Focus – Fully Informed

by Dr. James Read –
Director – Salvation Army Ethics Center

“We’re a married couple who have been trying unsuccessfully for about six years to have a baby. Friends have suggested that we inquire about IVF (in vitro fertilization), but before we go ahead we’d like your advice. We’re leaders in our church, and it’s very important that we consider whether IVF is ethically all right, not just something we really want.”

That was the gist of an e-mail message that came to the Ethics Center recently. Even across the impersonal internet I could hear the pain of this couple because they, along with about 15 percent of all couples, couldn’t have a baby in the “natural” way. The story reminded me of Hannah (1 Samuel 1). I hoped they were getting Christlike compassion from their congregation. I knew I couldn’t supply that. My support would have to be by way of ethical principles to inform their decision-making. What to say?

In some of my talks I emphasize social justice. The procedures needed to diagnose and treat infertility, and the systems to support these new reproductive technologies, are very costly. Meanwhile there are thousands of already-living children who suffer without parents to love them. On a global scale there’s something unfair about this.

While I hoped that my e-mail correspondents had considered adopting a child, I chose not to raise this as an ethical concern. The injustice of orphaned children is not the special responsibility of childless Christian couples.

I did advise them to inform themselves fully about the procedures that would be involved. Reputable medical professionals will insist that their patients understand the risk factors before consenting, because infertility treatments can pose significant physical and emotional risks. But there are other issues to be informed about too.

For example, most fertility clinics will expect a couple to be open to the use of “donor” sperm or egg. Not all Christian ethicists object to the use of donors, seeing an analogy to organ or blood donation–ethically praiseworthy actions. Others, however, note the differences between sperm and blood. Few would feel wronged if they didn’t know whose blood was transfused into them, but many would feel wronged if the identity of the person whose genes they bore was kept from them.

And, I would want this couple to ask, will there be “surplus embryos”? Clinics will not try to fertilize just one egg. The chance of failure is too high. So there will probably be several new lives in the petri dish. What will become of them? If all are transferred to the womb, the question may come up about whether all will be able to be carried safely to term. “Selective reductions” –in which some of the developing fetuses are aborted–may be proposed. A couple in that situation will inevitably face the agonizing matter of considering death of some for the life and health of others.

On the other hand, refinements in the technology available in some clinics may mean that donors don’t have to be used or selective abortion contemplated.

Official Catholic teaching would say that IVF is unethical even then. It is wrong, according to this perspective, for any action to separate the “procreative” from the “unitive” aspects of marriage. I don’t agree with this because, for one thing, experience shows that the loving union of a married couple can be strengthened by not having to worry each time whether pregnancy will ensue. However, the Catholics are getting at something important. And that is, that children have a right to be procreated in love not merely produced as a technological marvel.

“Once begetting is acknowledged to be under the laws of time and motion efficiency, then its absorption into the world of productive technique is complete,” says the Anglican theologian Oliver O’Donovan. “I do not know how to think of an IVF child except as the creature of the doctors who assisted at her conception.”

Now, baby-making technology doesn’t have to generate that attitude, and that’s what I said to the couple that wrote. But too often it does. Especially in a world in which kids conceived in the old-fashioned way are often treated by their parents as property and products and projections of adult ego.

Central to Christian ethics is the principle that parents don’t own their children. Kids are independently valuable images of God which parents are trusted to love. So a birth is not a sign of accomplishment, but of being blessed. And whether we are needing technological assistance or not, all parents need the grace to remember that children are to be received as gifts, not fashioned as products.