November 10, 2007
IVF and the ethical dilemmas of infertility
Justin and Heidi Dierking started trying to have children within months after they were married in 2004. At 32, Heidi married late (typical of many modern women) and knew that her body was in the late stages of its reproductive capabilities.
Still childless two years later, the Dierkings began medical tests, which failed to uncover any problems. The fertility drug Clomid didn't help. Finally, with the clock ticking, they sought help from the Center for Reproductive Medicine in Minneapolis, a clinic that is part of an estimated $3 billion fertility industry in the US, many specializing in in vitro fertilization (IVF).
IVF is a procedure in which sperm and eggs are combined in a petri dish and incubated in an environment favorable to reproduction. Once evidence of cell division is seen, the two healthiest blastocysts are carefully implanted into the woman's uterus where, if all goes well, they will attach and grow.
The procedure seems to have worked for the Dierkings; doctors harvested her eggs, combined them with her husband's sperm, and Heidi Dierking is now pregnant and expecting twins.
(The Minneapolis Star-Tribune's Chen May Yee and Josephine Marcotty have written an excellent series of articles on the fertility industry titled Miracles for Sale. Read these stories here, here and here. Free registration is required.)
IVF has made headlines because it has been used by single women and lesbian couples to conceive children outside of the normal confines of a marital relationship. But it is also becoming the accepted treatment of last resort for any couple who can't conceive children normally — the procedure is accepted enough to be covered by many insurance policies.
Most IVF clinics advertise 50% success rates, and competition has forced many to offer money-back guarantees if the expensive treatment doesn't result in a viable pregnancy.
Christian ethicists are trouble by IVF. In this explanation of Catholic teaching, IVF is called gravely evil, very strong words for what seems on the surface to be a medical procedure offering hope to childless couples.
1 Samuel 1 tells the touching story of Hannah, wife of Elkanah, who was tortured by her inability to have a child. Her husband loved her deeply, but Hannah still felt the grief and social stigma of her barrenness.
Hannah prayed and God answered by giving her a son, Samuel, who became an important priest in Israel.
Modern science — not having much patience with prayer — has learned many of the secrets of reproduction and has put that knowledge to work. IVF and many other fertility techniques pose ethical problems, however.
Multiple embryos are created in many of these techniques, requiring what is euphemistically called "selective reduction" or the intentional abortion of "extra" embryos, leaving only one or two to be carried to term. IVF tries to better the odds of creating a viable embryo by fertilizing a great number of eggs simultaneously. The most healthy are chosen for implantation while the others are frozen for possible later use, or destroyed outright.
Biologically, a human embryo is a living human being at its earliest stage of development. The embryo is dependent on a woman for nurture and life, but it is a genetically distinct organism, different from both the egg and sperm that it grew from, and it needs nothing more than nourishment to grow into a recognizable human being — a point on which both science and Christianity agree.
Therefore, Christians argue that the destruction of embryos in the IVF process requires the destruction of human life in order to create human life.
Just as troubling is the fact that IVF encourages the commoditization of human life. Young women, many of them single and in need of cash, are signing up on websites like Egg Donation, Inc., where they post photos of themselves next to their personal profiles, offering their eggs for cash. Typical profiles include details about their likes and dislikes, their ethnic background and their educational level and talents, in addition to such basic facts as height, weight and hair color. Egg purchasers are encouraged to browse the site in search of the perfect set of qualities for the child they hope to bear.
The Star-Tribune series profiled Caitlin, a young Canadian artist who received $6,000 for her first egg "donation" and $8,000 for a second one, both to women whose own eggs were no longer viable.
Caitlin was drawn to egg donation by the realization that her eggs were going to waste with every menstrual cycle. "I think it's great," she said. "Men have always been able to spread their genes. Now I can spread my genes."
Caitlin obviously got A's in her evolutionary biology classes.
Where does it take us as a society if the buying and selling of human life becomes normal? What will be the emotional impact on children who are conceived in a petri dish, especially those created from eggs and sperm purchased on the Internet? Will they come to see themselves as scientific freaks?
IVF already allows doctors to do genetic testing prior to implantation. Sex selection is possible, and with further technical refinements genetic "enhancements" might become an option. Will parents someday have the ability to select genes for intelligence, for artistic talent, or for beauty?
Will parents who pay big bucks for a quality embryo badger their children harder to achieve greatness? Will such a parent lose affection for her child if she turns out to be just your average, ordinary underachiever? (Can you sue an egg donor for product liability if your IVF child drops out of college?)
What we risk in this brave new world of human reproduction technology is the diminishment of human dignity. Christianity clearly teaches that every human being is the unique and precious creation of God, an individual whom God loves, an individual for whom God has specific plans and hopes, an individual for whom Christ sacrificed himself on the cross.
In the Christian view, we inherit our human dignity and worth from God, the author and creator of all life.
If we use our human genius to manufacture children in laboratories, if we purchase them on American Express and select them genetically like a Baskin-Robbins' flavor-of-the-month, we inevitably demean human beings and the intrinsic value of all life, in the process.
Hannah's childlessness grieved her terribly. As the father of two children, I understand something of that grief: my children have brought me immeasurable joy. If the church calls IVF a "great evil," it puts itself in the wretched position of labeling infertile women who turn to IVF "great evil-doers." The church must show these women Christ-like compassion and real help with their pain.
At the same time, the risks to society and human dignity posed by IVF and other such fertility technologies is enormous. We cannot let our compassion for childless women cause us to fail to take a hard look at the ethical implications of this new science. Science is in the business of pushing back the frontiers of knowledge. The church has to serve as science's conscience and the guardian of human dignity.
Photo credit: 3-day-old embryos created by IVF, from Sir Ganga Ram Hospital Centre of IVF and Human Reproduction.
Posted by Charlie at November 10, 2007 8:26 PM | print this! | TrackBackPosted to Abortion | Discovering God | Post-modern Culture
I too am extremely disturbed by IVF. Aside from all of the excellent moral issues you discuss in this post, I am concerned about the emphasis placed on biological children. Certainly it must be painful to discover that you cannot have a child, and there must be a grieving process. But there are so many children in the world who do not have families, and who could be adopted for a lesser monetary and physical cost than IVF conception. People go through multiple IVF cycles, draining their bank accounts (and in an age where many IVF couples are older, this often represents a depletion of retirement savings) and, in many cases, still do not conceive. I believe infertility is perhaps a little nudge to examine other options for parenting.
Posted by: Glitch at November 11, 2007 4:36 AMInteresting, Charlie! I will take some time to respond tomorrow. And to "Glitch" I would ask only one question...what is your personal experience with IVF and adoption? I mean no disrespect, but your comment came across as being from a man with many opinions, but not much factual knowledge on either subject.
Posted by: Kim at November 11, 2007 6:41 PMI'm not going to get into the morality issues since no one can know what we go through and no one should be in a positon to tell us what to go through. We are all very clever when it comes to using the bible to justify our own opinions. But I am hoping someone might be familiar with a new fertility retreat center in Hawaii.
Called the KaNeCa Fertility Institute. Thanks - Mat
Posted by: Mat at November 11, 2007 8:39 PMI don't think anyone would disagree that the creation of human life (from sperm and egg) is wrong...but rather it's destruction.
Sadly, so long as abortion stays legal in this country, I'm afraid any arguments about the unethicalness of embryo destruction will continue to fall on deaf ears in certain segments of the medical community.
All couples going through the IVF process have choices regarding the implantation and subsequent treatment and/or destruction of all embryos that are created. The clinics do not make these decisions, the patients do. However, many patients are unaware of how much power they really do have in this area.
To say that couples should not pursue IVF as an option to have a child because embryos might be destroyed in the process is the same logic as saying a man should not have bypass surgery because he may live to be an ax-murderer in the future. Both medical procedures would appear to be interfering with what *some other human being* feels is God's will for the life of another person.
I don't mean to sound flippant, but there is a lot of substance to this whole topic that I do not believe is as black and white as we'd like it to be. But I will say this - like Charlie, it is the destruction of embryos that I have an issue with, as well as the less-than-honest doctors and clinics out there who try to steer already emotionally-burdened couples into life and death decisions they may not feel they have any control over.
I also view it as complete silliness when anyone suggests that I am not submitting to God's will for my life because I chose IVF. I hope this discussion remains focused on biblical ethics, as I want to remain open to all knowledge on the subject.
Posted by: Kim at November 12, 2007 9:12 AMExcellent comments, Kim. I'm especially encouraged to hear you say that couples have a great deal of control over their medical choices in the IVF process. I'm confident that there are some good doctors out there, too, who will respect the patient's ethical concerns. Thanks for adding your insider's view of this emotional subject.
Posted by: Charlie at November 12, 2007 10:15 AMNope, not a man, not that I feel my gender has anything to do with my right to hold opinions. Which is what we all have. I'm sorry if my comments brushed you the wrong way. I don't think it's wrong or evil to go through IVF. But I have known several couples who did several cycles and ended up still not pregnant, just a lot poorer. That combined with the fact that there are many children waiting for adoption in the world makes me a little wary about the casual attitudes some people have about IVF.
Posted by: Glitch at November 14, 2007 5:29 AMWe are currently pregnant from an IVF. I don't have any guilt at all about the fact that we did not choose adoption.
Posted by: Ann at March 16, 2008 6:28 PMAll this talk about 'dignity'...yet you would say to couples with a medical problem, who use a medical treatment, that they are "manufacture[ing] children in laboratories". That is disrespectful in my view. IVF children are not "manufactured". They are grown in their mothers womb, after medical treatment that involved a medical facility to assist in the process of conception. Would you say to a heart transplant patient, that they were "ripped open and put together like Frankenstein"? I suspect you would show respect for them and the medical procedure the endured, not disrespect them by demeaning their medical treatment and make it sound like their was no "human dignity" in their treatment. How insidious and easy it can be manipulate language to further an agenda.
And to Glitch. I found your comments to be the most interesting of all. Of course there is an emphasis on biology. That is as natural as being human. Our bodies are designed to procreate. The experience of pregnancy and shared bond of creating a new life is a central part of life for the majority of people. In most cultures we celebrate the family, we celebrate our lineages, and shared physical characteristics as a natural part of life (the baby has his dad's eyes, she has her mother's sense of humor, she looks like great aunt Edna!, you look just like your sister...he is passing on our family name) and on and on.
As for adoption, they are two rather distinct issues that are too often put together to equate a problem=solution. Adoption does not address all the losses associated with infertility as if it were a fix for infertility. Adoption in not right for everyone either. And as for the idea that adoption is cheaper than fertility treatments. Think again. While it can be free, it often is just as much or more, it is also invasive and complicated, and can take considerable longer than medical treatment with no guarantees either. I hope you equally suggest that "fertile" couples adopt the children of the world that don't have families, and are not suggesting that infertile couples are more responsible than others to adopt needy children because they have a medical problem with their reproductive system. I was most amused though by the suggestion that you "believe infertility is perhaps a little nudge to examine other options for parenting." Imagine saying something similar to someone dealing with a different medical problem. Something like there is a "reason" they are afflicted with a medical problem, and that they should take it as some sort of 'sign" they are not destined to be "healthy", "walk", etc.. I suspect you wouldn't likely see things that way in their cases.
Posted by: Faith at March 26, 2008 11:06 PMHi, i a woman how have taking care of my sibiling all my life so i thank i have already adopted some kids and i thank it is my god giving right to have kids of my own .
Posted by: zandy at April 28, 2008 6:47 PMi have seven children masha-allah i'm prode that allah (god) has given children. everyday when i pray i thank god for giving and allowing me to have childre. there some women that can not have babies and there are some women that don't want to have children, these women that don't want to have children are thinking they have choices either to have children or not, but they are wrong because, i personally believe that god allowed you to have children and why waste this chance, you could die not having childre and when you see women with children you will feel guilty and believe me you would wish you had children. having children is a blessing thing god gives an individal so don't loss you chance of having children.
Posted by: sara at May 31, 2008 2:31 PM