Making Babies: Is there a right to have children? by Mary Warnock

Freeing the baby debate from fear and prejudice

Infertility inflames passions. On all sides, there is anger and despair. There are those who believe that IVF, donor insemination, egg donation and surrogacy are all evil, meddling with the natural order. Some even call it playing God. There are others – mostly the infertile – who see treatment as a right. They demand it be readily available and free.

In an area fuelled more by emotion and experience than reason and expertise, this slim book is welcome for being solid and sensible. Here are some of the questions it calmly poses: On what grounds might a couple be refused assisted conception? At what stage does an embryo become morally significant? Why do homosexuals want children? Are all methods of fertility treatment legitimate? Where will it end? The book is not an argument, but an exposition of what should be argued about. It sets out the limits of the debate and considers all sides. Its even-handedness can be exasperating.

Perhaps that is why Warnock has been such a prominent figure on government committees, including chairing the Committee of Inquiry into Human Fertilisation. The insights she gives into some of this committee's eminent members' attitudes towards patients are an unexpected bonus. One obstetrician said she would turn away a couple for fertility treatment whom she personally thought "unsuitable" due to her own beliefs. However, she would not tell the couple the real reason, but would say she was "exercising her clinical judgement". She would lie.

Concerned that medical personnel were exercising moral authority, the committee decided to invent a hypothetical situation. What if an infertile couple with a history of child abuse applied for treatment? It was clear that they would be unsuitable; no one disagreed. But even in this case, the obstetrician said she "would examine the couple and tell them that they were too old, or whatever pseudo-clinical reason she could think up for refusing them treatment".

The dishonesty of the medical profession towards patients could not be more blatantly revealed. In an atmosphere where such deceit is deemed acceptable, why should any infertile couple trust a clinician when told "No"?

Perhaps this committee gossip is just another trick by Warnock to woo us on to her side. For, despite all her seeming reasonableness, she makes some forceful statements. "Is there any reason, in principle, why human cloning should not be carried out?" she asks, always more comfortable presenting her conclusion as a question. She finds none. To this controversial statement she adds others: that donors should be identified; and that gay couples and those who have delayed having children due to their career should be given access to fertility treatment, although not necessarily on the NHS.

I hope that the obstetrician who will not tell her patients why she is refusing treatment reads this powerful little book. Faced with Warnock's unflinching honesty towards a subject usually shrouded in unfounded fears and prejudice, the obstetrician should first feel ashamed. And then, let us hope, become informed.