Coming soon to a Swiss fertility clinic near you?

Under the current regulations governing in-vitro fertilization in Switzerland Pre-Transfer Genetic Diagnosis (or in the German, Präimplantationsdiagnostik - PID) is forbidden. PID involves testing embryos for genetic abnormalities prior to transfer into the uterus, and is allowed in the US, Denmark, France, Norway and elsewhere. It is not permitted in Switzerland - or in Sweden, Austria, Germany, or Ireland.

Now the Swiss Parliament - first the Nationalrat (lower house) and then on Tuesday the Ständerat (upper house) - has voted to consider new regulations governing PID (link in English). It is now up to the Bundesrat - the seven member executive council - to formulate the specific regulations detailing exactly how and under what circumstances PID may be carried out. The Bundesrat's proposal will then be submitted to Parliament for a vote. (If you're following the institutional politics of this, yes, that means that essentially all that really happened is that the Swiss parliament voted to task the executive branch with making a proposal to place back before the parliament, which will then vote on - and could still reject - the particulars of the proposal. Swiss politics is nothing if not deliberative.)

The Bundesrat and an ethics commission have already indicated that they are in favor of PID under certain conditions, so assuming the Bundesrat can cobble together a narrowly defined proposal, it's safe to assume that sometime in the not-too-distant future Swiss regulations will change to permit PID in some circumstances. Swiss politics moves slowly, so "the not-too-distant future" is a relative term, of course. And use of PID will be narrowly circumscribed - at present it appears that the proposal will allow for PID in cases in which at least one of the prospective parents carries a known severe inheritable condition, and PID will be used to screen for that condition only.

Those who advocated lifting the current ban pointed out that pre-natal diagnostics via amnio, and a possible resulting termination should a severe condition be discovered, is allowed in Switzerland and has been for many years. Why then forbid what is essentially the same procedure prior to transfer, when the physical and physcological consequences would be so much less severe? Those in favor of retaining the ban - vor allem the center-right Christian Democrats (CVP) - pulled out the slippery slope arguement. Today we're testing for serious illnesses, tomorrow we're selecting for hair color. Opponents of PID fear that once we open that door, one ethical boundary after another will fall away.

I don't buy this argument. I never have. In fact, I hate this type of argument. It completely disregards the ability of governments and societies - and individuals - to make and adhere to distinctions. If the majority of Swiss people think limited PID - let's say only in cases where one or both parents carries a serious inheritable condition - should be allowed but rejects whole-heartedly sex-selection, then the job of the Swiss parliament is to codify those distinctions. There is no reason to assume that simply because we say yes to situation A it has suddenly become impossible for us to say no to situations B through Z. The standard slippery slope argument is dismissive of both the power of government and the basic intelligence of individuals to choose among multiple options and to recognize distinctions.

More importantly, it turns its back on the moral complexity of our daily lives and at its heart demonstrates a complete lack of faith in the ability of real people to make complex moral choices. It assumes that if prospective parents were allowed to screen for serious genetic conditions we would suddenly lose all bearing, all reason, and run amok selecting for eye color and height.

It's insulting.

Let me tell you something. Couples who go through IVF - who go to the ends of the medical universe to give life to the "sons and daughters of life's longing for itself"- aren't worried about eye color. We have more prosaic concerns on our minds. We're just looking for a heartbeat.

I've written between the lines here and there for those of you who care to read between them, but here's what you need to know about me to understand why I'm saying all this, why I'm saying what I'm about to say and why I say it so vehemently. R. and I have one Small Boy and what we call the Hockey Team. The Hockey Team is made up of our remaining embryos from the IVF cycle that gifted us with the Small Boy. They hover in the deep freeze, in suspended animation, for the day we decide to try for a second child. And if we were allowed to PID them to screen for the conditions you can screen for via amnio, we would. Neither of us, thankfully, carries any particular gene, but neither do we understand why we can't test at the eight-cell stage what we're allowed to test for at 16 weeks. The proposal that will probably come out of the Bundesrat will in all likelihood be narrowly tailored and R. and I will fall outside the rules. That makes no sense to either of us. But nobody asked us.

I am not simply a bystander in this debate, this isn't just the vagaries of Swiss politics for me. This is my life. And I hate it when people make moral choices about my life without asking me what I think. And I really hate it when people who never have to consider the enormity of infertility in their own lives assume that they can make better choices about fertility treatment than actual fertility patients can. And I can't tell you how much I hate it when people feel the need to be my moral compass. I have a moral compass, thank you very much. I have a true north.

His name is Small Boy.