We're back with another edition at the Federalist Radio Hour. I'm Emily Dashinsky,
culture editor here at the Federalist. As always, you can email the show
at radio at the Federalist dot com, follow us on ex at fdr LST.
Make sure to subscribe wherever you download your podcasts, and of course to
the premium version of the Federalist dot com as well. You get an ad
free experience comments with staff. It's a lot of fun, so join us
over there now. I am joined today by Emma Waters. Emma is the
senior Research Associate at the Richard and Helen Devas Center for Life, Religion,
and Family at the Heritage Foundation. She covers IVF and reproductive technology in general,
very very closely. She is one of the most clarion voices on this
topic and it has been a busy couple of weeks. Emma, thank you
for joining the show. Yeah, of course, Emilie, thanks for having
me on today. I was just telling you before we started recording that I
scrolled through your Twitter for kind of inspiration before we were starting this conversation.
And man, you have been on c SPIN, you have been on EWTN,
you have been quoted in a bunch of different places ever since the Alabama
IVF ruling was handed down. What was that, Emma, two weeks ago?
Now, maybe three going on three weeks? Yeah, from February sixteenth
to today, Okay, And just to set the stage a little bit,
when we recorded today, this very morning, I opened an email from one
of my favorite publications, the Free Press. Emma, I don't know if
you opened that email. It was riffing. The headline was riffing on and
Colter's argument that abortion has become the rights, defund the police. And it
was talking to women who had supported Ron de Santis in Florida but because of
the six week ban, and then because they were associating and I think actually
this was just a woman in Alabama, so not a desantist votter, but
because they were associating the ruling in Alabama with the Republican Party, they were
falling out of sort of love with the Republicans, or questioning pro life views,
all of that in the mix. And I set the table with all
of this just to say I want to start with the moral questions and not
the political ones, because I think what we're doing, not you, of
course, but I think what the media is doing, and even the Republican
Party is doing, is sort of conflating these things. So, just in
the last couple of weeks since the ruling came down, can you talk to
us a little bit about whether you've been surprised by the response? Is about
what you would expect. Did anything interesting happen in the last couple of weeks
as you watched this sort of morph into a huge national news story. Yeah,
it's a really good question. Emily. On the one hand, I'm
not at all surprised by the response that we've seen among a lot of people
who especially feel very sensitive about anything related to reproduction, be it an abortion
or IVF, and feel a very personal sense of autonomy and even a personal
threat when these topics are brought up, because we are dealing with some of
the most intimate questions in life, the question of procreation, the ability to
have or not have children, and I think that those questions really get at
the deepest part of who a person is, the values that they hold.
Imagine all of the discourse on this and how emotionally people respond when in future
fertilization in particular is brought up, and think of like the AOC comment recently
where she said she's not having children due to climate change, and her mother
in Puerto Rica was like, no, She's absolutely having kids. What are
you guys talking about? And just this funny interplay of what you value ultimately
comes out and what you think of children one way or the other. And
so thinking about in future fertilization, I think the thing that has really surprised
me has been specifically within the pro life movement and among pro life Christians or
among pro life conservatives. So in future fertilization as well as in natural conception
inside of a woman's body. I believe that life begins at conception. The
Alabama decision, both the fertility clinic and the parents affirm that life begins at
conception. This is our basic medical biological definition. And because of that,
I also attach a moral duty and responsibility to that that because life begins a
conception, because this is a live, unique, distinct human being that has
not come into existence, that that human being, even at this very early
and undeveloped stage of life, deserves the full force of the laws protections to
protect its life, to preserve its life, and to treat in a humane
way. And so I think the thing that has been surprising here has not
been the less response that's exactly part for the course, but it's those who
are consistently and affirmatively pro life when it comes to children in the womb.
But then the moment we begin talking about children created outside of the womb,
where we know that in a future fertilization the routine, normal way that it's
practiced right. There are certainly exceptions to this, but the common way that
IVF is practiced involves the creation of a surplus of embryos that are then tested
for genetic issues for the sex of the child, even for secondary features like
ones IQ or skin color. This technology is available throughout the United States,
and then that embryo, those embryos are then selected and the ones who are
wanted are implanted in the woman or frozen for later use, and the embryos
that are unwanted are routinely destroyed or donated to research. And so, even
if there is a pro life argument to make for IVF, or way that
one chooses to use IVF in a way that is life affirming, we can't
talk about IVF without actually taking in the full picture. And so it's been
very surprising to see a mini pro lifeer say, well, of course,
we're fully in favor of IVF. Why would we ever be opposed to this?
This is a great thing, like IVF creates children. We're pro life,
we want more children. And it's the lack of depth and substance that
a lot of people have brought to that in not making a distinction between something
that certainly does create life, but then also the factors in a beuture fertilization
that are certainly not pro life and are not life affirming in how many clinics
practice it. So I trust your take, I trust my colleague Jordan Boyd's
take on the shore and send some excellent coverage on this. And I'm wondering,
Emma, if you agree with Michael Knowles that IVF is sort of inherently
I think he used the word evil something like that because he said it separates
the reproductive act from the conjugal act. That's probably farther than I would go,
although I see where sort logically he's making that point. What do you
think about that? Because a lot of what you focus on actually is technology,
and there's no way around it. IVF is obviously a technological modification to
reproduction, and you've sort of started pulling at that thread and finding different ways,
different things that have become normalized, different things that we're on the path
to normalize. So are people like me who say, you know, I
think it's perfectly moral to separate the conjugal and the reproductive in these cases?
Are we sort of normalized? Have we sort of been conditioned in your perspective,
to accept things we shouldn't. Yeah, this is a really great question,
and I'll start off with saying I think there are many Christians, there
are many pro lifers. There are many people across the spectrum who are going
to come to different conclusions on this question, who are going to worship together
in the same churches, work together. So I do think that this is
a multifaceted issue where you will have people that you respect on different sides when
I come to this issue. So I'm in the Protestant tradition, so thinking
about this as a moral issue, as a theological issue, apart from the
policy discussion explicitly, I in January actually wrote two long form essays for American
Reformer on how Protestants should think about reproductive technology, specifically focusing on in future
fertilization, and so to address this question, I looked at an overview of
what Protestant denominations currently teach on the topic, an overview of a biblical theology
of infertility, how to Scripture inform the way that we think about this question,
And then I also looked at the question of technology itself. How do
we think about technology, because, as you said in vieuture, fertilization is
a reproductive technology and can't be separated from that. So I will take each
of those in part here. So the first thing is doing a deep dive
into the biblical theology. There are certainly many Catholics who have a very firm
stance on in future of fertilization, like Michael Knowles where per poch On pull
the Second and other teachings, any act that separates the conjugal act, be
that contraception or in future of fertilization, is actually inherently separating something that God
meant to remain together. And I think that there is a lot that's very
compelling about that argument, But particularly for Protestants, they're not necessarily going to
then take on the Catholic Church's teaching as much as they're going to ask the
question of what does the Bible say about this? And how can we discern
guidance from scripture to help inform our view of this, And so going through
scripture very briefly, we begin with Genesis one twenty seven where God creates a
man and woman he blesses them. I have to la you are like going
through scripture very briefly, starting with Genesis one and work our way to Revelation.
No, no, no, Genesis. We will get you through a
whole Bible. It's actually incredible. I am like a huge fan of Like
Genesis one through three is like kind of the greatest thing ever. It tells
you what you need to know about every other piece, including right becoming of
Christ. It's amazing. So Genesis one, God creates man and woman.
He blesses them in his image, and then he blesses them to be fruitful
and multiply and take dominion over the earth. And so this is a blessing
that includes per creation, but it is not a command in the sense that
one must absolutely pro create in order to be fruitful and multiply. It is
a blessing to do so. And there's a big distinction between the duties one
has to a blessing and the duty one has to a command, which I'll
get into in a second. We then shift to Genesis two and we see
Adam and Eve brought together in marriage, and Scripture says that man will leave
his mother and father, woman will leave her mother and father, and they'll
be united in one flesh, this sort of leave and cleave model. And
so in Genesis one we get the what man and woman in part are created
to be fruitful in a way that that can be manifested as through procreation,
and Genesis two we get the how. How that procreation in particular takes place
is through the marriage of man and woman. So right from the beginning we
see that when it comes to reproductive technology like IVF, it is meant to
be within marriage between man and woman, and that that is a blessing to
procreate, but not a command to do so by necessarily any any means necessary.
And then from here I think it's really interesting just to think about how
Scripture then talks about what I call this sort of package deal of marriage,
sex and procreation. And so I go through many examples in the American Reformer
piece, but Basically, every time you see marriage, sex, and procreation
discussed, you see all three of them together. So Mica two fifteen is
the perfect example of this, where within a single verse it talks about all
three of those factors, and every single time they're brought up, you see
scripture constantly leaving them back together. In the Anglican tradition, for example,
we say that like one of the blessings or the purpose of marriage is the
procreation of children, and that from marriage comes sex, and within the boundaries
of sex comes pro creation. And it's meant when the world is functioning as
it ought, though with sin and the brokeness of humanity, it's often not
that children should come from that unified bond. I am. Rather, that
seems very compelling to me as a vision for pro creation, and particularly them,
being very skeptical of any technologies that seek to separate those acts. So
the use of certain contraceptions certainly create a divide between sex and pro creation.
The use of them viature fertilization creates a divide between marriage, sex and procreation.
And it's not to say that I think those things are inherently evil.
So to say something as a sin right is to say that it is wrong
at all times, in all places, for all people, and that is
a very bold predicament. But I do think that this suggests that it's something
that should be considered not as a first option for Christians, but certainly as
maybe like a last result, a resort that if you're struggling with infertility and
you reach a point where perhaps nothing else has worked, that one can prayerfully
potentially consider in future fertilization. But we see again in Scripture there are blessings
for when these things are kept together. But then in the case of Abraham
and Sarah, right and the use of Hagar as effectively a concubine to have
the child that they desire, this circumventing of their problem of infertility actually is
one not blessed by God, but is in fact brings down a bunch of
purses on and each of their lives. Right, Sarah is incredibly cruel to
Hagar such the Abraham. Since Hagar away, Hagar is then found in a
desert with her son Ishmael, Ishmael and Isaac, their future generations end up
being in a lot of conflicts, sort of indefinitely right, and yet God
cares for Hagar right, and Hagar is actually the only person in scripture,
the only woman in scripture who names God and says you were the God who
sees me. So we still see the hand of God and the care of
God upon these deviant forms of childbearing, but it certainly is clear that this
was not the model initially step forward and then thinking about the question from the
technological angle, Oliver adonovan, an Anglican ethicist, and then Marshall mcclewan,
a Canadian philosopher, have provided I think some of the best insight on this
question. So Oliver O'Donovan points out that in future of fertilization does not heal
infertility. Infertility point to underlying causes within a man and or a woman's body
that contribute to the outcome of infertility. But when a couple uses infertility to
create a child, at the end of the day they are just as fertile
or just as infertile as they were to begin with. It in no way
actually heals the underlying conditions here. So instead it actually circumvents the problem.
And so which isn't to say we don't use technology to circumvent problems frequently,
but it is to say that we should be very clear and thoughtful about how
we are using technology to circumvent not only infertility infertility but also an aspect of
per creation. But then Marshall mccluan, he talks about how that we should
not assess a given technology simply based on what it does. So IVF creates
embryos literally, right, But we should assess a given technology based on the
social and psychic consequences that it bears on society. So how does the presence
and use of this technology actually reshape society and shape the way that we think
about marriage, sex and procreation. And frankly, that part of the discussion
is the one that I find the most compelling, even more than what we
can discern from scripture and other facets. It's the question of how has the
presence and availability of IVF shaped us as people, shaped us as a nation.
And so this isn't just looking at this individual example of IVF, but
the widespread use and availability of IVF and what we have seen from the presence
of IVF, the widespread accessibility of IVF is this move away from valuing the
inherent dignity and worth of each child to a fertility industry that profits from the
creation and destruction of human life, and in some sense this view of children
as a commodity right because in future of fertilization is not only for and fertile
man, woman, married couples, right, and feature fertilization is legally available
for anyone who chooses to use that, and we have no legal regulatory limitations
on that right, not even background checks for people who should not are not
safe to be with children. And so I think the question of how IVF
has shaped and deformed or view of children such that they're commodity and specifically that
they're an act of the will, that adults exert their will on the process
of procreation, the decision of when to create, and that children are a
byproduct of that. That seems to be the most corrupt part of this that
I think to just simply say we support IVF it's amazing actually misses the much
deeper concerns here, and frankly, I think should cause us to then step
back and say, can we in good faith use this technology without further contributing
to that commodification and in some sense to humanization of children based on the widespread
use I don't think that individuals who use IVF are typically doing that or intend
anything bit other than the best right, But it's just in how the industry
functions, how the technology shapes us. There's potentially more going on here than
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talk about that, actually, because you know, as you were walking through
all the research and the logic that you put into the American Reformer articles,
I was curious how those articles were received. But I'm extra curious if you
could just talk em because I think these things are connected actually about what people
who are generally pro IVF and you know, again understand like I do,
and or believe like I do, that there are circumstances in which IVF is
moral and wonderful. Even so, this is an industry with incredible excesses.
It is underregulated, It has a very dark side, the commodification angle.
You sounded like Katie Faust there wonderful hue compliment because her organization, it's just
been on to sow many times, is called them before us, this idea
that children exist to serve adults, and she draws that line into other conversations
about marriage and such. I know this is a big question, but if
you had to talk a little bit about what people who are pro IVF and
have seen it used to wonderful ends, what they aren't seeing under the hood
basically of this industry, because honestly, the media never covers it, you
would really have to dig to get a lot of this information. Great,
and yeah, I don't think that we would have the language to address this
issue without Katie Faust. Her impact on this movement is just huge. We
are all indebted to her, to say the least. But yeah, so
this is a really good question about the actual industry, the practice, the
nuts and bolts of in future fertilization. So, typically when a couple is
experiencing infertility, which in some states is defined as the inability to procreate without
technology, So same sex couples or single people could be deemed infertile, and
typically and medically, it has to do with the inability to naturally conceive a
child after a year of trying. So when this happens, oftentimes doctors say,
okay, we've run a test or to you, we're not sure what's
causing this infertility. You should go meet with a fertility clinic. So at
this point, you have a couple who deeply desires to have children, who
are going through a very emotionally difficult and fraught time trying to seek answers,
and so they come to a fertility clinic, and effectively, fertility clinics,
like you said, are underregulated. We have one federal law that governs the
practice of IVF, but it really only focuses on success rate reporting from clinics
and then tracks a few basic outcomes associated with the practice. But there is
no legally enforceable regulations that this federal law really confers on the practice of IVF
itself, and then certain states have different practices governing the moral and ethical side,
but those are rare and frankly few and far between. So in a
future of fertilization, a normal round would involve artificially stimulating a woman's hormones or
her ovaries in particular, so that she actually produces not one egg at a
given time, as a woman naturally does in a month, but produces anywhere
from five to twenty eggs at a given time. You can create more than
that, but that's usually the range. So a woman's body goes through the
deeply painful and difficult process of the hormone shots manipulation, and then there's the
egg retrieval process, which, if anyone has listens to the New York Times
Retrievals podcast, can go really well or it can go really really poorly if
things are going on. Basically, the hormones are incredibly difficult on her body.
Once the eggs are retrieved, they then receive sperm from the man.
If it's between a husband and a wife, I'll get into the third party
in a second. They receive sperm from the man, which like the unsavory
reality is oftentimes this is a man going into a specific room with a plastic
covered chair, access to pornography and a cup, and he's asked to rich
and it's pretty gnarly. So a lot of people have concerns even just in
how the use of pornography in a fertility industry, which is not required,
and I certainly don't think that everyone does it, but this is what's readily
available. At that point, the fertility clinic will then take the available eggs
and the available sperm and they will fertilize individual eggs and Petrie dishes in the
process of a viture fertilization. At that point they assess the number of embryos
they've created, and this is where it gets really interesting. We don't actually
have any laws or recommendations governing how many embryos should be created in a single
round of IVF, and we don't really have firm numbers on how many are
really created at a given time. So the most conservative estimate we have is
that about eight embryos are created in a single round of IVF, so eight
eggs fertilized by sperm. On the other hand, we have popular accounts from
people like Paris Hilton, who created twenty embryos in a single round of IVF
in order to hopefully select the sex that she wanted. And so at that
point, the embryos are created, and then they can undergo testing to see
which embryos are healthy, which embryos do they think are the most viable,
are the most likely to successfully implant in a woman. But they can also
test for a host of other features. They can test for the sex of
the child, for any genetic problems. It's this child more likely to have
Down syndromes, this child more likely to have another problem, right, But
they can also select for things like the skin color, the IQ of your
child, the hair and eye color. And there have been a few many
controversies in California where clinics openly advertised on the ability to design your own child,
to choose your perfect baby. And so that's a seventy five percent of
clinics in the US offer pre implantation genetic testing, which is what they used
to test them. Seventy three percent of them will let you choose the sex
and other secondary features. So then at that point the parents are then presented
with the options, and so one of the really heartbreaking parts of this is
that we have a number of reports where parents entering the process, we're not
aware of how many embryos were going to be created, right, So on
average families want to have around three kids, right, and especially if you're
using IVF, you're probably not going to use IVF for many more than three
children. So there have been heartbreaking instances where parents are then told, okay,
we have ten embryos here, what do you want to do? And
the parents are like, okay, we thought we were only going to have
a couple of embryos. This is a lot, all right, what do
we do from here? Placed in a really difficult position where certainly it can
take multiple embryos before you have a successful child that's conceived in the womb,
so you may need all ten embryos, But in many cases, parents have
the number of children they hope to have and then still have leftover embryos because
of the number that we're created, and in many cases are put in just
impossible situation whether than ask to decide the fate of these embryos of their children.
And I think that this reality is present not only for self avowed pro
life people, right, but look at the statistics. So in the United
States, we have reports show about a million encounting frozen embryos in the United
States currently. Many of these embryos have been frozen for years or decades at
a time, even parents keeping them even when they have the number of children
they want to have. And so what this tells us is that parents are
uncomfortable with the idea of destroying their embryos or donating them to research. Right,
they're choosing to continue to pay every month to maintain the lives, but
they also don't intend to use them themselves, and so they're left in this
difficult position where they don't want to destroy them, but they also don't know
what to do with them. And I think this is the most heartbreaking part
of the industries because we have no safeguards in place to really protect parents from
the emotional turmoil. And not only parents, but think about the children that
they do have. I have a number of friends who are now in their
twenties and they still have siblings that are frozen as embryos, and they are
living with the reality of I was chosen, But what about my embryonic siblings
who have not been chosen? And it is. So that's just like a
whole other thing that I think is going to grow into a really pressing problem
for future generations. Do we try to carry our own siblings in the what
do we do with these children that are there? So that's the industry,
aside from its huge because that's interesting because it's also what the Alabama case are
revolved around, which people suing for wrongful death because something life ended, their
embryos lost their lives, which is why they brought a suit under wrongful death,
and they were very upset about it. And then it created a situation
where I'm curious as to what regulations are like around the country on this.
People lost ownership over their embryos, and so some of the backlash to the
Alabama ruling was from people who were upset that these lives, what they saw
as human lives, no longer belonged to them and in the future, indefinitely,
you could cryogenically freeze for centuries theoretically longer than that, So the ownership
question becomes absolutely terrifying. And I don't know that we're prepared to deal with
that. No, we like certainly or not. We don't have the legal
practice we don't have the precedent for it, and frankly, there doesn't seem
to be much of an interest in the bioethic considerations when it comes to this
technology. It's oftentimes just oftentimes just reduced to this couple or person wants a
child. This technology can create a child. We should do that because we
value children, we want to see them happy, right, But then we
ignore all the other aspects of this, of what happens to the embryos that
are frozen indefinitely. One massive problem is what happens when the couple divorces.
So anecdotally, divorce rates seem to be rather high with couples pursuing children through
in future of fertilization, and so in many instances we've seen lawsuits across the
country where the couple then gets a divorce, they still have a number of
frozen embryos, and the woman's like, well, we're getting a divorce,
but I still want to have their children, like I want them and planted,
I want the chance to bring them into the world. And then in
some cases the father wants nothing to do with that, and he's like,
no, we're getting a divorce. I don't want these children anymore. I
don't want to be responsible for them, right, because that introduces all the
custody issues of child support and are you going to be a present father are
you not? And in many cases, the court's rule in favor of not
bringing the embryos into the world. In most instances they rule against the right
for the embryos to have a chance in life. And so thinking of ownership,
now, this woman has children, her children in an embryonic form that
she is legally not allowed to bring into the world because we've separated marriage,
sex and procreation such that you introduce a host of other issues that can now
manipulate the experience. And even our rights are our desire to write naturally care
for our children and interact with them as persons in that way. And of
course there's the money question, right. This is not a philanthropic, altruistic
industry. This is a highly lucrative industry that makes much money off of in
future fertilization. Fifteen to thirty thousand dollars for a single round of IBA on
average, it costs about sixty one thousand dollars from start to finish before a
couple will actually successfully birth a child. So multiple rounds of IVF paying for
the medications, paying for any storage fees, usually before they're able to successfully
birth a child. And on top of this, we have a lucrative egg
and sperm quote unquote donation market where men and women can sell their egg or
sperm and then other men, women are couples can buy their egg or sperm.
And this is not a one size fits all. There are different prices
for different types of egg and sperm that are available depending on who the parent
is. So, for example, it is illegal for credit card companies to
advertise on a college campus because we recognize that college students are probably going to
make some foolish decisions if they have unfettered access to a credit card. It
is not illegal for egg donation banks to advertise on college campuses saying, hey,
if you donate your eggs, we can pay you up to fifty thousand
dollars. Isn't that amazing? Come donate your eggs without any consideration of the
risks involved in this or the moral considerations of like this will now be your
DNA going out in the world. Yeah, so this is sort of like
looking under the hood. What we're looking at here is a business model that
is devoted to as little regulation as possible, limiting the way that they function
in the world. Which isn't it all a reflection on oftentimes the couples coming
into it, but it is a reflection on the fertility industry and their desire
to keep as much of this under wraps as possible. Don't believe the bs.
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Spotify or whatever you get your podcasts. You caught and I'm sure you're
aware of this. I'm not bringing into some mockery for a headline you wrote
for Heritage last week about how sex offenders basically would have access to the creation
of children with IVF you mentioned earlier, people could theoretically carry their siblings if
they've been and definitely cryogenically frozen. Like the future of this industry without not
just some sort of precise moral clarity in the regulatory space, but also in
the sort of cultural space, because and this is a good segue to just
asking you again about the reaction over the last couple of weeks, which you
said, you know, even pro life Christians sort of rushed to endorse things
that if they fully thought and paused about the ramifications of and sort of thought
ten years down the line, twenty years down the line, one hundred years
down the line, they might not endorse. It's just sort of easy because
the media pressure is so strong to kind of jump to different ends here.
But this is moving really quickly in some very very dark directions, and without
the cultural appetite for that regulation and that moral clarity, it doesn't matter if
you regulate, if you try to regulate it, because in the last couple
of weeks it's looked a whole lot like nobody wants to nobody has the stomach
to do appropriate regulations here because the politics of this are devastating for Republicans and
I just don't think there's any question about that. I think a lot of
women it fits this very powerful narrative, like the War on Women from twenty
twelve. You go back further to that, your cover photo on Twitter is
Phyllish Schlaffley, and the era absolutely smeared. The continue to smear her for
appousing equal rights of thement in ways that are utterly false and just completely ignore
her pressions. So what can be done, Emma? What can be done?
And so you bring up the crux of the matter that every time this
topic is brought up, we talk about it specifically through the lens of protecting
access to IVF, which, to clarify, is not focusing on how do
we help infertile couples receive the care that they need in order to heal their
infertility and have the children they desire. That is a very good conversation we
should be having, and that opens the playing field to actually focusing on the
problem at hand, which is a couple who desires to have children struggling with
a medical issue that doesn't allow them. But by focusing on IVF in particular,
right, we're actually saying, how can we make this technology available?
And in many cases it's about how do we make it available to anyone who
wants to use it. So Senator Duckworth recently introduced and pushed for a unanimous
consent vote, which was blocked by Senator Cindy Smith Hyde for the second year
in a row, that would for her Access to Family Building Act, So
her Access to Family Building Act, which is is a really good example for
a lot of the sorts of legislation that we're seeing on the federal and state
level that are aiming to quote protect access to IVF. It would make IVF
a statutory right for adults, no age limit, no requirements on who those
adults are, no background checks for are these adults fit to have children?
But simply IVF is a statutory right for adults and adults, these adults have
an absolute right to decide what happens to the gam meets they create, the
embryos that they create. Should they want to destroy them, freeze them,
test them, genetically edit them, clone them, turn them into designer babies.
They have an absolute right to that, and the law covers that,
and the CRS assessment of this law affirms those things. So that reminds me
so much actually of the Equal Rights Amendment. It reminds me of the Equality
Act. These laws that media picks up talking points from left wing groups,
but those talking points completely ignore the obvious legal ramifications that would come from these
things, and then conservatives cave to that media pressure and adopt the same sort
of talking points and all of the potential consequences down the road, which with
the Equal Rights Amendment, for example, we've seen are I we'll deal with
that when we get to it. Yeah, which I'm always happy to talk
about Equal Rights Amendment, right, But like, this is a very broad
and far reaching policy that, in failing to account for the narrow and particular
instances, opens the flood dates for a host of politically unpopular and very harmful
realities. And so what's so interesting to me is, as you're saying,
we're not only dealing with the IVF today, but we are legislating and building
a moral framework about the use of reproductive technologies for decades to come. And
that is why it's so important that we get things right and how we talk
about and think about and legislate IVF now. And here's why. So the
predominant focus on the federal and state level is to protect access to IVF,
building out a legal framework that enables any adult, regardless of the family structure
the lack thereof their background, to have the right to use IVF to create
children. There are, of course, still medical and natural law limitations on
what a person can do. So one individual who is mocking me on Twitter,
was like, well, should we have the same limits to IVF as
we do for natural born children? And I was like, well, if
we do, then only a man and a woman can use IVF, because
those are the literal, physical, natural limits we have. Right if he's
in favor of that, I will not stop him in the slightest But there
are certain biological limits that we have right now that we are using law to
obscure but are still in place. But IVF is actually a somewhat outdated and
fairly ineffective way at addressing this problem. But something that we are currently actively
and successfully testing on mice is in vitro gammotogenesis, so it's called IVG for
short. In twenty sixteen, Japanese researchers successfully tested and produced multiple generations of
mice using IVG in twenty twenty two and twenty twenty three. One of those
years, Brown University hosted a huge seminar on this issue, and basically what
IVG is is it allows scientists to reprogram modify any cell into a viable egg
or sperm, which means they could take a skin cell from your face,
from your cheek, from your leg, and reprogram that cell into a viable
egg and sperm cell such that you no longer need egg and sperm from individual
and distinct men and women, but you simply need DNA that you can remodify,
modify, reprogram into the given egger sperm. They've done this with mice,
using skin cells from the mouse's tell to then make an egg or sperm,
and then fertilize that egger sperm, either with the mouse's own whether they're
a man or woman, or with another mice, implant those embryos once they've
been created into the egger mice, and then birth children. But children not
conceived from egg and sperm. In IVF or egg and sperm, naturally conceived
children can sive from skin cells that were genetically reprogrammed. Now some of those
mice since twenty sixteen have been born without a brain or with significant genetic physical
deformities. But some of those mice have been born normal and able to naturally
reproduce with other mice and live a seemingly normal life. And so there's been
a massive shift in the scientific literature on reproductive technology to effectively say that when
we get to the point of testing IVG on humans, which is about fifteen
to twenty years down the road, that's like the sort of further end of
what people have estimated. What we're looking at here is an end to the
IVF industry as we know it. It's an end to the donor egins ferm
industries we know it because we no longer need those things. We only need
skin cells that can be reprogrammed. But with that it will biologically enable through
insane artificial reconstruction, a sexual reproduction, reproduction with two men or two women,
or even poly reproduction with multiple strands of DNA being used in the creation
of children. And so the thing to highlight here is right now in IVF,
we're establishing legal structures that enable any sorts of individuals to legally create children
through IVF the law. As a teacher, it reflects our morality it shapes
the way that we think, and it shapes what we value to some degree.
If we have widespread laws in place that only view IVF as a question
of access and legal access, then in twenty to thirty years, when IVG
allows scientists to medically and biologically create children through any of these means necessary,
we will have the legal structure in place to affirm it, and then the
medical technology to enable the creation of children from any sorts of human beings,
with any sorts of human beings based on skin cells, not the egg and
sperm, than a man or woman naturally create. That makes sense because this
is like it seems really far out, but like also is like literally just
being talked about normally in the literature today. Of course, yeah, I
mean, of course it's not surprising at all. It does make sense.
And I'm impressed that you've followed the science, as Anthony Fauci would say,
as well as you have, because that's there's just so much going on there.
And I think actually one of the ways these things metastasize is because there's
sort of a gatekeeping if you're not in the academic sort of world of bioethics,
if you're not in the world of these types of experiments, the places
that are doing this research, the institutions that are doing these research. This
research A, if you object to it, you're not an expert, so
you're not credible. And then B it's hard to follow in the first place,
because if you're not an expert, it actually is hard to dive into
all of this. So it I mean it, it has to be pretty
difficult to follow all of the developments because they're sort of intentionally gate kept from
people who oppose them. Yeah, and they're just right like not broadly available
yet. But I give that example to highlight why it's so important that we
do think very carefully about how we address current reproductive technologies, because if we
either a stay in the position where we're like, oh, I don't know.
IVF seems fine, Sure everyone has access, that's okay, right,
like kind of throw our hands up, like this is morally complicated, it's
personally complicated. We are not only failing to address the bioethic issues of our
day, but we're actively setting our children up for a much worse crisis when
it comes to these issues. Yeah, so I think just like this is
not just a matter of like the access of today, it's the technology of
tomorrow that will really reform member shape what we even think is possible now.
And one thing that I wanted to highlight on on IVF, especially along the
pro life question, and right again, I think that there are many pro
life people who are also pro IVF, and I think that you certainly can
practice IVF in a way that is life affirming, and so we need to
make room for that in our discourse. Right this isn't a strict binary between
either you support IVF no limitations or you're an anti IVF, anti woman bigot,
right Like, there's actually a lot of ground in between that we can
responsibly use this technology. How dare you call Michael Knowles a bigot? Ms?
Michael Wold appreciate the joke. I'm sure he would. So you know
from twenty twenty one data from the CDC that in that year a little over
four hundred and thirteen one hundred thousand rounds of IVF were practiced and of those
four hundred and thirteen hundred thousand rounds of IVF, about ninety seven thousand children
were born, which means that overall IVF has about a twenty three percent success
rate, which is a very low success rate. If you're viewing IVF as
the best or the only way to address in fertility, it's actually going to
be a very fraught and expensive process to try to have a child. If
you break that down by age groups, women in their twenties and thirties typically
have higher success rates base they typically have higher quality eggs or healthier bodies.
Once you reach the age of forty, the chances that a woman is able
to conceive a child with IVF drops well below ten percent. By forty five,
it's like a three percent chance. I think it's very very low.
But what these numbers don't tell us that I think is so important for pro
life people to keep in mind in particular, is that a single round of
IVF can create anywhere from eight to twenty embryos conservatively. So if you say,
on average, a single round of IVF creates about ten children, and
we had over four hundred and thirteen thousand children create rounds of ib in a
single year, that means that, based on twenty twenty one data, in
a single year, over four point one million embryos were created in the United
States. Of those, four point one million embryos, only about ninety seven
thousand children were actually born, which meant that the other embryos are either frozen,
failed to implant, were destroyed, or were donated to research. Those
are the only four options, which means that the success rate of IVF for
the embryos created is only about two point three percent, because ninety seven percent
of embryos on average that are created in a given year don't result in the
birth of a child. So these are very very low numbers and not numbers
right. We're talking about human beings, distinct human beings, embryonic human life
that through the current practice of IVF, don't actually aren't actually born as children.
There's just so much waste that's embedded in the practice of IBF, such
that we are creating millions of embryos in a given year for about one hundred
thousand children that are being born, which again isn't to say that that means
that one should never practice c IBF, but it does mean that one we
need much better regulations in place to ensure that we're actually creating the number of
embryos that we're intending to use, but also ensuring that the mbryos we do
create. We have the technology and we have the highest standard of medical care
in place such that they're not being destroyed or treated frivolously by the fertility industry,
such that a clinic can, as they did in Alabama, right leave
a door open for an unauthorized patient in the adjoining hospital to come and just
destroy a batch of embryos. Yeah, so I just think like we're creating
millions of embryos, very few children are born. It's a very low success
rate for the embryos. And again for people who care deeply for that question,
I think it brings a lot of concerns to the sort of wanton way
IVF treats human life or the fertility industry treats human life. Some of this
also reminds me of the Terry Schivo debate of the early aughts, because you
know, even in that Free Press article we were talking about at the beginning,
there's a woman in it who says she I think she used the phrase
m babies, which I'm sure you've heard, Emma, but is referring to
the embryos. And I have a pretty clear perspective on why we should,
uh you know, respect embryonic life and why we should respect the life of
uh non sentient uh you know, derisively referred to as vegetable adults like Terry
Schivo. But what would you say. I'm to a woman who you know
loves her m babies but says in the Free Press article they're not the same
as her children. I think she said, like, they're not the same
as my three children who are here right now. I can see them,
I can hold them, right, and it's right. So there is a
difference in our perception of the status of embryos versus the status of children who
were born that we're engaging with. And I think a really interesting example of
this is in the development of the sonogram machine. So sonograms are used to
observe the baby in uterow and when sonograms were introduced prior to that, for
like all the human history, right, because they were introduced them like the
twentieth century, you only saw a belly. You could sometimes feel the baby,
right, but you never saw the child inside the woman's body until the
child came out in birth right. And so the moment sonograms were introduced,
all of a sudden, you see a lot of people be like, wait,
that's a baby inside the woman. Right, Like, this isn't just
like a fetus or a block or some unknown object, right, Like,
this is a child that's moving, sucking, gets thumb, smiling when it
eats care It's like frowning when it eats broccoli, like some of the really
funny videos they've done as sonograms while others are eating. Right. And so
sonograms in many states are required before a woman chooses an abortion because they want
her to have to the best of her knowledge and understanding of what it is
inside of her body. I think that same analogy should be very insightful for
how we think about embryonic human life. It's incredibly small, right, it
doesn't look like a human. We can't perceive of it or see it in
the same way as we would a child who was born or a child in
the womb. But that doesn't mean that our perception is necessarily correct, right,
or seeing the full picture here. And so the thing that I would
say to this is we get into a very very very murky and very very
compromising waters the moment we try to choose an arbitrary line of what life is
valuable, what life is sentient, what life is worth preserving, and what
life isn't right. Quickly get into ablest lines of like, well, this
person has the ability can do this, and person who does oftentimes, whether
we intend to or not, reduced to the capabilities of the person involved,
be it the capabilities of an embryo or of a severely disabled person, right,
or of a child. Right. So, my daughter now is eleven
months old. She has just started to walk, She's started to say Mama,
Dad, Dad, is just like actually the cutest thing in the entire
world. Right, But she still doesn't have the ability to speak in full
sentences. She can't ride a bike, she can't walk to the door and
you know, open it to welcome a guest that's coming in. Right,
She is unable to do many of the things that we would associate with a
normal, functioning, healthy human being, And yet she is no less a
human being, right, She is just a human being at a different stage
of development than say, you or I are right, and we happen to
be what most adults tend to act and function as. Right, But in
no way are those usually usually right? Maybe from what I got after a
couple of drinks, yeah, right again, are drunk humans still humans?
Or like children? I don't know these questions right exactly, so, right
like, we can't decide the status, personhood, or worth of a human
person based on their abilities or based on our perception of them, because that
perception will always change his technology improves, and the abilities of a given child
or person, right like shouldn't determine their worth. My grandfather recently passed away,
and for the last five years of his life, he had a really
severe form of dementia, and so he was losing the ability to do the
things that he had been able to do his entire life, except he like
loved our daughter. And what was so funny is, in a lot of
ways, my grandfather at the end of his life and my daughter at the
beginning of her life function and very similarly, right they were delighted and very
beautiful and simple ways they would communicate to the best of their ability, but
a lot of the normal functions that we associate with an adult, right were
no longer present, and yet his life was no less worthy of protection.
And I just think it's actually like very like retroactive or not retroactive. I
think it's just very like limited to assume that like simply because we do not
have like a good understanding of like the status of an embryo, that somehow
like this is the most progressive and enlightened stance, because every time we think
we've reached the most progressive way of looking at human life, we typically find
out that was actually like really eugenic and evil, right, Like sterilizing people
that we didn't think we're fit to have children in the twentieth century seemed really
enlightened and seemed like a proper view of like the status of that human being.
Turns out we were actually just being really eugenic and racist and trying to
like literally remove a generation of people, right, a kind of people away.
We should not make the same mistake and apply that to embryos. I'll
stop there. I think you get the idea of what I'm saying at this
point, but no, no, that's it's just incredibly helpful, Emma.
And before we wrap, I know that you're not a campaign consultant, thankfully,
I don't know who would want that job. But you work at a
nonprofit think tank, and yet you follows that you so closely that you know
I'm curious as to what you think a way that bridges the sort of moral
and political gap for not just conservatives but also liberals who will hopefully take an
interest in the question of moral clarity on this and maybe some feminists at some
point, like they did with trans medicine and other issues, will come along
for the ride. Who knows. So this wouldn't just in any way be
relegated on one side of the oler or the other. What is a way
do you think, if there is, for lawmakers and anybody who's susceptible to
the sort of whims of the electorate to talk about these things. Yeah,
this is a great question, and it is certainly something I'm happy to get
into more detail with individual people if they're thinking about these issues, interested in
these issues from a legal policy perspective beyond the contours of this podcast. But
the first thing is that as we're thinking about this issue, our main focus
is on protecting and empowering parents and their embryonic children from the abuses potential abuses
of a largely unaccountable fertility industry. And we want to ensure that parents are
empowered with legal recourse and rights so that when they entrust clinics with their embryonic
children that they can expect the highest standard of medical care from the fertility clinics,
and that if a fertility clinics through neglect or carelessness fails in that they'll
be held accountable as we do with the Department of Health when it comes to
how fast food agents restaurants work in the United States. So when it comes
to actual policies that we could keep in mind here that I think could apply
and be desirable for a wide array of people are read that come to mind
that I am a big fan of. So the first is we should limit
the number of embryos that we create in a single round of IVF. Germany,
for example, limits the number of embryos that are created in a single
round of IVF to three. And then with those three embryos that are created,
the expectation is that you will transfer them into the woman and give them
a chance at life. So you can't transfer more than three embryos at one
time, and you can't create more than three embryos at one time. And
so what this does is it means that one parents will not find themselves in
this impossible situation where they're having to decide what to do with a surplus of
embryos. Two, if you are successful. Right with like the two children,
and you have one embryo leftover, you can decide what to do with
one embryo, which is a much better decision to be making than like what
to do with ten unused embryos. Also limiting the number that we create.
Yeah, so I think that's a really good starting point. Limited the number
we create. Germany limits it to three, Poland limits it to six embryos
at a time. Italy's laws a little unclear exactly what they do, but
it's around like three embryos at a time, and Italy actually generally says don't
freeze the embryos, but create and use them. So again, trying to
connect as much as possible that bond between marriage, sex, and procreation,
because the more delays and degrees of separation you add between those things, the
more ethical questions and problems are inserted into it. So keep it as close
together as possible. The second thing I would say is that official recommended guidelines
from the American Society of Reproductive Medicine, which unofficially regulates and guides the fertility
industry in the United States, they recommend only transferring one embryo at a time
into a woman's body. Sometimes they'll transfer three four five embryo and hopes that
one of them will actually implant to increase the success rate. What oftentimes happens
then is that the woman can sees multiple children. Twins, triplets are higher.
When that happens, it's not only a high risk pregnancy for the mother,
but it's also far less safe for the children involved, either because the
clinic will recommend selective reduction or the abortion of the additional children, or like
just there's only so many nutrients that can go around. Sometimes like only some
children actually survive a multiples pregnancy. So we should simply legally codify the recommended
guidelines that the American Society for Reproductive Medicine has limit the number that can be
transferred. And the third thing that I would say is that we should promote
access to natural restorative reproductive technology. So this is an in This is a
form of medicine that focuses on diagnosing and treating the underlying conditions of infertility in
women. Is anything from endometriosis, PCOS and hormonal imbalance, a hyperactive diorid,
anything that could be causing stress on her body. And if you can
actually target and then treat those underlying conditions, which in some cases can actually
be rather straightforward, right like a simple surgery, outpatient surgery, that sort
of thing you enable her to naturally conceive men. On the other hand,
commonly causes for infertility can be things like low sperm motility, low sperm count.
And we found in a lot of studies pere viewed and IHR just generally
talked about and referenced that men can actually reverse infertility through environmental factors, targeted
diet, targeted exercise time in the sun. I'm not endorsing the bronch talk
about these things right, getting into right, like cut the seed wills,
get all the chemicals out of your house. Men can actually like reverse their
infertility like naturally. So I'll have to say, as we're talking about infertility,
it should not simply be a conversation about IVF. But I would love
to see lawmakers on the state and federal level then say, Okay, how
can we promote access in the availability of these sorts of like in depth diagnostic
testing to really figure out what the underlying causes of infertility are. And so
I think those three approaches limit the number that we transfer for the health of
the mother and the child involved, limit the number we create so as not
to a put parents in an a possible situation be you're actually protecting clinics from
having to protect embryos for decades at a time. Right, this cuts down
on the surplus. And then three, we need to encourage and promote access
to these restorative reproductive technologies as a first course of action in our pursuit of
healing infertility. Em this has been beyond fascinating and you have so generous with
your time. I just want to thank you for all your work on this
issue, and thank you for coming on the show in the middle of what
has to be one of the busiest months probably of your whole career at this
point. Yeah, it's been so great, but Emily, thank you.
I always enjoy chatting with you, of course. And Emma, you've written
for The Federalist a few times, haven't you. I have mostly on SURC
and Chinese nationals, so a little If anyone's interested, yes, go check
out Emma's work. Follow her on Twitter again. She's a senior research associate
in the Richard and Helen Devas Center for Life, Religion, and Family at
the Heritage Foundation. Thanks again, Emma. Thanks you've been listening to another
edition of The Federalist Radio Hour. I'm Emily Dashinsky, culture editor here at
the Federalist. We'll be back soon with more. Until then, be lovers
of freedom and anxious for the first right.