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