Book Review: IVF and Justice: Moral, Social and Legal Issues related to Human in vitro Fertilization

This book provides a detailed examination of several of the moral issues raised by in vitro fertilization. Its primary concern is with those moral questions raised by the status ofthe very early embryo. Most of the argumentation in the book is for the conclusion that the human em bryo, from conception, is a person. The practical implication of this conclusion is that IVF does not, and as a practical matter cannot, respect the embryo as a person and so must be judged morally unacceptable. Six of the seven chapters in this book were written and published in journals and books between 1984 and 1987. The effect of collecting them, providing a common introduction, and adding a chapter on the analogy between brain death and the beginning of human life, is a tightly woven network of complementary arguments for the claims that the early embryo is a person and that IVF violates the rights of that person. Consequently, the repetition which is unavoidable in a collection of this kind, and the absence of a single, systematic line of reasoning do not detract from the value of this book. The first two chapters deal with general questions in medical ethics, and with the medical reality and ethos of IVF. The main point is that IVF cannot treat the embryo in the way a person should be treated. Most fundamentally, the problem is that those who practice IVF have never, and, in the nature of the case cannot, take the welfare of the newly conceived individual to be the paramount moral consideration which would override social and scientific interests as well as the desires of prospective parents for a healthy baby. The most interesting and novel part of this discussion is the author's persuasive argument that there cannot be a "simple" case of IVF in which the standard moral objections are avoided. Underlying the conclusions of these early chapters is the conviction that the early embryo is a person. The author's arguments for this conviction are developed at length in the remaining five chapters. Two sorts of argument are presented: criticisms of the positions which deny that the embryo is a person from conception, and a constructive account of why the early embryo is correctly judged to be a human individual, and of why all living humans are persons. The critical discussion of the variations on the view that the early embryo is not a person contains little that is completely new. But it is a helpful and competent analysis. It is helpful because it addresses virtually all the objections to the view that the embryo is a person from conception, and states these objections clearly and fairly. Much of the argumentation is philosophical, but the author carefully avoids the analytic technicalities and obscurity of much philosophical writing. The author does a particularly good job of laying bare the philosophical assumptions behind the central objections: the mind / body dualism underlying the Lockean view of the person as a self-conscious being is exposed and criticized effectively; the reductionistic mechanistism implicit in much of the philosophical and

Field of study: Medicine, Philosophy