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Frozen embryos in moral limbo

I remember the day my first child was born. He lay sleeping, swaddled, in a plastic bin at the hospital. That's when I finally understood what it meant to be a parent. "If we leave this hospital without this baby," I told my wife, "we'll be arrested."

It was a joke, but it was also true. You arrive at the hospital as two people, and you leave as three. You can't just make a baby and walk away. It's yours forever.

Unless, that is, you make a baby through in vitro fertilization. In that case, you can put the embryo away in a freezer and decide what to do about it later. Or never.

In the United States alone, approximately 500,000 embryos now lie suspended in this frozen world. Thousands more accumulate every year. They go there because we make more embryos than are necessary for one child, and we set some aside in case we need them for a second child. They're our backup kids. In our heads, they aren't real yet. But in the freezer, they are.

President Bush, God bless him, wants to find homes for them. He wants the parents who made them to let others gestate, deliver and raise them. It's a beautiful thought. But a survey published last month in Fertility and Sterility says it's not going to happen. The survey sampled more than 1,000 people who had embryos on ice. Only 7 percent said they were very likely to give their embryos to other parents. Twice as many were willing to consider donating embryos for research as for reproduction.

Why? Because we don't want other people raising our kids. In the survey, the authors found that "concern about or responsibility for the health or welfare of the embryo or the child it could become … was negatively associated with reproductive donation and positively associated with options not resulting in a child." For these people, the "sense of responsibility precludes their allowing their embryos to become children in any family except their own."

To prolifers, this preference for destruction is baffling. We're talking about an embryo in a freezer. Nobody's asking you, the genetic mother, to put it in your own body. We'll do all the work. Just let us have it. We'll give it life, love and a good home.

But the mind-set of possessive responsibility says: No. This embryo is mine. I can't let it grow into a child if I'm not there. I'd rather extinguish it. This is a cruel instinct, but it's pervasive. It's why Bush's father couldn't persuade women to choose adoption over abortion and why Bush can't persuade them to choose adoption even when no pregnancy on their part is required.

Imploring these people to embrace a babymaking "culture of life" is noble, but it isn't realistic. Nor is putting ads in church newsletters for 500,000 adoptive wombs. The realistic answer is to stop making and freezing so many extra embryos in the first place. That, too, requires moral strength. If you can't stand to become a parent to a batch of frozen embryos, why are you creating them? Sort out your ethics before you cross that line.

This, according to the survey, is exactly what's not being done. The authors find that "fertility patients are likely to face an unanticipated conundrum when they have completed treatment: a choice among unappealing disposition options." Unanticipated? Come on. IVF isn't a night of passion. It's an elaborate plan. How can you go into it without thinking through the eventualities?

The answer, the authors explain, is that "when embryos are initially cryopreserved, patients are focused on having a child and may not be prepared to consider fully their views about embryo destruction or donation." Furthermore, they report, "Our review of consent documents indicates that patients are often not asked their preference regarding disposition of excess embryos at the time of freezing. … Discussion of disposition options is not mandated by professional guidelines."

In other words, nobody focuses on the extra embryos. The patients and doctors are preoccupied with making a baby. If you get one, congratulations. Anything extra is an afterthought. We treat the leftovers as raw material, available to be used or thrown away. But they aren't raw material. Eggs and sperm are raw material. Embryos are what we make with that material. They're us.

So the leftovers sit in freezers, like souls in limbo. In this survey, nearly half the people with embryos on ice said they didn't want to have more kids. Yet among this group, the authors report that 40 percent "have yet to select a preferred disposition option, and nearly a fifth indicate they are likely to freeze their embryos indefinitely."

Compared with this, the abortion debate is almost quaint. There, the prochoice slogan is: Who decides? And the scripted answer is: The woman does. But in the world of IVF, the answer, too often, is that nobody does.

What does it mean to be prochoice in a world without time or fetal development? A world so frozen that no choice is required? Is it possible to respect each couple's choice but to demand that they choose one way or the other? Does the ethic of free choice require at least that much?

I'm a prochoice moralist. I don't want the government telling people what to do with their pregnancies or their spare embryos. But that freedom doesn't eliminate moral obligation; it intensifies it. Each of us has to decide how to respect life in all its complexity. To me, embryos aren't people, but they're the beginnings of people. They aren't to be created, killed or frozen lightly.

That means, among other things, that they should never be an afterthought. Don't have sex, at least not the procreative kind, without discussing what you'll do in the event of pregnancy. Don't make or freeze embryos without thinking through what you'll do with them. And if, after talking it over, you can't stomach the options ahead, maybe you should reconsider whether you're ready for this. That's a lot to ask, I know. But nobody said choosing would be easy.

William Saletan is Slate's national correspondent and author of Bearing Right: How Conservatives Won the Abortion War.

Frozen embryos in moral limbo 01/10/09 [Last modified: Wednesday, November 3, 2010 9:37am]
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