Tuesday, 14 March 2017 07:29

In Vitro Fertilization – What Many Christians Fail To Consider - Part 2

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Embryo Donation, Surrogate Motherhood & Genetic Engineering

This report is presented in two parts.  Part 1 introduced a broad perspective on IVF issues as well as reviewed the topic of gamete donation and pre-implantation screening and the related moral assessment.  Part 2 will now review matters dealing with embryo donation, surrogate motherhood, and genetic engineering with the associated moral assessment.

EMBRYO DONATION 

Embryo donation is the term used for a business enterprise that brings available embryos created via IVF to couples who want to purchase them and who were not involved in the original creation of the embryos such that the genetic make-up of the embryo is not part of their family line.  In the USA there are well-meaning, even altruistic efforts on the part of some businesses and couples to provide a positive fate for some of the approximately 1 million frozen embryos who are more likely than not to be discarded, to die in a frozen state, or be used for research.  One embryo donation center called National Embryo Donation Center in Knoxville, TN, screens potential recipients looking for heterosexual couples who have been married at least 3 years and who pass a home screen by an adoption agency.  Another embryo donation center in Florida called Embryo Donation International places no restrictions on who can purchase these embryos and will work with singles, homosexual couples, heterosexual couples, and surrogates believing that everyone has a right to a family as they define family.  

There are different approaches to donation. Donation can be anonymous, partially open, or fully open.  In a semi-open relationship, the donor and recipient families must approve each other.  In an open arrangement, a mediator helps all parties agree on the level of communication they will share possibly across the full life of the child.  The implications of this kind of screening are broad and can become difficult not only for the donor and the recipient but also for the future for the child.

Embryo donation in the USA is under the jurisdiction of contract law, the same law that applies to property management and disposition of goods.  It does not fall under adoption law that tries to balance the best interests of all parties including the child.  If the law establishes the embryo as property then a disputed owner can sue for the right to destroy the embryos.  In fact, high profile custody battles over frozen embryos have involved such litigation.  In one case, parents whose relationship ended, did not agree on whether or not their embryos could be implanted for birth, and what would be the ongoing responsibility of the parents if the child was allowed to be born. In this case, who would be liable for paying storage fees until gestation took place?  Could the dissenting party who wanted the embryos destroyed be held for child support if the embryos were allowed to be born?  These and related issues are complicated and contentious.

When a couple accepts and gestates an embryo through embryo donation it is the recipient couple’s names that appear on the birth certificate.  Under current contract law, genetic parents have no claims on the children born from their transferred embryos, and in many situations a child born through donation will have a hard time tracing his true genetic lineage if necessary or desired.  Contract agreements and relinquishment forms are legally binding between the two parties.  Keep in mind that this is a relatively new field and legal rulings can change in the future in this emerging world of embryo creation, storage, donation, and transfer.

The regulations associated with US property law are inconsistently applied from state to state.  Some US states will enforce contracts if they were written.  Others will not.  Some consider whether one party may have no other option for having a child in the future and allow this to influence the ruling.  Some courts rulings are based on earlier oral agreements of the couple whose gametes produced the embryo.  No matter what US state one files a court case with, the underlying issue results in situations where the human being in question, aka, the embryo, may be treated as property and therefore lacking in the dignity proper to all human beings under the law.  This is a travesty of justice.

 

SURROGATE MOTHERHOOD

Some individuals who want to have a child using IVF will contract with a woman to serve as a surrogate for the purpose of gestating the selected embryo and turning over the child at birth to the one who has paid the surrogate for the use of her womb.  Some donation centers will not agree to contracts involving surrogates.  In one California case, a man contracted with a surrogate to have a child from purchased embryos.  In the transfer process, the surrogate was implanted with 3 embryos and all 3 survived.  The man was expecting one or two to die during the gestation period but when he learned that he was going to be the parent of 3 children, he demanded that, since he only wanted 1 or 2 children, at least one of the embryos be aborted.  The surrogate was not agreeable.  The case received a lot of attention in the media.

Other surrogates have been pressured to abort children who have been discovered in utero to have a fetal abnormality.  The contracting parent only wanted a healthy child.  The ‘product’ they sought did not meet their expectations and like any other commodity purchase, they wanted to ‘return’ the merchandise.  If the child with abnormalities was brought to term against the contracting party’s wishes, the surrogate mother could be liable for her own medical fees and the support of the child.  If the surrogate was forced to abort a child she was carrying under contract, the result would be the death of a child, the potential health problems of the surrogate, and the surrogate being treated as a slave.

It is common practice for wealthy westerners to travel to India or other impoverished countries to contract for a surrogate mother.  In such situations, the embryo will be gestated at a lower price than would be available in the prosperous country, and the woman would get a fee for her surrogacy that is more than she could earn in several years.  It can happen in these situations that the genetic parents may not be told about multiple births.  If more than the contracted number of embryos are brought to live birth, the ‘extra’ children may be sold on a black market without the contracting individuals knowing about it.  It has been reported in some cases that surrogates were held in dorms against their wills, isolated from families and friends, and forced to deliver by cesarean section.  The ramifications of these western surrogacy contracts with poor women in foreign countries are many and are degrading to women.

GENETIC ENGINEERING and GENETIC ENHANCEMENTS Related to IVF

IVF genetic engineering goes beyond pre-implantation diagnosis. Genetic engineering refers to laboratory efforts to alter genes of an embryo.  The rationale for the genetic engineering varies.  In some cases there is a desire to find new ways to eliminate devastating inherited diseases.  In other cases, research is trying to discover therapeutic breakthroughs in treating classes of disease.  Genetic enhancement goes beyond therapy to modify genes to produce ‘enhanced’ or improved versions of the person conceived through natural or laboratory means.  One might want to modify progeny to have enhanced IQ, for instance, or unique talents for becoming a super-star athlete or a talented musician.  The theory is that gene enhancements can be done on embryos taken from IVF clinics to produce “better’ offspring, or at least offspring that satisfy a particular set of values for attributes not conceived naturally.  Once considered science fiction, new technology exists today to make this theoretically possible.  There are countries experimenting with IVF embryos now to research disease modification or elimination as well as enhancements.  Currently, such research will result in the death of the embryo rather than implantation of the modified embryo.  It is only a matter of time before a genetically modified or enhanced embryo is allowed full gestation.   

MORAL ASSESSMENT

IVF Production and Storage of ‘Spare’ Embryos

There are many techniques in the science of artificial reproduction that seem to be at the service of life which are actually opening the door to new threats to life.  One example is the unregulated creation of embryos in the USA. All sorts of eugenic issues come into play when the resolution of what to do with ‘spare embryos’ is considered.  In some countries such as Germany and Italy, during the IVF process, couples are only allowed to request creation of up to the number of embryos they are willing to implant with no ‘spare embryos’ being created.  Germany limits the number of embryos created in one IVF cycle to no more than 3 as this number is deemed manageable for implantation.  No spare embryos are created and there is no cryopreservation allowed for embryos in those countries.  Laws are needed in the USA and other countries to regulate this industry and to eliminate the creation of ‘spare embryos’ in order to avoid all sorts of moral issues which abound today in the reproductive industry.  There should never be ‘spare’ embryos created as the fate of these human beings is incompatible with the respect due to all persons.

There is clearly a very big dilemma in the USA alone concerning what to do with the approximately 1 million frozen embryos.  The scale of this problem worldwide is staggering.  Cryopreservation is a problem because 1) it places a human being in a state inappropriate for the dignity he/she deserves; 2) it exposes embryos to serious risk of death or physical harm due to the process of freezing and thawing; 3) it deprives embryos at least temporarily of maternal reception and gestation; and 4) it places the embryo in a situation in which he/she is susceptible to further offense and manipulation. Unfortunately with the large numbers of frozen embryos whose fate is uncertain, it is easy to fall into utilitarian rationalism and try to justify ways to ‘recycle’ these human beings.  This treats the embryo as biological material that can be recycled via scientific research or destroyed as we would recycle or discard our garbage.  Some say that these embryos are going to die anyway, why not use them for research?  This is the same argument that says if someone is going to die soon, why not expedite death for organ use.  This is morally reprehensible. ¹

IVF Surrogacy

Religious groups object to surrogacy for many reasons, including the degradation of women used as breeders and the commodification of children born through surrogates.  Surrogacy completely separates the creation of a child from the act of love of the genetic parents or from the parents who will raise the child.   Surrogacy creates a subclass of women who are used for the service of their reproductive organs but without concern for what is best for them as women.  Some surrogates become coerced into unwanted abortions because of conflicts with those contracting with them for carrying children.  This is a form of slavery and should not continue.

 IVF Relative to Embryo Donation, Research, & Genetic Engineering 

Science and technology have a role to play and are valuable resources for men and women when these resources are placed at the service of the family and help promote integral development for the benefit of all.  Science and technology cannot provide the meaning of a person’s existence and, as such, do not represent a full expression of human progress.  Rather, these are tools that should be used only in proper context relative to the moral values associated with the dignity of human existence.  There are means and methods for transmitting the life of plants and animals that are not appropriate for man.  This is because of the unique nature of man in relation to God.  Physical life does not itself contain the whole of a person’s value nor is it the supreme good of any man or woman who are ultimately called to eternal life with God.²

Medical interventions on the human embryo, as on any other human being, should be done with respect for his/her specific life and integrity and should avoid all disproportionate risks.  Such interventions should be directed towards healing, improvement of health, or individual survival.  The same rules that apply for research and interventions on children should be applied to embryos.  All interventions should be at the service of a specific life without doing harm to the individual’s integrity or worsening his/her conditions. 

Germ line cell therapy used for the purpose of resolving genetic diseases of progeny is not licit because the current state of science does not allow control of all the risks that the therapy introduces into inheritance for future generations.  Genetic engineering for the purpose of improving or strengthening the gene pool promotes eugenics and can create social stigma of people with characteristics that are considered ‘inferior’.  Genetic enhancements offer the temptation to modify human beings to produce desirable traits not otherwise present.  The definition of desirable traits is problematic.  Arbitrary criteria used for modifications of genes introduce new forms of discrimination and create unjust domination of man over man.  Ultimately such genetic ‘enhancements’ lead to man taking the place of God and trying to create a new type of human being. 

In conclusion, it may be helpful to reference a well-known ethicist by the name of Leon Kass.  He is paraphrased as once saying that we should recognize the wisdom in repugnance.  If married couples seriously considering IVF to address their infertility issues knew what they are getting into, and it appears that many do not, they would consider this rule of repugnance and reconsider their approach to building a family.  No matter how clever the marketing hype may be, the question remains, should anyone be able to ‘purchase’ manufactured children if they decide they want to have a family?  What kind of distortions is our society getting into by opening the door to widespread commodification of children and the commodification of gametes marketed independently with genetic engineering to create the child of one’s choice?  When we lose the notion of a family consisting of a mother and father and natural offspring, what kind of society will we be building?  Embryos cannot speak for themselves.  They need strong moral voices to represent them in the debates over the legitimacy of IVF.

SEEKING MERCY

All persons working in medicine and science are obliged to witness to the value of life by avoiding cooperation with evil and scandal.  In certain situations this will necessitate that one remove oneself from gravely unjust and immoral actions in one’s line of work.  Every medical professional and research professional must commit himself/herself to absolute respect for human life and its sacredness.  All are called to use their specific talents to collaborate in the creative work of God and courageously oppose practices that result in grave and unjust discrimination against unborn human beings. 

We need to remember that we don’t construct our own definition of what is good and holy.  We rather discover the good of our existence through the appreciation of our God-given human nature, respecting that nature, and living our lives according to that nature. As Christians we know what is good and holy specifically by living according to the teaching of Jesus Christ which comes to us through Sacred Scripture, Sacred Tradition, and the Magisterium of the Church.  If we have made mistakes, we need only ask God for forgiveness with a contrite heart and a firm purpose to change, and we will be forgiven in the Sacrament of Reconciliation.  Let us reflect on the implications of this and encourage those we know and love to turn back when they have offended God and encourage them to seek forgiveness.  The threats to human life presented by IVF, with so many embryos suspended in a bizarre state and with maturing genetic manipulation tools, are growing astronomically and the implications are very serious.  Let us be a voice for the voiceless and once again return to honoring life in all its most vulnerable stages.  God will see our efforts and return His blessing upon us.   

 

¹Ratzinger, Joseph, Instruction on Respect for Human Life (Donum Vitae), 1987, # I.6.  # I.4 goes on to say: “To use human embryos or foetuses as the object or instrument of experimentation constitutes a crime against their dignity as human beings having a right to the same respect that is due to the child already born and to every human person.” Donum Vitae quotes Vatican II: “Life once conceived, must be protected with the utmost care; abortion and infanticide are abominable crimes” (Gaudium et Spes, 51) and also says: “To use human embryos or foetuses as the object or instrument of experimentation constitutes a crime against their dignity as human beings having a right to the same respect that is due to the child already born and to every human person” (question 4 of section 1).

²Ratzinger, Joseph, Instruction on Respect for Human Life (Donum Vitae), 1987, # 2 & 4.  In 1995, John Paul II went on to elaborate in Evangelium Vitae #2:  “Man is called to a fullness of life which far exceeds the dimensions of his earthly existence, because it consists in sharing the very life of God. The loftiness of this supernatural vocation reveals the greatness and the inestimable value of human life even in its temporal phase. Life in time, in fact, is the fundamental condition, the initial stage and an integral part of the entire unified process of human existence. It is a process which, unexpectedly and undeservedly, is enlightened by the promise and renewed by the gift of divine life, which will reach its full realization in eternity (cf. 1 Jn 3:1-2).”

 

Sources used in this article:

Levada, William, Dignitatis Personae – Instruction on Certain Bioethical Questions, 2008, #´s. 26 - 27, 35.

 

Pope Paul VI, Dei Verbum – Dogmatic Constitution on Divine Revelation, 1965, #10.

 

Ratzinger, Joseph, Instruction on Respect for Human Life (Donum Vitae), 1987, # I1 & I3, II.A.3.

 

“Where in the world could the first CRISPR baby be born?” Nature 526, 310-311, Oct 15, 2015.

 

Dr. Knouse is a professional Catholic bioethicist who focuses on developing education materials and delivering instruction to clergy, teachers, students, and adult audiences on various topics related to beginning-of-life and end-of-life ethics.  She is able to draw from her extensive health care experience to bring a broad perspective to current issues while giving guidance that is actionable for her audiences.  Dr. Knouse also works with families in crisis during critical medical events to aid them in understanding the ethical implications of proposed medical interventions for loved ones who are dealing with an unanticipated health crisis.  

Dr. Knouse is passionate about helping those interested in practicing their Christian faith in those areas that pertain to the Gospel of Life.  She has a doctorate and a license in bioethics from Regina Apostolorum Pontifical University in Rome as well as a Master’s of Science in Health.  Through Esther Associates LLC, Dr Knouse provides consulting services as well as educational services in the fields of bioethics and health care.