Souls On Ice

"Few issues," Ronald Green writes, "are likely to generate more emotional opposition than federal funding of stem cell research." Fortunately, he has a plan for how Barack Obama should proceed:

Obama should minimize opposition by following the lead President Bush established in 2001. In justifying his policy of funding research on a limited number of human embryonic stem cell lines, Bush stated that "the life and death decision" had already been made on the embryos used to create those lines.

This is true of thousands of frozen embryos stored in fertility clinics around the country. More than 500,000 embryos created by in vitro fertilization to help couples have children are being stored. A large percentage of those embryos will never be used, because the couples have succeeded in having children, have given up or have grown too old to try. There is very little market for embryo adoption, so most of these embryos are destined to be destroyed. Circumstances have rendered the "life and death" decision on them almost as certain as it was on the embryos used before 2001 to make the stem cell lines that were approved to receive federal research funding.

By executive order, Obama could authorize the NIH to invite couples who planned to discard their frozen embryos to donate them for research. The couples would have to affirm that they no longer intended to use the embryos and had already decided to destroy them. Instead of the embryos merely being thawed and incinerated, as happens today, their cells could be used to produce lines for stem cell research. The moral parallel here is organ donation after death. In this case, the embryo's death is an unavoidable result of its creation and subsequent non-use for reproductive purposes. The production of stem cells from these embryos could easily be accomplished without federal support, and the resulting stem cells could be donated for federal research.

Like President Bush, President Obama could limit federal research to embryos created for reproductive purposes and abandoned before the statement of his policy. There are more than enough of these embryos to create all the lines we need for research. Under such a policy, there would be no use of embryos created with the intent of stem cell research.

Of course, when Bush talked about stem cell lines from embryos for whom "the life and death decision" had already been made, he was referring to embryos that were actually already dead. Whereas Green is redefining the phrase so that it refers to over 500,000 embryos that are very much still alive, and whose killing and subsequent dissection for (federally-funded) research is to be licensed on the grounds that "circumstances" have made their deaths "unavoidable." I think there's at least a slight difference between the two approaches.

Here I would ordinarily make some withering comment about the hollowness of the supposed "pro-life" case for Barack Obama, but in this instance it has to be allowed that John McCain's position was no better. Instead, as a counterpoint to Green's blithe and breezy take - "the embryo's death is an unavoidable result of its creation and subsequent non-use for reproductive purpose" - let me recommend (not for the first time) Liza Mundy's 2006 story in Mother Jones on America's embryo glut, and the moral dilemmas facing parents with offspring on ice. A few quotes:

... As with ultrasound technology--which permits parents to visualize a fetus in utero--ivf allows many patients to form an emotional attachment to a form of human life that is very early, it's true, but still life, and still human. People bond with photos of three-day-old, eight-cell embryos. They ardently wish for them to grow into children. The experience can be transforming: "I was like, 'I created these things, I feel a sense of responsibility for them,'" is how one ivf patient put it. Describing herself as staunchly pro-choice, this patient found that she could not rest until she located a person--actually, two people--willing to bring her excess embryos to term ...

... Dr. Robert Nachtigall, a veteran San Francisco reproductive endocrinologist, directed a study of patients who had conceived using ivf together with egg donation, another rapidly growing niche of fertility medicine ... Hard as it was deciding whether to go ahead with egg donation, these parents said, it was harder still deciding the fate of their leftover embryos

... Struck by these unprompted revelations, [Nachtigall] and fellow researchers decided to do a new study, this one looking explicitly at the way patients think about their unused, iced-down embryos ... Strikingly, Nachtigall found that even in one of the bluest regions of the country, which is to say, among people living in and around San Francisco, few were able to view a three-day-old laboratory embryo with anything like detachment ... Couples, he found, were confused yet deeply affected by the responsibility of deciding what to do with their embryos. They wanted to do the right thing. All of the 58 couples in his study had children as a result of treatment, so they knew, well, what even three-day-old embryos can and do grow into ... "Some saw them as biological material, but most recognized the potential for life," Nachtigall told colleagues at the asrm meeting. "For many couples, it seems there is no good decision; yet they still take it seriously morally."

For virtually all patients, he found, the disposition decision was torturous, the end result unpredictable. "Nothing feels right," he reported patients telling him. "They literally don't know what the right, the good, the moral thing is." In the fluid process of making a decision--any decision--some try to talk themselves into a clinical detachment. "Little lives, that's how I thought about them," said one woman. "But you have to switch gears and think, 'They're not lives, they're cells. They're science.' That's kind of what I had to switch to." Others were not able to make that switch, thinking of their embryos as almost sentient. "My husband talked about donating them to research, but there is some concern that this would not be a peaceful way to go," said one woman. Another said, "You start saying to yourself, 'Every one of these is potentially a life.'"

... Of the 58 couples Nachtigall and his group interviewed, the average couple had seven frozen embryos in storage. The average embryo had been in storage for four years. Even after that much time had elapsed, 72 percent had not decided what to do, and a number echoed the words of one patient: "We can't talk about it." The embryos keep alive the question of whether to have more children, a topic on which many spouses disagree. "I still have six in the bank," said one woman, who had not given up the idea of bearing them. "They call to me. I hate to talk about it. But they call to me."

Read the whole thing.