In Vitro Fertilization and the Church's Teaching

Ray Campbell
Director, Queensland Bioethics Centre
Reproduced with Permission
Queensland Bioethics Centre

This issue is a very emotional one and in some ways a complex one because of the possible variations involved.

Generally when we speak about In Vitro Fertilization we talk about it in the context of infertility - although that is rapidly changing day by day.

Infertility for most married couples is a tremendous blow to their hopes, their dreams of their married life together. Most couples marry with a view of having children some time in their married life. It is part of the life project that they adopt together.

To find out some time after having launched on this journey together that they cannot have their own children because of infertility can be a shattering experience. There are many diseases which may make us reassess our life plans, but nothing quite the same as infertility. Images that you have had regarding the future are suddenly empty.

Of course some couples know that they are infertile even before they marry. For them it is somewhat easier because they launch into their life plan together knowing they cannot have children. But even for such couples the inability to have children is often a sorrow they have to come to terms with.

It is understandable that when couples are offered the opportunity to have the children they desire, to have that which would fulfil what they had intended when they got married, they tend to jump at the opportunity and think that anyone who might question them for doing so is lacking in compassion and understanding.

However, the position in which they find themselves makes such couples very vulnerable and can make it very difficult for them to think clearly about all the issues which might be involved in pursuing their dream.

Before looking at what the Church teaches about procreation I will comment upon the "moral climate" within which we live. Various social commentators and philosophers have characterised the moral climate of the Western world as one of "emotivism". Emotivism is summarised in the expression, "if it feels good, do it."

Now a lot of people might deny that is their moral stance when it is put so simply, but it you look at much of the moral language used today to justify all kinds of things you will find that it is operative. What emotivism says is that morals, what is good and bad for humans is entirely subjective. The consequence is there can never be any appeal to something beyond ourselves to explain what is right or wrong. The logical consequence of emotivism is chaos, not just moral chaos, but political and social chaos. If there is nothing beyond subjectivism to support claims for right and wrong, then what is to be the foundation for our laws and public policy. Is it just majority rules? Emotivism offers no rational support for that position. So is it to be the rule of the most powerful? Fortunately very few people are consistent enough in their moral emotivism to carry it through to its logical conclusions.

When we come to what the Church teaches we meet something very different. Obviously it doesn't ground its teaching upon emotivism. However, it is important that we ask ourselves, upon what do we ground our moral decisions. How much are we influenced by the fairly widespread emotivism? Recently I gave a workshop on genetics and ethics to a group of teachers. The very first question or statement that one of them made was that ethics is entirely subjective. Now, if that is the case, then we are at the mercy of the most powerful and we can make no rational claim as to why we shouldn't be.

The Church's view is that there are some objective grounds upon which we can base our moral deliberations. So what does the Church say about these procedures? Upon what does it base its moral deliberations?

The document which expresses the Church's teaching on this matter is the Instruction on Respect for Human Life in its Origin and on the Dignity of Procreation from the Sacred Congregation for the Doctrine of the Faith issued in 1987. (http://www.vatican.va/roman_curia/congregations/cfaith/documents/rc_con_cfaith_doc_ 19870222_respect-for-human-life_en.html) However this document is part of an ongoing tradition of teaching upon such matters as the dignity of the human person, human sexuality and procreation.

At the heart of the Church's teaching is a call to respect the dignity of each individual. Every human being must be respected as a person and accorded rights and dignity equal to all other persons. Persons are to be respected for themselves and never reduced to instruments for the advantage of others, or treated as objects of scientific technology or of its control and domination. This respect is to be extended to the person in their unified totality, that is, as bodily persons. The human body is not accidental to our identity as human persons, but essential to it.

"For us Christians, the human person is the apex of everything created. Their great dignity is like a reflection of the divine image, an indelible imprint on their very being, and as such ranks above all other things, so that human beings can never be considered mere instruments to be used for the benefit of others. Unfortunately, modern technological and political mentality sometimes seems to ignore this, forgetting the values and the rights of the human spirit.

Since human beings are persons and the subjects of any action, there is no human reason or pretext in the scientific, social, political or economic order which could every justify a change in their function or status from subjects to objects." (Pontifical Commission on Justice and Peace, The Church and Human Rights, 1974).

Notice the emphasis on the equality of dignity and respect for rights, and the insistence that another person should not be used simply as an object to achieve some other end.

Now the question is how does one respect this equality of dignity in the very coming to be of a human person?

The way the Vatican document posed the question was: "What connection is required from the moral point of view between procreation and the conjugal act?"

Now as far as I am aware the Church is the only body which put this question clearly. Is there a moral relationship between the conjugal act and procreation? No matter what one's answer is to the question, surely it is a question which needs to be considered. Needless to say the popular media simply could not handle this question. They ignored it, and in so doing constantly misrepresented the position of the Church.

To highlight the significance of the question, consider this. If there is no relationship from the moral point of view, then IVF and other means of assisted reproduction are simply on the same level as marital intercourse, and should be open to people to choose as their preferred means, whether they are infertile or not. Indeed, as some would argue, it may be that ethics demands that all children be conceived through IVF and natural conception be seen as immoral.

If there is a connection - then what is it? And do we have the right to disregard or excuse from this connection?

Let us look at how the Church sees children being conceived in morally ideal circumstances.

Within marriage a couple celebrate their love for each other and give expression to their marital union through an act of marital intercourse. If a child is conceived that child comes about as a supervening gift following from their act of marital love. The couple might want a child. The couple might even plan their act of intercourse for a time when they know they are fertile and conception is more likely to occur. If a child is conceived he or she comes about through the bodily celebration of the unitive aspect of the couples sexuality and marriage.

In this act, the child is received as a gift supervening upon their act of intercourse, not as object of their making. The act of marital intercourse is an act of giving. It is unfortunate that we use the expression "make love". You don't make love, you give love. Marital intercourse is a very special giving of love. It is the reaffirmation of the total act of selfgiving between two people who have made themselves to be irreplaceable spouses. A child may come to be as a result of this act of self-giving. At no stage in its coming to be is such a child turned into or necessarily regarded as an object of the work of the couple. The child in his or her coming-to-be is respected in his or her unique dignity equal to his or her parents.

If we look at IVF the situation is very different. The child is not conceived in and through the very act which celebrates the two-in-oneness of the spouses. The child is conceived as a result of a whole series of acts and decisions, most of which are not the acts or decisions of the parents, but of others. The act of intercourse, if it takes place, is only accidental to the procedure. The spouses produce the gametes which are used by others in order to produce the end product. These acts are actions typical of a making, a producing. In IVF a person comes into being as an object of manipulation by the technicians. This is a relationship of radical dominance, which does not embody the respect for the dignity of the individual.

"When [children] come to be 'begotten' in the one-flesh union of husband and wife who choose to engage in the marital act and through it to open themselves to the gift of love and the gift of life, their personal dignity is respected as it ought to be. When they are 'made' in the laboratory, even for the noblest of reasons, they are treated as objects or products and their personal dignity is not properly respected" (William E. May).

In short the only way that a human person can be properly respected as equal in dignity in its coming-to-be and not be subject to a relationship of domination is through being conceived through the marital act.

The wisdom of this teaching in born out in the practices which have accompanied IVF. Although not absolutely necessary to IVF itself the procedure nearly invariably involves the creation of multiple embryos, the screening of these embryos, the discarding of some, the transfer of some and the freezing of others. All kinds of other scenarios are then possible. All of this reflects people carrying through the objective logic of their actions, i.e. regarding the new human being as a product rather than someone equal in dignity to themselves.

There are two other lines of reasoning which the document Donum Vitae also gives which I won't go into here.

However I would like to make this point. Husband and wives, by virtue of the gift they have made of themselves to each other in marriage, have the right and capacity to engage in the marital act i.e. an act of sexual intercourse open to the communication of spousal love and open to the reception of human life. They do not have a right to a child. They (nor anyone else) do not have this right because a child is, like them, a person, a being that is a subject of rights. A child is not a thing that others can possess or own, nor is it an act to which persons can have rights.

What about G.I.F.T.? (Gamete Intrafollopian Transfer)

Some people propose the procedure known as G.I.F.T. as a one which may help infertile couples while still being in accord with the teaching of the Church. G.I.F.T. is the acronym for Ògamete intra-fallopian transferÓ. In the Catholic version of GIFT a couple have marital intercourse, some of the semen containing sperm is collected in the act of intercourse through the use of a perforated condom or retrieving from the vagina. An egg is harvested from the woman similarly to IVF. The sperm is prepared, the egg and sperm are placed in a tube with an air bubble or a medium between them and are inserted into the fallopian tube.

Some Catholic theologians assert that because the act begins with marital intercourse and ends with fertilization occurring in the fallopian tube (if it occurs) then this procedure can be regarded as an assistance to the marital act and not a substitution for the act.

Other theologians disagree and assert that a) the act of intercourse becomes an act of gamete collection and not a genuine marital act; and b) the number of other actions involved between the marital act and possible fertilization are such as to dissociate the fertilization from the marital act.

The Magisterium of the Church has not given a definitive answer to this specific question. At the moment the question that people have to ask in conscience is: Is the procedure an assistance to this marital act (not marital acts in general), or does the procedure substitute for the marital act as the origin of the child?

However Catholic couples who want to use GIFT as possibly being in keeping with the teaching of the Church, should be aware that when many infertility clinics talk about offering GIFT they do not necessarily mean the Catholic version. For many GIFT simply means that the gametes are inserted into the fallopian tube before fertilization occurs. There is no reference to an act of marital intercourse. This Òsecular versionÓ of GIFT is not in keeping with the ChurchÕs teaching.

Unfortunately all the attention that IVF and its related procedures have attracted has meant that genuine cures for infertility have been put onto the backburner. Neither IVF nor GIFT cure infertility. They simply side step it.

The procedures also intrude into a very intimate part of the lives of married couples and places them under a great deal of stress. It is remarkable how much peer pressure couples suffering from infertility can be put under to undergo IVF or GIFT, from people who are ignorant of the enormous personal and financial costs involved and the very limited chance of success.

There are other alternatives which are not given as much consideration as they should be. Some couples have been helped by being taught how to recognise their own fertile times. Methods of Natural Family Planning are now used as much to assist couples to have a child as to avoid pregnancy. One centre in the USA has gone further in exploring alternative methods of assisting couples diagnosed as being infertile. The approach is called NaProTechnology. A complete description can be found at http://www.popepaulvi.com/. There are now doctors in Australia (including Brisbane) who are trained in this technology. Information can be obtained from the Queensland Bioethics Centre or from the national contact http://www.fertilitycare.com.au.

Couples suffering from infertility need support, encouragement, and affirmation to help them respond to their situation.

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