Moral theology includes concerns of a particular or special nature as well as those of a general or fundamental nature. There is thus a two-fold division in moral theology – fundamental moral theology (which we have been doing up to now) and special moral theology. They are intricately related. Special moral theology deals with concrete moral issues that relate to sexuality, medical practice, business relations, social ethics. Fundamental moral theology shows the ‘why’ behind the ‘what’ of special issues.
Disagreement at the level of concrete issues often can be traced to different understandings of the foundational concerns of morality. One of the most high profile special issues at the present time is Assisted Human Reproduction (AHR). This lecture concerns what is perhaps the most well known technique in the treatment of infertility: In Vitro Fertilisation (IVF). The First ‘Test-tube’ Baby On July 25, 1978, Louise Brown was born in Oldham, England, using IVF. She was the first so-called ‘test-tube’ baby, the culmination of years of pioneering research by Patrick Steptoe and Robert Edwards.
IVF is a gruelling, though relatively straightforward process. The ovaries are chemically stimulated to produce multiple eggs since pregnancy rates increase with transfer of more than one embryo. The eggs are recovered by laparoscopy, then coincubated with sperm for around 12-18 hours to allow fertilisation to occur. After an additional 48-72 hours, the embryo (or pre-embryo) is transferred to the uterine cavity by a catheter. If successful, implantation will occur in 2-3 days.
Success rate is 20-25 per cent – approaches that of the natural process….. much more expensive of course! Standard IVF: This is the simple procedure – sperm and ovum come from husband and wife, and the pre-embryo is implanted in the uterus of the wife. Church Teaching: Congregation For The Doctrine Of The Faith: “Instruction on Respect for Human Life in its Origins and on the Dignity of Procreation” (Donum Vitae). 1987. The CDF rejected ‘simple case’ artificial reproduction (AIH and IVF) with the gametes of husband and wife.
The analysis that led the congregation to reject IVF is as follows: “The Church’s teaching on marriage and human procreation affirms the 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”. The ‘unitive meaning’ refers to the union of two bodies in sexual intercourse; the ‘procreative meaning’ refers to the principle that all acts of sexual intercourse should be open to the possibility of procreation.
Both the unitive and procreative meanings of the conjugal act are derived from the natural law. Just as contraception separates the unitive and procreative dimensions of sexual expression, so also, in an analogous way, do technological interventions such as in vitro fertilisation and artificial insemination by husband (AIH). Some moral theologians, notably Richard A. McCormick SJ, argue against the teaching of the CDF, basing their arguments on the reforms of Vatican II.
The argument goes as follows: The centuries-old primacy given to procreation over other meanings of sexual expression was “publicly and definitively abandoned” by Vatican II. Another principal change is the criterion to be used in judging the rightfulness or wrongfulness of human conduct. The second Vatican Council shifted the criterion of moral judgement away from faculties and their purposes to a strong emphasis on the centrality of the person. It proposed as the criterion not “the intention of nature inscribed in the organs and their functions but the person integrally and adequately considered”.
One must discover what is promotive or destructive of the person. The physical faculties must not be considered in isolation from the person. McCormick argues that there is “an evolution of doctrine occurring with regard to the understanding of the unitive and procreative dimensions of sexuality.. ”. Development of doctrine usually involves both continuity and change. The thread that yields both continuity and change is the notion of the inseparability of the unitive-procreative dimensions of sexuality.
The continuity: the general validity of the insight. The change: a broadened understanding away from an act-analysis of this inseparability. Theologians argue that IVF is not a substitution for sexual intimacy, but a kind of prolongation of it, as well as a perfection of it in that it remedies infertility – it does not involve the total severance of the unitive and the procreative. The natural law principle can be upheld if the spheres of the unitive and the procreative are held together so that there is no procreation apart from marriage i. . , there is no procreation apart from the conjugal relationship as opposed to the conjugal act, and no full sexual intimacy apart from a context of responsibility for procreation. The inseparability principle is retained, but such inseparability is something to be realised in the relationship, and not the individual act. It must be stressed, however, that McCormick’s argument is not accepted by the magisterium of the Catholic Church:- cf. Vatican Council 2, Vol. 2, ed. by Austin Flannery (New York: Costello Publishing Company, 1982), p. 98, par. 3. Third party involvement: Third-party involvement in infertility treatment involves donor eggs, donor sperm, donor embryos, donor wombs.
Pius XII in 1949 said “Artificial insemination in marriage with the use of an active element from a third person is ….. immoral and as such is to be rejected summarily. Only marriage partners have mutual rights over their bodies for the procreation of new life, and these rights are exclusive, nontransferable and inalienable”. Between the child and at least one rearing parent there is “no bond of rigin, no moral and juridical bond of procreation”. Karl Rahner agrees: argued that AID fundamentally separates the marital union from the procreation of a new person. Rahner also faults the anonymity of the donor, which represents a refusal of responsibility as father and an infringement of the rights of the child. Does 3rd party involvement (via gametic donation or surrogate gestation) infringe on conjugal exclusivity? Does having a jointly raised child justify such infringement? McCormick answers ‘Yes’ to the first question and ‘No’ to the second.
The notion of conjugal exclusivity should include the genetic, gestational and rearing dimensions of parenthood. Separating these dimensions, except through rescue (as in adoption) contains a subtle diminishment of the human person. Where there is donor semen or eggs, there is a genetic asymmetry in the relationship of husband and wife to the child, with possible damaging psychological effects. Third party involvement separates procreation from marriage in principle – decisively breaks the natural law unitive-procreative principle.
The question of the freezing and destruction of embryos, the implanting of multiple embryos with the consequent high possibility of miscarriage and also the carrying out of ‘foetal reduction’. Genetic screening of embryos. The above are further important ethical issues that have arisen due to IVF. Resources: www. google. com Type in ‘Catholic Church teaching on IVF’, and ‘IVF’, etc. Catechism of the Catholic Church: pars. 2373-2379. The Catechism allows that homologous artificial insemination and fertilisation (standard IVF) are “less reprehensible” than those that involve third party donation of sperm, eggs or uterus.
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