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IVF professor warns against genetic engineeri -

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IVF professor warns against genetic engineering

Broadcast: 12/07/2007

Reporter: Ali Moore

Professor Robert Winston, one of Britain's best know doctors and scientists, was a pioneer of IVF
treatment in the 80s, setting up a successful clinic in London. Now he is back in the spotlight
warning the potential dangers of genetic engineering and the risks of taking the technology too
far.

Transcript

ALI MOORE: He's the fertility guru who's graced our television sets over the years. Professor
Robert Winston, one of Britain's best known doctors and scientists, was a pioneer of IVF treatment
in the 80s, setting up a successful clinic in London.

In 1995, he was made a life peer for his work in the field. To Australian audiences, Lord Winston
is best known as the presenter of a number of BBC television series, including the award winning,
'The Human Body'. Now he's back in the spotlight, warning of the potential dangers of genetic
engineering and the risks of taking the technology too far.

With his latest book Child Against All Odds, how far should we go in the struggle for life?

I spoke to Professor Robert Winston earlier in Sydney today.

(to Professor Robert Winston) Professor Winston, welcome to the program.

ROBERT WINSTON: Thank you.

ALI MOORE: A pioneer in reproductive technology, indeed also so-called pre implantation diagnosis,
the beginnings of selection, and yet you're very clear in your latest book that all these
technologies, quote, 'as well as carrying modest promises for improving the lot of many humans,
unquestionably contain seeds that could lead to our own destruction'.

Is the technology the seed, or is it what we may do with it?

ROBERT WINSTON: I love your point about modest promises, because I think that's a very accurate
description.

ALI MOORE: They're your words?

ROBERT WINSTON: Are they? I'd forgotten I'd written them. Well, I stand by that. I think actually,
again and again, we have scientific advances which are over hyped and if you look at the human
genome, for example, all sorts of promises were made about it and to some extent it's stem cell
biology which no doubt we'll come to in a second.

But certainly reproductive technology, people like me have pedalled in failure because most of the
people who are desperate women and men, but largely women because it affects women so much more
because they are the ones who are the patients who have these horrible things done to them, most of
them go away without success. IVF, even in the best hands never reaches a genuine 50 per cent
success rate.

I mean people massage the figures a bit, but actually the human embryo only implants and produces a
baby about 15 to 20 per cent of the time. The reason why I have this long winded intro is I think
that's what's led people to manipulate reproduction and therefore...

ALI MOORE: And that's the seeds of destruction?

ROBERT WINSTON: ...And that's the seeds of destruction in this book. The question really is, even
there's a modest amount you can do with the technology, will there come a time that with our
ambition, we will try to go too far with it? I think that's what the book is really about.

ALI MOORE: If you look at that question, are there paths that we don't follow? Are there research
directions that we shut off before we know the potential outcome for fear of what we might discover
we can do?

ROBERT WINSTON: Well, some countries have done that, of course, and the classic example is the ban
on stem cell research in a large number of countries, but I don't think you can argue that you
shouldn't do an area of research because of what might come out of it.

You see, the classic example would be, wouldn't it, nuclear technology. You know, radiation. Of
course, had we not gone down that research route we wouldn't have invented the atom bomb and the H
bomb and neutron bombs and so on. On the other hand, we wouldn't have had X-rays which have saved
more lives than any bombs put together, including the ones dropped on Japan for example.

So I think the question of how you use the technology has to be something that we do have to have
discussion, dialogue about.

ALI MOORE: But how do you get that consensus, and informed consensus, and ensure that the consensus
is keeping up with the science?

ROBERT WINSTON: What I'm arguing for is that regulation doesn't work. Because if you regulate, this
is from high, it's topped down, people who are clever will go overseas, you can't regulate
globally. I think there has to be change of culture. There has to be a recognition of citizenship,
of responsibility. If you go to any major university in Britain, America or Australia, ethics is
not taught routinely to all science graduates. It is to medical students but not to science
graduates.

There should be an understanding of commercial conflicts, conflicts of interests, the notion of
exaggeration. We always talk about science as if it's certain when actually science is really about
our uncertainty, and there needs to be a much greater recognition of those problems.

ALI MOORE: Isn't one of the key issues here that it's such a moving feast? One example from your
own life is that you openly admit to having qualms about so called designer babies and you include
in those qualms the context of families who select an embryo for a particular tissue type if
there's a sibling who is afflicted with a fatal disorder. You say that breeding, literally, to
provide the tissue for a transplant, now you say you were wrong to criticise that treatment?

ROBERT WINSTON: That's quite right. Well, I think I was a bit arrogant about it and I think that's
an issue for scientists. I think it's very easy for scientists to feel they know the answer and I
think I was wrong to feel like that and I think really, I had neglected a full understanding of
what those families were going through and a recognition that if they tissue typed a baby it
doesn't really threaten the moral fabric of our society. Very few people are going to do this.

ALI MOORE: What does affect the moral fabric of society? It's so intensely personal?

ROBERT WINSTON: Yes, what a difficult question that is, I'd have to think about that. But I think
that one of the issues here is the question of human autonomy. I think that we have to recognise
that as doctors we're responsible to the autonomy of the individual in front of us who's suffering
and we have to listen to them primarily.

I think we're not responsible for society's autonomy. We're not responsible for the health of
society. The interesting paradigm, the example would be the Nazi doctors before the war, who
believed absolutely in many cases altruistically, it seems bizarre, that actually they were acting
in the best interests of society to do the sorts of horrific things they did and they forget the
cardinal principle, that actually the individual is what they should be responsible for, not their
society. And I think that's one of the issues in our whole moral structure in medicine.

ALI MOORE: So when it comes to IVF, where do you draw the line? Who should not be deemed eligible?

ROBERT WINSTON: Well, you're asking me an impossible question and I don't mean that rudely, I mean
it's a question that we go through every day and we find it impossible to answer.

ALI MOORE: You wouldn't ever have a blanket age ban, for example?

ROBERT WINSTON: I think it comes back to being open minded about the individuals. I would be very
cautious about treating women over 50 and in general, I would be very cautious because I think it's
a misuse of the technology because you're treating a natural event, the natural menopause as
opposed to an unnatural menopause which is a bit earlier.

And I think the older the woman gets, the more careful you have to be, but on the other hand,
different people age at different rates. They have different prospects, and they may be able to
care for a child differently and love that child differently. So I think there has to be an
individual basis for research.

I've met in the course of writing that book, I think I mention it, I met Mrs Illiescue in Romania
who is now 67 and I mean, she looks ancient, she looks really old, quite sad. And you look at this
little child and I cuddled her baby who's now 18 months old, and she sat on my lap for two hours
while I interviewed her mother. She never once complained. Now I argue that her relationships are
odd. Now, will that matter when she grows up? I don't know.

ALI MOORE: Did you walk away from that experience, the oldest woman in the world to have a child,
did you walk away feeling happy?

ROBERT WINSTON: Uncomfortable. I didn't feel happy, I felt uncomfortable. I also felt a bit sad. I
also felt it was difficult to make judgements because I could see that she really loved her little
girl and that for her this was incredibly important and a huge focus.

Whether that little girl it's really in her best interest, I doubt and, of course, her mother may
die prematurely or may die soon. On the other hand, you have to say to yourself well, is it better
to exist than never to have existed at all?

ALI MOORE: And, of course, we have people like Rupert Murdoch who at the ripe age of 71, 72, 73,
fathers a child.

ROBERT WINSTON: Yes. Well, he might boast about that, Picasso was ten years older.