Pro-birth or pro-life?
The Catholic moral response to infertility.
Marta and Renee are both lifelong Catholics. They have been married for 12 years. During their first years of marriage they used natural family planning techniques to avoid pregnancy, but after buying a home and settling into jobs they decided it was time to get pregnant.
Now, after seven years of trying and not succeeding, they are considering in vitro fertilization. Marta's physician has given them a referral to an IVF clinic and suggested that this may be their "last resort." They know that in vitro techniques are forbidden by the Church, but don't really understand why. So they have made an appointment with the Parish Life Director, Mrs. Gonzalez, to see what she has to say.
Marta opens the conversation with a question. "If the Church encourages the use of science and technology in general, why can't medicine and science be used to help us get pregnant? After all, the Church teaches that procreation is one of the two reasons for marriage --- isn't that right?"
Renee speaks up and mentions that they have never used contraception and that they don't think it's fair that God won't let them have a baby when so many other couples are having abortions or throwing away their embryos. How can it be wrong to use medicine to accomplish one of the most important goals of marriage, having children? Surely, God must approve.
It is clear that more and more Catholics are contemplating turning to in vitro fertilization when their efforts to conceive have not been successful. Indeed, it is clear that others have attempted IVF and a number have conceived. What does the Church then teach about this growing phenomenon? What should Mrs. Gonzalez say to Marta and Renee?
Before answering the moral question, perhaps it is good to review the medical technique in question.
What is in vitro fertilization?
Basically, IVF involves removing eggs from a woman after giving her drugs to "super-ovulate." Multiple eggs are then removed with a biopsy needle, inserted through the vaginal wall into the ovary. Most of the eggs are fertilized. The resulting embryos, human beings at the very beginning of their existence, then undergo genetic screening and those deemed "defective" are discarded. Then three or four of the embryos are injected into the woman's uterus.
The national success rate for a single attempt of IVF is less than 20 percent. The cost for each cycle (implantation) whether successful or not can range from $10,000 to $30,000 or more. A small percentage of women will end up with multiple pregnancies. In these cases, physicians will often suggest "selective fetal reduction" or selective abortion.
Embryos that are not implanted are frozen to await further attempts at implantation or are abandoned. It is estimated that there are more than 500,000 abandoned frozen embryos in the United States.
Respect for those who ask 'why?'
In any discussion with a sincere Catholic couple struggling with infertility, it would be important both to understand their very real pain and be willing to enter into a mature dialog with them.
It would be wrong to suggest that a couple's questions about why the Church teaches what it does about in vitro fertilization are inappropriate in any way. The parish life director, lay ecclesial minister, deacon or priest who has the opportunity to work with a couple like Marta and Renee needs to remember that asking "why" is both the right and privilege of every Catholic regarding the Church's moral teachings.
Asking "why" should never be interpreted as a sign of disrespect for Church authority or disloyalty to Church teaching. In fact, Mrs. Gonzalez has the responsibility, as does every parish minister, to have a reasonable answer to the questions that arise from sincere Catholics.
Mrs. Gonzalez has, in fact, two responsibilities in her response to Marta and Renee and to all the parishioners in her care. She should be able to communicate clearly, both "what" the Church teaches about in vitro fertilization and "why" the Church teaches what it teaches in this regard.
Marta and Renee are suffering and in pain. They deserve to be treated with respect and compassion and they deserve clear and cogent responses to their questions.
Defining the moral boundaries
In its 1987 instruction, Donum Vitae, the Congregation for the Doctrine of the Faith, acknowledges and addresses the issue of infertility:
"The suffering of spouses who cannot have children or who are afraid of bringing a handicapped child into the world is a suffering that everyone must understand and properly evaluate. On the part of the spouses, the desire for a child is natural: it expresses the vocation to fatherhood and motherhood inscribed in conjugal love. This desire can be even stronger if the couple is affected by sterility which appears incurable" (DV, II.8).
The Church is open to using science and medicine to address infertility, but as in all scientific endeavors, there are moral boundaries:
"Research aimed at reducing human sterility is to be encouraged, on condition that it is placed at the service of the human person, of her or his inalienable rights, and his or her true and integral good according to the design and will of God" (Cathechism of the Catholic Church, n. 2375).
In its latest document on assisted fertilization, Dignitas Personae (2008), the Congregation for the Doctrine of the Faith states, "Techniques which assist procreation are not to be rejected on the grounds that they are artificial. As such, they bear witness to the possibilities of the art of medicine. But they must be given a moral evaluation in reference to the dignity of the human person…" (n. 12).
Here it is made clear that the moral analysis of in vitro fertilization is not based on that fact that it is "artificial" or "scientific," but on how it impacts negatively the innate dignity of the human person. Any technique that disrespects a human being, created in the image of God from the moment of conception, is unacceptable.
The 'right' to have a child?
Thus, in its moral analysis of in vitro fertilization, the Church wants to reflect on several issues, all of which deserve attention.
First, addressing fertility is not only, or even primarily, about the married couple. Hence the Church focuses on the child who is the goal of assisted fertilization. The "desire" for a child should not prevent us from asking whether in vitro fertilization respects the innate dignity due to every human being and is not seen simply as a "legitimate scientific means" with no moral value in and of itself. In fact, it is clear that the desires of the parents, no matter how understandable, certainly can never trump the inalienable rights of the child.
It is therefore important to notice that the Church insists on addressing the rights of the child in its moral discussion of in vitro fertilization. Donum Vitae (II.8) addresses this issue clearly:
"Marriage does not confer upon the spouses the right to have a child, but only the right to perform those natural acts which are per se ordered to procreation. A true and proper right to a child would be contrary to the child's dignity and nature. The child is not an object to which one has a right, nor can he or she be considered as an object of ownership; rather, a child is a gift, 'the supreme gift' and the most gratuitous gift of marriage, and is a living testimony of the mutual giving of his or her parents.
"For this reason, the child has the right, as already mentioned, to be the fruit of the specific act of the conjugal love of his parents; and he also has the right to be respected as a person from the moment of his conception."
'Intention' vs. sad reality
Second, besides the fundamental fact that IVF by its nature turns a child from "gift" to "commodity" through the production process that is used, there are other moral issues that make IVF unacceptable.
IVF involves the deliberate destruction of human life. Currently, the number of embryos sacrificed, even in the most advanced IVF clinics, hovers at around 80 percent. The assumption by some that the issue of embryo destruction would be lessened if not substantially resolved by improving "techniques" has proven to be untenable. Others have argued that it is not the intention of those involved in IVF to destroy embryos but to help bring about a pregnancy.
The Church points out that genetic testing and multiple implantations are deliberate aspects of IVF that result in the loss of life. Therefore it cannot be cogently argued that IVF is not involved in the "intentional" loss of human life. Dignitas Personae points out these facts clearly:
"In fact, techniques of in vitro fertilization are accepted based on the presupposition that the individual embryo is not deserving of full respect in the presence of the competing desire for offspring which must be satisfied. This sad reality, which often goes unmentioned, is truly deplorable: the various techniques of artificial reproduction, which would seem to be at the service of life and which are frequently used with this intention, actually open the door to threats against life" (DP, n. 15).
Approved 'assisted fertilization'
Are all techniques of "assisted fertilization" forbidden by the Church? No, only those that do not respect the dignity of the child or the procreative nature of the sexual act. Any procedure that assists marital intercourse in reaching its procreative potential is moral.
The U.S. bishops teach that "those techniques of assisted conception that respect the unitive and procreative meanings of sexual intercourse and do not involve the destruction of human embryos, or their deliberate generation in such numbers that it is clearly envisaged that all cannot implant and some are simply being used to maximize the chances of other implanting, may be used as therapies for infertility." (Ethical and Religious Directives for Catholic Health Care Services, 4th edition).
Another question that often can arise is about "fertility drugs." Can Mrs. Gonzalez suggest to Marta and Renee that they might want to look for another physician who works within a Catholic moral framework? Dignitas Personae addresses this issue more clearly than previous magisterial statements:
"Techniques aimed at removing obstacles to natural fertilization, as for example, hormonal treatments for infertility, surgery for endometriosis, unblocking of fallopian tubes or their surgical repair, are licit. All these techniques may be considered authentic treatments because once the problem causing the infertility has been resolved, the married couple is able to engage in conjugal acts resulting in procreation, without the physician's action directly interfering in that act itself" (DP, n. 13).
Any technique for assisted fertilization that substitutes for marital intercourse and/or results in the destruction of embryos is morally unacceptable. Marta and Renee are challenged, as are other couples struggling with fertility issues, to see that in the case of IVF, the end is not justified by the means. While IVF suggests itself as "pro-birth," it certainly is not "pro-life." Vincentian Father Richard Benson is academic dean and professor of moral theology at St. John's Seminary, Camarillo. His column appears monthly in The Tidings.
In the Feb. 20 issue, Father Benson wrote on "In Vitro Fertilization through a Catholic lens," an article that may be viewed online at http://www.the-tidings.com/2009/022009/bensonvitro.htm. |