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JOHN M. HAAS
Infertility is a growing problem in the United States. And in true American fashion, there has been a corresponding growth in a "reproductive technologies industry" to provide a solution.
In 1987, the Sacred Congregation for the Doctrine of the Faith issued a document known as Donum Vitae ("The Gift of Life"), which addressed the morality of many modern fertility procedures. The document concluded that some methods are moral, while others — because they do violence to the dignity of the human person and the institution of marriage — are immoral. Without questioning the motives of those using these techniques, Donum Vitae pointed out that people can do harm to themselves and others even as they try to do what is good, that is, overcome infertility.
Donum Vitae teaches that if a given medical intervention helps or assists the marriage act to achieve pregnancy, it may be considered moral; if the intervention replaces the marriage act in order to engender life, it is not moral.
In vitro fertilization
One reproductive technology which the Church has clearly and unequivocally judged to be immoral is in vitro fertilization, or IVF. Unfortunately, most Catholics are not aware of the Church's teaching, do not know that IVF is immoral, and some have used it in attempting to have children. Children conceived through this procedure are children of God and are loved by their parents, as they should be. Like all children, regardless of the circumstances of their conception and birth, they should be loved, cherished, and cared for.
The immorality of conceiving children through IVF can be difficult to understand and accept because the man and woman involved are usually married and trying to overcome a "medical" problem (infertility) in their marriage. Why, then, is IVF immoral?
In vitro fertilization brings about new life in a petri dish. Children engendered through IVF are sometimes known as "test tube babies." Several eggs are aspirated from the woman's ovary after she has taken a fertility drug which causes a number of eggs to mature at the same time. Semen is collected from the man, usually through masturbation. The egg and sperm are ultimately joined in a glass dish, where conception takes place and the new life is allowed to develop for several days. In the simplest case, embryos are then transferred to the mother's womb in the hope that one will survive to term.
Obviously, IVF eliminates the marriage act as the means of achieving pregnancy, instead of helping it achieve this natural end. The new life is not engendered through an act of love between husband and wife, but by a laboratory procedure performed by doctors or technicians. Husband and wife are merely sources for the "raw materials" of egg and sperm, which are later manipulated by a technician to cause the sperm to fertilize the egg.
Invariably several embryos are brought into existence; only those which show the greatest promise of growing to term are implanted in the womb. The others are simply discarded or used for experiments. This is a terrible offense against human life. While a little baby may ultimately be born because of this procedure, other lives are usually snuffed out in the process.
IVF is also expensive, costing at least $10,000 per attempt. Over 90 percent of the embryos created perish at some point in the process. In a desire to hold down costs and enhance the odds of success, doctors sometimes implant five or more embryos in the mother's womb. This may result in more babies than a couple wants. In Canada, one woman gave birth to five children engendered by IVF. She had wanted only one, so she sued her doctor for "wrongful life," demanding that he pay for the cost of raising the four children she did not want.
To avoid the problems of carrying and rearing "too many" babies after several have been implanted, doctors sometimes engage in something euphemistically called "fetal reduction" or "selective reduction." Here they monitor the babies in utero to see if any have defects or are judged to be less healthy than the others. They eliminate those "less desirable" babies by filling a syringe with potassium chloride, maneuvering the needle toward the "selected" baby in the womb with the aid of ultrasound, and then thrusting the needle into the baby's heart. The potassium chloride kills the baby within minutes, and he or she is expelled as a "miscarriage." If it cannot be determined that one baby is less healthy than the others, some doctors simply eliminate the baby or babies who are easiest to reach. Again we see the unspeakable diminishing of the value of human life which can arise from this procedure.
Not everyone who has had a child through IVF has used donor eggs or sperm, collected the sperm through masturbation, or killed "extra" unwanted babies in the course of the pregnancy. Yet there is still a moral problem with the procedure itself. Why?
Human beings bear the image and likeness of God. They are to be reverenced as sacred. Never are they to be used as a means to an end, not even to satisfy the deepest desires of an infertile couple. Husbands and wives "make love," they do not "make babies." They give expression to their love for one another, and a child may or may not be engendered by that act of love. The marital act is not a manufacturing process, and children are not products. Like the Son of God Himself, we are the kind of beings who are "begotten, not made" and, therefore, of equal status and dignity with our parents.
In IVF, children are engendered through a technical process, subjected to "quality control," and eliminated if found "defective." In their very coming into being, these children are thoroughly subjected to the arbitrary choices of those bringing them into being. In the words of Donum Vitae:
"The connection between in vitro fertilization and the voluntary destruction of human embryos occurs too often. This is significant: Through these procedures, with apparently contrary purposes, life and death are subjected to the decision of man, who thus sets himself up as the giver of life and death by decree."
The document speaks of "the right of every person to be conceived and to be born within marriage and from marriage." To be within and from marriage, conception should occur from the marriage act, which by its nature is ordered toward loving openness to life, and not from the manipulations of technicians.
The dehumanizing aspects of some of these procedures is evident in the very language associated with them. There is the "reproductive technology industry." Children are called the "products" of conception. Inherent in IVF is the treatment of children, in their very coming into being, as less than human beings.
Any number of morally acceptable interventions may be used to overcome infertility. For example, surgery can overcome tubal blockages in the male or female reproductive system which prevent fertilization from taking place. Fertility drugs may also be used, with the caution that large multiple pregnancies may put mother and infants at risk. There are also many ways of tracking natural reproductive rhythms to enhance the chances for achieving pregnancy. The Pope Paul VI Institute at Creighton University in Omaha, Nebraska has been successful in helping couples overcome infertility using natural methods.
Most theologians consider the procedure known as LTOT (Lower Tubal Ovum Transfer) to be morally acceptable. This involves transferring the wife's egg beyond a blockage in the fallopian tube so that marital relations can result in pregnancy. Another method, more morally controversial, is called GIFT (Gamete Intra-Fallopian Transfer). It involves obtaining a husband's sperm following marital relations and aspirating an egg from the wife's ovary. Egg and sperm are placed in a tiny tube separated by an air bubble, and the contents of the tube are then injected into the wife's fallopian tube with the hope that fertilization will occur. Some theologians consider this to be a replacement of the marital act, and therefore immoral. Other theologians see it as assisting the marital act, and therefore permissible. Because the teaching authorities of the Church — the pope and bishops — have not made a judgment about GIFT, Catholic couples are free to choose or reject it depending on the guidance of their own conscience. If the teaching authority of the Church should judge the procedure to be immoral, however, GIFT should no longer be used.
The Church has great compassion for those who suffer from infertility. Out of love for all human life and respect for the integrity of marital relations, however, the Church teaches that some means of trying to achieve pregnancy are not licit. Some of these means actually involve the taking of innocent human life, or treating human life as a means toward an end or a "manufactured product." They do violence to the dignity of the human person.
In America we have a tendency to think that we can solve all problems with the right "technology." But children are not engendered by technology or produced by an industry. Children should arise from an act of love between a husband and wife, in cooperation with God. No human being can "create" the image of God. That is why we say that human beings "procreate" with God. Engendering children is a cooperative act among husband, wife, and God Himself. Children, in the final analysis, should be begotten, not made.
Faith Facts. "Reproductive Technology." Lay Witness (January/February 2001).
Reprinted with permission of Lay Witness magazine.
Lay Witness is a publication of Catholic United for the Faith, Inc., an international lay apostolate founded in 1968 to support, defend, and advance the efforts of the teaching Church.
Dr. Haas is the president of the National Catholic Bioethics Center in Boston, MA, and a consultant to the NCCB Committee for Pro-Life Activities.
Reprinted from Respect Life, copyright © 2000, United States Catholic Conference, Inc., Washington, DC. All rights reserved.
Copyright © 2001 LayWitness