GILLIAN is in her forties. She has three healthy children but they didn't arrive very easily. Conception was difficult every time and she had several miscarriages. Her youngest child Melanie, now a healthy toddler, was born extremely prematurely at 28 weeks and survived only with a great deal of hi-tech intervention. Gillian feels it gives her a particular interest in the battle currently raging about what should be permitted in the name of fertility.
'I feel a certain sympathy with the 59-year-old who had twins because I can so easily understand the overwhelming desire to have children. I think she was selfish - why should we think we are entitled to so much that we can defy age - but I understand the desire.'
But on the latest fertility furore, Gillian has no such sympathy. She is repulsed by the idea of using eggs from aborted foetuses in fertility treatment. 'I'm not against the use of foetal material for treating Parkinson's disease. But I am disgusted at the thought of eggs from aborted foetuses.
'I worry about who would be getting this treatment, whether it would be available for everyone on the NHS or just spare parts bought by richer women from poorer ones. I have had two miscarriages in hospital and would be horrified by the idea of having a 'grandchild' I knew nothing about.'
Disgust has been the response of many people when confronted with this, the third ethical dilemma on fertility treatment in as many weeks. And it is not just the tabloid press that has been squeamish about the idea of using foetal material in fertility treatment. Two members of the Human Fertilisation and Embryology Authority - charged with overseeing the developments in embryonic engineering - have talked publicly about the 'yuk factor' in this issue.
'There is an unquantifiable yuk factor which is very disturbing,' said Dr Steve Hillier, of Edinburgh University's reproductive endocrinology laboratory. 'There is a consensus that it would not be in the public interest to allow it.'
That the media should pick up on the 'yuk factor' should come as no surprise. The press has used the term to disparage what seems freakish and abnormal, furnishing its readers with a sense of their own normality. Sensationalised case studies allow us to unite in horror at the antics of the white-coated ghouls and womb-robbers, servicing the sad childless freaks. But surely we might expect a more measured and considered response from a committee of the great and good, charged with policing the unstable ethical boundaries in a rapidly changing field?
Some commentators have interpreted the Authority's acknowledgment of a 'yuk factor' as evidence that the issue of using aborted foetuses has really touched base in terms of what is ethically possible in embryonic engineering. 'Yuk means no,' said Brian Appleyard in the Independent last week. He suggests that the churning of our stomachs, and the response of our guts, is a true indication that such a practice would transgress the limits of what we think acceptable.
Sue Heron, an occupational therapist with one young child, agrees. 'It's hard to explain moral feelings, but a strong positive or negative gut feeling is a pretty good indication of what is right and what is wrong.'
But is this disgust really telling us where to draw the line? After all, children feel total disgust when they first find out the facts of life. That's not about affronted morals, but about affronted categories. Children are upset because the firm line between what belongs inside, and what belongs outside, has been transgressed. It could be the same squeamishness about the same transgression which feeds any discussion of foetuses. And we do have to remember that different cultures find different things disgusting, and that disgust can just be social prejudice.
Speaking to people in depth on this subject reveals that there can indeed be very profound disgust at play, but that there can also be a panic-stricken distaste at not knowing where to draw the ethical boundaries. Sue Heron, like Gillian, feels sick at the idea of using aborted foetuses in fertility treatment but doesn't think she is being quite logical. 'I intensely dislike the idea of material being taken from a dead body that has never lived. It doesn't feel the same as donating kidneys where the person has lived out the life they were meant to live. I don't know why I feel there's a difference, but I do. It feels as if you are stealing from someone who has never been allowed to have it'.
Others do not feel the genetic potential contained in the ovaries is of any great significance. Jamie, a father of two young boys, did not think that receiving an ovary in fertility treatment has any more significance than a blood transfusion or a huge dose of fertility drugs. 'The egg just gives a genetic blueprint, you don't 'own' it. I can't take seriously the concern that child produced this way would never have a mother. I worry more about a child produced by artificial insemination. That child really may never be able to know its father. This child would have a mother.'
Lillian, a mother of three teenagers, agrees. 'You're not a mother or grandmother just because you donate an egg. The mother is the one who carries the child in the womb. I'm not squeamish about using eggs obtained this way. But then I'm not squeamish about abortion - I even think that it's not wrong to stifle a child at birth if it had massive problems. What worries me is the desperation to get pregnant which many of these women feel. It bothers me that so many women seem to feel it's the only source of what's valuable in them.'
Robert, a computer technician, also sees the main problem in this debate as women's desperation for pregnancy, not the transgression of moral absolutes. 'I think there are more important things to worry about than whether or not you are fertile. Personally, the eggs of an aborted foetus are no more significant to me than fish eggs. But other people think they are, so it's insensitive to use them. People are entitled to those feelings, so I agree with a ban.
'It's not the same as banning abortion because that would take away the liberty of women who want abortions. But aborted foetuses are not the only source of eggs. Why offend people needlessly?'
Cultural sensitivity about the foetus is at the heart of the controversy. Even if you deny that a foetus is a person, it's hard to deny that it is emotionally-charged spare tissue. Women feel that the foetal mass is part of themselves, and some mourn its loss even when that loss is the delivery of a perfectly healthy baby. That mass is especially charged, given it is potentially a human being. To take eggs from an aborted foetus is to plunder where significance is intense, and to do so points up a contradiction. To abort involves not seeing the foetal mass as human. But taking its eggs means it is human enough to have its potential raided.
Dr Celia Pyper, an Oxford GP and co-author of a new book, Pandora's Box: Understanding Our Fertility, thinks that much of the disgust is discomfort at facing these unresolved feelings about abortion. 'Everyone I speak to has had the same reaction. They see it as depriving a being of life, yet exploiting it. Abortion is still a difficult issue for people even if they support it. I know lots of nurses who spend their time supporting women who have had abortions. They do it brilliantly, but they still feel uncomfortable. It's unsavoury for people to look too closely because it does involve a dead baby.'
Dr Pyper strongly supports legal abortion - to do otherwise, she believes, would open the way to needless suffering. But she does think the emotional cost both of abortions and of new fertility treatments is high. She thinks we would do better evolving a new approach to the whole question of fertility rather than constantly asking people to redraw their moral boundaries.
'People need far more information about fertility so they can make the right choices at the right time. There needs to be far more emphasis on the prevention of infertility so that people can avoid using some of these treatments.'
But she also thinks that attitudes to fertility need to change. Currently, the discourse is all about rational choices. It is assumed that if people do not want babies, they use contraception; then they plan families at the right moment; sometimes they have accidents, sometimes they change their minds and want help. Dr Pyper says that most pregnancies are emotional rather than rational decisions and there needs to be far more acknowledgment of that. 'There needs to be deeper insight into the emotional factors in fertility, why people feel ambivalent about babies, why they delay until too late, why they get 'accidentally' pregnant, what their fantasies around pregnancy are. Maybe if the 59-year-old woman had received counselling rather than technical help she could have fulfilled her fantasies differently.'
Dr Pyper's words make us aware that focusing on the pros and cons of any one form of fertility treatment tends to deflect attention away from wider issues. What these current arguments ought to open up is a debate about how we are managing fertility in public and in private.
The HFEA, in naming the 'yuk factor' and opening up the issue to wider consultation, have allowed people to face their disgust. But it is to be hoped the response will not stop there. There are better ways of proving our humanity than letting our guts condemn other people as freaks and ghouls.
LAST week's article 'The Yuk Factor' stated that Dr Celia Pyper 'strongly supports legal abortion'. We understand that this does not reflect Dr Pyper's views, or the thesis put forward in the book Pandora's Clock which she co-authored with Maureen Freely, and apologise for the embarrassment caused.Reuse content