Johnstone, Brian V.

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The Linacre QuarterlyVolume 49 | Number 2 Article 105-1-1982[Book Review of ] From Chance to Purpose: AnAppraisal of External Human Fertilization, by CliffordGrobsteinBrian V. JohnstoneFollow this and additional works at: http://epublications.marquette.edu/lnqPart of the Ethics and Political Philosophy Commons, and the Medicine and Health SciencesCommonsRecommended CitationJohnstone, Brian V. (1982) "[Book Review of] From Chance to Purpose: An Appraisal of External Human Fertilization, by CliffordGrobstein," The Linacre Quarterly: Vol. 49: No. 2, Article 10.Available at: http://epublications.marquette.edu/lnq/vol49/iss2/10(. incredible and inconceivable. If one can so trivialize abortion, one could do likewise with racial prejudice, genocide, and a host of other horrendous evils. The purpose of a Catholic educational institution is to teach and promote what Catholics believe to be true. This truth is not some secondary or peripheral aspect about life, such as accounting, but rather the truth of what life is all about. Jesus Christ - His person and His teaching - is the central truth of a Christian education. It is in Jesus Christ and through His teachings that one finds salvation and newness of life, for He alone is "the way, the truth, and the life" (John 14:6). All true Christian educators from the early Fathers, to St. Thomas Aquinas, to St. Ignatius Loyola, to John Henry Cardinal Newman have known this truth. This is why they gave their lives to teaching and to founding schools and universities. They desired to bring to life the Gospel of Jesus Christ in the hearts and minds of their students. There is no doubt that Jesus was full of compassion and love. However, Burtchaell's picture of Jesus as a tolerant, broadminded, sympathetic academician is hardly the Jesus of the Gospels. The scribes and pharisees knew very well that Jesus did not treat sin ligh Uy nor was He sympathetic toward the ir refusal to hear the truth. His words to them were: "Woe to you scribes and pharisees .... " Jesus desires to forgive sin. He died on the cross and rose to glory in order to overcome sin. Through the power of the Holy Spirit He renews people' lives so that they no longer need to be slaves to sin. What Jesus does not do is tolerate sin. - Fr. Thomas Weinandy, OFM, Cap., Ph.D. Mother of God Community, Washington, D.C. From Chance to Purpose: An Appraisal 0/ External Human Fertilization Clifford Grobstein Addison-Wesley, Massachusetts, Advanced Book Program, 1981, xvi + 207 pp., $1 7. 50 (paperbound). This book deals with some of the recent advances in bio-technology, some possibilities for the future and the ethical, legal and policy issues which these raise. These matters have, of course, been discussed before. But there are some \. features of the work which make it especially commendable. The author approaches these complex questions as a scientist (a biologist) who is concerned with the appropriate role of science in the formation of public policy. The responsibilities of the scientist, as he sees them, are 1) to summarize accurately the existing state of relevant knowledge; 2) to highlight the gaps in knowledge relating to public policy and, if possible, to suggest ways to dispel these; 3) to examine policy options and their consequences; 4) to make this information available to all parties; and 5) to present personal value judgments, if warranted, but in a clearly labeled way. He does not propose that science alone can solve questions of ethics and policy, but it can establish common ground and exclude imaginable options not rooted in verifiable fact. These proposals establish May, 1982 187 the scope of the book. Having had some experience in inter·disciplinary policy committees concerned with such questions, the reviewer found the,e orientations highly relevant. Professor Grobstein concentrates his attention on questions arising from "external hum an fertilization," a more accurate designation for what is usually called "in vitro fertilization." This enables him to deal at some length with the medical and ethiaal problems. He sets the issue in its historical context and pro· vides a clear, non·technical description of the procedures. This is a preparation for a dispassionate handling of the ethical questions. Matters are moving ahead so rapidly in this area that it is very difficult to keep up. The author provides an addendum, giving more recent information. However, as would be expected, further advances again have been made since the addendum was written. (For example, I would refer the reader to the reports published in the medical literature by the Melbourne team of Wood, Trounson, Leeton and Kovacs.) Nevertheless, the fundamental ethical and policy questions remain the same and Professor Grobstein's work is still on target. The controversy surrounding external human fertilization highlights sharply the conflicting value systems of our pluralistic society. The author's strategy is to identify five broad focal values which are taken as basic to our culture. These are sexuality in the biological sense, interaction between the sexes, childbearing and parenting, and marriage and family. He then presents diverse views as distinct expressions of these basic values and seeks a way of proceeding which will best ensure respect for them. Some who hold a definite position may not be content with the way their case is presented. For example, defenders of the "natural law" will probably find their views over·simplified. However, the author has clearly set out to be fair to differ· ent points of view. The result is a clear and intelligent survey of diverse approaches which is presented as providing a basis for a possible policy consensus. I believe the author is correct in identifying as a key issue, the introduction of artificiality into the generative function itself - artificiality that affects procrea· tion and allows it to be separated from sexual behavior (p. 63). In the view of a number of significant critics, this opens the way to further assault upon the family. One issue which obviously arises here is the accessibility of the external· ized egg and early embryo, which makes feasible other kinds of manipulation beyond the limited kind involved in the procedure under discussion in the book. However, the separation of sexual union and procreation is an important issue in itself. In some value·systems, notably that upheld by the Roman Catholic Church, this touches on the very meaning of human sexual ity and parenthood. The author does not pass over this view. He recognizes that, if fertilization becomes too clearly a totally biological process, this "baser" element may subvert the loftier ones - conjugal love, the miracle of creation, the presumed selfless bonding of mother and child. This, in turn, may lead to the threatening of essential human qualities that support stable order (p. 66). A countervailing view would maintain that the externalization of fertilization could be carried out with appropriate respect and reverence, so that this danger would not necessarily ensue. Some of the other crucial arguments are explored. Will external fertilization set us on the "slippery slope" to much more dangerous possibilities such as genetic manipulation and cloning? Does the developing embryo have rights? When and how are they acquired? When does a "person" come into being? What are the ethical and policy implications of this? The treatment of these complex questions is necessarily brief. But a clear overview is provided .. Many, no doubt, are still perplexed by these profound questions. Some will have quite definite convictions. Professor Grobstein is concerned less with advo· cating a particular view than with displaying different arguments against the background of certain basic values. I believe this is a most useful undertaking. One 188 Linacre Quarterly ., I {, { , may hold and defend a certain view with passionate intensity. But there is another task - a demanding ethical task - which involves contributing to a feasible social and political policy on these vital dilemmas. Anyone who has been seriously involved in such a task will admit how perplexing it can be, even to find a way of proceeding. The author has faced up to this problem and suggests a "policy process." The mechanism he proposes calls for three basic features: 1) credibility and dignity to match the profundity of the subject; 2) a suitable gathering of expertise; and 3) appropriate public access and participation. On the basis of experience gained from earlier discussions, he proposes a more detailed program of consul tation. A valuable appendix contains the Report of the Ethics Advisory Board of the Department of Health , Education and Welfare. This gives a useful outline of a variety of positions on the eth ical and legal issues. For anyone with a serious interest in these vital matters, this book would be well worth acquiring. - Brian V. Johnstone, C.SS.R. The Catholic University of America Bad Blood James H. Jones The Free Press, Macmillan, New York, 1981. In order to comprehend how the scandalous Tuskegee Syphilis Experiment could have been sustained for 40 long years, it is necessary to understand the mystique surrounding research in general in the American medical establishment. Research, of whatever quality, has been accepted as conferring a kind of intrinsic nobility upon those who pursued it. In the mid-20th century especially, research attained its zenith as a preferable choice to mere patient care. The National Institutes of Health galvanized a bloc of heavily endowed deans and department heads who were lavished with the exorbitant federal largesse of the 1950s and 1960s. The ideal dean was a Nobel laureate; the ideal department head was an M.D., Ph.D. who had never left his laboratory to condescend to attend a clinic. The econom ies of survival were inevitably intertwined with the ability to compete for federal research funds, and clinical journals were co-opted as places where the most pedestrian projects could be "recorded" to justify a grant. When voices were raised against vivisection-type experiments carried out on liveborn aborted infants, the protesters were characterized in a major medical journal as preachers of "Know-Nothingism." The Tuskegee study involved 600 men from Macon County, Alabama, followed over a period from 1932 to 1972. Only men in the tertiary stage of syphilis were selected for the study since the purpose was to study the late complications, including the fatal complications of the disease. No real pretext of informed consent was ever attempted. The subjects were mostly poor and illiterate, and the U.S. Public Health Services offered various incentives including free medical care, free transportation, meals at the clinic and a guarantee of burial stipends to be paid to survivors. The latter inducement was a powerful one to impoverished Southern blacks whose constant preoccupation was proper burial. There is some evidence that the study was really portrayed as membership in a burial society. May, 1982 189 

[Book Review of] \u3cem\u3eFrom Chance to Purpose: An Appraisal of External Human Fertilization,\u3c/em\u3e by Clifford Grobstein

https://epublications.marquette.edu/cgi/viewcontent.cgi?article=2574&amp;context=lnq

[Book Review of] \u3cem\u3eFrom Chance to Purpose: An Appraisal of External Human Fertilization,\u3c/em\u3e by Clifford Grobstein

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