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For health and legal professionals with an interest in bioethics
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For sale: a better baby
The touching story of a sick child and its desperate parents is being used to promote a growing industry. THE RECENT NEWS that an IVF clinic has created two saviour siblings is more than an ethical challenge -- it is slick public relations. Sydney IVF made world headlines after revealing that it had selected embryos to be perfect tissue matches for sick children in need of bone marrow transplants. This marks an advance on techniques used by Melbourne clinics which have tested embryos for genetic errors. It is the first time embryos have been matched for compatible blood groups in Australia. Other couples are now queueing up in the hope of cures for their children. This is not just a reminder of scientists' amazing ability to manipulate embryos. It also highlights the fact that fertility medicine has swollen from a single baby 25 years ago into an immense industry with growing political and social clout. Sydney IVF, for instance, is a public unlisted company which employs 150 people. Its chairman is not a doctor, but an investment banker, Rowan Ross. And until last October its chief operating officer was a Harvard MBA. According to its website, Sydney IVF has started or assisted clinics in Thailand, Brunei, Saudi Arabia, Singapore, Indonesia, Turkey, India and Bolivia, plus many Australian centres. And Sydney IVF is just one of several Australian IVF companies aggressively touting their business in regional centres and overseas. Like any player in a highly competitive market, an IVF company needs to create new products and it needs to open up new markets. That's why IVF clinics are moving from a meat-and-potatoes product like in vitro fertilisation for infertile couples to deluxe services like sex selection and pre-implantation embryo diagnosis, and now, saviour siblings. IVF doctors know that their industry has a bright future. With more and more women waiting until their 30s to have a child, long after their fertility has begun to decline, their market will grow as the Australian birthrate declines. Furthermore, they can always count on strong demand. Many couples are so eager to have a child that they are willing to suffer any indignity, any inconvenience, any pain -- or pay any price -- to bring a baby into their lives. With nearly 2 per cent of births now due to assisted reproduction, IVF clinics will soon have a significant effect upon national health, family structures and social welfare. Such an industry ought to be subject to close government scrutiny of its impact on the social environment. But this isn't happening. Instead, these medical-commercial hybrids are writing their own rule books. The recent news about saviour siblings is a perfect example. The public face of Sydney IVF, its medical director, Professor Robert Jansen, says that his independent ethics committee gave it a thumbs-up. How independent is this ethics committee? Who sits on it? And by whose criteria was it deemed ethical? What happens next, now that Sydney IVF says it's ethical to cull embryos and create tissue-compatible siblings? It already offers a service which many of us feel queasy about -- sex selection. WHAT'S next, super-intelligent, super-athletic babies? Or what if a cloned child were the only way to cure a sick baby? These services are now illegal, but the law could change. Most of the disputes over ``designer babies'' have centred on the fate of the embryos that are created, culled and destroyed in the process. This is a serious ethical issue, but it is not the only ethical issue. The commodification of human life for profit is another. IVF long ago ceased to be purely a medical matter. With a million IVF babies around the world -- and 40,000 in Australia -- it has become a transnational industry with links to pharmaceutical and biotech giants. Its development is being guided not just by the needs of its patients, but by shareholder demands for a return on their investment. It's said that our ethics are playing catch-up to science. But in the case of IVF, it might be just as true to say that ethics are playing catch-up to business. It's time the Government turned the spotlight on an industry that cuts its ethical cloth to match its products. This is no ordinary industry. Other businesses manufacture widgets; IVF businesses manufacture lives. mcook@australasianbioethics.org.
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