Humanae Vitae and Making Babies
July 25, 1968 is the date of Paul VI's encyclical Humanae Vitae, in which he affirmed: "there is an inseparable connection, willed by God and unable to be broken by man on his own initiative, between the two meanings of the conjugal act: the unitive meaning and the procreative meaning" (no.12). This meaning is severed by contraception and also by the new modes of generating human life in the laboratory: artificial insemination by a donor (better expressed as "artificial insemination by a vendor"),1 in vitro fertilization, cloning, and other artificial reproductive technologies (ARTs).
July 25, 1978 is the birthday of Louise Brown, the first child conceived in vitro to be brought to term. The doctors who "made her" in the laboratory through in vitro fertilization and succeeded in implanting her in her mother's womb and managing her pregnancy were Patrick Steptoe and Robert Edwards of England. They began their experiments with in vitro fertilization in 1968, and hundreds of babies generated in the laboratory died either while still in the laboratory or in wombs into which they had been implanted before their "success" with Louise.
Paul Ramsey's Critique of "Making Babies" as Intrinsically Evil and "Subject to Absolute Moral Prohibition"
During the years when Steptoe, Edwards, and others were experimenting with in vitro fertilization and embryo transfer, the Protestant Christian ethicist, Paul Ramsey, a great champion of life and opponent of abortion and euthanasia who taught at Princeton University, developed an argument against in vitro fertilization and other ways of producing children in the laboratory. He argued that "making babies" in this way is inherently evil because it constitutes an unethical experiment upon a future possible child. Even without considering abortion (clearly indicated if the "product" of such baby making does not measure up to standards), we must conclude, he maintained, that this way of making babies cannot exclude the possibility that harm will be done to the child-to-be. We cannot, he argued, even come to know whether damage will be done by the manipulation of ova and developing embryos unless we are willing to inflict such damage in order to find out.2
Test-tube fertilization is not, Ramsey continued, "therapeutic." At that time (the early 1970's) it was a purely experimental research procedure3 of no possible medical benefit to the "subject" of the research, namely, the possible future child. The experiments in question could not diagnose any malady that could affect the child, cure it, or prevent it. It was an experimental procedure designed for the benefit of others at the expense of that "subject." Thus, Ramsey concluded, "in vitro fertilization constitutes unethical medical experimentation on possible future human beings, and therefore is subject to . . . absolute moral prohibition."4
Peggy Orenstein's "In Vitro We Trust," New York Times Magazine July 19, 2008
Evidence now shows that the various kinds of procedures used in "making babies" in the laboratory through in vitro fertilization and its varieties does in fact do harm to the babies made in this way. This is shown in an article Peggy Orenstein wrote for the New York Times Magazine of Sunday, July 20, called "In Vitro We Trust" to commemorate the 30th birthday of Louise Brown on July 25, 2008. Orenstein, who herself had delivered a child "made in the laboratory," and is a strong supporter of the new reproductive technologies, nonetheless had to acknowledge that their use has caused serious harm to the babies generated by them. Thus she wrote: "Thousands of couples . . . have used intracytoplasmic sperm injection, a treatment for male infertility, despite some evidence that the resulting children may have higher rates of birth defects, learning disabilities, and sterility in boys."5 Orenstein does not provide this evidence, but I will do so later in this essay.
Orenstein, an advocate of IVF and other ARTS, declared: "it makes me uneasy to propose government involvement in matters of reproductive choice. If a woman wants to give I.V.F. a whirl at age 44 when her chances of success are 1 percent or a couple want to 'go for twins' — a two-for-one bargain, a ready-made family — who is Uncle Sam to say no?" But she expressed concern that American fertility clinics, in order to increase the odds that an embryo will successfully implant in the womb, routinely fertilize several ova and implant them in wombs. She then noted that "twins are 6 times more likely and triplets 17 times more likely than singletons to die in infancy." She pointed out that law professor Naomi Cahn "argues that a distinction can be made . . . between reproductive privacy and public-health concerns. States could license donor-egg agencies, for instance (heck, even manicurists have licenses). The feds could create a national registry to track the long-term health of I.V.F.-conceived kids." We may then be able to put more trust in I.V.F.
Evidence That IVF and Other Artificial Reproductive Technologies (ARTs) Cause Grave Harm To Children Conceived by Their Use7
Orenstein reported that intracytoplasmic sperm injection has caused thousands of children conceived in vitro to have birth defects. Michèle Hansen and others give massive evidence for this. She and her associates found that infants conceived in the laboratory were more likely to be delivered by Caesarean section, to have a low birth weight and to be born before term. Of babies conceived by intracytoplasmic sperm injection, 8.6% had a major birth defect diagnosed in their first year. For children conceived by in vitro fertilization the percentage was similar (9%), whereas for babies conceived naturally major birth defects diagnosed in the first year were only 4.2%. This study showed that infants conceived as a result of these technologies were more than twice as likely to have a major birth defect than naturally conceived infants.8 The Hansen et al. study is confirmed by Robert P. Jaffe.9
Other studies have turned up similar findings of the harms done by in vitro fertilization and other ARTs. Michael DeBaum et al. showed that the Beckwith-Wiedemann syndrome (BWS) was four to six times as prevalent among children who had been conceived as a result of ARTs than among those conceived naturally. This syndrome can cause the tongue and internal organs to be abnormally large, resulting in high birth weight. It also increases the risk of certain cancers including Wilm's tumor, hepatoblastoma, and neuroblastoma.10 A study by Annette C. Moll and others suggested a link between ART and childhood retinoblastoma (a malignant tumor affecting the retina). Use of IVF, in the judgment of these investigators, may cause an increased risk of this serious malady of the order of five- to seven-fold.11
Other studies could be cited, but those noted in this brief paper show how true Ramsey was in unequivocally condemning in vitro fertilization and other ways of "fabricating man" as intrinsically evil and subject to absolute moral condemnation. Recently Professor Julian Savulescu, an Oxford professor who thinks generating life through ARTs is morally required in order to produce better babies than those we get through heterosexual intercourse (or what the late Joseph Fletcher called "reproductive roulette"), received a huge grant from the Welcome Trust to further his program for enhancing human beings.12 In view of this some lines written in 1972 by Leon Kass, who served as first chairman of the President's Council for Bioethics from 2001-2008, seem appropriate for bringing this paper to a close. Kass wrote as follows: "The price to be paid for the 'optimum' baby is the transfer of procreation from the home to the laboratory and its coincident transformation into manufacture. Increasing control over the product is purchased by the increasing depersonalization of the process. The complete depersonalization of procreation shall be, in itself, seriously dehumanizing, no matter how optimum the product. It should not be forgotten that human procreation not only involves human beings but is itself a human activity."
- For the accuracy of calling the procedure "artificial insemination by vendor" see George Annas, "Artificial Insemination: Beyond the Best Interests of the Donor," Hastings Center Report 9.4 (August, 1979), 14-15, 43.
- Paul Ramsey, "Shall We 'Reproduce'?" Journal of the American Medical Association 220 (June 5, 1972): 1346.
- Today it is no longer "experimental" because it has succeeded in leading to the birth of thousands of children throughout the world. Some 30,000 children produced by new laboratory means were born in the US in 2000, for example. But the procedures are still intrinsically and absolutely unethical.
- Ramsey, "Shall We 'Reproduce'?," 1347. On this subject also see Ramsey's book, Fabricated Man (New Haven: Yale University Press, 1970).
- Peggy Orenstein, "In Vitro We Trust," New York Times Magazine, July 20, 2008, p. 12. This article is accessible at http://www.nytimes.com/2008/07/20/magazine/20wwln-lede-t.html.
- In what follows I summarize research done by my former student Patrick Carr. A paper he wrote for me in a graduate course in bioethics at the Pontifical John Paul II Institute for Studies on Marriage and Family is outstanding. Entitled "The Risks To the Life and Health of Children Conceived Using Assisted Reproductive Technologies" can be found at http://www.christendom-awake.org/pages/may/patrickcarrr.htm. I am much indebted to him for his work.
- Michelle Hansen, Jennnifer J. Kurincuk, Carol Bower, and Sandra Webb, "The Risk of Major Birth Defects After Intracytoplasmic Sperm Injection and In Vitro Fertilization," New England Journal of Medicine 346 (2002) 725-730.
- See his "The Risk of Major Birth Defects After Intracytoplasmic Sperm Injection and In Vitro Fertilization" in Obstetrical and Gynecological Survey 57.8 (August, 2002) 517-518.
- Michael DeBaum, Emily L. Niemitz, and Andrew P. Feinberg, "Association of In Vitro Fertilization with Beckwith-Wiedemann Syndrome and Epigenetic Alterations of LITI and H19," American Journal of Human Genetics 72 (2003) 156-160.
- Annette C. Moll, Saskia M. Imhof, Johannes R. M. Cruysberg, Antoinette Y. N. Meeteren, Maarten Boers, and Flora F. van Leeuwen, "Incidence of retinablastoma in children born after in-vitro fertilization," The Lancet 361 (2003) 309-310.
- On this see Jennifer Kimball's "Genetic Screening for Disease and Enhancement," GOPUSA Info Center, accessible at http://www.gopusa.com/commentary/guest/2008/jk_0709.shtml.
- Leon Kass, "Making Babies — The New Biology and the 'Old' Morality," originally published in Public Interest 1972 (Winter edition) and reprinted in Genetics and the Future of Man, ed. Michael Hamilton (Eerdmans: Grand Rapids, 1972).
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