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Bioethic information and analysis newsletter

Following Letter

N°44 - August 2003

The embryo on the couch, psychopathology of human conception - Benoît Bayle

« The embryo on the couch, the psychopathology of human conception » explains, through the history of knowledge of the embryo from Antiquity to the present, how we have come to the « conceptional revolution » of the 20th century, and provides an essential contribution to thinking on the embryo.

Benoît Bayle, à psychiatrist specialised in perinatal psychiatry, shows that the perinatal period is the first phase in the psychological development of human beings. « The human embryo, as soon as it is conceived, possesses a conceptional identity which flourishes in all the human ways, both biological and psycho-socio-cultural ». One can therefore already consider treating the embryo.

The "conceptional revolution"
The contraceptive and procreative revolution is a conceptional revolution which concerns society as a whole, and not merely a small group of children conceived artificially. The condition of arrival in the world has been modified for every child.

The development of contraception, followed shortly afterwards by the boom in medical practices for pregnancy termination, marked the beginning of the conceptional revolution. Medically assisted procreation is an extension of these first two stages. These practices, whose nature appears so different, represent so many interventions on human gametes and on the embryo, and intervention on human conception at these three levels has resulted in the mass procreation of embryos, most of which are condemned to die.

Artificial procreation leads to the logic of overproduction and of embryo selection (experimental phase of embryos before considering their transfer in utero, conception of a multitude of human embryos for a limited number of births).

Welcome for the child
What benefit is there for a psychiatrist in highlighting this reifying logic of embryonic overproduction, selection and destruction which constitutes one of the characteristics of the conceptional revolution ?

Benoît Bayle is studying the welcome for the child in this new conceptional environment, marked by contraception and abortion. The child is no longer desired for itself ; it represents first and foremost a child which has to comply with the desires of those who give it life. If it remains alive, if it has been chosen, surely this means that it is of greater value than the others, than those which did not survive. The child, subjected to the all powerful desire of others becomes an all powerful child, for which it may be difficult to establish limits ; « one has « killed » for the love of it, the expression may be shocking, but the subconscience is very capable of such short-cuts. » The author then analyses the conceptional survivor syndrome (following embryonic reduction, among other things), the introduction of a third party in medically assisted procreation and the secret of the source, the case of true and false asynchronous twins (according to whether they are the result of embryonic freezing or of cloning) and the greater or lesser upheaval of the order of generations.

A mental identity as early as the antenatal period.
In the context of natural procreation, the conception conditions may also influence the psychological development of the child : replacement child (conceived to replace a dead child), conception after a sexual trauma (rape or incest.. ), child of a schizophrenic mother, pregnancy denial, « conceptional survivor », conceived after a series of intentional abortions…

In the psychological development of the embryo, the author underlines the importance of the mental nesting of the conceived human (in parallel with its biological nesting) and of the creation in the mother of a mental space intended for the conceived new being. This maternal space of mental differentiation and identification of the conceived being plays an essential role in its psychological development. Human beings possess, from their antenatal period, a mental identity ; they receive from others a set of psycho-socio-cultural determinations which may or may not find expression in their future. The conceived being already forms a relationship with those who conceive it and with society, at the very heart of its being.

What role is played by the psychiatrist ?
The heredity at work in conceptional mental heredity is not like genetic heredity, or like biological development, but is an epigenetic type of heredity ; the expression of a psycho-socio-cultural determination in fact depends on the relationships between the conceived being and its psycho-emotional environment and this is where the psychiatrist comes in. In rejecting absolute determinism, the human conception psychopathological clinic aims to screen and to treat at an earlier stage the difficulties which are liable to modify the mental development of the conceived being.

Conclusion
The numerous clinical studies presented in this work seem to demonstrate that psychological development begins at the moment of conception and the author concludes that biomedical intervention at conception should give this more consideration, should concern itself with the history of the conceived human being and act in accordance with that history. Today, the logic of embryonic overproduction, selection and destruction concerns society as a whole and the new way of conceiving children. What consequences will this have on future generations, does this logic contribute to modifying the very identity of the conceived beings ?

Ref. The embryo on the couch, the psychopathology of human conception, preface by Claude Huriet, published by Masson, coll. Médecine et psychothérapie, April 2003.

The end of mankind - Francis Fukuyama

« Aldous Huxley was right : the greatest threat exerted by contemporary biotechnology is that it will modify human nature itself and will propel us into a post-human phase of our history. » In his latest book, « The end of mankind. The consequences of the biotechnological revolution », Francis Fukuyama, philosopher, lecturer at John Hopkins University and member of the President's Council on Bioethics, is sounding a warning.

One of the reasons for Fukuyama's pessimism is that contrary to other scientific advances, the biotechnologies mix together the obvious advantages and the subtle disadvantages in the same package.

This challenge is not merely ethical in nature, but also political. Since it is the political decisions which we shall be taking over the coming years, concerning our relationships with this technology, which will determine whether or not we are to enter a post-human era ; and they will define the potential moral abyss that such a future will open up in our path.

The challenges of science
The science of the brain will enable us to understand and to treat hereditary traits such as intelligence, criminal tendencies, sexuality, etc. Neuropharmacology will be able to control behaviour, as is already the case with antidepressants such as Prozac, or Ritaline which stimulates the central nervous system ; increasing life expectancy will result in ageing of the population of wealthy countries such that within a couple of generations, the average age will be sixty, whereas in the developing countries it will be twenty ; what might be the social impact of this ?

Genetic engineering and the creation of synthetic babies with all the genes specific to characteristics such as intelligence, size, self-esteem, etc. will lead to soft eugenics, responding to the wishes of parents who want the best for their child, and not the obligations imposed by a coercive State. The social elite will therefore be able, not only to transmit social advantages, but also to anchor them genetically, and generate other social conflicts !

Which man to protect ?
After these descriptions, Fukuyama draws us into a search for what constitutes the higher human moral status and the exclusive characteristics of human beings (creation in the image of God for Christians, human capacity for moral choice according to Kant...), in order to determine what should be protected from these biotechnological developments. He concludes that it is the respect for human dignity which will enable the avoidance of the increase in genetic inequalities and the policy of selection of future human beings.

Candid optimism
Despite the occasional apocalyptic descriptions of what lies ahead for the post-human mankind of the 21st century, Fukuyama is trustful of human wisdom and the effectiveness of the existing control mechanisms. Everything must be done to supervise science, but if that is found to be impossible, the human species has its own regulating resources, a kind of survival instinct, which is sufficient to protect the dignity of adult and normal human beings.

But the underprivileged, « who have a little less than their share of capabilities which we have defined as characterising human specificity », in particular unborn children, possibly babies, the terminally sick, the aged suffering from degenerative diseases and the handicapped, may well be deprived of such protection...

Ref. Francis Fukuyama, The end of mankind. The consequences of the biotechnological revolution, Published by : La Table Ronde, October 2002.