Trent Arsenault, 36, of Fremont offers his sperm for free to women he meets through his website. In addition to the 14 already born, he says four more are on the way. In the meantime, he is contesting a U.S. Food and Drug Administration order to cease and desist.

While sperm bank donors remain nameless and some men offer their sperm through anonymous ads on Craigslist, Arsenault’s site is filled with photographs of the trim, blond Midwest native. In its letter, the agency describes Arsenault’s service as a business. Arsenault disagrees.

“This is not a business or a clinic. It’s just people partnering up to have a baby out of compassion,” he said.

Arsenault says he donates sperm out of a sense of service to help people who want to have children but can’t afford conventional sperm banks. The 36-year-old minister’s son has four more children on the way.

“I always had known through people praying at church that there’s fertility issues,” Arsenault told The Associated Press. “I thought it would just be a neat way of service to help the community.”

The FDA sent Arsenault the letter late last year telling him he must stop because he does not follow the agency’s requirements for getting tested for sexually transmitted diseases within seven days before giving sperm. The FDA did not immediately respond to requests for comment.

Violators of FDA regulations on human cells and tissues face up to a year in prison and a $100,000 fine, according to guidelines published on the agency’s website.

Arsenault gets tested regularly, but following the FDA’s rules would make it impossible to keep offering his sperm for free, he said.

“The regulations may be little bit strict, but I think that’s appropriate,” said Dr. Mitchell Rosen, director of the University of California, San Francisco Fertility Preservation Center.

Rosen said it’s not uncommon for women to use donated sperm from someone they know. But trusting a donor who is being honest about his background is no substitute for screening for diseases that could be passed on to the mother or child, he said.

A sperm bank will also isolate the actual sperm cells from the donor’s semen, which reduces the risk of passing along pathogens, Rosen said. “In this situation there’s no reduction of risk. It’s just as if they’re going out and having a one night stand.”

At the time of the FDA letter, the Silicon Valley computer security specialist had made 328 sperm donations to 46 women, a number he said is now higher. He can continue to donate sperm while the case is pending.

Experts say the volume of sperm donations by Arsenault creates risks for future generations. They say the greater the number of children, the greater the chances of spreading a genetic defect. Children who don’t know they’re related could also unwittingly have sex, though unlike the anonymous sperm donor system used by sperm banks, Arsenault keeps careful track of his offspring.

“There’s a danger of accidental incest or inbreeding if you’re the father of 14 children” and a habitual sperm donor, said bioethicist Arthur Caplan at University of Pennsylvania. “Nobody should be involved as a sperm donor on that level. It’s not safe.”

Caplan said the FDA may have a tough time asserting its authority over this kind of informal activity, though. Other medical experts think the agency may have a case since it deals with the safety of public health.

Arsenault has fathered 14 children in the last five years through free sperm donations to childless couples he meets on the Internet. The U.S. Food and Drug Administration sent Arsenault a cease-and-desist letter late last year telling him he must stop because he does not follow the agency’s requirements for getting tested for sexually transmitted diseases within seven days before giving sperm.

Through the  lens of a series of surveys conducted by Children’s Hospital Boston, the Down syndrome experience looks far different — and far happier — than the one most of us are used to picturing.

Most parents who answered the survey said they were proud of their child with Down syndrome, felt their outlook on life was more positive because of the experience — and had no regrets about having the child.

Those with Down syndrome and their siblings also reported an overwhelmingly positive quality of life.

Still, as heartening as these findings are, I don’t think they will make a bit of difference to parents deciding to end pregnancies once Down syndrome is discovered in a fetus.

Already, you might have noticed that you don’t see as many people with Down syndrome around as you used to.

The condition, caused by an extra chromosome, is easy to spot. The flat nose, smaller head and upward slanting eyes usually signal a range of intellectual impairment 

and other health problems, such as heart and stomach defects.

Down syndrome is almost universally seen as something to be avoided. There is little research on this issue, but genetics clinics report that the vast majority of expectant women who find out their fetus has the extra chromosome end the pregnancy.

That’s what makes the surveys by Dr. Brian Stotko of Children’s Hospital Boston and his colleagues so interesting.

Now, there are serious limits to these findings, published in the American Journal of Medical Genetics. Only half 

Only half the parents the surveys were sent to answered, and those who did were far better off economically than the average American family.

Parents who raise a child are certainly likely to see value in that child — a view often reinforced by common religious views that teach acceptance of every child as a “gift from God.” The responses from 284 people with the condition came just from those able to respond; other are too disabled to do so.

Still, the bottom line is that Down syndrome is not uniformly bleak for those who have it nor for their families. This is clearly information that ought to get more play among doctors, genetic counselors, relatives and neighbors — all of whom often weigh in with nothing good at all to say about Down kids to prospective parents.

All that said, I doubt this first-of-its kind information about the quality of life enjoyed by those with Down syndrome and those who know them best will make much difference in the decision to end these pregnancies.

Testing for Down syndrome is moving earlier and earlier in pregnancy and is becoming less invasive and much safer due to new tests that can find and analyze fetal cells in a mother’s blood at nine weeks of pregnancy. The earlier the test, the less difficult the choice of abortion becomes for many.

Add in the fact that ours is a society obsessed with perfection in ourselves and our offspring and, the climate for having kids with Down syndrome, happy though they may be, is not good.

Having an abortion for medical reasons is a highly personal decision. Those making it need accurate information even if parents-to-be intent on raising a “perfect” child are not likely to be swayed. But for families with Down syndrome, perfect is in the eye of the beholder.

Arthur Caplan, Ph.D., is director of the Center for Bioethics at the University of Pennsylvania.

© 2011 msnbc.com.  Reprints

Readers may recall that Venter’s paper touched off a big debate about the potential benefits and dangers of ‘creating’ life in the lab. President Obama asked his Bioethics Commission to hold several hearings on the topic and issue a report with recommendations on how the new field of synthetic biology (syn-bio) should be monitored. At the end of last year, the Commission recommended moderate oversight.

But Baker’s piece is largely about the new problems scientists face in synthesizing more complicated genomes before viable commercial products can be developed. The promise of inexpensive vaccines and alternative fuels is probably a long way off yet.

“Most of us are still working on a small scale because there are interesting questions there and because that’s what we have the technology to build,” says James Collins, a biomedical engineer at Boston University in Massachusetts. “We frankly don’t understand biology well enough to start designing genomes de novo.”

Many technologies must fall into place before researchers will be able to routinely work with even tens of genes at a time. Putting together huge DNA molecules is time-consuming and expensive, and designing biological components to perform a particular task is a challenge for parts of genes, let alone whole genomes. Transplanting DNA molecules into cells is not easy, nor is getting the DNA to ‘boot up’ once it is in place. And because the genomes will be far from perfect, researchers will need ways to tweak and test many variants.

Baker quotes Venter, who thinks that adapting genomes to work in different cell types will prove to be the biggest challenge to scientists. The creation of the first synthetic cell was illustrative, she writes, as Venter’s team “had to remove certain enzymes from recipient cells to keep them from cutting up the foreign DNA. And moving to other species is going to be even more difficult.”

Increasingly, however, clinics are preparing to match these embryos — which could survive for decades in suspended animation — with infertile couples who long for a child of their own. It’s a form of third-party procreation that experts predict will only become more common as the number of surplus embryos grows.

Embryo donation has been called the most humane answer to an sticky ethical situation: How to dispose of leftover embryos that are created by infertility treatments and then literally frozen in time?

For the donors, allowing their unused embryos to be thawed and implanted into another woman’s womb means giving their potential offspring a chance at life, when the only other options are to destroy them, donate them to medical research or keep them in deep freeze indefinitely.

For a woman or couple facing infertility, these donor embryos — loaded into straws and immersed in liquid nitrogen three to five days after conception — are often the only hope left at a pregnancy.

But the practice is raising difficult ethical issues, including concerns about the rights of children who would be born to parents with whom they have no genetic ties.

And should such children have the right to know the identity of the people whose DNA created them? Should we even be producing more embryos than can be used at once?

Toronto’s Mount Sinai Hospital — among the largest hospitals in the country — is preparing to begin offering anonymous embryo donation in coming months through its Centre for Fertility and Reproductive Health, Postmedia News has learned.

Vancouver’s Genesis Fertility Centre has also been working on developing an embryo donation program for more than a year. And in Calgary, between 75 and 100 children have already been born through embryo donation at the city’s Regional Fertility Program.

Across the country, embryo donations are being arranged sporadically, here and there, without national guidelines.

Some couples are finding one another on the web, raising concerns that despite a federal act outlawing the purchase of human sperm, eggs and embryos, money may still be changing hands.

“We’ve had people who met on the Internet, which is always dicey,” says Dr. Calvin Greene, medical director of Calgary’s Regional Fertility Program. “Are they selling it, because that’s against the law . . . All you can do is ask them. We don’t send out the RCMP or check their chequebooks.”

Kerry Barnes received a donated embryo in 2009, after six years of infertility treatments that included four rounds of IVF, two surgeries and three miscarriages. Her stomach was once so marked with needle punctures from the hormone shots that she couldn’t find anywhere left to inject herself.

“After the fourth IVF, we said ‘what else can we do?’ ” the Ottawa woman recalls.

A couple with twins born after IVF donated three embryos that had been frozen for almost five years to Kerry and her husband. Only one survived thawing. “We named him Tiger, because he would have been born in the year of the tiger.”

Five weeks after the transfer, Kerry began spotting. By seven weeks, “we knew we had lost him.”

She says more should be done to encourage and help couples donate embryos they no longer want or need.

“I think most people would always be thinking about them in the cold. I know I would.”

Just how many embryos are in deep freeze in the nation’s IVF clinics is a mystery. No one — not the Canadian Fertility and Andrology Society, the professional body of fertility doctors, nor Assisted Human Reproduction Canada — keeps track.

The latter body — a federal agency whose mandate is to protect the “health, safety, dignity and rights of Canadians” who use, or are born of human reproductive technologies — says it has no authority to collect this data.

Only each clinic knows how many are in its freezers at any one time. One large Toronto clinic, for example, has 2,800 embryos.

As of August 2003, the last published count, a total of 15,615 embryos were in storage at 13 IVF clinics that responded to a survey by Dalhousie University researchers. There are 33 IVF clinics in the country today. And there have been about 60,000 cycles of IVF since 2003.

Experts predict the number of cryopreserved human embryos is now probably triple the 2003 count.

In some cases, couples move away, drop out of treatment or can’t be contacted, effectively abandoning their embryos, some of which have been in cold storage for more than a decade.

The buildup is a byproduct of the IVF process, which requires ovarian stimulation. A woman has to inject herself daily for about 10 days with fertility drugs that simulate her ovaries to produce multiple eggs — 10 to 30 — instead of the usual one. Only the two or three best-looking embryos — fat, round embryos with no evidence of crumbling of any of the cells — are selected for fresh transfer.

The worry is that if doctors keep stimulating women’s ovaries the way they have in the past, “the number of embryos is going to grow,” says Dr. Roger Pierson, a past president of the Canadian Fertility and Andrology Society. “If we stay on the track that we’re on, in five to 10 years, the problem is going to be enormous.”

That will leave more couples who have struggled with infertility facing the anguish of how to “dispose” of their leftover embryos.

Mount Sinai, in Toronto, is compiling a list of patients willing to donate their embryos.

“Their families are complete, the only other option for what to do with the embryos is either store them indefinitely, which is really just delaying a decision, having them destroyed or donating them for use in research studies — and some people aren’t feeling comfortable with any of those options,” says Dr. Ellen Greenblatt, medical director of Mount Sinai’s Centre for Fertility and Reproductive Health.

With embryo donation, “you’re using material that otherwise is sort of wasted to help women and couples form families that they perhaps otherwise could never have,” she says. “And for the couples that have extra embryos in the freezer that really can’t get their heads around not giving that embryo a chance at becoming a child, it’s a very good option for them.”

Under the Toronto program, patients — including couples where both partners are infertile, as well as single women — will be placed on an embryo donation waiting list. Embryos will be offered on a “first-come, first-served basis.” Donors would have to agree to be re-screened for a raft of viruses, such as HIV and hepatitis, before the embryos are thawed and transferred. Donated embryos will only go to women under 50.

Recipients will receive non-identifying information about the donor, such as family history of diseases, but donors will decide whether to reveal their identity when the child reaches 18.

And that’s where things get controversial.

Adult children conceived via donor sperm are already going to court for their right to the records of their biological fathers. Some ethicists argue that it’s wrong to pass on human life anonymously, but infertility clinics say that many donors won’t donate if they can’t do so anonymously.

In Ottawa, Dr. Arthur Leader, a professor of obstetrics, gynecology and medicine at the University of Ottawa and a founding partner of the Ottawa Fertility Centre, once worked with a couple that specified their unused embryos couldn’t go to anyone living within a 100-kilometre radius.

“People put restrictions on where the embryos can go. . . . They don’t want to see children that look similar to their own children,” he says.

Questions have also been raised around who “owns” an embryo, whether it has “rights” under the law. The issue is so controversial that the American Society for Reproductive Medicine has urged clinics in the U.S. not to use the term embryo “adoption.”

The group’s ethics committee argues that while an embryo deserves a higher “moral status” than other human tissue because it holds potential for life, it shouldn’t be viewed as a “person.”

Under Canadian law, the woman who gives birth — and not the biological mother — is the mother of the child. Legally, the baby belongs to whomever delivers it, Greene, of Calgary, says. “Nobody could ever take that baby away from them.”

So far there’s no known shelf life for frozen embryos. Embryos from animals have been cryopreserved for 25 years, thawed and produced offspring.

“The current thought is that they are probably there for millennia,” Pierson says.

That raises the prospect of cross-generational pregnancies. For example, a couple freezes their embryos in 1990. They have a child, but keep paying their annual storage fees to keep their extra embryos in cold storage. Now their daughter is 25 and she and her partner have fertility problems.

“And mom says, ‘Hey, I still have some embryos from the IVF cycle that you were created from. Let’s try those,’ ” Pierson says.

Embryo donation is so new, little is known about the psychological impact on the children born.

“These children would grow up knowing that their biological parents created embryos with the intention of them being born to the genetic parents, but then the parents changed their minds and relinquished them,” says Dr. Christopher Newton, a psychologist at The Fertility Clinic at Ontario’s London Health Sciences Centre.

But the argument has been made that life is better than no life at all.

“These parents took these embryos and raised them and gave children the opportunity to be born and live,” Newton says. “If they hadn’t done that, what would have happened to the embryos?”

Their only access was through a clinical trial testing whether risky prenatal surgery was better than standard surgery after birth. Participating meant being randomly assigned to one surgery or the other.

“They take you to a room and a paper tells you what part of the trial you were randomized to,” said Jessica Thomas, 26, of Stansbury Park, Utah, assigned to prenatal surgery when pregnant with her son Tyson. “It was my only sense of hope to try to give him a better life.”

Amy Shapiro, 40, of Leander, Tex., was assigned to postnatal surgery, performed on her son Zachary the day after he was born.

“It was one of the hardest decisions I had to make to be in the study,” said Ms. Shapiro, who knew how disabling spina bifida was because her sister-in-law has it. “It was a big disappointment that we didn’t get the prenatal surgery because I knew that that was the surgery that was most likely going to help him the most, because otherwise why would they be doing the study? But at the same time, he could have died or been born prematurely from prenatal surgery. When they explained everything to us, I wanted to be in it regardless.”

Now, results are in: Fetal surgery, while increasing premature births and causing tearing at some mother’s incisions, made babies more likely to walk and less likely to have neurological problems or need shunts to drain brain fluid.

Besides the groundbreaking results, the seven-year study spotlights ethical dilemmas in research.

The surgery was becoming popular in the 1990s, even appearing on a Time magazine cover, and some experts believed that it might eventually eliminate most symptoms. But given the risks, others wanted proof that it was better than postnatal surgery.

“There were no systematic data regarding safety and efficacy,” said Dr. Jeremy Sugarman, a bioethicist at Johns Hopkins University who participated in early discussions. “Many things we believe to be true and right and appropriate ultimately are shown to be harmful and ineffective.” Spina bifida researchers believed that few women would participate if the surgery were available elsewhere, so they persuaded all but the three hospitals in the trial to stop doing the procedure, an unusual agreement.

“I frankly have a lot of problems when a group of physicians get together and in effect shut down everything so they can have a trial,” said Baruch A. Brody, director of the Center for Medical Ethics and Health Policy at Baylor College of Medicine. “For physicians who believe in it, why should they be pressured into stopping? For families who believe they should have the surgery, why should they be told they can’t?”

But several ethicists praised the pause. “It’s impressive to see that kind of collaboration,” said Dr. Jeffrey R. Botkin, a pediatric ethicist at the University of Utah. “The sophistication surgeons need to do this is so high, it makes sense to answer research questions by allowing it only at a few centers.”

The surgery proved beneficial enough that an independent monitoring board stopped the trial, not wanting to deny more women the opportunity for prenatal surgery. But stopping trials early sometimes limits the information researchers can collect that might benefit future patients.

Monitoring boards “walk a very fine line,” said Dr. Steven Goodman, an epidemiologist at Johns Hopkins and editor of the journal Clinical Trials. “At what point is the benefit of getting more information outweighed by the consequences of not releasing results and continuing to randomize patients?”

In some trials, if one treatment proves superior, other participants can then receive that treatment. But with prenatal surgery, that isn’t possible, said Jeffrey Kahn, director of the University of Minnesota’s bioethics center. “Some people are accepting risk for the benefit of those who will come after them.”

Still, regardless of therapy, “people who enroll in clinical trials, for the most part, do better than people who don’t, because care is controlled and monitored,” Dr. Goodman said. “You simply can’t go back and say, ‘In every trial people who didn’t get the winning therapy were deprived.’ ”

Tyson Thomas emerged from prenatal surgery with no need for a shunt and, at 22 months old, uses a walker but is almost walking independently. Zachary Shapiro, 6, has a shunt, walks with braces, and has some attention problems. Both boys, who received their surgery at the University of California, San Francisco, need catheters.

Ms. Shapiro, a kindergarten teacher, said of her son, “I do feel like he benefited, even though he didn’t benefit from the actual surgery.”

She added, “He benefited from the research that has happened about his disability.”

The baby was born at the Antoine Beclere Hospital in Clamart, in the suburbs of Paris, said doctors Rene Frydman and Arnold Munnich.

The child, born to parents of Turkish origin and named Umut-Talha (Turkish for “our hope”), was conceived through in-vitro fertilisation and was born on January 26 with a weight of 3.65 kilos (8.03 pounds), they said.

“He is in good health,” Frydman told AFP.

The child’s embryo was genetically selected to ensure he did not carry the gene for beta thalassemia, from which his siblings suffer, but was also a close enough match to provide treatment cells from umbilical cord blood, a rich source of stem cells.

Beta thalassemia produces an abnormal form of haemoglobin, the protein in red blood cells which carries oxygen around the body. It causes destruction of red blood cells, which in turn leads to anaemia.

The world’s first “saviour sibling” was Adam Nash, born in the United States in 2000.

The issue has been hedged with moral concerns about so-called designer babies and the morality of conceiving life to help a child with a genetic disorder.

Half of the gains that wealthier children show on tests of mental ability between 10 months and 2 years of age can be attributed to their genes, the study finds. But children from poorer families, who already lag behind their peers by that age, show almost no improvements that are driven by their genetic makeup.

The study of 750 sets of twins by Assistant Professor Elliot Tucker-Drob does not suggest that children from wealthier families are genetically superior or smarter. They simply have more opportunities to reach their potential.

These findings go to the heart of the age-old debate about whether “nature” or “nurture” is more important to a child’s development. They suggest the two work together and that the right environment can help children begin to reach their genetic potentials at a much earlier age than previously thought.

“You can’t have environmental contributions to a child’s development without genetics. And you can’t have genetic contributions without environment,” says Tucker-Drob, who is also a research associate in the university’s Population Research Center. “Socioeconomic disadvantages suppress children’s genetic potentials.”

The study, published in the journal Psychological Science, was co-authored by K. Paige Harden of The University of Texas at Austin, Mijke Rhemtulla of the University of Texas at Austin and the University of British Columbia, and Eric Turkheimer and David Fask of the University of Virginia.

The researchers looked at test results from twins who had taken a version of the Bayley Scales of Infant Development at about 10 months and again at about 2 years of age. The test, which is widely used to measure early cognitive ability, asks children to perform such tasks as pulling a string to ring a bell, putting three cubes in a cup and matching pictures.

At 10 months, there was no difference in how the children from different socioeconomic backgrounds performed. By 2 years, children from high socioeconomic background scored significantly higher than those from low socioeconomic backgrounds.

In general, the 2-year-olds from poorer families performed very similarly to one another. That was true among both fraternal and identical twins, suggesting that genetic similarity was unrelated to similarities in cognitive ability. Instead, their environments determine their cognitive success.

Among 2-year-olds from wealthier families, identical twins (who share identical genetic makeups) performed very similarly to one another. But fraternal twins were not as similar— suggesting their different genetic makeups and potentials were already driving their cognitive abilities.

“Our findings suggest that socioeconomic disparities in cognitive development start early,” says Tucker-Drob. “For children from poorer homes, genetic influences on changes in cognitive ability were close to zero. For children from wealthier homes, genes accounted for about half of the variation in cognitive changes.”

The study notes that wealthier parents are often able to provide better educational resources and spend more time with their children but does not examine what factors, in particular, help their children reach their genetic potentials. Tucker-Drob is planning follow-up studies to examine that question.

The full study is available at http://pss.sagepub.com/content/early/2010/12/17/0956797610392926.full.pdf+html

In a report being issued Thursday, the Presidential Commission for the Study of Bioethical Issues says that at present the technology — which involves creating novel organisms through the synthesis and manipulation of DNA — poses few risks because it is still in its infancy.

Instead, the report recommends self-regulation by synthetic biologists. It also says the president’s office should better coordinate government agencies that oversee different aspects of the field.

“The commission thinks it imprudent either to declare a moratorium on synthetic biology until all risks can be determined and mitigated, or to simply ‘let science rip,’ regardless of the likely risks,” the report says. “The Commission instead proposes a middle ground — an ongoing system of prudent vigilance that carefully monitors, identifies and mitigates potential and realized harms over time.”

Synthetic biology uses genetic engineering and other techniques to create novel organisms tailored for particular tasks. The idea is that by synthesizing DNA and by combining standard genetic building blocks, engineers can efficiently design a biological machine much as they might design a bridge or computer chip.

Synthetic biology is already being used to engineer micro-organisms to manufacture a malaria drug and produce biofuels, so it might form the basis of a huge new bio-economy that could partly supplant petroleum-based industry.

But the promise is accompanied by the risks of “bio-terror” and “bio-error” — that the same techniques, either nefariously or inadvertently, might create organisms that would harm public health or the environment.

President Obama asked the commission, which he created about a year ago, to examine synthetic biology as its first order of business in May, right after the scientist J. Craig Venter announced that he and his colleagues had created what might be called the first “synthetic organism.” Dr. Venter’s team had manufactured the complete genome of a bacterium from chemicals and transplanted it into another closely related type of bacterium, where it took over control of the organism.

While the feat raised concerns that man was now playing God, the commission’s report says that Dr. Venter’s team did not create life, since it had duplicated a known genome and transplanted into an already living cell. Nor, the report says, are truly novel creatures on the immediate horizon.

“Here’s something significant in science, but there’s no cause for fear and dread about what is going to happen immediately next,” Amy Gutmann, the chairwoman of the commission, said in an interview Wednesday.

Dr. Gutmann, who is president of the University of Pennsylvania, said the 13 scientists, ethicists and public policy experts who make up the commission had unanimously endorsed the report’s 18 recommendations. Among those recommendations was that training in ethics be required for researchers in the field.

Some critics of synthetic biology lambasted the recommendations. “This is a disappointingly empty and timid little report,” Jim Thomas of the ETC Group, a Canadian environmental organization, said in a statement. Mr. Thomas testified at the first of three public meeting the bioethics commission had on synthetic biology.

More than 50 environmental groups from around the world signed an open letter to federal officials calling for a moratorium on the release and commercial use of synthetic organisms until the risks are understood and regulations developed.

“The commission’s lack of attention to the ecological harms posed by synthetic biology is irresponsible and dangerous,” the letter said, adding that “self- regulation amounts to no regulation.”

Brent Erickson, executive vice president of the Biotechnology Industry Organization, which represents companies that use the technology, called the report “reasonable, well balanced and insightful.” He said the commission had recognized that synthetic biology “is not something radically new and threatening, but is part of an ongoing continuum of biotech innovation that has resulted in safe and successful products and public benefits for the past 15 or 20 years.”

Drew Endy, a Stanford engineer who is considered one of the most influential researchers in synthetic biology, said he welcomed leadership from the executive branch of the government, which he said was needed for the field to thrive. He also praised a recommendation in the report asking the government to evaluate whether patents might be hindering progress.

Dr. Venter, whose work precipitated the commission’s study, also praised the recommendations as “wise, warranted and restrained, which will help to ensure that this young field of research will flourish in a positive manner.”

In his introduction, Camosy, who is pro-life, outlined three goals: 1. Better map disagreements; 2. Find common ground across divides; 3. Have open hearts and open minds. Kissling, who is pro-choice, compared her pre-event anxiety to preparing for a wedding that both families believe is a horrible mistake. (Perhaps such fears were eased as the conference unfolded because there were security guards at the doors on the first day but not the second.)

After the conference, Camosy described it as largely successful in meeting these goals despite pockets of incivility, while Evangelical participant David Gushee (MacAfee School of Theology, Mercer University) described it as an audacious attempt that largely failed to find common ground.

Gushee was on the first panel, “Bridging the Abortion Divide: Recurring Challenges, Emerging Opportunities,” with his Common Ground colleague Rachel Laser, Mary Jacksteit of the Public Conversations Project (which initially attempted to bridge the abortion divide in the 1990s) and both Kissling and Miller. While I learned a lot from each discussion, theirs was the only one I attended that didn’t devolve into a remix of worn-out debates. Perhaps this is because all five speakers were already committed to the goal of exploring shared values.

Laser (who is pro-choice) and Gushee (who is pro-life) became friends through their work on an abortion governing document that was submitted to President Obama’s transition team. They described themselves as comrades in arms who bonded as they fended off friendly fire from their respective sides. In his opening remarks, Gushee described abortion as a tragedy. Kissling objected to this definition. She said the moral right of women to make decisions about reproduction is essential for them to be recognized as human beings and while she respects the “category of fetal life,” she doesn’t “have a sense of individual fetuses as possessing high value.” Even so, she’s troubled by what she sees as a coarsening of discourse over the issue.

Gushee’s use of the term tragedy initially struck me as emotionally loaded too. I did not choose abortion when I had an unplanned pregnancy, but several members of my social circle did in similar circumstances and only one of them seems to have experienced it as a tragedy. The rest have occasionally communicated feelings of guilt about their abortions, but not regret.

I have written for Christianity Today from a strongly pro-life perspective and yet I’m not sure I ever thought of abortion as tragedy either. Instead, I’ve thought of it and continue to think of it as morally wrong. When I think of tragedy nowadays, I tend to think of my son Gabriel’s suicide. The issues are related in that he didn’t have the right to take his own life any more than I had the right to take it and yet they are different because he was mentally impaired by depression when he did so. (Despite notions to the contrary, the American Foundation for Suicide Prevention says suicide is overwhelmingly a function of mental illness rather than free will.)

Because Gabriel’s death left his brother with no siblings in this world, I’ve become increasingly grateful for his cousins, several of whom were conceived outside of marriage and whose biological parents either never married or married and later divorced. That is a different kind of heartbreak, and yet all these young people are flourishing as are our bonds with one another despite the complications and pain common to all blended and broken families.

My gratitude for them has gotten me thinking about those other children who are missing from my social network because of abortion. I experience Gabriel’s death as tragic because I had the opportunity to know and love him, while I experience those children as mere absences because I never got the chance to know them. I’ve subjectified them as thoroughly as Kissling has.

This is an oft-cited problem with discussions about abortion that pit the life of the unborn child against the welfare of the mother. Women can speak for themselves while unborn children can’t and we are incapable of fully comprehending what we are missing, even if we can glimpse it from the joy other children bring us.

I talked to Gushee about his use of the word tragedy. He said it may not have been the most philosophically precise description, but he was trying to communicate that abortion reflects a deep brokenness in the human condition. This sounds exactly right.

When I think about how tragic my son’s death is, I’m reminded that I would much rather live with the anguish it causes me than envision a life in which I never knew him. Abortion is a tragedy in and of itself, regardless of whether or not we, as individuals or as a society, feel that it is so.

1 Corinthians 13:12 says we see things imperfectly in our finite understanding, but one day we will see with perfect clarity. Only then will our perception of abortion match reality.

By Christine A. Scheller, Huffington Post

Jeffrey Kahn directs the Center for Bioethics at the University of Minnesota Medical School. And, Jeffrey Kahn, have four million births through IVF trumped all the moral and ethical questions that were posed by the procedure?

Dr. JEFFREY KAHN (Director, Center for Bioethics): I think at the outset there was such concern about the new and uncertain technology that this proposed that people were quite afraid. But four million births later, those early issues went away, but new ones certainly came in the aftermath.

SIEGEL: As for the old issues, though, I mean, there were concerns of the potential eugenic consequences of IVF, that it wouldn’t just help people who couldn’t conceive, but it would help people who couldn’t conceive with the kind of mate they would like to conceive. That, I guess, is part of life today.

Dr. KAHN: Absolutely. And I think that technology has evolved in ways that have brought some of those concerns to light so we can now test embryos outside of the body and make decisions about which ones to implant based upon the results of those tests. And that’s what people were fearful of in 1978. The technology just didn’t exist until well into the 1990s.

SIEGEL: You spoke, though, of concerns that were anticipated back in 1978 that have developed. What would place in that category?

Dr. KAHN: Well, I think things around new combinations of parents, effectively. So now we have the ability to combine sperm from one man, egg from one woman, that resulting embryo can be implanted into a third woman. And then the child born from that pregnancy can be raised by a separate couple.

So we have, in that case, five different people involved in the creation and eventual rearing of a single child. And that, I think, wasn’t thought about in prospect quite in the way that it turned out to be a reality.

SIEGEL: There is another area of concern, which is the notion that embryos that are not implanted are frozen and whatever we do with them, are we doing that with human life? Is disposing of them disposing of human life?�That problem persists.

Dr. KAHN: Absolutely. And I think it’s something that was foreseen in some respect. But the numbers at which we create and now store the excess embryos has really gotten to the point where we need a societal conversation and maybe a policy decision about what to do with those leftover embryos. The estimates are something like a million frozen embryos left in the United States alone. And we don’t really have good plans for what ought to be done with them.

SIEGEL: What about the ethical and moral issues for doctors? That is, should they facilitate multiple births for a woman who has no apparent means of support of sextuplets or octuplets? Or is it the doctor’s job to honor the patient’s wishes and let the chips fall where they may?

Dr. KAHN: Well, it may be even a more fundamental conflict than that, in that we think about the right to have children as a basic fundamental liberty that we recognize. And so, when an individual says I’d like to have children, we don’t usually ask why or how many or what techniques do you propose to use.

And so we have the technology that allows us to create these high multiple birth pregnancies bumping up against what we think of as a quite fundamental liberty. And we really haven’t wrestled that to the ground either. And that’s an issue that started in 1978, and then certainly persists today.

SIEGEL: There’s another level of discussion of medicine, which is what do we think are the normal needs of making people well that should be covered by insurance plans – public and private. Have we settled that one when it comes to fertility treatments and IVF? Do we understand what it is that every woman or every couple is entitled to?

Dr. KAHN: No, absolutely not. In fact, in the United States there’s quite a variety of coverage when it comes to reproductive medicine techniques. So some policies will cover a few cycles of in-vitro fertilization for any one individual. Many, many policies don’t cover it at all, viewing it not as treatment of an illness or a disease but something that is rather more optional than that.

So it is far from being a settled issue when it comes to who pays and if they pay for it, how much.

SIEGEL: Jeffrey Kahn, thank you very much for talking with us today.

Dr. KAHN: My pleasure.

SIEGEL: So Jeffery Kahn, who is director of the Center for Bioethics at the University of Minnesota Medical School.

Copyright © 2010 National Public Radio®. All rights reserved. No quotes from the materials contained herein may be used in any media without attribution to National Public Radio. This transcript is provided for personal, noncommercial use only, pursuant to our Terms of Use. Any other use requires NPR’s prior permission. Visit our permissions page for further information.

NPR transcripts are created on a rush deadline by a contractor for NPR, and accuracy and availability may vary. This text may not be in its final form and may be updated or revised in the future. Please be aware that the authoritative record of NPR’s programming is the audio.