giving birth, that their baby had died and were then asked, while still in a shocked state, to sign a paper relating to the birth and death without independent support or advice. Some found out years later that the paper was an adoption agreement. Pressure on some young women continues today.
Adoption and sperm donation.
Adoption is known to occur with animals, members of a group can take over the nurturing of young when a parent dies. Pregnant ewes that have yet to give birth will often attempt to adopt a lamb born nearby. Domestic cats and bitches will sometimes adopt the offspring of other species and produce milk for them.
In our society, legal adoption is a relatively recent innovation. In 1881 New Zealand became the first country in the British Empire to legalise adoption. The new adoption law recognised and sought to control what had been a covert practice, the trade in unwanted babies known as baby farming, and sought to provide a solution to the crowded and costly orphanages and the problems of destitute children.
Before the 1881 adoption law, baby-farmers provided a social service. They usually worked covertly and would take unwanted children from single teenage mothers or poor families with too many children and offer them to couples who wanted children but had been unable to produce their own. They would accept donations from both parties to cover their expenses and provide an income. The practice had problems; the exchange of money could encourage some people to snatch babies and sell them to baby farmers who would find new homes for them. In 1895, Minnie Dean, known as the "Winton baby-farmer", was accused of killing babies some years earlier, presumably when the local supply exceeded demand, and she became the only woman in New Zealand history to be executed despite her protestations of innocence ? she claimed the children had died of natural causes. The new adoption law sought to overcome the problems associated with baby farming by providing a free service and making it unlawful for payments to be made for babies.
With the new law, adoption soon became the normal remedy for childless couples. Society now acted to convince them that it was their duty to adopt children and babies were provided free. Barren couples, thwarted in their desire to propagate their own genes, still felt the instinct or desire to nurture children and were willing to adopt and single mothers were pressured to supply the babies. The orphanages were progressively emptied and the cost of running them removed from the state.
In New Zealand before 1970, a near balance in the number of babies available for adoption and the number of childless couples seeking babies was achieved. This was probably due to a lack of sound government policy rather than skilful management. The balance was achieved by controlling acceptable behaviour, the "double standards"; and by restricting contraceptive knowledge and supply to young people resulting in a relatively high teenage pregnancy rate.
In other countries the balance was not achieved and shortages of babies for adoption led to black markets. Babies or children were stolen to order for often unsuspecting parents prepared to pay high prices for them. Other prospective parents travelled to countries where babies for adoption can be supplied from orphanages or be purchased from desperately poor mothers. So strong is the instinct to nurture children in some people it leads to desperation ? particularly when a woman over 30, who has dreamt since early childhood of having her own family, finds she is unable to conceive.
The improvements in medical science during the 20th century allowed the causes of infertility to be better determined. Artificial insemination methods using sperm from the husband could be used for some problems and sperm from a donor for others. For some men donating sperm was the ultimate means of spreading genes with no personal cost, for others the lack of personal sexual benefit and concern over who might receive their sperm and how the children might be raised were disincentives. For the couples receiving the donated sperm, the lack of knowledge about the donor and his genetic history could be a disincentive. Often it was the female?s desire for a child to propagate her genes that overrode the concern about the lack of knowledge of the donor. Some sperm banks deliberately mixed the sperm from several males to preserve the anonymity of the donors. Years later the offspring of such inseminations wondered just who their genetic father was and have found it difficult to trace their genetic ancestors. Some children so produced have equated the practice of sperm donation with rape by a stranger!
Adopted children also began to demand knowledge of their genetic ancestors and many women who gave up their children for adoption continued to wonder and pine for their lost offspring. Adoption bought with it other risks. A loved baby could grow to be a troublesome teenager and rejections between parents and child could occur. While many adoptions were successful some adopted children grew up feeling that they had been rejected by their genetic parents, that they had been deceived, and that they were now unwanted and unloved by their adopted parents. Anne Else, writing in New Zealand Humanist (September 1994),2 describes how she, as the child of a successful adoption, still felt the need to make contact with her genetic mother who gave birth to her. She goes on to question the wisdom of any birth process, such as adoption or sperm and ova donation, which separates a child from her genetic ancestry.
Adopted children have been found to be at a much higher risk than natural children of being physically, emotionally, and sexually abused, or killed by their adoptive parents. In 1978 a study by Daly and Wilson found that a stepparent was between 40 and 100 times more likely than a biological parent to kill a young child.
New Zealand Adoption figures
From 1955 to 1971, the number of babies being placed for adoption increased steadily. In 1955, 1,366 babies were adopted but by 1971 the number had increased to 3,231. Strangers adopted the majority of babies, 72% in 1955 but by 1971 this had declined to 67%. Non-stranger adoption included adoptions by one of the birth parents, other relatives, and other non-strangers. In addition to the known adoptions, other adoptions occur that may increase the totals by about 10%. These adoptions include informal Maori adoptions and other informal adoptions where other family members or non-strangers assume responsibility for a child?s upbringing. Adoptions by strangers are regarded as relatively rare for non-formal adoptions.
From the early 1970?s, the supply of children for adoption has dwindled. In the 1960s, welfare authorities were concerned at the annual increase in babies being placed for adoption. They believed that the sexual liberation of the 1960s would result in an increase in teenage pregnancies and reacted to a perceived possible oversupply of children for adoption. In reality, the increase in babies being placed for adoption was largely due to the post-war baby boom that had now reached childbearing age and the number of couples seeking to adopt continued to provide homes for these babies. But the welfare authorities now believed that it was better for a young never married single mother to raise her own child, believing that the responsibility of a child would discourage these mothers from having more children before marriage. In some cases this may have worked but not in all. Single, never married, mothers with several children have become common in some areas of New Zealand, and the state provides funds to support them. This has resulted in consequential increases in welfare costs to the nation.
The number of babies available for adoption peaked in 1971 but has declined since. Continual improvements in sex education, contraceptive knowledge, the availability of the pill since its introduction in 1960, improved availability and reliability of contraceptives generally, allowing some legal abortions, and welfare payments that allow young mothers to keep their children, have all reduced the supply of babies for adoption. By 1996, the number of babies placed for adoption was just 14% of the 1971 number, despite an increasing population.
In 1971, 3,231 babies were placed for adoption with 2,176 or 67% adopted by strangers. In 1996, 484 babies were placed for adoption with just 114 or 23% adopted by strangers. In 1971 the number of babies available for adoption substantially met the demand from infertile couples, but by 1996 the supply of babies met significantly less than 10% of the demand. There have been increases in inter-country adoptions but in 1996 only 70 babies were adopted from other countries.
The trend away from adoption by strangers is related to a move away from closed adoptions where adopted children are deprived of all knowledge and access to their natural parents, formerly considered to be in the best interest of the child, toward open adoptions where the child is raised with full knowledge of and access to their natural parents. Traditional Mäori adoption is of the open type. Open adoption is now favoured by welfare authorities and is usually favoured by women giving up their children for adoption but current New Zealand adoption law prohibits open adoption!
New Zealand now has more than a 100,000 infertile couples and in any one-year we might expect that some 10,000 couples are unsuccessfully seeking to conceive a child. With the supply of babies available for adoption significantly curtailed, couples with fertility problems have turned to other alternatives, such as adoption from other countries and new reproductive technologies. There are problems with inter-country adoption and welfare authorities do not encourage it ? the result is a substantial increase in demand for fertility treatments and other birth technologies.
New birth technologies
The shortage of babies for adoption and growing concerns about closed adoption, where the adopted children have no knowledge of or access to their natural parents, put greater pressure on couples to conceive their own children but medical science provided new possibilities. An infertile woman could be given fertility treatment ? hormones to stimulate ovulation. The risk was the simultaneous production of too many ova, multiple births were an unwanted result. In vitro fertilisation (IVF, meaning in glass) was introduced to overcome cases of tubal obstruction. In 1978, Louise Brown, the first so-called test tube baby, became headlines around the world but the practice is now relatively common and babies produced by this procedure do not rate mention in the news. The cost however prevents many couples using it and reliability remains a problem. For the couple however the result was satisfactory, the child was a mixture of their genetic material and could be treated as a normal child in all respects. In a knee jerk reaction, some religious authorities sought to ban IVF as they thought it was an interference with god?s plans, but few governments have moved to outlaw it.
Still all the problems were not solved. Some women were able to produce ova but not able to give birth to a child. Here, in vitro fertilisation could be used to implant the fertilised ovum into another woman. Sometimes the female?s mother or sister would volunteer to act as a surrogate, carrying a child for their close relative. Here we may see in operation the instinct to perpetuate the survival of some of one?s own genes by helping to propagate the common genes of a close relative. In this respect, it differs little from the assistance that a grandmother or an aunt might offer after a birth as members of an extended family. Risks and problems are almost unknown. Despite this, some countries including New Zealand, have either prevented or outlawed all forms of surrogacy or put obstacles in the way that make it difficult for many people to use surrogacy!
Funding Infertility in New Zealand
Funding varies from region to region and waiting lists are long. Health authorities are inclined to give low priority to infertility, preferring to devote funds to people with treatable conditions and illnesses where the quality of life can be improved. As a result, fertility services are not available in many areas and clinics must make decisions on the allocation of available funds. Clinics prefer to spend money where results are most likely to be achieved. The Human Rights commission have suggested however that this, particularly a preference for treating women younger than 30, contravenes Human Rights legislation and have suggested the use of a lottery system.
To resolve the issues, a new report prepared by Associate professor Wayne Gillett of Otago University and John Peck of Fertility Associates for the National Health Committee, recommends that the $4.5 million spent annually (well below comparable nations) should be doubled and funds allocated according to a scoring system. Points would be allocated according to the probability of success, taking into account factors such as contributing disease, weight, smoking and age; social criteria such as length of infertility and the number of children already in the family and exclusion factors such as mental instability and the risk of child abuse. q
When an unrelated female is asked to act as the surrogate and carry a child that has no genetic relationship to her the problem becomes more complicated. In principal, it could be controlled with a simple legal contract. She provides a service in return for a sum of money ? few are prepared to do it without monetary compensation. Experience has shown that when the surrogates are carefully screened problems are rare. Some women are quite prepared to provide this service for others and it has its similarities with the cuckoo syndrome. In this case, she has no genetic claim on the child but in rare cases problems can occur when the mother becomes attached to the child she is carrying and then finds that she does not want to give it up after birth. She may have to fight a natural bonding instinct that bonds a mother to the child she carries and gives birth to. Interestingly, despite the long history of evolution, many women will deny having or feeling this instinct but exhibit it just as strongly as any other animal. Perhaps it is easier to observe it than to feel it.
Some countries have banned commercial surrogacy but allow expense payments to surrogate mothers. It is found that these expense payments tend to be as large as the payments made in countries where commercial surrogacy is allowed and when the expense payments are limited by law additional payments are often made surreptitiously. Comparisons between countries indicate that problems that occur with surrogacy arrangements tend to be higher in countries where commercial surrogacy is banned.
In some cases of infertility, the woman fails to produce ova. With in vitro fertilisation, a woman can be implanted with the ovum of another woman fertilised with her husband?s sperm. The supply of ova, the cost of the procedure, and a shortage of facilities providing IVF treatment, remain a problem. Similar problems to those associated with adoption and sperm donation, such as the need of children to identify their genetic parents, also occur.
Having gained some respectability when used with IVF, surrogacy gained greater acceptance. It came to be seen again as an alternative means of providing children in cases of female infertility. The husband?s sperm could simply be used to inseminate another woman. The complications however increased. The surrogate mother would now be supplying half the genetic material and her genetic claim on the child could be seen as equal to that of the male who supplied the sperm. Again, screening of potential surrogates and legal contracts, service for money, provided sufficient safeguards in most cases. Some women it seems are willing and able to provide this service without complications. Knowledge of and access of the genetic mother to the child after birth may however help both the genetic mother and child as it has with adopted children and those conceived by sperm donation. Other cases have occurred where the child is born less than perfect and the couple who contracted for the child refuse to accept it after birth, despite the husband being the supplier of the sperm. Such fathers have argued that the responsibility for the problem lies with the surrogate-genetic mother and that she has failed to meet her contractual obligations ? while ignoring his contractual obligations to take the child.
Cloning ? the future ?
For double infertility adoption seemed to offer the only solution. Nevertheless, many couples desire that their children inherit their own genetic material or that of their spouse. Now cloning, essentially the creation of a younger identical twin, seems to be an imminent possibility. In early 1997, the first successful cloning of an adult sheep was announced. The resultant lamb, named Dolly, was an exact genetic copy of its parent but the only success from 277 attempts. The procedure it seems has not been perfected to the level where it can be readily and safely used with humans. Attempts to clone animals have produced damaged and deformed foetuses and offspring and there are concerns that with the rare successful attempts, such as Dolly, the animals produced will age prematurely. Many people argue that the safety of the foetus needs to be assured with further animal testing before any attempt is made to clone a human and some countries have placed a moratorium, rather than a ban, on human cloning until the procedure can be proven safe for human use. Further improvements in the cloning technique are expected and it is possible that that in the future humans may be cloned with no greater risk to the child produced than would occur with a normal birth.
Will we soon see some childless couples reproducing by cloning? In the short time since Dolly was born, infertile couples have already approached clinics asking for a cloning service. To them, the possibility of reproducing themselves, both male and female, through cloning is preferable to the introduction of foreign genetic material and the problems that they believe may occur with adoption, donor ova, artificial insemination, and surrogacy. Love it seems can lead to a desire to pass on the genes of a loved one as well as one?s own. Some clinics are poised to offer the service and one organisation has announced plans to set up a facility in a country where it is allowed. We have also seen the usual outburst of reaction from those who would seek to ban the practice and governments rushing to introduce controlling or banning legislation. Should some of the more developed countries ban the practice we may well see people travelling to third world countries for the service. In the United States of America, a presidential commission recommended placing a five-year moratorium on human cloning to allow the safety of the practice to be demonstrated with animal experiments. This is to ensure that the foetus or infant produced is not harmed.
In the past many people who would have made great parents and passed on good genetic material died without issue. Perhaps an accident made them infertile or they mated with an infertile person. Because of infertility, some couples become depressed and marriages have failed, sometimes after the childbearing years have passed. Such couples could see cloning as a means of providing their gene sets with a second opportunity to engage in a normal fertile relationship in the next generation.
A number of objections to cloning have been raised. The first is the affect on the gene pool, the possibility that genetic diversity might be reduced. Simply reproducing a single person in this manner would have no affect on the gene pool. Should a person be cloned more than once it would dilute the gene pool by a negligible amount. Large scale cloning of a single person would reduce genetic diversity but such cloning seems unlikely, except perhaps in dictatorial countries and then the results are likely to be dubious. Should a despicable dictator clone himself on a large scale the clones, like newly hatched queen bees in a hive, may well seek to eliminate one another.
A second objection to cloning is that the parents will have unreasonable expectations for the child and that this will create undue emotional problems. At first look, there may appear to be some truth in this. Many parents now have quite unreasonable expectations for their children and often treat them as if they were clones of themselves. Nevertheless, will the expectations of parents of cloned children be any higher than those of parents who have sought pregnancy through donor insemination, in vitro fertilisation, or other birth technologies, or the expectations of parents who have a naturally conceived child? Looking at these other parents who have used various human reproductive technologies, we find that their expectations for the children that they have gone to so much trouble to conceive is little different from that of parents who have conceived children by normal means. Looking at the argument we find that it is an extension of one originally started by those opposed to contraception, who tried to prove that randomly conceived children in large families were loved more and were better balanced than the wanted children in smaller families where contraception was used! In the past, some researchers, opposed to any interference with god?s plan, even contraception, have tried to prove using dubious research techniques that any planned child, as opposed to those conceived at random, has unnecessary expectations placed on it and that consequently contraception should be outlawed! But their research was flawed and planned children on average do better on a broad range of measures than unplanned children.
Most parents have high expectations for their children but expectations for a child can vary considerably. Those parents that do not have expectations for their children often have other problems including lack of personal self-esteem or motivation. Perhaps parents who seek to clone themselves could undergo counselling and education first but the argument of unreasonable expectations for cloned children seems to fall well short of a reason for a blanket ban on human cloning.
We may find that cloning leads to improved bonding between a parent and child, a greater understanding of each other, and an appreciation of the others weaknesses just as natural identical twins ? and a clone is an identical twin ? often have a much stronger bond between them than ordinary siblings. Rather than causing emotional problems, we might find that cloned children have fewer problems, are more stable and better adjusted than most children and particularly those who have been adopted or cannot trace their genetic ancestry due to sperm or ova donation. Only good statistics gathered over time will settle this definitively.
A third objection is that the cloned children will attract an unreasonable amount of media attention. No doubt the first one will, just as the first child produced by in vitro insemination did, but now children produced by in vitro insemination are frequent and do not warrant a mention in the press. The same will happen with cloned children.
Of course, it is true that a cloned child will not be an exact replica of the parent-original in all aspects of its personality. Differences in rearing and life experiences will make it different. Natural identical twins raised together can develop personality differences. We cannot clone a great composer for instance and guarantee that the child will grow up to emulate the compositional achievements of its original. Nevertheless, the probability is that the child will at least have some bent in that direction, more so than a child conceived through a mixing of the genes. Should we allow cloning to produce great scientists if we have a need of them? Perhaps some countries may try this. The results are likely to be variable, with the right education some clones may achieve the results expected of them but others, like some identical twins, may go off in a different direction altogether.
Should we prevent parents from cloning a loved child that has died? Even now, many parents will conceive a child to replace such a child. If they are capable of normal conception then we might argue that they should follow this path. Perhaps normal conception is not available or they may have some reason for preferring cloning ? perhaps the lost child was one of exceptional talent or had a very desirable personality and died in an accident. It may be that the couple have a high chance of producing children with genetic problems and that the lost child represented a one in four chance of a child without the genetic problem. If, however, the first child died of disease and a clone will have an increased susceptibility to the same disease, then cloning is not desirable. When there are no good reasons to prevent cloning, we could let parents choose cloning if they prefer this path providing they are aware that they cannot produce an exact replica of the personality of the first child. In many cases where cloning is a desirable or a desired option, the world could benefit from the children produced.
Should we allow children to be cloned so that they can be used to keep dying adults alive? A case has already occurred where a couple, with a teenage child dying of leukaemia for whom a suitable bone marrow donor could not be found, deliberately became pregnant in the hope that the new child could provide the needed bone marrow. The chances of a match being achieved were only one in four but they were successful on the first attempt and a life was saved. A clone of the first daughter would have ensured a correct match. In this case, the donation is benign and does not harm the donor, but cloning and producing a viable child that is then killed for spare body parts is clearly murder and certainly should not be allowed.
Cloning to produce an individual to donate a spare organ such as a kidney, we need only one to kidney to survive, is questionable, even if the cloned child was allowed to grow to the stage where it is able to give informed consent, perhaps adulthood. Donating a kidney during childhood or early adulthood leaves the person with only one kidney for life and perhaps increased chances of suffering kidney failure during that life. Such a cloned child is likely to feel enormous emotional pressure to agree to the donation it was created to provide. Research has shown that when children act as donors for their siblings, they are likely to suffer adverse psychological consequences in the long term, even for relatively benign donations such as bone marrow. The consequences are likely to be greater when a clone realises that it was created to safe a life and not because it was wanted for itself.
Perhaps in the future methods will be developed that will enable the desired spare parts to be grown separately without producing any brain development or a viable and independent person.
Cloning to Produce Replacement Organs.
Recent news items report that some success has been achieved in growing cloned body organs in isolation.
Future transplants of body organs grown from cloned tissue from the person into whom they will be transplanted overcome problems of rejection and eliminate the ongoing medical costs of immunosuppressant drugs and other complications that occur with present transplants.
If this is achieved it will help eliminate the covert trade in body parts. At present, some wealthy individuals are known to travel to countries, such as India, where poor and not well-informed people have been selling their kidneys to doctors who perform illegal transplants. q
Should we allow single people to clone themselves? Already we see the phenomena of single professional women with a successful career and nearing the end of their childbearing years suddenly seeking to become pregnant. Some of them desire a child and to remain single. In the future, they may seek cloning rather than insemination. As many such women are able to find a way to get pregnant now we should probably not be unduly concerned. Men, and women unable to produce ova, may also seek to clone themselves but the problems are different. They will supply the nucleic DNA but not the cell material. The men and some women will need a surrogate mother. In such cases, the cloned child will have different mitochondrial DNA in its cells and will not be such an exact copy.
Recently, one woman asked that her dying father be cloned. Should we allow woman to clone their fathers, or men their mothers? We could doubt their motives but it may result in desired and desirable people being born. Is it not better that people born are desired rather than people that nobody would want?
Do we want some people to clone a succession of genetically identical Elvis Presley?s or Michael Jackson?s? Opinions will vary but it is difficult to argue that any real harm will come from such activity as long as the number of clones is kept to reasonable limits. Will our clones be a new fashion statement, to be displayed at the supermarket?
The world may well benefit from some cloning activity. We might consider it highly desirable to clone some people while others would not benefit the world. The natural tendency would be for parents to clone when there are no great genetic defects. Of course, it is also desirable that cross breeding continues to occur. All the great and unique people of the past were produced by the random assortment of genes that occurs with normal conception and the same will continue to occur in the future.
With cloning technology, it may be easy to steal another person?s genetic material and clone that person. Cells from which DNA can be extracted can be easily obtained from saliva or other samples. We might see the genetic material of high earning athletes being stolen by unscrupulous people who have a long-term objective to raise athletes from whom they can make a fortune or to sell embryos to prospective parents at a high price. Perhaps we need to pass laws to prevent this and to invest the copyright or patent for any person?s genes with the individual whose genes they are.
Should we allow "gay" people to use cloning to breed? In the past homosexuality has tended to be self-eliminating as many did not reproduce. If there is a genetic factor in homosexuality then cloning may increase the survival and frequency of such genes. Perhaps we need not be too concerned.
Paedophilia and conviction for sexual crimes, however, are probably cases where we should not allow any form of birth technology or adoption. Many adopted and foster children have found themselves in homes where they have been molested. Other violent or undesirable criminal behaviour also needs to be considered. In all cases we need to consider the best interest of the child and the interest of the child should be paramount.
If cloning is restricted to individuals reproducing themselves in a normal family situation no harm will come to a society. Just as with normal human reproduction, society will benefit from some children so produced and not from others. If undesirable people, paedophiliacs, rapists, and violent criminals, are discouraged, perhaps by the lack of state assistance, or prevented from reproducing by cloning and other assisted reproduction methods, then we might expect society to benefit by a very small amount. The benefit will be very small for the majority of people will continue to reproduce by normal means. If the state does assist these undesirable people to reproduce, perhaps because of antidiscrimination laws, then the state will be in the very dubious position of providing funds to create children that will be born into a high-risk environment and will be in part responsible for any harm that comes to these children.
Reproductive freedom
Returning to look again at reproductive freedom, this is an argument for responsible and safe behaviour and the right of adults to have wanted children ? to conceive when they want to free of coercion and harm from others ? and the right to not have children. It is not the right to insist that women carry unwanted children, not the right to have children that cannot be supported by the parents or children that would put too much stress on the state or the earth, and not the right to produce children by rape. It is the right to the knowledge and use of contraceptives, the right to abortion when needed, and the right of infertile couples to use methods that will overcome their problems ? such as donor ova or sperm, in vitro fertilisation and surrogacy or adoption and the right to cloning when available. As we have discussed, some of these methods can cause problems and appropriate systems and safeguards need to be put in place to protect the interest and safety of the child but the problems come nowhere near reasons for banning the practices.
Such is the desire to reproduce, to pass on our genes, that underground practices are likely to occur when unnecessary restrictions are introduced. Controls on contraception lead to unwanted pregnancies and abandoned children. Banning abortion produced back street and unsafe abortions and resulted in travel to other countries for the service. Preventing surrogacy has led to covert, unregulated, and risky surrogacy and travel to countries where it is legal and regulated to obtain the wanted child. Infertility, lack of reproductive support with alternative birth technologies and shortages of children for adoption has in some countries led to many undesirable practices including kidnapping and the trade in babies and children. Banning cloning may lead to couples travelling to countries where it is allowed to achieve the wanted pregnancy.
It is perhaps significant that the principal opponents of contraception, abortion, homosexual law reform, genetic donation, in vitro fertilisation, and cloning have all been religiously motivated. Led by the Vatican and backed to a greater or lesser degree by other Christian denominations (some have been quite liberal in regard to some of these issues). One parliamentarian, proposing a ban on cloning, said that it "could lead to people doing ?it? for pleasure rather than procreation," an argument previously used by catholic apologists to oppose contraception and abortion. Yet it is the pleasure that helps to establish and maintain the good relationships that ultimately lead to procreation and the safe rearing of children. Others who have joined in seem to have a fear of the unknown, a reluctance to see the potential for new technologies, a fear of the future and a tendency to see one negative factor as a reason for blanket bans even when such a ban may cause harm or suffering and liberalisation brings benefit.
New Zealand Legislation
NZPA reports that Labour MP, Dianne Yates, who has introduced a Human Assisted Reproductive Technology Bill to parliament, that seeks to ban cloning, will fly to Edinburgh to meet the cloned sheep Dolly and speak to Dolly's creator, Dr Ian Wilmut, to learn why he was adamant that cloning was appropriate for sheep and not for humans.
We are left wondering why Dianne Yates, who has church interests, finds the trip is necessary when we have telephones.
Is there also a concern that birth technologies and cloning will allow other people an advantage in the race to propagate our genes? The instinct is to propagate our genes at the expense of others, to outbreed the opposition. To some, cloning could be seen as giving another person a greater chance of providing genes for future generations.
Are clones really more of a problem than identical twins or are we just concerned that cloning will make us redundant? Women will reproduce without the need for men and men may ultimately reproduce using professional surrogates or artificial wombs. Perhaps we need not worry. Our natural instincts will ensure that normal heterosexual mating will continue to be the dominant behaviour and the primary means of reproduction and cloning a minority activity.
Restrictions on sexual behaviour and reproductive freedoms are an example of the tyranny of a fertile and heterosexual majority directed at the minority of infertile people or those with alternative sexuality.
Before we jump and outlaw all cloning, we should look carefully at our motives for doing so. One of the problems with passing laws is that a significant percentage, often a majority of the population, are then convinced that whatever is outlawed must be wrong even when the law is clearly wrong. To correct the law can then be very difficult and even take centuries.
Further reading:
The original of this article appeared in New Zealand Humanist No. 134, June 1997. This version contains a number of minor revisions.
Iain Middleton is a Council and Wellington member of the Humanist Society of New Zealand.
"Evolutionists get a bit sensitive because historically there was a movement called Social Darwinism and more recently there was Hitler. There have been people who have misused the idea of evolution and used it as a doctrine for how we should live This is based on the fallacious view that because something is true - and there is no doubt that Darwinism is true - then that's how life came to be the way it is, that's what gave life its purpose, but there are people who think that that means we should base our societies on the Darwinian model and that might mean the weakest should go to the wall.
That might mean that anyone who is disadvantaged in anyway should not be protected by the state, should not be given welfare, should not be given medical care at the states expense, should be allowed to die, because that is the Darwinian way. Now one could build a politics or a system of ethics on that view. All I can say is that is not the kind of society in which I would wish to live and unlike some people who tried to use Darwinism as the basis for a philosophy of how to live - Julian Huxley was one for example - count me out is all I can say."
(Richard Dawkins, at Victoria University Wellington, September 1996)
The original of this article was published in
New Zealand
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