Friday 12 December 2008

Powerful re-statement of ethical unacceptability of IVF in new Vatican Instruction

In an Instruction published today, the Congregation for the Doctrine of the Faith has powerfully re-stated the ethical unacceptability of IVF.

Fr John Fleming (pictured right), SPUC’s bioethics consultant, and a corresponding member of the Pontifical Academy for Life, has sent me his review of Dignitas Personae which I publish in full below.

The Vatican’s unambiguous prohibition of IVF is expressed in compassionate terms. As Fr Fleming points out, below: “ … [Dignitas Personae] reminds us that the Church is not unmindful of the ‘legitimacy of the desire for a child and understands the suffering of couples struggling with problems of fertility. Such a desire, however, should not override the dignity of every human life to the point of absolute supremacy.’[1]

Regarding what can be done with frozen embryos, the Instruction rejects destructive research, providing children for other couples, surrogacy and pre-natal adoption. Fr Fleming comments: "Sounding a note of exasperation with the continuing use of embryo freezing, itself an insult to human dignity, and the plight of the 'thousands of abandoned embryos', [Dignitas Personae] describes it as 'a situation of injustice which in fact cannot be resolved.'" [2]

It’s as if the church is saying to the secular world: “You created this situation by wantonly and irresponsibly creating human embryos in vitro and you are asking the church to solve the problem. It’s up to you to solve this unjust situation yourself by stopping creating embryos outside the body and freezing them.” [1] DP, n 16 [2] Ibid and DP, nn 18-19

Fr Fleming's review in full:
The new document on bioethics from the Congregation for the Doctrine of the Faith (CDF), Dignitas personae (DP), addresses a range of new issues that have emerged since 1987 in the light of the criteria set out in the Instruction Donum Vitae (1987) (DV). DP also examines some issues that had already been treated in DV but which were in need of additional clarification.

The document has many positive things to say about the importance of science and its achievements. At the same time it recognises that “there are also persons in the world of philosophy and science who view advances in biomedical technology from an essentially eugenic perspective.”[1]

The First Part

The First Part of DP deals with the anthropological, theological, and ethical aspects of human life and procreation. While supporting developments in science which “serve to overcome or correct pathologies and succeed in re-establishing the normal functioning of human procreation”, DP condemns those developments which “involve the destruction of human beings or when they employ means which contradict the dignity of the person or when they are used for purposes contrary to the integral good of man.”[2]

Then DP sets out what it considers to be the fundamental ethical criterion used in DV which is to be used to evaluate all moral questions arising from any procedures which involve the human embryo:

Thus the fruit of human generation, from the first moment of its existence, that is to say, from the moment the zygote has formed, demands the unconditional respect that is morally due to the human being in his bodily and spiritual totality. The human being is to be respected and treated as a person from the moment of conception; and therefore from that same moment his rights as a person must be recognized, among which in the first place is the inviolable right of every innocent human being to life.[3]

The Second Part

Following a detailed discussion of the implications of this fundamental ethical criterion, and especially within marriage, DP then deals with “New Problems Concerning Procreation”.

Again, DP makes it clear that the Church approves techniques which act “as an aid to the conjugal act and its fertility.”[4] Some techniques to remove obstacles to natural fertilisation such as “hormonal treatments for infertility, surgery for limited endometriosis, unblocking of fallopian tubes or their surgical repair, are licit.”[5]

But DP reiterates the ethical unacceptability of in vitro fertilisation (IVF) since “all techniques of in vitro fertilisation proceed as if the human embryo were simply a mass of cells to be used, selected, and discarded.”[6] DP comments on the very high wastage of human embryos associated with IVF and related procedures. “In many cases the abandonment, destruction and loss of embryos are foreseen and willed.”[7]

The case against IVF is forcefully put in terms of the commodification of the embryo as an entity to satisfy criteria which must be satisfied such that the gift of life is not accepted unconditionally.

At this point DP considers the plight of frozen embryos in storage, unwanted and abandoned. What is to be done with them? Immediately excluded are the uses of embryos for destructive experimentation, the provision of children to other infertile couples, and surrogacy. DP describes the proposal for “prenatal adoption” as “praiseworthy with regard to the intention of respecting and defending life”[8], but is nevertheless to be excluded ethically because it occasions similar ethical problems to the transfer of embryos to other infertile couples and surrogacy.

Sounding a note of exasperation with the continuing use of embryo freezing, itself an insult to human dignity, and the plight of the “thousands of abandoned embryos”, DP describes it as “a situation of injustice which in fact cannot be resolved.”[9]

The ethical unacceptability of the dissociation of “procreation from the integrally personal context of the conjugal act” is emphasised again in DP. At the same time DP reminds us that the Church is not unmindful of the “legitimacy of the desire for a child and understands the suffering of couples struggling with problems of fertility. Such a desire, however, should not override the dignity of every human life to the point of absolute supremacy.”[10]

Unacceptable procedures widely practised, but considered by the Church as ethically illicit, also include intracytoplasmic sperm injection (ICSI) [11], freezing embryos [12], freezing oocytes [13], embryo reduction of multifetal pregnancies [14], preimplantation diagnosis with the purpose of ensuring that only embryos free from defects, or being the desired sex or other particular qualities are transferred [15], and new forms of interception and contragestion such as the morning after pill. [16]

The Third Part

The Third Part of DP then moves on to consider “New Treatments which Involve the Manipulation of the Embryo or the Human Genetic Patrimony”. These issues include gene therapy, human cloning, the therapeutic use of stem cells, and hybridisation.

The discussion of these issues is carefully nuanced with somatic cell gene therapy being seen as generally acceptable while germ line gene therapy is not. Gene therapy put in service of enhancing a human being as distinct from a therapy for pathology is also called into question. It is seen as an attempt to create a new type of human being” such that “one can recognise an ideological element in which man tries to take the place of his Creator.” [17]

Human cloning is seen as intrinsically illicit whether done for so-called reproductive purposes or so-called therapeutic purposes. [18] On the other hand the use of stem cells is evaluated positively when stem cells are taken from the human body in ways “which do not cause serious harm to the subject from whom the stem cells are taken.” Examples of this are when stem cells are taken from an adult, the blood of the umbilical cord at the time of birth, and from foetuses which have died from natural causes. The taking of stem cells from a living human embryo invariably causes the death of the embryo and is therefore gravely illicit. [19]

There is a long discussion on hybridisation with the Church drawing attention to the significant moral and health dangers associated with the mixing of animal and human genetic material.

In its conclusion DP notes that the Church often seems to be presented as having a moral teaching which contains too many prohibitions. DP answers this criticism, and refers to the many other moral prohibitions with which all would agree, such as slavery, racism, unjust discrimination and marginalisation of women, children, and ill and disabled people. In other words the Church continues to apply the principles of the culture of life which exclude certain practices in order that the intrinsic dignity of the human being and his or her inviolable and inalienable rights are properly safeguarded, and not discounted to meet utilitarian considerations.

[1] DP, n 3 [2] DP, n 4 [3] Donum vitae, 1,1:^45 80 (1988), 79, cited in DP, n 4 [4] DP, n 12 [5] DP, n 13 [6] DP, n 14 [7] DP, n 15 [8] ibid [9] ibid and DP, nn 18-19 [10] DP, n 16 [11] DP, n 17 [12] DP, nn18-19 [13] DP, n 20 [14] DP, n 21 [15] DP, n 22 [16] DP, n 23 [17] DP, n 27 [18] DP, nn 28-29 [19] DP, n 32