Debates on assisted reproduction should begin in the classroom

Minister for Health Leo Varadkar’s proposed Bill for assisted human reproduction and stem-cell research will be put before the Cabinet later this year and not a minute too soon. It has been a decade since the Commission on Assisted Human Reproduction’s report outlined the urgent need for legislation for the many complex cases likely to be more common in future given the rate of advance in reproductive technologies. Recent attention was given to cases before the High Court and Supreme Court where there were disputes about whether parentage should be given to the genetic mother or to a surrogate.

Many other complications also need clarification. While there is a proposed legal mechanism for transfer of parentage in cases of surrogacy in the Bill, in other areas such as gamete donation, stem-cell research and genetic screening there are new proposals that, while common in other countries, will rock Ireland out of its legal and philosophical stupor on issues around new forms of family and definitions of the unborn. Under the proposed Bill, embryo donation will be permissible to enable fertility and, in some cases, for embryo research.

We are looking at a future Ireland with exciting changes in lifestyles, family structure and developing medical technologies. As a society we will face complicated but important decisions, and they should be dealt with in legislation and, given their societal impact, continuously revisited as we debate the issues including in our schools.

Genetic screening of embryos for serious disorders and therapeutic cloning are possibilities now, opening up all kinds of ethical dilemmas. For example, pre-implantation genetic diagnosis allows a range of genes to be targeted to identify susceptibility to conditions such as cystic fibrosis, Duchenne muscular dystrophy and Huntington’s disease. Parents can be faced with the dilemma of what to do if there are hereditary genetic markers for a condition present in a family’s profile.

A messy kind of politics

In Ireland, the use of assisted human reproduction beyond in-vitro fertilisation has become enormously politicised and can be polarised in public debate. We are given the impression of simple questions, with “pro-life” groups pitched against advocacy and patient groups. Are we talking about screening of disorders or a type of positive eugenics? Are we eradicating disease or a human life? This is not surprising: reproductive technology is political.

And it is a messy kind of politics, with more complex positions between the extremes on how and when such technologies should be used, who can be the beneficiaries, what is the appropriate sense of justice for individuals, for families and for society. It is the type of messy politics that needs to be engaged with from secondary school upwards. How might we use genetic screening responsibly, rather than as represented by the movie Gattaca where a future society contains the chosen ones that are genetically enhanced and the less well-off who are not, creating a genetic underclass? When does genetic selection for therapeutic reasons cross over into enhancement and how far should it go? To prevent a child having a life threatening disease? For better quality of life in a changing world? Can there be a change in thinking from religious orthodoxy to a more nuanced consideration, with one type of embryo that has potential to be human, and another whose sanctity is not in its potentiality but its very centrality to life-giving or medical intervention?

These questions have broader moral dimensions, that might be termed “genethics” or “biopolitics”, with no simple answer, but are real questions facing us, and form a type of critical thinking for education.

This is the subject of my book on how the issues around reproductive technologies might be introduced in education, especially with senior cycle/transition years. I set up a debate programme for six Irish secondary schools (comprehensive, private and vocational) and investigated what students and teachers thought about the controversies of teaching and learning about such topics.

More than 200 students participated. There was a high degree of sophistication in how students saw the varying decision points, and the weighing up of values between a future child, future parents and a technology that promises such good but also carries such responsibility for the control of genetic traits in progeny.

It was interesting that only one student said “being a Catholic” was the main reason for her opposition; other opposition was based on the possibility of a threat against “nature taking its course” for human genetics.

The six participating science teachers were positive about such a programme in biology but confined by the narrow remit of the curriculum and teaching practice, having little training or support in dealing with social and ethical issues of these new genetic and reproductive technologies.

Reproductive ethics has not been given serious consideration in second-level education. The current Leaving Certificate biology syllabus has fleeting references to ‘Contemporary Issues and Technology’ and the one reference each to IVF or ‘screening test diagnosis because of changed genes’ rarely appears in the exam. The good news is that senior curriculum reform is in progress. Here is an opportunity for science syllabi to include genetic engineering under crucial future-oriented topics. Until now, teaching the complex, brave new world of new genetics depended on the creativity of individual teachers to introduce and facilitate discussions.

The path to progress

Although there are debates and consultations debate still to be had about religious patronage in schools, this issue is not as simple as science versus religious dogma. If Ireland could take the next steps for legislation, it would be a mark of progress for the education system to include debate and discussion around future genetics as a core part of the curriculum, connecting to a “life politics” of the future.

It is crucial that teachers are supported with tools to look ahead to the near future when those who will soon be young adults will be faced with these decisions.

In many ways, it is part of a broader discussion about the introduction of philosophy and ethics at second level, examining the issues facing our lives as well as the processes of responsible science and innovation and their impact on society. It requires newer, interdisciplinary teaching and assessment. As discussed recently in these pages, opportunities to instil critical thinking are missing from the Irish curriculum. In the UK, the GCSE Twenty First Century Science Suite covers these topics extensively. Suddenly, in this type of progressive curriculum, our classrooms begin to speak directly to future parliaments and law.

Over the next year or two, legislation might be in place, as might a new senior biology curriculum. How equipped are we as a changing society to address these combined technological and societal challenges affecting future generations?

• Dr Padraig Murphy is a lecturer in science communication and director of the Societal Impact Platform at Dublin City University