Priests For Life Canada

REPRODUCTIVE TECHNOLOGIES

Artificial Insemination | In Vitro Fertilisation | Natural Procreative Technology | NaPro Technology vs. ART | Preaching Points | Church Teaching | Quotes | Church Documents

The two principal forms of Artificial Reproductive Technologies (ART) are artificial insemination (or intrauterine insemination) and in vitro fertilization (IVF).

Artificial insemination, the simpler of the two procedures, involves the doctor introducing semen, via syringe or other means, into the vagina outside of the normal act of intercourse between the two spouses. This may be combined with a stimulation of the ovaries to produce multiple ova. This process, of course, can be done with semen from the husband or from any “third party” donor. The moral status of this latter “donor” option should be understood without further clarification. It stands in direct opposition to the unity of husband and wife and their vocation to mutual love and fruitfulness. Artificial insemination by the husband may require a closer look, though.

One of the first, though by no means the strongest, objections to a husband’s sperm being introduced artificially into the wife is the means by which the semen is collected. Quite often, this is done through masturbation. While masturbation for such an end might seem quite different in intention from masturbation for selfish pleasure, we must remember the sacramental and incarnational logic that guides the Christian. Genital acts, by the nature inscribed in them by their creator, are meant at all times and in all circumstances to be interpersonal. No good intention can change this purpose. But semen could, in theory, be collected in other medical ways.

The main concern with artificial insemination is essentially the same as with contraception. Contraception is a violation of the natural procreative potential that is intrinsic to every marital act. It contradicts the sacramental language of the body as the fulfilment of total self-giving. Well, just as the procreative potential of the marital act can be thwarted, so too can the unitive aspect. And this is precisely what artificial insemination does. By removing the conception of a new human being from the environment of total self-giving of the spouses and placing it in an environment of technical efficiency and control, we have violated the intrinsic unitive aspect of the marital act. In doing so, we essentially violate the personal dignity of the child— placing him or her on the level of a product of technology instead of the fruit and pure gift of self-giving love.

In vitro fertilization yields to a similar moral analysis, but adds a much more serious element to the picture. In IVF, the woman’s ovaries are, again, stimulated to produce multiple ova. These ova are surgically removed from the mother and placed, literally, in vitro (that is, “in glass” – a petri dish). Semen from the husband is obtained, artificially capacitated, and then placed in the dish with the ova. The result is often multiple conceptions in the dish. A process of genetic analysis usually follows to determine if any of the conceived embryos have defects. These will most often be “discarded”. Those determined to be most healthy will be implanted into the mother’s womb. Though the couple may “want” only one child, the failure rate for successful implantation is so high as to necessitate multiple implantations – assuming that most will die. Any remaining embryos are then frozen for later “use” or destroyed.

Couples experiencing infertility have a right to learn about the morally acceptable methods of fertility assistance provided by NaPro Technology.

NaPro Technology (which stands for Natural Procreative Technology) is a medical extension of the Creighton Model of Natural Family Planning. One of the fundamental principles of NFP is that each woman’s fertility cycle contains informative “bio-markers”, which, if tracked and recorded, can reveal to a couple times of natural fertility and infertility. There is a medical institute in the United States that has taken this principle many steps further through two decades of research and practice. Using more specific charting methods, they are able to diagnose and treat many forms of gynaecological problems, including certain types of infertility. The key to their uniqueness and success is the close attention they pay to the very specific signs contained in the woman’s fertility cycle; signs which reveal problems that more general gynaecological diagnosis can miss.

They specialize in hormonal treatments, advanced ultrasound testing, and surgical interventions where needed. As you can imagine, the particular focus of their work puts them in a position to assist couples not only with the physical, but also the emotional and psychological effects of reproductive problems. Their “underlying cause” approach to infertility often yields results better and at much less cost than artificial and morally unacceptable methods. NaPro Technology was developed by Dr. Thomas Hilgers at the Pope Paul VI Institute for the Study of Human Reproduction, which he founded in Omaha, Nebraska in 1985.

Artificial Reproductive Technologies = Openness to life without union.
Natural Procreative Technologies = Openness to life with union.

• Artificial reproductive technologies pose the opposite moral problem to contraception. Whereas contraception violates the procreative dimension of conjugal love, artificial reproduction violates the unitive dimension.

• If a technical means facilitates the conjugal act or helps it to reach its natural objectives, it is morally acceptable. If, on the other hand, the procedure were to replace the conjugal act, it is morally illicit. (DV II, 6)

• The mystery of life as a pure gift… The Church’s teachings on artificial reproduction brings into sharp focus the true mystery and dignity of the creation of human life. Life is truly a gift over and above all else. That gift, which is a new human person, must be the fruit of the conjugal act of spouses.

• Why must human beings be conceived only through the conjugal act? The fullest expression of mutual self-giving love is the conjugal act. By this act, the two spouses make of themselves, body and spirit, a gift to the other. In doing so, they image and sacramentally participate in the life of the Trinity and the love and desire for communion of Christ and the Church. There is no more appropriate place for God to offer the gratuitous gift of a new immortal human person made in his image than in such an act of complete giving of self.
  
  Procreation must be the fruit and sign of this specific love, and this love must always at least be open to the gift of procreation. Never can we reduce the gift of life to a matter of simple technical efficiency and mastery. To do this would be to make of the person an object of technology in their very origins.

• There is no “right” to have children… Unfortunately, it has become merely quaint to think of each child as a unique creation and gift of God the Father. Children, it seems, are more like planned acquisitions in our culture – acquisitions that should fit into our expectations about the ease and enjoyments that should characterize our lifestyle. A “right” to have a child is contrary to the child’s dignity and nature. The child is not an object to which one has a right, nor can she be considered as an object of ownership. Rather, a child is the most gratuitous gift of marriage, and is a living testimony of the mutual giving of her parents. For this reason, the child has the right to be the fruit of the specific act of the conjugal love of her parents; and she also has the right to be respected as a person from the moment of her conception. (DV II, 8)

• The true suffering of infertility… The desire for children is a full expression of the fruit of married love. Infertility is, thus, a tremendous burden. This burden can be all the more acute as couples experiencing infertility see the gift of children so often squandered and unappreciated in reckless and selfish attitudes and behaviours toward sexuality in others. Again, it is very important that couples who believe they are infertile explore the assistance of NaPro Technology.

Donum Vitae, CDF 1987
http://www.vatican.va/roman_curia/congregations/cfaith/documents/rc_con_cfaith_doc_19870222_respect-for-human-life_en.html

Dignitas Personae, CDF September 2008: http://www.vatican.va/roman_curia/congregations/cfaith/documents/rc_con_cfaith_doc_20081208_dignitas-personae_en.html

Veritatis Splendor, Pope John Paul II, 1993
http://www.vatican.va/holy_father/john_paul_ii/encyclicals/documents/hf_jp-ii_enc_06081993_veritatis-splendor_en.html

“Scientific, medical, or psychological experiments on human individuals or groups can contribute to healing the sick and the advancement of public health” (CCC, #2292).

“By themselves however they cannot disclose the meaning of existence and of human progress. Science and technology are ordered to man, from whom they take their origin and development; hence they find in the person and in his moral values both evidence of their purpose and awareness of their limits”(CCC, #2293).

“Natural law is nothing other than the light of understanding infused in us by God, whereby we understand what must be done and what must be avoided. God gave this light and this law to man at creation” (VS, #12, quoting St Thomas).

“Research or experimentation on the human being cannot legitimate acts that are in themselves contrary to the dignity of persons and to the moral law. The subjects’ potential consent does not justify such acts. Experimentation on human beings is not morally legitimate if it exposes the subject’s life or physical and psychological integrity to disproportionate or avoidable risks. Experimentation on human beings does not conform to the dignity of the person if it takes place without the informed consent of the subject. or those who legitimately speak for him” (CCC, #2295).

“The use of human embryos or fetuses as an object of experimentation constitutes a crime against their dignity as human beings who have a right to the same respect owed to a child once born, just as to every person” (EV, #63).

“Organ transplants are in conformity with the moral law if the physical and psychological dangers and risks to the donor are proportionate to the good sought for the recipient. Organ donation after death is a noble and meritorious act and is to be encouraged as an expression of generous solidarity. It is not morally acceptable if the donor or his proxy has not given explicit consent. Moreover, it is not morally admissible to bring about the disabling mutilation or death of a human being, even in order to delay the death of other persons” (CCC, #2296).

Catechism of the Catholic Church

(http://www.vatican.va/archive/ENG0015/_INDEX.HTM)

2374 Couples who discover that they are sterile suffer greatly. “What will you give me,” asks Abraham of God, “for I continue childless?”164 And Rachel cries to her husband Jacob, “Give me children, or I shall die!”165

1654 Spouses to whom God has not granted children can nevertheless have a conjugal life full of meaning, in both human and Christian terms. Their marriage can radiate a fruitfulness of charity, of hospitality, and of sacrifice.

2375 Research aimed at reducing human sterility is to be encouraged, on condition that it is placed “at the service of the human person, of his inalienable rights, and his true and integral good according to the design and will of God.”166

2293 Basic scientific research, as well as applied research, is a significant expression of man’s dominion over creation. Science and technology are precious resources when placed at the service of man and promote his integral development for the benefit of all. By themselves however they cannot disclose the meaning of existence and of human progress. Science and technology are ordered to man, from whom they take their origin and development; hence they find in the person and in his moral values both evidence of their purpose and awareness of their limits.

2376 Techniques that entail the dissociation of husband and wife, by the intrusion of a person other than the couple (donation of sperm or ovum, surrogate uterus), are gravely immoral. These techniques (heterologous artificial insemination and fertilization) infringe the child’s right to be born of a father and mother known to him and bound to each other by marriage. They betray the spouses’ “right to become a father and a mother only through each other.”167

2377 Techniques involving only the married couple (homologous artificial insemination and fertilization) are perhaps less reprehensible, yet remain morally unacceptable. They dissociate the sexual act from the procreative act. The act which brings the child into existence is no longer an act by which two persons give themselves to one another, but one that “entrusts the life and identity of the embryo into the power of doctors and biologists and establishes the domination of technology over the origin and destiny of the human person. Such a relationship of domination is in itself contrary to the dignity and equality that must be common to parents and children.”168 “Under the moral aspect procreation is deprived of its proper perfection when it is not willed as the fruit of the conjugal act, that is to say, of the specific act of the spouses’ union . . . . Only respect for the link between the meanings of the conjugal act and respect for the unity of the human being make possible procreation in conformity with the dignity of the person.”169

2378 A child is not something owed to one, but is a gift. The “supreme gift of marriage” is a human person. A child may not be considered a piece of property, an idea to which an alleged “right to a child” would lead. In this area, only the child possesses genuine rights: the right “to be the fruit of the specific act of the conjugal love of his parents,” and “the right to be respected as a person from the moment of his conception.”170

2379 The Gospel shows that physical sterility is not an absolute evil. Spouses who still suffer from infertility after exhausting legitimate medical procedures should unite themselves with the Lord’s Cross, the source of all spiritual fecundity. They can give expression to their generosity by adopting abandoned children or performing demanding services for others.

Evangelium Vitae

(http://www.vatican.va/holy_father/john_paul_ii/encyclicals/documents/hf_jp-ii_enc_25031995_evangelium-vitae_en.html)

14. 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 new threats against life. Apart from the fact that they are morally unacceptable, since they separate procreation from the fully human context of the conjugal act, 14 these techniques have a high rate of failure: not just failure in relation to fertilization but with regard to the subsequent development of the embryo, which is exposed to the risk of death, generally within a very short space of time. Furthermore, the number of embryos produced is often greater than that needed for implantation in the woman’s womb, and these so-called “spare embryos” are then destroyed or used for research which, under the pretext of scientific or medical progress, in fact reduces human life to the level of simple “biological material” to be freely disposed of. …

Donum Vitae: Respect for Human Life

(http://www.vatican.va/roman_curia/congregations/cfaith/documents/rc_con_cfaith_doc_19870222_respect-for-human-life_en.html)

Section I

6. WHAT JUDGMENT SHOULD BE MADE ON OTHER PROCEDURES OF MANIPULATING EMBRYOS CONNECTED WITH THE “TECHNIQUES OF HUMAN REPRODUCTION”?

Techniques of fertilization in vitro can open the way to other forms of biological and genetic manipulation of human embryos, … the hypothesis or project of constructing artificial uteruses for the human embryo. These procedures are contrary to the human dignity proper to the embryo, and at the same time they are contrary to the right of every person to be conceived and to be born within marriage and from marriage.(32) …

Section II

* By the term heterologous artificial fertilization or procreation, the Instruction means techniques used to obtain a human conception artificially by the use of gametes coming from at least one donor other than the spouses who are joined in marriage. Such techniques can be of two types

a) Heterologous IVF and ET: the technique used to obtain a human conception through the meetingin vitro of gametes taken from at least one donor other than the two spouses joined in marriage.

b) Heterologous artificial insemination: the technique used to obtain a human conception through the transfer into the genital tracts of the woman of the sperm previously collected from a donor other than the husband.

** By artificial homologous fertilization or procreation, the Instruction means the technique used to obtain a human conception using the gametes of the two spouses joined in marriage. Homologous artificial fertilization can be carried out by two different methods:

a) Homologous IVF and ET: the technique used to obtain a human conception through the meetingin vitro of the gametes of the spouses joined in marriage.

b) Homologous artificial insemination: the technique used to obtain a human conception through the transfer into the genital tracts of a married woman of the sperm previously collected from her husband.

A. HETEROLOGOUS ARTIFICIAL FERTILIZATION

2. DOES HETEROLOGOUS ARTIFICIAL FERTILIZATION CONFORM TO THE DIGNITY OF THE COUPLE AND TO THE TRUTH OF MARRIAGE?

Through IVF and ET and heterologous artificial insemination, human conception is achieved through the fusion of gametes of at least one donor other than the spouses who are united in marriage.Heterologous artificial fertilization is contrary to the unity of marriage, to the dignity of the spouses, to the vocation proper to parents, and to the child’s right to be conceived and brought into the world in marriage and from marriage.(36) Respect for the unity of marriage and for conjugal fidelity demands that the child be conceived in marriage; the bond existing between husband and wife accords the spouses, in an objective and inalienable manner, the exclusive right to become father and mother solely through each other.(37) Recourse to the gametes of a third person, in order to have sperm or ovum available, constitutes a violation of the reciprocal commitment of the spouses and a grave lack in regard to that essential property of marriage which is its unity. Heterologous artificial fertilization violates the rights of the child; it deprives him of his filial relationship with his parental origins and can hinder the maturing of his personal identity. Furthermore, it offends the common vocation of the spouses who are called to fatherhood and motherhood: it objectively deprives conjugal fruitfulness of its unity and integrity; it brings about and manifests a rupture between genetic parenthood, gestational parenthood and responsibility for upbringing. Such damage to the personal relationships within the family has repercussions on civil society: what threatens the unity and stability of the family is a source of dissension, disorder and injustice in the whole of social life. These reasons lead to a negative moral judgment concerning heterologous artificial fertilization: consequently fertilization of a married woman with the sperm of a donor different from her husband and fertilization with the husband’s sperm of an ovum not coming from his wife are morally illicit. Furthermore, the artificial fertilization of a woman who is unmarried or a widow, whoever the donor may be, cannot be morally justified.

The desire to have a child and the love between spouses who long to obviate a sterility which cannot be overcome in any other way constitute understandable motivations; but subjectively good intentions do not render heterologous artificial fertilization conformable to the objective and inalienable properties of marriage or respectful of the rights of the child and of the spouses.

3. IS “SURROGATE”* MOTHERHOOD MORALLY LICIT?

No, for the same reasons which lead one to reject heterologous artificial fertilization: for it is contrary to the unity of marriage and to the dignity of the procreation of the human person. Surrogate motherhood represents an objective failure to meet the obligations of maternal love, of conjugal fidelity and of responsible motherhood; it offends the dignity and the right of the child to be conceived, carried in the womb, brought into the world and brought up by his own parents; it sets up, to the detriment of families, a division between the physical, psychological and moral elements which constitute those families.

* By “surrogate mother” the Instruction means:

a) the woman who carries in pregnancy an embryo implanted in her uterus and who is genetically a stranger to the embryo because it has been obtained through the union of the gametes of “donors”. She carries the pregnancy with a pledge to surrender the baby once it is born to the party who commissioned or made the agreement for the pregnancy.

b) the woman who carries in pregnancy an embryo to whose procreation she has contributed the donation of her own ovum, fertilized through insemination with the sperm of a man other than her husband. She carries the pregnancy with a pledge to surrender the child once it is born to the party who commissioned or made the agreement for the pregnancy.

B. HOMOLOGOUS ARTIFICIAL FERTILIZATION

Since heterologous artificial fertilization has been declared unacceptable, the question arises of how to evaluate morally the process of homologous artificial fertilization: IVF and ET and artificial insemination between husband and wife. First a question of principle must be clarified.

4. WHAT CONNECTION IS REQUIRED FROM THE MORAL POINT OF VIEW BETWEEN PROCREATION AND THE CONJUGAL ACT?

a) The Church’s teaching on marriage and human procreation affirms the “inseparable connection, willed by God and unable to be broken by man on his own initiative, between the two meanings of the conjugal act: the unitive meaning and the procreative meaning. Indeed, by its intimate structure, the conjugal act, while most closely uniting husband and wife, capacitates them for the generation of new lives, according to laws inscribed in the very being of man and of woman”.(38) This principle, which is based upon the nature of marriage and the intimate connection of the goods of marriage, has well-known consequences on the level of responsible fatherhood and motherhood. “By safeguarding both these essential aspects, the unitive and the procreative, the conjugal act preserves in its fullness the sense of true mutual love and its ordination towards man’s exalted vocation to parenthood”.(39) The same doctrine concerning the link between the meanings of the conjugal act and between the goods of marriage throws light on the moral problem of homologous artificial fertilization, since “it is never permitted to separate these different aspects to such a degree as positively to exclude either the procreative intention or the conjugal relation” (40) … Homologous artificial fertilization, in seeking a procreation which is not the fruit of a specific act of conjugal union, objectively effects an analogous separation between the goods and the meanings of marriage. Thus, fertilization is licitly sought when it is the result of a “conjugal act which is per se suitable for the generation of children to which marriage is ordered by its nature and by which the spouses become one flesh”.(41) But from the moral point of view procreation is deprived of its proper perfection when it is not desired as the fruit of the conjugal act, that is to say of the specific act of the spouses’ union.

b ) The moral value of the intimate link between the goods of marriage and between the meanings of the conjugal act is based upon the unity of the human being, a unity involving body and spiritual soul. (42) Spouses mutually express their personal love in the “language of the body “, which clearly involves both “sponsal meanings” and parental ones.(43) The conjugal act by which the couple mutually express their self-gift at the same time expresses openness to the gift of life. It is an act that is inseparably corporal and spiritual. It is in their bodies and through their bodies that the spouses consummate their marriage and are able to become father and mother. In order to respect the language of their bodies and their natural generosity, the conjugal union must take place with respect for its openness to procreation; and the procreation of a person must be the fruit and the result of married love. The origin of the human being thus follows from a procreation that is “linked to the union, not only biological but also spiritual, of the parents, made one by the bond of marriage”.(44) Fertilization achieved outside the bodies of the couple remains by this very fact deprived of the meanings and the values which are expressed in the language of the body and in the union of human persons.

c) Only respect for the link between the meanings of the conjugal act and respect for the unity of the human being make possible procreation in conformity with the dignity of the person. In his unique and irrepeatable origin, the child must be respected and recognized as equal in personal dignity to those who give him life. The human person must be accepted in his parents’ act of union and love; the generation of a child must therefore be the fruit of that mutual giving (45) which is realized in the conjugal act wherein the spouses cooperate as servants and not as masters in the work of the Creator who is Love. In reality, the origin of a human person is the result of an act of giving. The one conceived must be the fruit of his parents’ love. He cannot be desired or conceived as the product of an intervention of medical or biological techniques; that would be equivalent to reducing him to an object of scientific technology. No one may subject the coming of a child into the world to conditions of technical efficiency which are to be evaluated according to standards of control and dominion. The moral relevance of the link between the meanings of the conjugal act and between the goods of marriage, as well as the unity of the human being and the dignity of his origin, demand that the procreation of a human person be brought about as the fruit of the conjugal act specific to the love between spouses. The link between procreation and the conjugal act is thus shown to be of great importance on the anthropological and moral planes, and it throws light on the positions of the Magisterium with regard to homologous artificial fertilization.

5. IS HOMOLOGOUS ‘IN VITRO’ FERTILIZATION MORALLY LICIT?

… The desire for a child – or at the very least an openness to the transmission of life – is a necessary prerequisite from the moral point of view for responsible human procreation. But this good intention is not sufficient for making a positive moral evaluation of in vitro fertilization between spouses. The process of IVF and ET must be judged in itself and cannot borrow its definitive moral quality from the totality of conjugal life of which it becomes part nor from the conjugal acts which may precede or follow it.(48)

It has already been recalled that, in the circumstances in which it is regularly practised, IVF and ET involves the destruction of human beings, which is something contrary to the doctrine on the illicitness of abortion previously mentioned.(49) But even in a situation in which every precaution were taken to avoid the death of human embryos, homologous IVF and ET dissociates from the conjugal act the actions which are directed to human fertilization. For this reason the very nature of homologous IVF and ET also must be taken into account, even abstracting from the link with procured abortion. Homologous IVF and ET is brought about outside the bodies of the couple through actions of third parties whose competence and technical activity determine the success of the procedure. Such fertilization entrusts the life and identity of the embryo into the power of doctors and biologists and establishes the domination of technology over the origin and destiny of the human person. Such a relationship of domination is in itself contrary to the dignity and equality that must be common to parents and children.

Conception in vitro is the result of the technical action which presides over fertilization. Such fertilization is neither in fact achieved nor positively willed as the expression and fruit of a specific act of the conjugal union. In homologous IVF and ET, therefore, even if it is considered in the context of ‘de facto’ existing sexual relations, the generation of the human person is objectively deprived of its proper perfection: namely, that of being the result and fruit of a conjugal act in which the spouses can become “cooperators with God for giving life to a new person”.(50) These reasons enable us to understand why the act of conjugal love is considered in the teaching of the Church as the only setting worthy of human procreation. For the same reasons the so-called “simple case”, i.e. a homologous IVF and ET procedure that is free of any compromise with the abortive practice of destroying embryos and with masturbation, remains a technique which is morally illicit because it deprives human procreation of the dignity which is proper and connatural to it. Certainly, homologous IVF and ET fertilization is not marked by all that ethical negativity found in extra-conjugal procreation; the family and marriage continue to constitute the setting for the birth and upbringing of the children. Nevertheless, in conformity with the traditional doctrine relating to the goods of marriage and the dignity of the person, the Church remain opposed from the moral point of view to homologous ‘in vitro’ fertilization. Such fertilization is in itself illicit and in opposition to the dignity of procreation and of the conjugal union, even when everything is done to avoid the death of the human embryo. Although the manner in which human conception is achieved with IVF and ET cannot be approved, every child which comes into the world must in any case be accepted as a living gift of the divine Goodness and must be brought up with love.

6. HOW IS HOMOLOGOUS ARTIFICIAL INSEMINATION TO BE EVALUATED FROM THE MORAL POINT OF VIEW?

Homologous artificial insemination within marriage cannot be admitted except for those cases in which the technical means is not a substitute for the conjugal act but serves to facilitate and to help so that the act attains its natural purpose.

The teaching of the Magisterium on this point has already been stated.(51) This teaching is not just an expression of particular historical circumstances but is based on the Church’s doctrine concerning the connection between the conjugal union and procreation and on a consideration of the personal nature of the conjugal act and of human procreation. “In its natural structure, the conjugal act is a personal action, a simultaneous and immediate cooperation on the part of the husband and wife, which by the very nature of the agents and the proper nature of the act is the expression of the mutual gift which, according to the words of Scripture, brings about union ‘in one flesh’ “.(52) Thus moral conscience “does not necessarily proscribe the use of certain artificial means destined solely either to the facilitating of the natural act or to ensuring that the natural act normally performed achieves its proper end”.(53) If the technical means facilitates the conjugal act or helps it to reach its natural objectives, it can be morally acceptable. If, on the other hand, the procedure were to replace the conjugal act, it is morally illicit. Artificial insemination as a substitute for the conjugal act is prohibited by reason of the voluntarily achieved dissociation of the two meanings of the conjugal act. Masturbation, through which the sperm is normally obtained, is another sign of this dissociation: even when it is done for the purpose of procreation, the act remains deprived of its unitive meaning: “It lacks the sexual relationship called for by the moral order, namely the relationship which realizes ‘the full sense of mutual self-giving and human procreation in the context of true love’ “.(54)

7. WHAT MORAL CRITERION CAN BE PROPOSED WITH REGARD TO MEDICAL INTERVENTION IN HUMAN PROCREATION?

The medical act must be evaluated not only with reference to its technical dimension but also and above all in relation to its goal which is the good of persons and their bodily and psychological health. The moral criteria for medical intervention in procreation are deduced from the dignity of human persons, of their sexuality and of their origin. Medicine which seeks to be ordered to the integral good of the person must respect the specifically human values of sexuality.(55) The doctor is at the service of persons and of human procreation. He does not have the authority to dispose of them or to decide their fate.

A medical intervention respects the dignity of persons when it seeks to assist the conjugal act either in order to facilitate its performance or in order to enable it to achieve its objective once it has been normally performed”,(56) On the other hand, it sometimes happens that a medical procedure technologically replaces the conjugal act in order to obtain a procreation which is neither its result nor its fruit. In this case the medical act is not, as it should be, at the service of conjugal union but rather appropriates to itself the procreative function and thus contradicts the dignity and the inalienable rights of the spouses and of the child to be born. …

Section III

a) … The possible recognition by positive law and the political authorities of techniques of artificial transmission of life and the experimentation connected with it would widen the breach already opened by the legalization of abortion. … Civil law cannot grant approval to techniques of artificial procreation which, for the benefit of third parties (doctors, biologists, economic or governmental powers), take away what is a right inherent in the relationship between spouses; and therefore civil law cannot legalize the donation of gametes between persons who are not legitimately united in marriage. Legislation must also prohibit, by virtue of the support which is due to the family, embryo banks, post mortem insemination and “surrogate motherhood”. …

Footnotes:

(32) No one, before coming into existence, can claim a subjective right to begin to exist; nevertheless, it is legitimate to affirm the right of the child to have a fully human origin through conception in conformity with the personal nature of the human being. Life is a gift that must be bestowed in a manner worthy both of the subject receiving it and of the subjects transmitting it. This statement is to be borne in mind also for what will be explained concerning artificial human procreation.

Dignitas Personae: On Certain Bioethical Questions

(http://www.vatican.va/roman_curia/congregations/cfaith/documents/rc_con_cfaith_doc_20081208_dignitas-personae_en.html)

Techniques for assisting fertility

12. With regard to the treatment of infertility, new medical techniques must respect three fundamental goods: a) the right to life and to physical integrity of every human being from conception to natural death; b) the unity of marriage, which means reciprocal respect for the right within marriage to become a father or mother only together with the other spouse;[19] c) the specifically human values of sexuality which require “that the procreation of a human person be brought about as the fruit of the conjugal act specific to the love between spouses”.[20] 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, who is called to realize his vocation from God to the gift of love and the gift of life”.[21]

In light of this principle, all techniques of heterologous artificial fertilization,[22] as well as those techniques of homologous artificial fertilization[23] which substitute for the conjugal act, are to be excluded. On the other hand, techniques which act as an aid to the conjugal act and its fertilityare permitted. The Instruction Donum vitae states: “The doctor is at the service of persons and of human procreation. He does not have the authority to dispose of them or to decide their fate. A medical intervention respects the dignity of persons when it seeks to assist the conjugal act either in order to facilitate its performance or in order to enable it to achieve its objective once it has been normally performed”.[24] And, with regard to homologous artificial insemination, it states: “Homologous artificial insemination within marriage cannot be admitted except for those cases in which the technical means is not a substitute for the conjugal act, but serves to facilitate and to help so that the act attains its natural purpose”.[25]

13. Certainly, 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. None of these treatments replaces the conjugal act, which alone is worthy of truly responsible procreation. …

16. The Church moreover holds that it is ethically unacceptable to dissociate procreation from the integrally personal context of the conjugal act:[29] human procreation is a personal act of a husband and wife, which is not capable of substitution. The blithe acceptance of the enormous number of abortions involved in the process of in vitro fertilization vividly illustrates how the replacement of the conjugal act by a technical procedure – in addition to being in contradiction with the respect that is due to procreation as something that cannot be reduced to mere reproduction – leads to a weakening of the respect owed to every human being. Recognition of such respect is, on the other hand, promoted by the intimacy of husband and wife nourished by married love.

Intracytoplasmic sperm injection (ICSI)

17. Among the recent techniques of artificial fertilization which have gradually assumed a particular importance is intracytoplasmic sperm injection.[32] This technique is used with increasing frequency given its effectiveness in overcoming various forms of male infertility.[33]

Just as in general with in vitro fertilization, of which it is a variety, ICSI is intrinsically illicit: it causesa complete separation between procreation and the conjugal act. Indeed ICSI takes place “outside the bodies of the couple through actions of third parties whose competence and technical activity determine the success of the procedure. Such fertilization entrusts the life and identity of the embryo into the power of doctors and biologists and establishes the domination of technology over the origin and destiny of the human person. Such a relationship of domination is in itself contrary to the dignity and equality that must be common to parents and children. Conception in vitro is the result of the technical action which presides over fertilization. Such fertilization is neither in fact achieved nor positively willed as the expression and fruit of a specific act of the conjugal union”.[34]

19. … The proposal that these [frozen] embryos could be put at the disposal of infertile couples as a treatment for infertility is not ethically acceptable for the same reasons which make artificial heterologous procreation illicit as well as any form of surrogate motherhood;[38] this practice would also lead to other problems of a medical, psychological and legal nature.

The freezing of oocytes

20. …In this regard it needs to be stated that cryopreservation of oocytes for the purpose of being used in artificial procreation is to be considered morally unacceptable.

The reduction of embryos

21. Some techniques used in artificial procreation, above all the transfer of multiple embryos into the mother’s womb, have caused a significant increase in the frequency of multiple pregnancy. This situation gives rise in turn to the practice of so-called embryo reduction, a procedure in which embryos or fetuses in the womb are directly exterminated. The decision to eliminate human lives, given that it was a human life that was desired in the first place, represents a contradiction that can often lead to suffering and feelings of guilt lasting for years.

From the ethical point of view, embryo reduction is an intentional selective abortion. It is in fact the deliberate and direct elimination of one or more innocent human beings in the initial phase of their existence and as such it always constitutes a grave moral disorder.[41]

Preimplantation diagnosis

22. Preimplantation diagnosis is a form of prenatal diagnosis connected with techniques of artificial fertilization in which embryos formed in vitro undergo genetic diagnosis before being transferred into a woman’s womb. Such diagnosis is done in order to ensure that only embryos free from defects or having the desired sex or other particular qualities are transferred.

… Preimplantation diagnosis – connected as it is with artificial fertilization, which is itself always intrinsically illicit – is directed toward the qualitative selection and consequent destruction of embryos, which constitutes an act of abortion. …

Human cloning

28. Human cloning refers to the asexual or agametic reproduction of the entire human organism in order to produce one or more “copies” which, from a genetic perspective, are substantially identical to the single original.[47]

…

Human cloning is intrinsically illicit in that, by taking the ethical negativity of techniques of artificial fertilization to their extreme, it seeks to give rise to a new human being without a connection to the act of reciprocal self-giving between the spouses and, more radically, without any link to sexuality. This leads to manipulation and abuses gravely injurious to human dignity.[48]