A man committed to improving humanity’s lot

Professor Sir Robert Edwards died this week aged 87. He was jointly responsible, with Patrick Steptoe and Jean Purdy, for pioneering in-vitro fertilisation (IVF) treatment, leading to the birth of the first ‘test-tube’ baby, Louise Brown, in 1978. In 2010, his work earned him the Nobel Prize for Physiology or Medicine. Here, to mark Edwards’ death, we republish an interview with him by Ann Furedi, writing under her maiden name Ann Bradley, and originally published in Living Marxism, October 1989.

Sitting in his office at the Physiological Laboratories in Cambridge, Professor Robert Edwards does not look like a mad scientist. Beverly, his over-worked secretary, describes him as ‘a lovely man who is down to earth and, well, ordinary’. She has never seen him in a white coat and thinks he’s more like a genial grandfather than an eminent scientist. She tells how at a recent party for the families helped by Edwards, ‘he sort of disappeared. We couldn’t find him. Journalists from all over the world were waiting to do interviews and he’d been swallowed up among the children. It was lovely. But that’s the kind of man he is.’ Even the publishers of his new book, Life before Birth: Reflections on the Embryo Debate, describe Edwards as ‘a very cuddly man’.

Many people take a quite different view of Professor Edwards. To some, he represents an embodiment of evil. When the Sun ran a headline screaming ‘Frankenstein tests to be banned’, Robert Edwards was one of the Frankensteins they were panicking about.

Edwards experiments on embryos, and that is not a popular job. His work has been described as ‘repugnant’, ‘immoral’ and ‘offensive to human decency’ by people across the political spectrum.

‘Egg-snatcher’

Patricia Spallone, a biochemist turned feminist writer, describes him in her book on reproductive politics, as an ‘egg-snatcher’ trying to further the interests of male-dominated science at the expense of women’s bodies. Religious spokesmen accuse him of trying to play God and interfering in the ‘natural order’. Politicians don’t know what to think. The government has avoided introducing guidelines on embryo research for years, Edwards wishes they’d get on with it, because at least then scientists have a clear idea of what they can and can’t do. He jokes that his work is the one thing that unites Protestant Ian Paisley, Catholic John Hume and a large number of atheist feminists.

Outside medical circles, Edwards is best known as the ‘co-creator’ of Louise Brown, the world’s first test-tube baby. That was over 11 years ago. In-vitro fertilisation is now a relatively commonplace procedure. Over 4,000 test-tube babies have been born in Britain, and it’s estimated that around 5,000 women a year undergo IVF treatment. Test-tube babies have become so widely accepted that Gail in Neighbours is trying for one (so I’m told).

The notion of test-tube babies had its critics from the moment news of Edwards’ research into the fertilisation of human eggs outside the body broke almost 20 years ago. In his new book, he recalls the headline reactions to some of his first experiments: ‘Ban the test-tube baby’ (Sun, 25 February l970), ‘Chief rabbi attacks test-tube stud farming’ (Sunday Express, 1 March 1970, ‘The obsolescent mother’ (Atlantic Monthly, May 1971). Cartoonists were kept busy producing variations on the theme of banks of bottles containing identical babies. There were countless warnings about the dangers of the creation of genetically identical children-cloning (Edwards says he calls it ‘clowning’), and lots of allusions to Nazis.

Mail ethics

The entire project was plagued by lack of funds. Unable to get funding for projects from the authorities, he was originally backed by the American Ford Foundation and the Daily Mail. He was grateful for their money but admits that as a staunch Labour Party man ‘it was ironic to have to turn to foreign capitalists for funds’. Both of them suddenly pulled out, worried by the ethical controversies.

With the arrival of Louise, Edwards work was given the benefit of the doubt. He was, after all, helping women to fulfil the role that society carves out for them – that of mothers. As Edwards asks, pointing to a photograph of some of the children born as a consequence of IVF at his own clinic, ‘who can argue that these children should not have been born?’. It’s a strong moral argument, but once the uses of embryo research moved away from pictures of dewy-eyed mums with newborn babies, it no longer held. And controversy broke out with a vengeance.

The rights and wrongs of embryo research have dominated debates on medical ethics throughout the Eighties. Edwards has lost count of the number of times he has been forced to put pen to paper to defend his work. He is certain that over the next year the debate will reach its climax. ‘The government have promised to introduce legislation to control embryo research, and Mary Warnock’s recommendations are before parliament, so this could be it.’ He is particularly worried by the considerable support which Enoch Powell received for his bill calling for a ban on research.

Edwards insists that stringent curbs on embryo research would be a significant blow to medical science. He believes a study of embryonic material can provide answers, and possibly solutions, to a wide range of problems facing humanity. His book puts a convincing case for his work.

The most obvious area that benefits from embryo research is research into infertility. To those of us who have spent years trying not to get pregnant, it may come as a surprise that human fertilisation is extremely inefficient. As many as one-in-10 couples are believed to be infertile. In many cases, there seems to be no reason other than that the sperm fails to penetrate the outer membrane of the egg. Nobody knows why. Edwards believes that in the future it may be possible physically to inject sperm into an egg to help fertile men become fathers. And he points out that once we learn more about how to fertilise eggs ‘the reverse may also apply: such research may also teach us how to develop new contraceptive techniques, sparing men and women the intrusiveness of present methods’.

Further research is needed to discover why so many human embryos fail to develop beyond an early stage. Work by the Medical Research Council has shown that nearly two thirds of all fertilised eggs fail to develop normally beyond a couple of days after fertilisation, and around half of all fetuses abort spontaneously in early pregnancy. Today, embryologists are efficient at fertilising eggs, but they know that once the fertilised eggs have been reimplanted there is only a 15 per cent chance that a pregnancy will result.

Curing cancer

Edwards believes that research into the way fetal cells develop could provide vital insights into the development of cancerous cells (which develop in a similar way). And from this therapies for the suppression of cancer could follow.

Research into genetic material in embryos also holds the promise of new clinical breakthroughs on physical and mental disabilities. Before we can avert genetic problems in embryos we have to know what causes them. Edwards maintains that research on ripening human eggs at the moment when chromosomes (23 in normal conditions) are reorganising can reveal a great deal about what goes wrong in some human eggs. Chromosomal defects alone are responsible for many forms of abnormal development including Down’s Syndrome. Edwards was first able to study chromosome patterns in mouse eggs over 30 years ago; work on human eggs is now common, but it has a long way to go.

Several genetic problems cannot, at present, be identified until 10 weeks of gestation, or even five months of pregnancy. If these problems could be detected in the first few days of embryo development it would be a major breakthrough. The control of Lesch-Nyhan Syndrome is a Case in point. Lesch-Nyhan Syndrome is a congenital abnormality which only affects boys. It inflicts spasticity of the limbs, involuntary movements, gross mental retardation and compulsion towards self-mutilation. Fortunately, it is extremely rare.

Mice and women

Currently, parents at risk of having a Lesch-Nyhan child have to start a pregnancy, wait until is sufficiently advanced for an amniocentesis, and then, if the fetus is found to be afflicted, choose between a late abortion or a child condemned to a tragic life. Given that the chance is one in four for an ‘at risk’ parent producing such a child, the prospective mother may have to undertake several late abortions.

Researchers have recently found a way of diagnosing the condition in mouse embryos when they have developed to only eight cells. They tested for the presence of a protein, an enzyme known as HPRT. If it is not present, it means the mouse suffers from the genetic defect that is Lesch-Nyhan Syndrome in humans. Work is now under way to see if the same principles can be applied to human eggs. There is no logical reason why not, but mouse embryos are different, so much more research has to be done on human embryos. If this is successful, it will open the way for genetic screening. The mother would simply take a fertility drug to ensure that she produced a larger number of eggs than usual. The eggs would then be washed out of her womb before they had a chance to implant. A doctor would test the eggs and re-implant those which were not afflicted.

The work that Edwards is most excited about today is the transfer of fetal tissue itself. This is already well under way in the treatment of Parkinson’s disease; fragments of brain from aborted fetuses are inserted into the brain of Parkinson sufferers. The fetal cells can replace the chemicals necessary to control physical movement. Edwards now wants to go back to the foundation cells of the body – stem cells – and look at the opportunities for transplant work with them. He thinks we can go so much further than the medical methods used today: ‘When you think of the primitive way in which we do surgery at present – a chap whips a kidney out of someone, puts it in a box, transfers it by plane or whatever – we have to do better than this. What we need is to put new cells in.’

To grow a new heart… it sounds like science fiction, but Edwards insists that, as science develops, ‘what is abstract and rarified one day may very easily become urgent and relevant the next’. Genetic engineering is a good example of this.

‘At this very moment’, Edwards writes, ‘mice in laboratories all over the world are carrying genes that were injected when they were microscopic, newly fertilised eggs, human genes perhaps, or cattle genes, alien substances which instruct their metabolisms to produce growth hormones, antibodies or novel medicines of one kind or another… These animals are called transgenics, and transgenic mice and pigs are tailored, for example, to produce the human growth hormone used in several child clinics, mostly in the USA.’ Near Edinburgh, a flock of transgenic sheep are apparently capable of supplying enough human blood-clotting protein in their milk to treat all the haemophiliacs in Europe. Edwards thinks the benefits of work like this represent the reason why ‘even at its most abstract, no line of study should be lightly abandoned’.

Edwards is worried that when the government does get around to legislating, it will impose restrictions to prevent necessary test-tube research being carried out. He has frequently called for legislation on research to be introduced. But he’s worried about the climate that surrounds discussion on embryo research today. He detects a rising hostility towards the very idea of scientific progress. ‘The climate is moving more and more towards people being suspicious of scientific advance. Instead of looking at what good you can get out of research, people are immediately suspicious. It seems to be the ethics of Dr Jekyll, Dr Strangelove and Brave New World that informs opinion on these things. It is very backwards looking.’

He thinks the arguments that fetal research should be banned because it is dealing with the creation of life are misinformed. He begins his book with the observation that ‘Nobody can create human life artificially, not in a test tube, a Petri dish or anywhere else. Such claims are ridiculous, pathetically arrogant… The most any of us can do is to help make life possible and to make it healthy and good. And that was what I wanted to do – to help make human life possible, and healthy and good.’

Edwards insists that his motivation for driving back the frontiers of science is to improve humanity’s lot. He is deeply offended by the ‘Green feminists’ who are opposed to his work, and the growing sympathy for the argument that male-dominated science is being used to abuse women’s bodies.

Hyper-emotional

Since the mid-Eighties, groups like the Feminist International Network of Resistance to Reproductive and Genetic Engineering (FINRRAGE) have become increasingly influential in Europe, especially in Germany where Green politics has deeper roots. They argue that the methods pioneered by Edwards are suspect because they ‘were not invented to serve women’s interests, but the needs and desires of medical scientists, and the state, to further technological progress and to aid population-control aims’ (1).

Edwards is scathing about their claims, and their characterisation of him as an abuser of women’s bodies. He admits that research has not always been used wisely but points out that this ‘only tells you about the kind that society we live in, not that science is inherently bad’. He brandishes a photograph of some of the women who have been involved in his IVF programmes. ‘Look at the happiness of those women. They wanted this treatment. I am fighting for these women. Feminists should be arguing for more of this kind of help for women, not less of it.’

Edwards is even more worried about the broader consequences of their anti-science and anti-technology arguments than their attacks on his personal motives. ‘People who call for bans on fetal research are people who would take us back to the dark ages.’ He believes that humanity has had to try to solve the problems it faces. ‘People have problems and we have to do our best to overcome those problems. That’s what makes mankind what it is. We struggle to overcome problems. I cannot accept this hyper-emotional stuff that says that some areas are out of bounds and cannot be touched. People say that we scientists are trying to play God, and that man shouldn’t interfere in these matters. But it is possible to look at it another way. If we know we can do something to prevent terrible things like Parkinson’s disease or Alzheimer’s disease, and we don’t because we choose not to, who’s playing God then?’

‘What I say is these things are determined by man. All the issues facing us are man-made and man-decided. We’ve created medical technology, drugs, the means to intervene. Now we have to decide what to do with them. There’s no saying God should decide. You have to put it right yourself.’

It is easy to understand why those in the establishment are so unsettled by embryo technology. The techniques pioneered by Edwards don’t just challenge scientific boundaries, they challenge existing moral and ethical boundaries too.

IVF techniques provide the potential for a separation between reproduction and the family. Professor Edwards always stresses that he sees his work as strengthening the family, but he recognises that it also raises the possibility of alternative arrangements. In his book, he argues against the notion that marital sex is the natural way to reproduce, created and ordained by God: ‘It was evolution rather than a one-off act of God, that bound the transmission of life to the sex act, and… the connection is therefore always open to modification or abandonment.’ IVF offers the chance for modification and abandonment. It provides an effective way for lesbian couples to have children without the direct involvement of a man; single women could have children without a partner; frozen embryos would allow a woman who so wished to have her partner’s child after his death. It is easy to see why those in authority who have promoted the ‘sanctity of family life’ for so long are ambivalent about the development of these areas.

Whose embryos?

Storms still regularly break over the moral validity of the possibilities offered by fetal technology. In Tennessee, Mary Sue Davis is battling out a custody case over her right to implant embryos now that her marriage has ended and her former husband no longer wants to father her child. Two years ago, the Voluntary Licensing Authority (the unofficial watchdog on such matters) ruled that it was unethical for an 18-year-old woman to donate eggs to her 45-year-old mother who had remarried. Had the operation gone ahead the woman would have given birth to her own granddaughter, and the child would have been raised as the stepsister or brother of its genetic mother.

Edwards is sensitive to these ethical rows, although he thinks much of it is mystified. Wrapping up a debate over surrogacy in his book, he muses: ‘The British Medical Association has recently been reported in the Times as concluding that “the interests of the [infertile] couple are outweighed by legitimate social conditions”. I honestly can’t see why. Do doctors consider “legitimate social conditions” before they swap bone marrow or kidneys between consenting adults?’ He concludes that ‘it seems unlikely’. One reason why he wrote the book was to cut through the mystifications and inform people about the ‘facts of the matter’.

Politics of ethics

Edwards is not in favour of a total scientific free-for-all. ‘In every profession you get people who are out of control, and who worry you, but you can’t judge any profession by the wild element. You have to establish with the body as a whole what are the laws of control. The vast majority of us are sincere, concerned about our patients, stimulated by our research and want to do more to help.’ But he is concerned that, even before the government brings forward an embryology bill, there are already things that can’t be properly researched because of current restrictions.

‘The problem is that you have to work problems out on the basis of rational discussion, and with issues like this, people work on emotion. Mary Warnock has done a very good job shaping her report [which is expected to provide the basis for legislation], but even she encourages this. She says – I think she’s quoting David Hume – “Ethics are about emotions”. We have to ask, what shapes Mary Warnock’s emotions? Emotions are about politics. They’re shaped by your current circumstances.’

Edwards argues that, if those seeking to hold back science prevail, the dangerous ramifications will go way beyond the issue of research and affect society. In his book, he explains that ‘moral laws must be based on what man knows about himself, and this knowledge inevitably comes from science’. Ask him to expand on this and he becomes impassioned. ‘Today we are directly in conflict with widely held moral laws. This is like Darwinism all over again, in a battle of judgement over what is right and what is not. But we cannot afford to give way and allow the Catholic Church to stand in the way of development.’

Look forward

‘If only people would look forward to what could be done through responsible scientific research, rather than conjuring up Frankenstein images. We need a bit of vision.’ His book holds up the vision of an Italian scientist, Mantegazza. In 1850, he predicted that semen from farm animals would one day be frozen and transported over long distances for subsequent artificial insemination. Amazing foresight, especially since the temperatures needed to store spermatozoa did not become available for another 40 years. It took almost a century for science to make Mantegazza’s prediction come true.

Professor Robert Edwards would like to see a little more of Mantegazza’s forward thinking and a little less philistinism about science. ‘Once you turn your back on progress, it’s back to the dark ages.’

This interview was originally published in Living Marxism, October 1989, under the byline of Ann Bradley.