The Art of Making Children: The New World of Assisted Reproductive Technology, by Francois Ansermet

Posted on Nov 07, 2017

Life, but not as we know it

“In man, creature and creator are united: in man there is not only matter, fragment, excess, clay, mud, madness, chaos; but in man there is also creator, sculptor, the hardness of the hammer, the divine spectator and the seventh day” – Friedrich Nietzsche, Beyond Good and Evil

 

The fabrication of human life disrupted by contemporary technologies

Where do children come from?  That is the impossible question par excellence.   Why am I me and not someone else?  Why was I born here, rather than somewhere else?  Why now, rather than at another time?  Whatever the explanation may be, origin remains something that cannot be represented, cannot be thought, inaccessible, ungraspable – as is revealed with such clarity through the question of a little girl to her pregnant mother, once the mother had exhausted all manner of explanations, without any of them answering the question: “Yes, I know all of that, but my question is a different one: me, before I was in your belly, where was I?”

The question of origin inevitably comes up against the gap in any explanation given.  Hence the proliferation of origin myths: myths that include the elusive nature of origin in their narrative.  It must be remembered to what extent theories of fabrication have been more mythical than biological – myth being a way of processing the unthinkable.

Science itself does not manage to grasp origin.  If science can explore many of the stages, the beginning eludes it.  Science’s field is that of the ‘how’; the ‘why’ lies beyond its prospects.  What one sees under the microscope does not solve the mystery of what life is.

The reproduction of life carries just as much mystery.  Indeed should one really talk of reproduction?  The fabrication of life is always the production of something new: a new that is always unexpected, surprising.

 

New modes of origin

The biotechnologies of reproduction add their complexity to all this; they bring new recipes for making children.  Indeed today we can disjoin sexuality from procreation, procreation from gestation, origin from filiation.  Temporal disjunctions can also be made through the preservation of gametes or embryos, intending them for use at a later date by the genitors, or for donation to others.  All these technological possibilities can be combined, resulting in more and more complexity in origin.

The world of procreation is currently changing faster than our ability to keep up with it.  The new uses of biotechnologies outstrip our ability for representation.  Classic points of reference no longer allow for the conceptualisation of these new situations, nor for their representation.

A child has just been born.  Who should we include in the photo?  There could be an increasing number of people.  We have gone beyond what was known.  As was the case with a photo sent by smartphone: in it we see the couple who have procreated using their own gametes, holding the child in their arms, but there is also, in front of them, laying on the bed, the woman who performed the gestation – the person we would call the surrogate mother.  If donor gametes had been used, and supposing the donors were not anonymous, we could have added the sperm and egg donors to the photo.  Then, why not, the doctor and the biologist of reproduction who worked to perform this assisted reproduction.

These new uses of biotechnologies also overthrow anthropological reference points: through donor eggs and surrogacy, the mother can in effect become as uncertain as the father.  Mater incerta est:what will be the consequences of this beyond the pater incertus est?  Couples made up of two women who procreate through artificial insemination with donor sperm (AID) sometimes alternate the task of bearing the child, taking it in turn from one pregnancy to the next.  Others choose to proceed via IVF where one provides the egg and the other performs the pregnancy.  If at a later date they separate, the question of filiation becomes complex.  From a legal standpoint the child is that of the woman who gave birth, but at a genetic level it is the child of the one who gave the egg.  It remains to be seen who the sperm donor was.  Then we could introduce to this genetic aspect the debate around epigenetic traces that are transmitted during the pregnancy.

Let us come back to our photo.  We could add the zygotes that were surplus to requirement, and are cryopreserved.  Indeed the supernumerary zygotes in an IVF medically assisted reproduction are preserved.  They remain, outside the body, outside time, in abeyance, until it is decided to unfreeze them – opening them up to a future that had been held back in liquid nitrogen at -196°C.  Conceived at the same time, these zygotes can be implanted at a later date and in succession, creating non-identical twins, staggered in time.  Origin can in effect be staggered in time through the action of cryopreservation of zygotes or embryos.

Today oocytes can also be preserved, through the technique of vitrification.  Thus we can have oocytes that are delocalised from the body, and protected from the passage of time that is taking place for the woman.  This new technological recipe opens up the possibility for auto-preservation.  Time passes by for the woman, but not for her oocytes that remain in a state of eternal youth.  The possibility of evading time comes into play in the new modes of fabricating children.  Time becomes yet another actor; how to make it figure on the photo?

Oocytes, like sperm, can therefore be used ulteriorly.  By preserving her oocytes, a woman can be a donor to herself: a temporal donation.  However these gametes that have been preserved can also become caught up in the laws of the market.  They can be sold, along with their characteristics or their genetic potential.  There are sperm banks, why not egg banks?

The preserving of oocytes has also made its entry into the world of employment.  Apple and Facebook have proposed to the women who work for them to freeze their oocytes, even going so far as to pay for the procedure.  Something that potentially gives these organisations the right to decide, by contract, the time of their employees pregnancies –  while at the same time justifying this procedure as a step towards an equality in career opportunities between men and women.

 

The vertigo of technologies

The current age is multiplying the disruptions in the fabrication of life: in procreation, in gender, in filiation, in prediction.  These disruptions provoke multiple vertiginous emotions: questions of origin, questions of difference, questions about what one will become.  Vertigo engenders, in equal parts, feelings of anguish and attraction.  One can feel drawn in by a void that fascinates as much as it causes fear.

To know whence children come becomes an increasingly unfathomable question, even when we know all the protagonists.  Which one matters?  From whom is one descended?  Conception becomes a collective matter.  With biotechnologies there is no longer a superimposition of the genitors and the parents.  Others are busy making the child – while at the same time remaining as perplexed as the next person about what it is to reproduce life.

A new type of vertiginous question could be added to the list: the dizzying feeling provoked by the use of devices introducing a new disruption, a disruption between the living and the machine, between the human and the non-human – leading to the fabrication of a non-human human.  It is from this disruption that the robot proceeds.  The robot is not born; it does not die either.  It has been created without being procreated.  The robot is a creation made by man, without resorting to procreation, without sexual reproduction, without gametes, without even the need to resort to the body of a woman.  The robot is made adult from the outset, without travelling the paths of a childhood that implies the other and time.

The other, if he is there, is there in hybridisation.  The robot can be partly human, partly machine, as is the case with cyborgs.  To the extent that it is difficult to know where the frontier with the human lies,  is it a machine that integrates the human or a human grafted onto a machine?  The prospects introduced by strategies to enhance the human are numerous.  These strategies can range from prosthetics that are substituted for a missing limb, and which can be guided directly from the brain; to an exoskeleton that can enable a tetraplegic person can stand and walk.  Examples are proliferating, the main issue being in the technological interface that comes into direct contact with the brain, and which makes it possible to guide these artificial devices.

This evidently raises the question of whether we have here a human fitted out with and enhanced by a device, or a machine that takes control over the human.  Who decides?  Where does the boundary of freewill lie?  Would there by a risk that these machines take control of the person they enhance?  Could the enhanced human, paradoxically, find himself diminished, or at any rate alienated from the mechanism that has been added to him?  If we imagine an interface with memory chips, what will this enhanced memory be?  Such a prospect opens onto the crucial question of knowing what, ultimately, is the biological and psychical function of forgetting.  To this we might add that it would be possible to add memories that would disrupt the identity.  The prosthetic interface could be guided by others, altering the person who has been fitted with it.  Who knows if the machine itself might not take over, as does the computer in Kubrick’s film 2001: A Space Odyssey.  Will it be necessary to envisage a red button to switch off the robot if its artificial intelligence took over from the human intelligence, with the intention of destroying?

On the topic of entirely artificial robots, one can be struck by the fact that we seek to give human, android, forms to robots.  This with a desire to construct a resemblance that is sometimes taken to the extreme, through facial expressions, a life-like gaze, an artificial intelligence programmed to respond to questions.  An example of this could be the robot Sophia made by the company Hanson Robotics, modelled on the features and expressions of Audrey Hepburn, and who came to make a speech at the U.N. in a session on artificial intelligence on October 11th 2017.  This same robot having recently been given the citizenship of Saudi Arabia during an event “Future Investment Initiative” held in Riyadh from the 24th to the 26th October 2017.  Able to produce many expressions, with a gaze that seems alive, answering the questions put to her, she surprised all those who encountered her, and who exchanged a few words with this disquietingly familiar machine.

Can the machine become human? Like Pygmalion’s statue that suddenly becomes animated, and has repeatedly done so under numerous guises since it was first formulated in Ovid’s Metamorphosis.  One example of this retelling is Rousseau’s astonishing lyrical drama Pygmalion, which depicts the metamorphosis of the statue into a woman.  Flesh colours diffuse through the material, a spark appears in the eyes, and movement occurs: “He turns and sees the statue move and come down the steps”, Galathea points to herself and says: “Me”, Pygmalion echoes this and exclaims: “Me!”, Galathea points to herself again and says: “It is me”.  Pygmalion thinks he is the victim of a hallucination, but Galathea proceeds to go and touch a block of marble that stands in the workshop and says “It is no longer me”, she then touches Pygmalion and says: “still me”.  Pygmalion transported by his emotions tells Galathea that she is his masterpiece, that they are one.  For this is indeed what is at stake, the creator is also his creature, the creature is its creator; a binary aspect comes into play between the creature and the creator, a mirror effect, an imaginary relationship.  We no longer know who is who, who lives through whom; as Pygmalion states at the end of this lyrical drama: “I have given you all of my being; I will live only through you”.  Pygmalion is ready to die so that he may live through her “to live in Galathea”.

“Pygmalion has created a statue that has come alive”

Clearly, Pygmalion has created a statue that has come alive.  The robot, on the other hand, is not alive; it simulates life.  It is a machine that evades time.  The robot has no body.  Detached from the living, detached from time, detached from the body, the robot can appear as a melancholic figure.  The robot is without organs: an analogy could be drawn with Cotard’s Syndrome, the nihilistic delusion where the patient believes themselves to be without soul, without heart, without brain, without sex, “in a state that is neither life nor death: they are living dead”.

Then in any case, can one be alive if one evades time?  Let us return to Pygmalion and his statue metamorphosed into a woman; a woman who is immortal through the auspices of her creation.  Is she immortal, or incapable of dying?  This is what plunges Pygmalion into dejection in the face of his creation, into an “excess of despair”.  Already, when she was still only marble, for Pygmalion it was her perfection that was her defect.  How will it be once she is alive?  Then in any case, will she be mortal, or will she be immortal?

The question of death also inevitably comes up when we consider robots.  It is a question that troubles us, more so than the apparent life of the robot.  Potentially the robot is immortal. It will survive its creator.  Immortality is a figure of melancholia: “a melancholic immortality” as Jean Starobinski points out.

It is thus that, as a counterpoint to the robot, we could place the creature fabricated by Victor Frankenstein: constructed out of death, from collected fragments of dead bodies, to which he gives life through the forces of magnetism.  This creature also, has not required procreation, nor the passage through the body of a woman.  It is also adult from the onset, and without name, so that the monster is sometime confused with its creator: Frankenstein is indeed not the name of the creature but of its creator.  Victor Frankenstein confronted with the life that takes possession of what he has created takes flight, overcome by horror; and leaves this life that has emerged in solitude, without connection, without the presence of an other. The creature is left so alone that it has to try to educate itself, something that is not without consequences, one being its particular destructiveness.

Is it to be feared that a similar destiny will grip the machine created in the image of humans?  Does this depend on the machine or on the human that created it?  On the human that uses it?  The problem with such artifices hinges on the fact that they tend to resemble the human who creates them.  Perhaps it would be better to avoid giving them an android form to prevent this slide towards destructiveness that comes from their creator themselves.

 

Beyond the disruptions

Technologies appear to make it possible to breach all limits;  as far even as the artificial fabrication of an android robot.

Let us return to the fabrication of the living.  There also, the question of knowing how far one should go is asked.  What stance should we adopt?  Should one be on the side of the techno-prophets, caught up in a fascination with technology, or on the side of the bio-catastrophists who denounce the worst, taking as example the most extreme situations, delving into the fabrication of artifices such as those we have discussed?

If there is something at stake here, it is as Lacan stated, to be equal to the times in which we live: “Let whoever cannot meet at its horizon the subjectivity of his time give it up then.”  What needs to be avoided is being drawn onto the slippery slope of conservatism.  One cannot curse the time in which one lives.

To go with the idea expressed by Jacques-Alain Miller, we are in an age where there is a desire to touch the Real by acting upon nature: to make it obey, to mobilise it and use its power.  When we force reality, we touch on the Real, we unveil the Real – a Real which is, in the Lacanian sense, that which it is impossible to grasp.  Science comes up against an absence of knowledge, a non-knowledge.  If classically science’s first aim was to produce a new knowledge from which to draw techniques, today science operates first on the world through its techniques, producing a new world, an invented world, which we do not yet apprehend.

Should we consider, as Freud puts it in Moses and Monotheism, that science has irrevocably made a pact where “progress has allied itself with barbarism.”?  Or should we rather recognise that through its advances, we come up against what is impossible to think, impossible to say, on the impossible as such.  Lacan talks of the “logical obstacle” of the impossible: a logical obstacle because, inevitably, it emerges from the structural failing of the symbolic.  Then as Lacan goes on to specify, it is from there that the Real emerges, to such an extent that it leads to what he calls “panic points”.

We have entered into a vicious circle: the more one intervenes, the more the Real emerges.  The more it emerges, the less we can know what it is.  The more the panic rises.  To have all these recipes for making children at our fingertips leaves us without a recipe to cope.  Thus we end up with the questions that are, urgently, addressed to ethics committees,  committees that become all at once observatories of the Real, observatories of the perplexity, and on occasion even observatories of contemporary panic.

The new recipes for the fabrication of children take us from one panic point to the next; and the more one is gripped by panic the more one runs, faster and faster.  We force nature, a Real emerges, we include it in a fantasy scenario, which becomes new technologies.  A real vicious circle.

Are we heading towards a crisis in the Symbolic?  Should we not rather consider that today the cursor of the Symbolic is moving faster than our ability to keep track of it?  In order to follow it, we need rather to return to clinical practice, to the methodology of clinical practice, to the case by case, far from the generalisations that can be said or thought on this subject.  Ultimately, for psychoanalysis, there is only an ethics of the particular.  We need therefore to return to the detail that escapes us, to the surprise.  Not to bring the subject back to his sole mode of procreation, not to make a destiny of that mode of procreation; but rather to follow the subject’s answers, his solutions, his inventions.  All of these can go far beyond the advances of science and the technologies that come for them.

François Ansermet is a Psychoanalyst, Honorary Professor of the Universities of Geneva and Lausanne, member of the French National Ethics Committee in Paris, and a member of the World Association of Psychoanalysis (WAP).

His latest book, The Art of Making Children: The New World of Assisted Reproductive Technology, has recently been published by Karnac.

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