A Child Against All Odds by Robert Winston

Powerful yet humane critique of those involved in the baby-making business
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The Independent Culture

He is Britain's best known doctor. The "lord of creation" with the twinkling eyes, avuncular manner and Groucho Marx moustache has achieved celebrity status through his television series, the latest of which is showing now.

This book is the tie-in, but vastly greater in scope. It is his reflections on the field of "reproductive manipulation", peppered with anecdotes about his own work over the past 30 years. And, as we have come to expect, it involves a deal of finger-wagging at the activities of individuals and organisations involved in the field.

The book - erudite and accessible, powerful and humane - is no hymn of praise to his chosen specialism. An important theme is established in the acknowledgements: "Fertility treatment is life-changing when it works, but it is accompanied more often by failure than success."

This is not the language favoured by many in the business of making babies. Its achievements have been miraculous, from the birth of Louise Brown, the world's first test-tube baby, in 1978 to the experiments in gene manipulation in which Winston himself has played a part. But, while he is happy to celebrate successes, he is dismissive of those who go too far: "It is a matter of constant surprise to me that so many members of my own profession, who ought to know better, do not seem remotely to appreciate the limits of [pre-implantation diagnosis]."

This is the technique of testing embryos of couples known to carry a gene defect before implanting them in the womb, in order to select ones unaffected by the defect. It is hugely valuable to the couples. But it will not, as some scientists have breathlessly claimed, eliminate genetic disease.

The temptation to oversell achievements is immense in such a field. The book includes an account of the catastrophic fall of Professor Hwang Woo-Suk, who claimed in 2005 to have cloned a human embryo, only to be forced to admit, sobbing before the world's media, that his work had been faked.

The book starts and ends with a warning about the dangers of genetic meddling. Selecting embryos to avoid passing on disease is one thing. Trying to eradicate disease by altering the germ line so that certain genes are eliminated altogether is another. It will change our idea of what it is to be human. In the fevered world of reproductive medicine, it is a warning we should heed.

Jeremy Laurance is health editor of The Independent