In this book, J. Benjamin Hurlbut of the Arizona State University examines the changing paradigms of bioethics principles and legislation in the United States in the late twentieth century, particularly since the 1970s. In a dynamic era of biomedical research, the bioethics principles are bound to change to accommodate dynamic knowledge production in human embryo research. Biotechnological research in non-human subjects also drew a similar kind of worldwide attention and debate as scientists dealt with animal genomes and cloning projects. Now, academic and political discourses are sharpened to focus on implications of human embryo research for society and humanity at large. The politics of bioethics probably gets complicated due to a mixed level of stakeholders’ maturity. Public ignorance and ill-informed debates also shaped the political discourses of national and international frameworks in bioethics. While conflicts of interests are the undercurrent in political decision making concerning the human embryo research as a sustainable solution for the future of humanity, the blanket opposition by some interest groups against the subject leads us nowhere. The author of this book gets to a sociopolitical understanding of complicated scenarios involving institutional ethics committees and a subjective assessment of advisory boards.
In the introduction, the author revisits the birth of the first child conceived through the in-vitro fertilization (IVF) techniques in July 1978 in the United States. IVF marked the beginning of an era offering new hope for parenthood, particularly for those who were seeking solutions to an infertility condition. IVF techniques involve the creation of human embryos from eggs and sperms in a laboratory environment. While IVF became commercially available and widespread in the country from the 1990s, the production of in-vitro human embryos increased in private centres and clinics. Many of these embryos would be kept cryogenically frozen against want of future babies. The surplus frozen embryos become a question of ethical dilemmas, similar to the moral debates surrounding human abortion. The author posits that ‘[b]y the early 2000s, there were an estimated four hundred thousand frozen embryos in the United States. A decade later, there were more than a million’ (p. 6). The book deals with the institutionalization of bioethical bodies to look into the governance and regulatory compliance of human embryo research. The statutory institutions formed by the different national and local bodies look into detailed research proposals and their expected outcomes on a case-by-case basis for identifying ethical challenges and setting up the norms for curbing morally disruptive clinical (mal)practice at the hands of private IVF specialists.
In Chapter 1, titled ‘New beginnings’, Hurlbut examines the political consensus behind the formation of the first bioethics body in the United States. In the same year as the birth of the first test-tube baby, a national-level Ethics Advisory Board (EAB) was formed by the erstwhile Department of Health, Education, and Welfare (HEW) with a mandate for case-by-case review of ethically complex research proposals. The EAB's work played an important role in shaping approaches to ethical deliberation to cope with the new normal. There were deep ethical uncertainties, while the EAB's judgments incited subsequent debates on the assistive reproductive technology of human IVF. The author delves into the details of the contributions of the short-lived EAB in shaping the agendas of responsible biomedical research in the USA.
In Chapter 2, ‘Producing life, conceiving reason’, Hurlbut inspects how an object of human embryo research became a mass-market commodity with the establishment of hundreds of IVF clinics in the USA in the 1980s. Thus the requirement of the self-regulatory framework, in the absence of the erstwhile EAB, was fulfilled by the Ethics Committee of the American Fertility Society (AFS, now the American Society for Reproductive Medicine) – an umbrella organization for IVF specialists. The AFS helped in the determination of the moral status of human embryos concerning the unregulated or under-regulated human IVF industry. They established a mechanism to review conflicting human IVF cases ethically. The chapter also reveals the advent of a new consumer class seeking human IVF intervention within a set of socio-legal norms. A significant number of reproductive choices were made available to the new consumers; the cryopreserved embryo was one of them for deferred parenthood.
In Chapter 3, ‘Representing reason’, the author delves into the deliberations of the Human Embryo Research Panel (HERP) established under the auspices of the National Institutes of Health (NIH). HERP ensured reinstatement of human embryo research in laboratories, which was in a state of a de facto moratorium in the absence of the erstwhile EAB.
In the 1990s, human embryonic stem cell (HESC) research came to prominence with the emergence of the somatic cell nuclear transfer (SCNT) and related techniques. The cloning of mammals, including human beings, also became a reality when a Scottish sheep, ‘Dolly’, was born out of a laboratory experiment utilizing SCNT techniques in 1997, and achieved the distinction of being the first asexually produced mammal. The National Bioethics Advisory Commission (NBAC) was established in 1996 in the USA for governing the HESC and other areas of human embryo research. While the NBAC became involved in producing a new set of norms for public reasoning, the politics of democratic consensus reached a new height. In Chapter 4, ‘Cloning, knowledge, and the politics of consensus’, Hurlbut reflects how the NBAC was driven ‘to rectify a new kind of failure in the public square: the failure of Americans to reason properly about a morally complex technical domain’ (p. 175).
In Chapters 5 to 8, the author describes the politics behind the research on human cloning, while the curtailing of federal funding for embryonic stem cell research was on the agenda in the USA. He then elaborates on the role of interim bioethics bodies which shaped the national-level debates and clinical practices in the country, such as the President's Council on Bioethics (PCB). The author then exemplifies the United Kingdom's efforts in the rationalization of human stem cell research through institutions and legislation such as the Human Genetics Advisory Commission, the Human Fertilization and Embryology Authority, and the Human Fertilization and Embryology Act of 1990. In Chapter 7, ‘Religion, reason, and the politics of progress’, the author critically examines the sentiments of socio-religious organizations (particularly the Catholic Church) and the secular forces shaping the debates on human cloning and embryonic stem cell research.
The scope of this book is generally limited to the United States, while a broader global perspective is needed in future studies. The book helps us understand the complex matters related to human embryo research in the new light of the conceptual framework of responsible research and innovation – which includes an element of ethical research practices in the scientific experiments. This book is thus recommended to scholars engaged in the areas of the social shaping of technologies, the public understanding of science and the history of biomedical technologies.
