Wednesday, July 1, 2009

Playing God - Part 2 and Part 3

The Pope and I are having a disagreement. Not a full-fledged brawl. But it’s a fight. And quite frankly, I’m a bit peeved at him. He is opposed to not only what I do for a living, but to how I conceived my children. He says I’ve violated their rights.

You read correctly. Pope Benedict XVI says my wife and I have violated my children’s rights by conceiving them the way we did.

I know this from his writings that are available through the Vatican Web site. This would probably bother me a lot, if I were Catholic. As a Presbyterian, I can be a bit more, well, philosophical.

Before he became the Pope, in 1987 Cardinal Joesph Ratzinger was the principle author of the Catholic Church’s position statement on treatments for infertility. I wanted to see how the Church justified its opposition to IVF, so I read it. The paper is titled, “Respect for Human Life” and is also known as the “Donum Vitae.” Translated literally, the Donum Vitae means the “gift of life.”

I was shocked by what I read. It wasn’t the conclusions that surprised me, but the rational and the basis for the rationale. At a minimum, I expected a scripturally-based argument. But it was (and is) not.

All told there are 64 references in this paper. Of these 64 references, only three are biblical passages. The remaining references are Papal and other Vatican writings.

The first quoted scripture noted that man should have dominion over earth. (I thought this sounded like an argument for IVF.) The other two scriptures said we should value life:

God created man in his own image and likeness: "male and female he created them, entrusting to them the task of "having dominion over the earth" (Gn. 1:27-28).

In the light of the truth about the gift of human life and in the light of the moral principles which flow from that truth, everyone is invited to act in the area of responsibility proper to each and, like the good Samaritan, to recognize as a neighbor even the littlest among the children of men (cf. Lk. 10:29-37). Here Christ's words find a new and particular echo: "What you do to one of the least of my brethren, you do unto me" (Mt. 25:40).

If that were all there was to the Donum Vitae, we would not really have an argument.

I agree that man, scripturally and by default, does have dominion over the earth. I also think we should value human life.

So exactly what is my beef with the Donum Vitae?

First let’s look at some of the declarations made by the Donum Vitae, then we’ll discuss them. I’ve paraphrased some of what comes below, because much of what the Church declares is obfuscated in ornate language (like this sentence.). The Donum Vitae says:

  1. The child has the right to be conceived, carried in the womb, brought into the world and brought up within marriage and from marriage.

  2. Donor insemination is immoral because it violates the rights of the child; it deprives him of his filial relationships with his parental origins and can hinder the maturing of his personal identity. Donor insemination is also wrong because it violates the child’s right to be conceived and brought into the world in marriage and from marriage.

  3. Donor eggs are immoral for the same reasons as donor sperm.

  4. Masturbation to achieve sperm is immoral.

  5. Artificial insemination is permissible only when the procedure is not a substitute for the sexual act but instead facilitates the sexual act to have a child.

  6. Fertilization achieved outside the body is immoral.

  7. The freezing of embryos is immoral because an embryo may not survive and it deprives them temporarily “of maternal shelter and gestation, thus placing them in a situation in which further offenses and manipulation are possible.”

  8. Life begins at conception.

Of course there is much more in the Donum Vitae about genetic testing and scientific research. I’m not going to focus on those issues during this entry, mainly because it would take too long, and only a small fraction of patients ever opt for these treatments.

Life Begins at Conception

The overriding issue addressed by the Donum Vitae is respect for human life. A key question is when does life begin? A reasonable position is the Church's position: life begins at conception. After all, an embryo is human; an embryo is alive. This is a reasonable assumption.

Others might argue that life begins in the sperm and the egg before fertilization. After all, the sperm and egg are both human, and both alive. Of course, we could argue that neither is a complete being.

So is an embryo a complete being? It usually has the genetic material to become one. But clearly an embryo is vastly different from a fetus, which is vastly different than a child, which is different from an adult. All are human. All are alive.

At what point does an embryo become a human life?

I would contend that if life is a gift from God then no matter the level of intervention, man cannot create life.

For example: in the lab, we cannot force a sperm to fertilize and egg. We cannot force the embryo to grow. We cannot force the embryo to implant in the uterus and to prosper. If we could do these things, our success rate would be 100%. As a specialty, we fall woefully short of this. All we can do in the lab is to create situations where fertilization is more likely, statistically. We can nuture embryos to the best of our abilities. But we cannot create a baby. Way too much is out of our control. This is at once humbling and reassuring to me.

It’s conceptually easy to believe that the human soul enters the embryo at the time of conception. After all, an embryo is alive. An embryo is human. Of course, these two points don’t make it a human being, no more than a fetus is a child, or a child is an adult. These are all points on a continuum and we don’t have the real ability to say when someone leaves childhood and becomes an adult. All we have are conventions. One convention says we become an adult at age 16, when we can drive. Another says 18, when we can vote. Another 21, when we can drink. Another 24, when we can rent an RV (at some rental shops in Colorado.)

I say all of this to show that it is convention to say that life begins at conception. Quite frankly that is how I have always, and continue to look at it.

But what if I’m wrong. If God is the giver of life, then when does He give an embryo a soul? Does this happen at the moment of conception? If so, then why are 50% of naturally achieved pregnancies lost prior to the onset of menses and the woman never knows she was pregnant? What would be the purpose of this? The truth is, we cannot know. The best we can do is to make our own assumptions. I look at it this way: an embryo is alive and it is human, but I know it’s not a child – yet. It is a potential child. For this reason, I would not elect to destroy my embryos.

This brings us to statement number 7, that Egg Freezing is immoral. The Church’s argument against egg freezing is that it places the embryo at risk and deprives it of maternal shelter. My response to this is that twin, triplet and quadruplet pregnancies can all do the same thing. High order gestations can create an environment that is unsuitable to sustain a pregnancy or might cause harm to the unborn child.

If I am creating embryos with IVF and not all of the embryos will be used, some of them might die if I freeze and thaw them. I am not trying to dispose of them. Rather, I am giving them a chance at life that they didn’t otherwise have. I am also maximizing their chance of having a safe pregnancy.

New freezing techniques are not perfect, but very few embryos are lost. Those that are lost, the intent is not to kill them, it is to save them so that they can be used. Yes, we place embryos at risk. How is this much different from a woman who is high risk for pregnancy who decides to conceive naturally? These pregnancies can be lost, too. Did she do something wrong? According to the Donum Vitae, this woman should not use contraception either.

Statement 6, saying that fertilization is immoral if it occurs outside the body. I don’t quite know what to say here, except, “According to whom?” Obviously, this is not in the Bible, so it is difficult to make a scripturally based argument against this. I think suitable scriptures to argue against the Church would be: “Man shall have dominion over the earth” and “Be fruitful and multiply.”

Statement 5, limiting the use of artificial insemination. Though the Donum Vitae doesn’t say this implicitly, this implies you can use a condom that has a small hole in it to allow some sperm to escape during sex, but you can then recover much of the sperm from the condom and use it for artificial insemination.

I at once welcome this exception, and yet I see the hypocrisy in it. The Donum Vitae is very clear that a child should be born of sexual relations between a man and wife. If the purpose of the sex is really to get sperm for IUI, rather than the IUI assisting the sex, it’s more likely that the sex act is assisting the IUI.

Statement 4, masturbation is immoral because the Church says so. No scripture is quoted to support this claim. I have looked for Biblical references on this. There is a lot about lust. Masterbation is not mentioned. So if lust is removed, then I see little to say this is wrong, espeically if it is being done to "be fruitful and multiply."

The story of Onan is commonly used to promote the idea that masterbation is wrong. However, as noted below, Onan's sin was not "spilling his seed" per se, but disobeying his father by refusing to help his dead brother's wife conceive a child.

Admittedly, we can get sperm from a Catholic-Safe Condom (one with holes in it); however, the results are less reliable.

Statements 2 & 3, donor egg and sperm are immoral because they deprive the child of its right to be conceived in the womb and of and from marriage. The reasons given by the Church have no basis in Biblical teaching. I hope I don’t go to Hell for what I am about to say, but even Jesus was conceived out of wedlock with 3rd party reproduction. Mary had the ultimate donor!

There is also reference to donor sperm, in Genesis. Onan was commanded to impregnate his dead brother’s wife, so that the brother’s clan line could be continued. When he refused to complete the act of sex and spilled his seed upon the ground, he was killed.

Onan was killed for disobeying the command to partake in the Biblical era's version of artificial insemination. He disobeyed his father and was killed for it.

One area where the Catholic Church and I can agree is that there is danger to this sort of reproduction. One of the ethical concerns with 3rd party reproduction is that children may grow up with a sense of loss if they do not know their genetic parents. This can be especially frustrating if it is thought that the parent is still alive and does not know.

It is in our nature to blame our anxiety on our circumstance in life. For example, if I were a minority and got bad service at a restaurant, I might wonder if it was the color of my skin. Or if I were a woman passed over for promotion so that a slightly less qualified man could be hired, then I might assume race or gender discrimination was a factor. Similarly, if a child is born from donor egg and sperm, he or she is also at risk for blaming the troubles in life on the fact that the biologic parent is unknown.

This is a very legitimate concern and while not all offspring suffer this, it is important to be aware of this potential problem prior to using donor eggs and sperm.

Statement 1, a child has the right to be conceived within the womb and born of and from marriage. I do not see this written anywhere that this is a child’s right. However, this has been frowned upon in the scriptures and through the ages. Jesus was sometimes referred to by Jews who opposed him as, “The Son of Mary,” meaning he was born out of wedlock.

I do believe that the best environment in which to be raised is in a loving home. I want there to be a mother and father in the house because this was how I was raised.

Final thoughts....

I think much of the debate around the Donum Vitae surrounds what is "natural." God's laws and natural laws are often seen as the same. But to say that an IVF baby was conceived unnaturally is to say that we are above God's laws, above nature. As a human, I am part of nature. Everything I do is part of nature. Kevlar is a natural product if man made it.

It is the hieght of vanity to assume that what man has made is above or outside of nature.

To an automobile is unatural is to say an anthill is unatural. The anthill was constructed. It's primitive, but constructed.

So my children, conceived with IVF were not conceived outside of nature. They were and are the product of a loving, committed relationship.

So, I did not violate my children's rights through their conception with IVF. The Pope owes me, and them, an apology.

I won't hold my breath waiting.