It's been a year and a half since Baby Louise, the first child ever conceived in a dish, was born. Since then, at least two more babies have come into the world with the aid of this technique. One of them was born in Calcutta, where the streets teem with the unwanted refuse for whom Mother Teresa cares.
Today three sets of parents are, I am sure, more worried about their children's development than their origins. To them, at least, the procedure has seemed an unmitigated good.
Now, in Virginia, a private clinic has been okayed by the state. In about two months, if the opposition is unsuccessful, the clinic will begin fertilizing eggs, implanting embryos, creating new life in America.
And so the controversy is open again between the claims of the would-be parents and the qualms of society.
To some, this procedure is nothing more than a "bridge" to take the sperm and egg across a gap of broken Fallopian tubes. To others, it is a social tunnel into the unknown.
To some, it is just a small medical step, another helping tool that we will soon accept the way we now accept the once-diabolical diaphragm. To others, it is a step down the long road to a Brave New World in which Aldous Huxley foresaw a human hatchery and fertilizing center in the middle of London.
A fear of many who protest the opening of this clinic is that doctors there will fertilize myriad eggs and discard the "extras" and the abnormal as if they were no more meaningful than a dish of caviar. But this fear seems largely unwarranted.
The clinic's procedure is likely to mirror that of nature. The clinic will in all probability harvest one egg at a time and fertilize one at a time, the way people do. In our lives, of every 1,000 fertilizations that occur, only 400 will develop to term. Of the 600 lost, 450 have a chromosomal abnormality. Of those born, only 5 to 7 per thousand are abnormal. The statistics of the scientists in terms of discards and abnormality may be no more harsh than those of nature.
But whether this is acceptable or not depends on whether we consider each two-cell embryo a human being and how seriously we regard the desires of the would-be-parents.
Our attitudes also depend on which we see as more humane: helping the infertile couple or keeping the human body as the sole vessel of creation.
Leroy Walters, the director of the Center for Bioethics at the Kennedy Institute of Ethics at Georgetown University and a member of the HEW advisory committee that has put together an 860-page report on in vitro fertilization, sees it as "an entirely pro-life activity":
"I take the desire of couples who wish to have children very seriously. Should they be legally prohibited from seeking help? My answer to that would be a very decisive 'no' unless it can be proved that it would mean serious damage to the society in general or to the offspring."
He sees neither of these, saying, "In the spectrum of risks that we as a human race face, the risks from some couples using in vitro fertilization are very low-level."
But two other members of the ethics committee, Leon Kass and Paul Ramsey, see it as "a giant step toward full laboratory control of human reproduction."
As one committee member who did not want to be quoted by name put it, "What really concerns me is 'intervention,' our posture that we are in the world to master and control and manipulate. It seems to me that this is the posture of a community headed for a fall. I take this to be a very grave matter, far more grave than the providing of children to couples who want them."
Those who are for and those who are against in vitro fertilization agree with Dr. Walters' statement that "I see it as another step in the control by human beings of reproduction." But they disagree about whether this is good or bad. Should we, they ask, respond like a consumer society to the demands of the buyer? If we don't stop here, where do we stop?
The questions are cosmic. But the issue in front of us at the moment is quite specific: one clinic.
As a person with qualms, it seems to me that fertilization and transplant are no more dehumanizing than artificial insemination, no greater or lesser a moral issue than the IUD, no more unsettling to some than it is hopeful to others.
I think we should neither fund such a clinic at this time nor prohibit it. We should, rather, monitor it, debate it, control it. We have put researchers on notice that we no longer accept every breakthrough and every advance as an unqualified good.
Now we have to watch the development of this technology -- willing to see it grow in the right direction and ready to say no.