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The purpose of this blog is to stimulate thought and discussion about important issues in healthcare. Opinions expressed are those of the author and do not necessarily express the views of CMDA. We encourage you to join the conversation on our website and share your experience, insight and expertise. CMDA has a rigorous and representative process in formulating official positions, which are largely limited to bioethical areas.

How We Got Where We Are: Same-Sex Reproduction

April 12, 2018

by Robert E. Cranston, MD, MA (Ethics)

There are many examples of issues that were once unthinkable slowly becoming somewhat accepted, then becoming ordinary and commonplace, and eventually, for many in society, becoming the new standard of normality. Some of these are technological—why would anyone want a carriage without a horse? Some are theological—there is no way a practicing lesbian will ever be ordained to pastor a church. Some are bioethical—how could anyone imagine, much less condone, partial-birth abortion?

In the realm of sexual reproduction, the idea of in vitro fertilization, a technological (and for many an ethical) impossibility years ago, is now commonplace. And, as foreseen in the futuristic movie Gattaca, it may someday become the standard method of reproduction.

An initially parallel, but presently converging, technology has been the isolation, manipulation and now creation of human embryonic stem cells. A once raging debate about the pluripotentiality of human stem cells is largely being eclipsed by the creation of induced pluripotent stem cells (iPS), and more recently by in vitro gametogenesis (IVG), a process by which adult somatic cells can be converted into sperm or egg cells. Editor Rachel Lehmann-Haupt elaborates in the article “Get Ready for Same-Sex Reproduction” from NEO.LIFE.

In a complex six-stage process, thus far only accomplished in a mouse model, researchers at Kyoto University in Japan have “turned cells from a mouse’s tail into induced pluripotent stem cells and then made those into eggs that went on to gestate into pups.” Now researchers worldwide are “racing to recreate the mouse formula and reprogram human iPS cells into sperm and egg cells.” They eventually hope to create eggs or sperm from adult somatic cells from males or females. The creation of an XX egg from an XY male or an XY sperm from an XX female has until very recently been considered impossible. Now it looms on the horizon. Should this become a reality, the ramifications are mind-boggling. Gay and lesbian couples could have children from the gametes of each of the partners, a female or a male could conceivably grow an embryo from their own somatic cells—essentially becoming the biological egg and sperm donor for their own child. When the artificial uterus is perfected, the entire reproductive process could be accomplished technologically by either a single female or a single male. The child would have DNA from only one person.

The definitions of gender and family have already been stretched beyond previous imagination with the transgender revolution, legalized same-sex marriage, growing acceptance of pedophilia, surrogate pregnancies and polyamorous group relationships. In this new narcissistic twist, a child’s parent could be both the biological mother and father.

Society, blinded by the technological imperative of “if it can be done, it will be,” often fails to weigh the implications of major transitions before the fact. As we think about these new developments, a few cautions:

  1. Many embryonic lives will be lost perfecting the process. Think “Dolly,” the cloned sheep.
  2. The costs will be enormous during development and implementation. At a time when the our country’s expenditures for healthcare are the highest in the world and rising continuously, is this the best way to spend our research dollars?
  3. The law of unintended consequences has demonstrated time and again that even seemingly innocent changes in ethics and mores can have massive unforeseen ramifications. This alone should give us great pause. No one can foresee the outcomes of this process.
  4. Autosomal recessive diseases would almost certainly be significantly increased by obtaining all DNA from one carrier.
  5. God has a plan for the flourishing family. Whenever possible, it is centered on a long-term, monogamous, female/male partnership.
  6. The godly, flourishing, God-designed family is possibly the single most important force in maintaining a thriving culture and society.

We need to speak up now while there is a chance to affect the outcomes of these actions. In the shadow of World War II, Martin Niemoller preached, ”First they came for the Socialists, and I did not speak out—because I was not a Socialist. Then they came for the Trade Unionists, and I did not speak out—because I was not a Trade Unionist. Then they came for the Jews, and I did not speak out— because I was not a Jew. Then they came for me—and there was no one left to speak for me.”

As Edmund Burke said in 1910, “The only thing necessary for the triumph of evil is that good men should do nothing.” We can’t stand by and do nothing. The issue of same-sex reproduction is not going away. If successfully implemented, it has the power to change all of society as God designed it, and as we have known it. We dare not remain silent.

Robert E. Cranston, MD, MA (Ethics)

Robert E. Cranston, MD, MA (Ethics)

Robert E. Cranston, MD, MA (Ethics), MSHA, FAAN, CPE, is a board certified neurologist, with additional training and experience in palliative medicine, executive coaching and medical leadership. He is completing his 30th year serving at Carle Health, (formerly Carle Foundation Hospital) in Urbana, Illinois, as an attending neurologist, and (Past Chair—14 years) of the Carle Ethics Committee. He is a clinical professor of medicine (neurology) at Carle Illinois College of Medicine in Urbana-Champaign and is on the clinical faculty of University of Illinois, Urbana-Champaign. He is a member of the CMDA Ethics Committee. He and his wife Tammy are grateful for their five grown children, their daughters- and sons-in-law and their 11 grandchildren.