IVF, morality and public policy

The parliamentary select committee’s report on assisted procreation concluded recently contains a number of positive recommendations. It calls on the government to regulate reproductive technology; to make IVF treatment available only to heterosexual couples; to set up an independent regulatory authority to oversee the sector; to provide infertility treatment, including IVF, on the national health service in order to give access to couples who do not afford the treatment in the private sector; and to prohibit the donation of gametes by third parties.

In March 2009, I had also insisted on these issues when the Parliament’s Social Affairs Committee invited me to present my reactions to the recommendations of the 2005 Puli Report in the light of the Catholic Church’s bioethical document On The Dignity Of The Human Person (Dignitas Personae, 2008).

However, the committee’s recommendations to permit the freezing of human embryos and to make the IVF technique available to unmarried couples raise serious ethical concerns. The report justifies the freezing of human embryos on two grounds. First, it is claimed it would lower the risk of multiple pregnancies caused by the implantation of multiple embryos in a woman’s uterus and it would reduce the pain caused to the woman by hormone treatment.

Beyond doubt, these medical facts cannot be ignored and for this reason they should be taken seriously into consideration in every attempt of fertility treatment. However, they do not morally justify the creation of human embryos destined for cryopreservation. What happens if a couple loses its interest to implant its spare embryos, if they separate or decide not to have any more children? Who decides on the embryos’ fate? What will happen to these “orphan” embryos? Wherever the creation of supernumerary embryos in connection with IVF treatment is legally permissible, thousands upon thousands of frozen embryos are abandoned, discarded or treated as mere biological material for research purposes.

To resolve the morally contentious issue of the deliberate destruction of frozen human embryos, the report recommends embryo adoption by infertile couples. This proposal, praiseworthy with regard to the intention of respecting and defending human life, presents various moral problems and does not guarantee full respect to the dignity of every frozen human embryo. There is no proportionate reason between the committee’s proposal to safeguard the health of the prospective mother undergoing IVF treatment and to improve the chances of success and the moral and scientific risks involved in permitting the creation and freezing of spare human embryos, thereby opening the door for new threats against human life.

Rather than attempting to resolve the moral problem by embryo adoption or donation, common sense and moral intuition recommends that, in the first instance, no such problem should be intentionally and deliberately created. Does it make sense to create human beings for “prenatal adoption”? This recommendation opens the wedge for a culture of death that perceives human embryonic life from the perspective of utility. The end, no matter how praiseworthy and noble it may be, does not justify the means.

Way back in 1987, the Catholic Church, in its Instruction Donum Vitae (The Gift Of Life), distinguished morality from public policy. Though the Catholic Church finds moral objection to IVF treatment, the document on bioethics says that a legislation permitting reproductive technologies can be tolerated for the sake of public order and in order to avoid a greater evil, namely the unregulated practice of assisted procreation.

However, Donum Vitae insists that parliamentarians and legislators should keep in mind two fundamental rights that cannot be traded off: every human being’s right to life and the physical integrity from the moment of conception, and the rights of the family and marriage as an institution and the child’s right to be conceived, brought into the world and brought up by his/her parents. This was confirmed by Pope Benedict XVI, then Cardinal-Prefect of the Congregation for the Doctrine of Faith, in one of his dialogues with the Italian philosopher and politician Marcello Pera.

The recommendation to make IVF treatment available to unmarried couples raises a number of pertinent questions. Is this recommendation in the best interest of the prospective child? Can the stability and commitment of an unmarried couple be ascertained by checking their medical records as recommended by the select committee? Should the government sanction IVF treatment for stable unmarried couples as illegal? Should the government provide IVF treatment free of charge on the national health service to married couples only as a form of positive action to support the family without however banning the service from the private health sector?

While many recommendations of the select committee’s report may be commendable, others do not respect human life and the family. Let us hope that when the draft Bill is presented for discussion in Parliament, Catholic politicians will enlighten their conscience by the teachings of Donum Vitae in the interest of the common good!

Rev. Prof. Agius is dean of the Faculty of Theology at the University of Malta and member of the European Group of Ethics in Science and New Technologies (European Commission).