About 10% of women of child-bearing years, that is 6.1 million women in the U.S., suffer from infertility (the inability to get pregnant after 1 year of trying or after six months of trying for those 35 or older). For many, an infertility diagnosis leads them to seek out assistance through artificial reproductive technologies (ARTs) like in-vitro fertilization (IVF) or gestational surrogacy, the use of which helps many infertile couples have the children they always dreamed of. The Roman Catholic Church, however, is well-known for its opposition to the use of such technologies, a stance which has become increasingly unpopular as ARTs become more common (You can read about the Church’s position on IVF here and here). Sean Savage, a Roman Catholic himself, presents an impassioned plea over at CNN’s Belief blog, for the RCC to change its stance on ARTs to accommodate for Catholics like him and his wife who resort to IVF to have the children they always dreamed of.
Babies born of IVF are here because their parents loved, respected and longed for these children well before conception. These children could not get here through the conjugal love of their parents and it took a very deep love, respect, and commitment to pursue the medical treatment needed to conceive through IVF. There is no doubt in my mind that God is working through loving parents and ethical doctors to allow these children to come into this world.
The Church’s opposition to IVF is based on a number of factors. On one hand, there is the concern that unused embryos will be destroyed, which the Roman Catholic Church categorizes as murder since life begins at conception. On the other hand, there is the emphasis on the dignity of the marriage act where “human procreation is a personal act of a husband and wife, which is not capable of substitution.” Savage addresses both of these arguments in his post, concluding that neither is a convincing counterpoint to couples like him who try desperately to conceive, and fail.
In any moral response to IVF, it is important to remember how painful and stressful infertility is for couples like the Savages. They watch their couple friends get pregnant, attend baby showers and baptisms, and ooh and ah over all the baby pictures that their friends put up on Facebook, all the while mourning their inability to fully share in the joy of having a child. For many couples, the stress and anger over an infertility diagnosis can negatively impact the marriage as well.
For many couples like the Savages, doctors are unable to identify a clear cause of their fertility problems. This uncertainty can heighten the couples stress as they wonder if they themselves are to blame. They wonder, “Is it something I am doing or have done?” Was it because I exercise too much? Because I drank a glass of wine at dinner? Is it something I am eating or not eating?” Many women do not tell others they are struggling with infertility in fear of receiving blame from others who do not understand why they can’t have a baby if nothing is physiologically wrong with them. Compounding all of this is the claim that stress also causes infertility. But infertility is nothing if not stressful, and stress becomes just another thing to feel guilty about: “Am I not having a baby because I am too stressed out?”
Despite all of this, I want to try and approach the question of the morality of Artificial Reproductive Technologies (ARTs) like IVF from a different angle than the Church’s official documents. I want to ask: What sort of people do these technologies turn us into? Does IVF lead us into a more Christ-like way of life? This approach is what we call a character-based approach to morality, as opposed to an act-based approach which attempts to argue that certain acts like IVF are morally licit or illlicit. A character-based approach to morality focuses on the moral agents themselves, and sees the acts as both expressions of their moral character, and causes of character formation.
Savage would clearly say that IVF allowed him and his wife to become the loving parents they had always dreamed of, and I think he’s right. I can recognize and marvel at how IVF has allowed so many people who could not have children on their own become loving parents. But on the other hand, the use of IVF and other ARTs also potentially reinforces in our own lives and our own characters the consumerist mentality that we can have whatever we want whenever we want it, and that true freedom resides in having as many options as possible.
A recent article on NPR’s Morning Edition does a good job illustrating how ARTs reinforce this consumerist mentality.
As more women postpone motherhood into their 30s, even 40s, they’re hitting that age-old constraint: the biological clock. Now, technology is dangling the possibility that women can stop that clock, at least for a while. . .
. . . Dr. Alan Copperman of Reproductive Medicine Associates of New York wastes no time laying out this harsh reality: By the time a woman hits her 40s, 90 percent of her eggs are abnormal. The chances of a typical 40-year-old getting pregnant in any given month? Ten percent. Unless, that is, she gets pregnant with her younger eggs — eggs she had frozen years before. . .
. . . The whole process — a week of hormones, plus the procedure to collect the eggs — runs $12,000 to $14,000. And because it takes 10 to 20 eggs for a reasonable shot at success, some may need to do this several times. Plus, there are annual storage fees. Then, when you’re ready to use your eggs, you’ll need in vitro fertilization, another pricey procedure. All told, costs can easily exceed $40,000.
Women are postponing motherhood as they pursue things like education and career, both good things. The consumerist mentality reinforces to these women, however, that they should be able to have a family too—on their terms (and with a hefty price tag). Such practices as the ones mentioned in this article also render children into a commodity, something to be purchased, rather than lovingly received. For Christians, a child is seen not as an object which one has a right or an entitlement to, but as a gift. Sean O’Malley, my own bishop, expresses well how ARTs commodify children:
One of the greatest absurdities of contemporary society is that our country has approved of people aborting all unwanted children and at the same time permits an immoral technique (in vitro fertilization) that allows a few women to have the experience of a pregnancy. In both of these circumstances the fate of the children is subordinated to the convenience or the personal aspirations of the parents.
Savage too, despite his good intentions of love and parenthood, also reinforces this consumerist mentality. Additionally, his article points to another problem with ARTs: they potentially render us inhospitable people:
Carolyn and I would have been happy to save thousands of dollars and a decade of emotional ups and downs by conceiving the “old-fashioned way,” but that wasn’t possible. We turn to medicine for a litany of medical maladies and impairments, but infertile Catholics are supposed to avoid treating a medical condition which prevents them from building or expanding their family?
Yes, adoption is a wonderful option for the couples who decide it’s right for them, but adoption should never be forced on anyone.
Later on, Savage argues against what he sees as the Church’s discrimination against his child conceived through IVF, writing that “one child is as perfect as another.” Yet his refusal to adopt in light of his strong desire to “have a big family” would suggest that in his eyes, children of strangers are actually not as perfect as those who share his DNA.
Hospitality is the virtue that allows us to welcome the stranger. Hospitality is the virtue which tears down the boundaries between “us” versus “them.” It is hospitality most of all that I see missing from Savage’s argument for IVF. He wants children, and lots of them, but only if they are “his own.” And while it is clear that he loves his children, there seems to be a big difference for him between what constitutes “his” child and the child of a stranger. Of course, from a Thomistic perspective, I would say that the order of love demands that we love our family and care for them more than strangers. But the order of love does not give us the license to make demands about who is going to be included in our family. When God offers the gift of a child, we welcome them as our family whether the child is the product of a pregnancy or an adoption.
Adoption in Savage’s case would be an exercise in hospitality. Adoption, unlike ARTs is also a social practice which reinforces the mentality that children are gifts to be lovingly received, and not commodities subject to our convenience. Pope John Paul II wrote in Familiaris Consortio: “Christian families, recognizing with faith all human beings as children of the same Heavenly Father, will respond generously to the children of others, giving these children support and love, not as outsiders, but as members of the one family of God’s children. Christian parents will thus be able to spread their love beyond the bonds of flesh and blood, nourishing the links that are rooted in the Spirit.”
Open adoption especially is an exercise in hospitality. In open adoption, the child is raised knowing they are adopted:
She can feel confident and comfortable (instead of disloyal) by being curious or inquisitive about her birthparents. She is encouraged to care about her adoptive family and her birth family. She has a sense of belonging because she knows her birthparents selected her parents” (Catholic Social Services of Montana)
In open adoption, the adopting family opens their home and their hearts not only to the adopted child, but also to the birthparents who are given the opportunity for ongoing contact with their child. In open adoption, the gift of life is something that can be valued by both the adoptive and the birthparents as both marvel in gratitude and humility at the life that unfolds before them.
It is true that adoption isn’t for everyone. I am in no way trying to articulate a duty to adopt. I am arguing, though, that for people like the Savages, the desire for a big family and the corresponding refusal to adopt does seem morally problematic. This is especially true for Christians who are the adopted children and heirs of God (Galatians 3, Romans 8).
Now, I do think that the Church has done an insufficient job laying out a theology of adoption. The adoption of children as a solution to infertility receives only passing glance in the Catechism of the Catholic Church:
2379 The Gospel shows that physical sterility is not an absolute evil. Spouses who still suffer from infertility after exhausting legitimate medical procedures should unite themselves with the Lord’s Cross, the source of all spiritual fecundity. They can give expression to their generosity by adopting abandoned children or performing demanding services for others.
While organizations like Catholic Social Services do wonderful work making adoption possible, the Church’s “no” to IVF and other ARTs might be easier to swallow if it were accompanied by a more confident “yes” to adoption.
In conclusion, when looking at an ethical issue like IVF, I think it is important to do so from the perspective of character, asking “What sort of people is this practice (of IVF) turning us as a society into?” Savage’s desire to have a child is not what I find problematic. It is the perspective that sees a child as a right and the desire to have only the child you choose that I have a problem with. A child is a gift, and when it comes to gifts, we readily accept what we are given rather than demand precisely what we want. In my mind, the Church’s teachings on IVF and other ARTs are there not to keep people from having families (and big families at that), but rather, to inculcate in them the habits necessary to view and receive the gift of life–habits like hospitality, gratitude, and humility.
Gratitude is a part of justice, of giving to others what is due to them. For Aquinas, in receiving a gift, more attention is given to the magnanimity of the giver than the gift itself. As such, the repayment of gratitude should be in excess of the gift received because gratitude responds not only to the gift, but to the benefactor. The benefactor, he writes, deserves praise for “having conferred the gift without being bound to do so” (II-II, 106.6). When it comes to life, God is the benefactor, and God is under no obligation to bequeath on us the gift of life. The virtue of gratitude allows us to see that children are not something God owes us and subsequently, that having a child is not a right. Closely related to gratitude, then, is the virtue of humility.
Humility is the virtue which restrains the appetite from pursuing things not in accord with right reason, or things that are not in accord with one’s station. Aquinas says that it belongs to humility “that a man restrain himself from being borne towards that which is above him” (II-II 161.2). But nothing is further above humans than to give and take life because God is the Lord of Life (Deut. 32:29). This is not to deny that we can use medicine to help women have children. But IVF, unlike other treatments like hormone therapy, allow us to choose which lives will come into existence and under which circumstances (the thousands of “spare” embryos frozen around the country are a testimony to this—spare lives to be used if the first round of IVF doesn’t take). IVF and other ARTs usurp this sovereignty God has over life. The moral theologian who has best articulated this argument against IVF, Stanley Hauerwas, is actually not Catholic, but his argument holds for Catholics. In his testimony on IVF before the Ethics Advisory Board of the Dept. of Health, Education, and Welfare, Hauerwas stated:
“Christians must surely be doubtful of any moral defenses of in vitro fertilization that claim this technique as an extension of freedom from natural necessity. From our perspective, such a claim involves the pretentious assumption that there is no limit to the right of people to perpetuate themselves.”
We are the beneficiaries of life, not the producers of life. By refusing IVF and other ARTs which promise to give us the child we want, we develop the virtues of gratitude and humility which are necessary to be good stewards of life. By pursuing adoption, we become more hospitable people, people who take seriously the prophetic injunction to care for the orphan.