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Brave New Families?


The Ethics of the New Reproductive Technologies


by Scott B. Rae



Summary


The new reproductive technologies give great hope to infertile couples and make many new reproductive arrangements possible. They also raise many difficult moral issues. Artificial insemination by husband is considered moral, but artificial insemination by donor raises questions about a third party entering reproduction. In vitro fertilization is acceptable within limits: the couple should ensure that no embryos are left in storage and that the risk of selective termination is avoided. Commercial surrogate motherhood raises problems because it is the equivalent of selling children, can be exploitative of the surrogate, and violates a mother's fundamental right to raise her child. Even altruistic surrogacy raises questions about the degree of detachment the mother must have from her unborn child to successfully give it up after birth.



On March 27, 1986, Mary Beth Whitehead gave birth to a little girl whom she named Sara. That same day, Elizabeth and Daniel Stern named the same baby Melissa. Both were convinced that the child (called Baby M in the press) belonged to them, and both were prepared to take drastic measures to win custody over what they thought was their child. The Sterns had hired Whitehead to bear their child. She was, and is to this day, the most publicized person to perform the role of a surrogate mother. Their contest over that child was carried on in court for almost two years, and it illustrates the potential problems and complexities involved with many of the new reproductive technologies.


Medicine has made some remarkable advances in the field of reproductive technology. The term reproductive technology refers to various medical procedures that are designed to alleviate infertility, or the inability of a couple to produce a child of their own. These include artificial insemination, in vitro fertilization (or "test-tube" babies), and surrogate motherhood. When successful, these technologies are the miracle of life for couples who have often spent years trying to have a child, and who have exhausted all other avenues for conceiving a child of their own. But many of these techniques raise major moral questions and can create thorny legal problems that must be resolved in court.


These new technologies make possible all sorts of interesting childbearing arrangements. Here is a sampling of what is now possible for couples contemplating parenthood in unconventional ways:

†††††††††(1) A man who cannot produce sperm and his wife want to have a child. She is artificially inseminated with sperm from an anonymous donor, conceives, and bears a child.

(2) A woman who cannot produce eggs and her husband want to have a child. They hire a woman to be inseminated with the husband's sperm, and she bears the child for them.

(3) A woman is able to produce eggs but is unable to carry a child to term. She and her husband "rent the womb" of another woman and she gestates an embryo that was formed by laboratory fertilization of the husband's sperm and his wife's egg.

(4) A lesbian couple wants to have a child. One of the women provides an egg, and after it is fertilized by donor sperm, the embryo is implanted in the uterus of her partner.

(5) A couple desiring to have children cannot produce any of the sperm or eggs necessary for conception. So the woman's sister donates the egg and the man's brother donates sperm. Fertilization occurs in vitro, that is, outside the womb, and the embryo is transferred to the wife of the couple, who carries the child.


As mentioned above, these new reproductive technologies raise complicated issues, not only for the law, but also for morality. What is society to say to these technologies that, in many cases, redefine the family and turn traditional notions of reproduction upside down? In addition, since many of these issues are not directly addressed in Scripture, in what way does the Bible speak to these issues?


ARTIFICIAL INSEMINATION


Artificial insemination is a relatively simple procedure in which sperm, either from the woman's husband or a donor (if the husband is unable to produce sperm), is inserted into the woman's uterus directly rather than through sexual intercourse. It is normally the first infertility treatment a couple will try because it is simple to accomplish, involves no pain for the woman, and is inexpensive compared to other reproductive technologies. It is most often employed when a woman's husband has a low sperm count, or his sperm has difficulty in reaching the woman's egg.


When the woman's husband's sperm simply needs help in fertilizing the egg, artificial insemination by husband (AIH) is performed. Most people have no moral difficulty with such a procedure. It is simply viewed as medical technology providing assistance to what could not be accomplished by normal sexual intercourse. The genetic materials that are combined when conception occurs (and frequently it takes more than one insemination for conception to occur) belong to the woman and her husband, and they are the ones who plan to raise the child. Most people agree that there are no morally significant differences between AIH and procreation by intercourse. The exception to this is the Roman Catholic tradition, which views most reproductive interventions -- including contraception -- as a problem (see below).


There are many cases, however, in which the husband is not able to produce sperm at all. In these cases, instead of artificial insemination being performed with his sperm, a donor provides the sperm. This is called artificial insemination by donor (AID). The donation is almost always made anonymously so that the father cannot be traced by the child, nor can the father elect to make contact with the child, potentially disrupting a harmonious family. In most cases, the sperm of two or three donors is mixed together, thus making it easier to conceal the identity of the father.


AID raises ethical questions that are not raised by AIH. Since AIH takes place between husband and wife, the integrity of the family is maintained, and there is continuity between procreation and parenthood. But AID introduces a third party into the reproductive matrix, and someone who donates sperm to be used for AID is now contributing genetic material without the intent to parent the child that will be produced through the use of his genes.


The assumption of Scripture is that children will be raised by the people to whom they are genetically related. The Bible assumes the concept that only husband and wife will be parents of children. There is a continuity between the genetic and social roles of parenthood. The Bible never clearly defends this notion; it simply assumes it. Perhaps the reason for this is that it is a notion that does not need defending, similar to the doctrine of the existence of God.


Of course, Scripture could not directly address situations in which these reproductive technologies were available. But even though techniques like AID are not the subject of direct biblical teaching, there are biblical principles that can be applied to these different methods of alleviating infertility. Christian tradition on the family, for example, has always assumed that children will be born into a stable family setting of monogamous marriage in which sexual relations between father and mother result in the child's birth. The principles underlying such an assumption are the integrity of the family and the continuity between procreation and parenthood. Adoption is widely recognized as an exception to the general rule, or an emergency solution to the tragic situation of an unwanted pregnancy. Just because the exceptional case is allowed, however, that does not justify it as the norm.


Catholicism and Natural Law


The Catholic tradition of natural law (i.e., basing morality on the natural tendencies or function of a thing) has also emphasized the continuity between procreation and parenthood, even to the point of denying the moral legitimacy of contraception, something that clearly interrupts that process. This is also the basis for Catholic opposition to abortion and most reproductive technologies. If everything progresses as God designed it, sexual relations result in conception and childbirth. In the same way that God designed an acorn to grow into an oak tree, He likewise designed sexual relations to come to fruition in the birth of a child. Thus there is a God-designed, natural continuity between sex in marriage and parenthood. Every sexual encounter has the potential for conception, and every conception has the potential for childbirth and parenthood. This is why sex is reserved for marriage, and why Catholic tradition makes little room for any reproductive technology that would interfere with a natural p