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17 septembre 2007 1 17 /09 /septembre /2007 06:22
Introduction

There is no disguising the fact that the title of my presentation at this conference does not closely resemble the other titles.  Oddly enough, however, after 15 years’ of working in the pro-life movement, my first thought upon receiving Dr. Spieker’s invitation here, was to speak on assisted reproductive technologies.  This is because there are important relationships, for purposes of Catholic Social Teaching, between the values inherent in legally sanctioned abortion and in unregulated assisted reproductive technologies (ARTs) practices.  To put this another way,  I wish to confound the notion that the distinction between these practices – one involving the desire to end life, the other a fervent desire to create it – renders the latter less threatening to basic human, family and social values.  In fact, because of the primal human desire for children,  and  because of the lower level of repugnance associated with ART processes relative to abortion, the possibility exists that the market for ARTs will simply continue to expand, unchecked,  and that more and more ART methods increasingly alien to traditional moral values will become commonplace.  
In some ways, it might be said that the values encouraged by many ARTs mirror those inherent in legalized abortion. A willingness to destroy human life in the name of “freedom,” is the most obvious shared value, and one discussed amply earlier during this conference. There are, however, several other shared values. After proposing these, my presentation will characterize -- as briefly as I can, considering the size of the topic --   current ARTs practices,  highlighting only what I believe  necessary to apply a reasonably complete Catholic Social Teaching analysis about ARTs’ effects upon the foundations of society, marriage and the family. Third, I will specify those aspects of Catholic Social Teaching, especially concerning marriage and the family, engaged by ARTs and the laws governing them.  Fourth and last, I will attempt a realistic assessment of how Catholic Social Teaching applicable to ARTs might be put forward in the current legal and cultural environment. This will include an analysis of how how ARTs fit within the scheme of current public laws and norms concerning parent-child relations;  it appears that there are some secular developments might bode well for a greater receptivity towards Catholic Social Teaching in this area, but of course the hurdles remain great. 

I. Turning first then, to those values shared by proponents of abortion and proponents of ARTs. One, is that both practices assume that adult interests should prevail over children’s, that the strong may legitimately dominate the weak.  “Choice,” not fidelity, not responsibility, is the essence of the adult-child relationship. Adults are not, in the words of Familiaris Consortio (14) “chosen” for the “gift of responsibility.”  ARTs, in a sense, complete what abortion began. Adults choose, even assuming the power of death over children. With ARTs, they have the  additional power to give life, and even to shape its genetic makeup.
Two, both abortion and ARTs propose that when it comes to evaluating the morality of an action, good personal intentions easily trump the bad physical structure and consequences of the action.  Abortion first cut through the thicket of natural objections to this notion: it is killing for some claimed good intention.  After legal abortion, it is only too easy for many to accept that merely experimenting upon human embryos, or accidentally, unavoidably harming embryos, let alone separating procreation from an act of human love, were small prices to pay if driven by the intention to create a wanted child.
Three, proponents of abortion and of ARTs strenuously maintain that both practices are essentially private. Abortion proponents manage this trick fairly successfully, at least in legal arenas, even though the practice in question is killing. They do so on the basis of the privacy traditionally accorded parents’ reproductive decisions and to doctor’s medical judgments.  ART practitioners have been even more successful shielding their practices from effective public scrutiny and regulation, mostly by asserting that their medical nature places them outside the competence of lawmakers.  Further, because ARTs are better known for making babies than for destroying or compromising their human participants,  the traditional privacy given to parent’s reproductive decisions is asserted here as well.
Beyond the common values proposed by abortion and ARTs,  ARTs present additional threats, especially to the first cell of society, the family. The second matter I now take up, therefore, is a general summary of current ARTs practices insofar as these might engage Catholic Social Teaching. 

II. Beginning with the participants in ARTs, in addition to the medical personnel involved, ARTs involve a variety of adults. These include the individual or couple intending to legally parent a child, possibly one or more gamete donors, and sometimes a surrogate mother, who may provide only a womb, or both her egg and her womb together.   While there are a variety of methods for bringing about the fertilization of the egg by the sperm,  the most common include In Vitro Fertilization (combining gametes obtained separately from a man and a woman,  in a test tube outside the parents’ bodies),  or Intra Uterine Insemination of sperm into a woman.  A surrogate mother may be involved in either of these processes.
 In addition to married persons, today, a single person -- heterosexual or homosexual --  can also seek ARTs in many countries. So may unmarried heterosexual or homosexual partners.   Individuals and couples may use their own gametes or embryos, receive these from friends or family members, or purchase those of strangers.  Sales are made over the Internet or by visiting a sperm or egg “bank” or a fertility specialist.  Donors relinquish all legal rights and disclaim all legal responsibilities to their genetic children, by signing an agreement provided by the bank or clinic.
The process of obtaining semen from men --  who are often allowed to “donate” an unlimited number of samples – regularly involves masturbation in the presence of pornography. For egg donors, the process is longer and often painful, involving a regular series of hormone shots producing hyperovulation (the release of many eggs in one month), mood swings, and other risks.  Studies show that egg donors are usually younger and worse off financially, than egg recipients. Surrogate mothers have the same profile.  A Harvard University economist recently reported that in 30% of U.S. cases, surrogates are of a different race than the mothers intending to rear the children carried.   British investigative reporting has turned up a flourishing international egg trade; the eggs of the young and poor in the Ukraine and in Cyprus are being sold to women in wealthier western nations. Generally, prices are assigned gametes on the basis of their progenitors’ degree of good looks, education, accomplishments, height, and health. 
Financially, donors receive the smallest share of the very large profits generated by the ARTs industry. Clinics, banks and their doctors receive the largest.  In the U.S. alone, ARTs are a multi-billion dollar industry. 
New developments in ARTs processes create further moral dilemmas.  Egg freezing, for example, is increasingly being mentioned as an alternative for young women wishing to preserve their young eggs – not just in the face of a disease – but on the chance that they might want to embark on a relatively long career before reproducing. 
The freezing of embryos “leftover” from IVF procedures is common; there are 400,000 frozen embryos in the U.S. alone.  Freezing and thawing processes may damage or kill the embryo. Some embryos are donated for destructive research, while others will be thawed intentionally and left to die, or preserved indefinitely.
Another increasingly common ART technique is pre-implantation genetic diagnosis. While developed initially to screen out embryos with sex-linked disorders, it is  now frequently used by fertile couples wishing to choose their children’s sex.  As science makes more and more discoveries linking genes with the diseases they express, pre-implantation genetic diagnosis will increase doctors’ abilities to identify and to select out for destruction, those embryos evidencing various genetic disorders.  The insertion of “foreign” (e.g. belonging to neither parent) genes into embryos in order to correct defects has also begun. 
Thirty five to fifty percent of ART pregnancies produce multiple children. But multiples have more complicated deliveries and more long-term health problems. Because of this, fertility specialists regularly counsel mothers of multiples toward a “selective reduction,” procedure – essentially abortion.  Doctors will destroy one or more unborn children on the basis of their size, location in the womb, or disability, in order to improve the prognosis for the remaining child or children.   It is increasingly reported that not only multiple ART pregnancies, but also “singletons,” result in  a higher than average rate of genetic disorders in children.
One might go on much longer about this constantly changing field, but for our purposes, enough has been said. It need only be added that, annually, tens of thousands of children will be brought to birth via ARTs..  Nearly 50,000 are born annually in the U.S. alone.  According to a leading economist of the ARTs industry, the market in the U.S is poised to expand. There is nothing effectively checking it.

III. Third, I now turn to those aspects of Catholic Social Teaching, especially concerning marriage and the family, engaged by ARTs.   I have already noted that I would not be addressing the Catholic Social Teaching concerning the respect due unborn life, as that has been  treated already in this Conference.  Rather, I will begin where Donum Vitae (the 1987 Instruction of the Congregation for the Doctrine of the Faith concerning ARTs) begins --  with the central principle of the dignity of the human person in its several aspects. Following this, and given the ways in which ARTs have developed over the past 19 years, I will suggest additional aspects of the social teaching on human dignity that might fruitfully be stressed in the current environment.
Donum Vitae considers ARTs  largely under the umbrella of the principle of the dignity of the human person. Two aspects of this principle receive particular attention: the dignity of the child and the necessity for the actual processes by which human life is transmitted to reflect this dignity. As to the first aspect, the dignity of the child is a reflection of his or her creation in God’s image. The human person is thus the highest thing in nature.  Furthermore, the person is a unity of body and soul.  Interventions upon the human body must always be considered according to this unity. Evaluated according to these standards, it is easy to see that ARTs contradict the dignity of the person.  The  child is being created in “man’s image,” according to the values of the market and of  technology.   The child’s genetic traits are selected, or selected against. Gametes and embryos are priced according to current worldly standards of value.  And the many physical interventions – even experimental processes – to which the child is subjected are not at all considered from the perspective of their total effects upon the child’s body/soul unity. 
Donum Vitae teaches that ARTs affect a second aspect of human dignity as well – how human life is transmitted.  Its transmission must reflect that human beings originate with God’s love – a selfless and faithful love -- and are destined for unity with God.  In the world, the only environment that can hope to reflect this, if still imperfectly,  is marriage.  Marriage can give rise to procreation by means of a personal and conscious act of human love, within a relationship defined by permanent, self-sacrificing love, and the capacity to nurture the child to adulthood within the context of this love.
These two aspects of human dignity remain the guiding principles for any Catholic Social Teaching consideration of ARTs.  In light of the increased volume of ARTs births today, however, and particularly in light of  new social and scientific developments in the practice of ARTs,  Catholic Social Teaching should bring forward  or stress certain additional aspects of the teachings on the dignity of the human person. I will note seven new developments.

First, considering  the more frequent resort to ARTs today, by nontraditional households – for example, by single parents and homosexual partners – the social teaching about the child’s right to be reared in a stable, two-parent, opposite-sex  environment ought to be stressed. The easy availability of ARTs for homosexual couples in the U.S. has even led some courts to conclude that states have abandoned completely any interest in preserving the connection between marriage and procreation.  Here, Catholic Social Teaching can derive some considerable help from the social science on child well-being. 

Second, the principle of the dignity of the child is also implicated more visibly today as a critical mass of studies have begun to emerge in the last few about the problematic physical and psychological effects of ARTs on children, the latter experienced more by children conceived with anonymous gamete donations.   The ARTs industry has not responded to this evidence.  It is unclear even whether they include it in the informed consent information provided to parents.  But in any event, they have not brought it to bear upon the health of the child.

Third, another important development in the practice of ARTs over the past 19 years concerns the principle of the dignity of women.  There is hard evidence of an international trade in the eggs of relatively impoverished women, for the benefit of wealthier women.  The procedures by which women are made to hyperovulate can be risky. Full informed consent is not always given them.  And in any event, the financial incentives induce poorer women to assume those risks they know.  It is further well known that women’s eggs are often evaluated and priced according to the progenitor’s physical beauty, in addition to her education, and to her proven ability to bear children.  The use of relatively poorer surrogates, and surrogates in less privileged racial groups also raises alarms about ARTs’ long-term effects upon the dignity of women.

Fourth, another modern trend regarding ARTs – their increasingly high cost – signals that Catholic Social Teaching on consumerism might need to be stressed today.  Via regular media reporting on the subject, the public has gained the impression that healthy babies of the desired sex can be made to order for wealthier parents.  A strong response to this fact is in order.

Fifth, some more recently available ART procedures are being used today even by those not suffering infertility, in order that parents might play a greater role in shaping the child’s make-up.  These include pre-implantation genetic diagnosis to avoid the birth of a disabled child, but also for sex selection in pursuit of “family balancing.”  Furthermore, more donor gametes area available and are being used, than ever before.  They are priced and selected according to a worldly evaluation of their worth.  There are also children born by means of ARTs who possess genes inserted into them from sources other than their biological parents. The birth of cloned human beings is a real possibility in the coming years as well. Catholic Social Teaching on the transcendent origins of the human person, and the gap between divine and human reason needs to be brought forward to meet this rush to create persons in man’s image alone.  Evidence regarding ARTs’ health effects on children, as well as evidence of the folly of sex –selection (e.g. China’s dramatic gender imbalance and its social effects) can be brought to bear on this.

Sixth, another modern development affecting ARTs laws and practices is the demographic decline being experienced today most acutely in prosperous Western nations. This might easily lead to a worsening of the tendency to view children in an instrumental way -- as commodities necessary for economic progress or the preservation of a culture.  Some nations already offer state aid for the use of ARTs as part of a population strategy.   Children’s intrinsic value, their nature as a gift for which adults’ assume responsibility, might easily be lost in such an environment. 

Seventh and finally, ARTs have gone unregulated or lightly regulated in many countries for several decades now.  Specialists in the field, as well as the public, increasingly assume that they are beyond public scrutiny.  In response to this, all of the resources that Catholic Social Teaching has to offer in this area need to be brought forward before this impression crystallizes further. My fourth and final point suggests both opportunities and hurdles for this Catholic Social Teaching task. I turn now to this.

IV. I propose that a very general model for understanding both the public’s past reception of Catholic Social Teaching regarding ARTs,  and its possible future reception, is offered by the history of our teaching regarding contraception.  Both topics face chronic difficulties arising from listeners’ unwillingness seriously to consider several Church teachings on sexual intercourse, particularly about the link between the unitive and its procreative elements of this intercourse,  and the necessity of the link between love and new life.   Difficulties also arise from an unwillingness to understand love as Pope Benedict XVI explains it in his marvelous Deus Caritas Est. Even that document understood that readers had first to be disabused of their inclination to connect love solely with emotional, sexual ecstasy, before  proceeding to teach of love’s essential nature as permanent, faithful, and directed to the good of the other.  People continue to ask:  “What’s the real harm?” of employing of contraception, or of ARTs.   Only over time did it seem that  many come to understand their effects.  With contraception it was the its long-term contribution to an extreme dissociation procreation from sex, to the skyrocketing rates of nonmarital sex, pregnancy and abortion, to the sexualization of even young girls and boys, to harmful health effects on  the bodies of women, and to the willingness of states to use contraception to control reproduction by certain segments of their population. In the U.S., just weeks ago, the federal government approved the distribution without a prescription of high dose birth control pills even to older men buying them for their minor sexual partners.  There is a greater receptivity to the notion that at the very least, contraception is not an unmitigated good, and at best, that it is socially  harmful.
While I do not want to overstate matters, perhaps now that some longer-term evidence about the industry values and the human consequences of ARTs has coming to light, perhaps now that cloning is on the horizon, the time has come for Catholic Social Teaching to take up ARTs in an increasingly visible manner.
Some current developments in the family law arena argue for this possibility.  In the past decade or so, there have arisen efforts– nascent but persistent – to move the law and social practices toward a more child-centered, and marriage centered focus.   There has been, in other words, a moving back toward laws and norms more prevalent in earlier 20th century. Parents are being urged to place children’s interests first, to avoid out-of -wedlock childbearing, to stay married, and to cooperate if divorced.  Strenuous legal efforts are being made to tie both biological parents, emotionally and financially, to their children.  
It turns out that a substantial number of adults and children are dissatisfied with their experience of modern family laws and values.  Social scientists looking at the data on the well-being of both adults and children, are provide ample empirical evidence of the harm caused by easy divorce,  out-of-wedlock parenting,  fatherless households,  and  even cohabitation.   For the first time in U.S. history, significant government money is flowing to fatherhood programs, abstinence education, marriage education, and the like. States are experimenting with programs to stabilize marriages before and after the wedding.
ARTs, on the other hand, freely dissociate procreation from marriage, prioritize parents’ desire for a child over the even the physical well being of the child, and operate as if parent’s primary relationship to children is best described in the language of “rights,” versus “responsibilities.”  In practice, ARTs also reject the natural priority society had always assigned to biological parents over all other would-be parents.
Yet, would not want to overstate the good news about current family trends. In many ways, the values inherent in ARTs are a natural fit with many laws and practices that swept into being during the later part of the 20th century. By these I mean to include the values represented by easy divorce, easy access to contraception including for single persons and minors, abortion on demand, and recently, legal recognition for cohabitation and same-sex unions.  I mean also to reference the increasing rates and acceptance of out of wedlock births, all types of nontraditional sexual partnerships, the increasing number of persons marrying later or not at all, and declining birthrates. Being from the U.S., I should also add that sodomy has even become a federal constitutional right in the early 21st century. With their tendency to vault adults’ interests above children’s, separate  procreation from sex, affirm the benefits of increased control over procreation, stress individual rights over group rights, and dethrone the values of  fidelity and self-sacrifice – these modern developments reinforce the values inhering in ARTs.  One further late 20th century casualty should be noted here too. The traditional willingness to derive norms about the family from its organic and historical shape fell away. It was replaced by a willingness to abdicate to technological experts and to individuals, decisions about what could be done within the family.
In this way, ARTs and modern family law and practices still complement and  mutually reinforce one another’s worst tendencies. And there are other hurdles as well to the advancement of Catholic Social Teachings concerning ARTS.  Scientific hubris and resistance to lay “interference,” is if anything, greater today than ever in this age of genetics.   Futhermore, couples today are as desirous as ever, even desperate, to have their “own” children.  And apparently they are not at all deterred by the price-tag for ARTs.   The current environment for reception of Catholic Social Teaching on ARTS is also hindered by the likelihood that the market for ARTs will improve via the continued flourishing and legalization of social practices and policies resulting in more infertility and infertile couples.  These include for example, premarital promiscuity, high rates of sexually transmitted diseases, abortion, later marriage, postponed childbearing, and legally recognized homosexual unions.  Not only did it become therefore, practically more difficulty to oppose the emotional desires of couples for children.  But it became nearly impossible to denounce certain ART practices, without simultaneously calling into question a host of other now socially-entrenched practices. 
I leave you, however, with two final thoughts regarding the outlook for our social teaching on ARTs. First, there appears to be relatively little awareness even in the Catholic community, let alone among the wider public, of Church teachings in this area (to wit the many parishioners, colleagues and even pro-life activists who have used ARTs).  Our situation really should improve with sustained efforts. Finally, intellectually, we are in a better position than ever to communicate our teachings on ARTs in the language of Pope John Paul II’s Theology of the Body.  It has what we call in the United States, “grass roots appeal,” and it has equipped many more Catholics than in the past with the necessary vocabulary and concepts for taking up our teaching about ARTs .

Professor Helen M. Alvare
Catholic University of America, Washington DC, USA
alvare@law.educ

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