The Choices, the Issues

Imagine the anguish of a married couple who desperately want to have a child yet because of infertility cannot. They look to medical science for help and find that many techniques and therapies have been developed to overcome infertility. Does it matter which one they choose, if any?

TODAY infertile couples have options that were not available just decades ago. But along with the choices comes a serious question, What are the ethical and moral implications of assisted reproductive techniques? Before we consider that, though, let us see how various religious groups view such treatments.

What Do Religious Groups Say?

In 1987 the Catholic Church issued a document that addressed the morality of fertility procedures. The statement, known as Donum Vitae (The Gift of Life), held that if a medical technique assists the marriage act in achieving conception, such a treatment may be viewed as moral. On the other hand, the document indicated that if a medical procedure replaces the marriage act, such a treatment is morally wrong. According to this view, surgery to correct tubal blockage and the use of fertility drugs would be considered moral, but test-tube fertilization would be immoral.

The following year a U.S. Congressional committee surveyed religious groups as to their stand regarding fertility treatment. The final report showed that a majority of them accepted traditional medical interventions, artificial insemination using the husband’s sperm, and in vitro fertilization treatment, provided that both the egg and the sperm belonged to the married couple. Moreover, most of the groups surveyed declared that the destruction of embryos, artificial insemination by a donor, and surrogate motherhood are morally wrong. *

In 1997 the European Ecumenical Commission for Church and Society (EECCS), a body of Protestant, Anglican, and Orthodox churches, indicated in a position paper that in their ranks there are divided opinions on assisted reproduction. Emphasizing that individual conscience and personal responsibility are involved, the paper stated: “The implication is that it is difficult to speak of ‘the’ position of the member churches of EECCS. There is, rather, a plurality of positions.”

It is evident that opinions on assisted reproduction differ a lot. The UN World Health Organization admits that the field of assisted reproductive techniques “constantly challenges social norms, moral and ethical standards and legal systems.” What are some factors that people should consider before making a decision involving assisted reproduction?

What Are the Issues Involved?

A basic factor to consider is the status of a human embryo. This relates to the crucial question, When does life begin​—at conception  or later on during pregnancy? The answer would certainly affect the decision that many married couples make regarding treatment. If, for example, they believe that life begins at conception, then there are some key questions that must be considered.

● Should the couple allow doctors to follow the common procedure of fertilizing more eggs than the one or more being inserted, thus keeping a surplus stock of embryos for future use?

● What would happen to such stored embryos if the couple became unable or unwilling to have more children?

● What would happen to any stored embryos if the couple divorced or if one of them died?

● Who would shoulder the weighty responsibility for destroying such embryos?

The issue of what is to be done with unused or stored embryos cannot be dismissed lightly. Legal guidelines in certain countries now demand that the couple present a written consent specifying how the extra embryos should be handled​—that is, if they should be stored, donated, used for research, or allowed to perish. Couples should be aware that in certain places it is ethically acceptable for a fertility clinic to destroy stored embryos without any written authorization if they have been abandoned for more than five years. Today, hundreds of thousands of frozen embryos are stored at clinics worldwide.

Another factor to consider is that couples may be urged to donate unused embryos for stem cell research. The American Infertility Association, for example, has encouraged couples to make their unused stored embryos available for research. One purpose of stem cell research is to find new ways of treating illnesses. But this field of research has been a subject of much controversy because the  process of extracting embryonic stem cells essentially destroys the embryo. *

New genetic technologies raise yet other ethical issues. Consider, for example, preimplantation genetic diagnosis (PGD). (See the box “What About Preimplantation Genetic Diagnosis?”) This technique involves submitting embryos to genetic screening and then selecting the one​—perhaps of the desired gender or free of a certain disease-causing gene—​that is to be implanted into the uterus. Critics warn that PGD could lead to gender discrimination or that it might eventually be used to let couples choose other genetic traits for their children, including hair or eye color. PGD raises the ethical  question, What happens to the embryos that are not selected?

Will the Marriage Bond Be Affected?

When considering certain forms of fertility treatment, there is another aspect to consider. How would the use of a surrogate mother or donated sperm or eggs affect the marriage bond? Some techniques may introduce a third party (a donor) or even a fourth party (two donors) or a fifth party (two donors and a surrogate mother) into the childbearing process.

Regarding treatment that involves donated genetic material, the parties involved need to consider other factors too.

● What long-term emotional effects may such a birth have on the parents when only one of them​—or neither—​is the genetic parent?

● How will the son or daughter handle learning that his or her birth resulted from such an unusual form of conception?

● Should the child be informed about his or her parentage and be allowed to look for the biological father or mother?

● What are the moral and legal rights and obligations of the one or more individuals who donated genetic material?

What About Anonymity?

The policy in many countries is to keep donors anonymous. The Human Fertilisation and Embryology Authority, which regulates the use of human reproductive material in Britain, explains: “Except where donation is intentionally between people known to each other, current and past donors will remain anonymous to the couples treated with their eggs or sperm, and to the children who may be born as a result of that treatment.”

However, this policy of anonymity is the subject of heated debate in some places. A few countries have changed their policy or laws accordingly. Those who are against the policy of anonymity emphasize that children must have a full sense of their identity. A report says: “Over 80 per cent of adopted people search for birth relatives, many of them to help satisfy the long-standing curiosity about origins which most people share. Almost 70 per cent want to identify important background information about possible hereditary medical conditions of birth parents.”

Another report, based on interviews with 16 adults conceived by donor insemination, revealed that “many were shocked to discover their biological origins.” The report added: “Many of the children faced problems with personal identity and feelings of abandonment. There were feelings of deceit and mistrust towards the families.”

How Will You Decide?

Medical science will no doubt carry the development of assisted reproduction even further. Some predict that in the future 30 percent of all babies born will be the result of this technology. The debate over the ethical and moral issues involved will continue.

True Christians are guided by an even more important consideration​—the viewpoint of our Creator, the one who arranged for procreation. (Psalm 36:9) Of course, the Bible does not directly comment on modern assisted reproductive techniques, for such procedures were not available in Bible times. However, the Bible does set out clear principles that indicate God’s thinking and viewpoint. (See the box “What Does the Bible Say?”) Such principles help us to make decisions that are ethical and moral and that leave us with a clear conscience before God.​—1 Timothy 1:5.

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What Is A Preembryo?

The term “preembryo” refers to the unborn’s stage of development during the first 14 days after fertilization. After that, it is called an embryo until the end of the eighth week. From then on, it is called a fetus. Why is the word “preembryo” used?

According to the International Journal of Sociology and Social Policy, the term was “used as the rationale for permitting human embryo research” during the first 14 days after conception. One reference work says: “If one defines the embryo as the structure destined to become the baby, its earliest rudiments do not form until about two weeks after the sperm meets the egg.” But can this preembryo be dismissed as a mere mass of cells, fit for little more than research? Consider what really happens during this two-week period.

After the sperm has penetrated the egg, it takes about 24 hours for the male and female chromosomes to fuse. During the next few days, the cell divides. Within four or five days after fertilization, the cluster of cells develops into a hollow sphere (still smaller than a pinhead) with an outer cell layer and an inner cell mass. It is now known as a blastocyst. Many of the cells of the outer layer will develop into nonembryonic tissues. From the inner cell mass, however, the baby itself will develop.

About a week after fertilization, implantation in the womb occurs. The blastocyst attaches itself to the womb and begins the construction of the placenta, which will allow the passage of oxygen and food from the mother’s bloodstream and the release of wastes. According to the book Incredible Voyage​—Exploring the Human Body, by about day nine the inner cell mass starts “the task of constructing a new human being.” It adds: “Those 20 or so cells must perform a series of restructurings and differentiations over another five or six days to create the first structural element of the actual embryo.” So by the end of the second week, this “first structural element,” from which the central nervous system eventually develops, begins to appear.

Because of this preparatory step-by-step process that goes on within the early human embryo, some argue that “there is no one biological event or moment that can be considered the start of a new human embryo.”

True Christians, however, believe that life begins at conception. The fact that the original fertilized cell contains the program for the construction of the placenta, the implantation, the connections with the mother’s blood vessels, and more only increases their admiration for the divine Designer, Jehovah God.

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Human embryo at three days (magnified about 400X)

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Courtesy of the University of Utah Andrology and IVF Laboratories

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WHAT ABOUT PREIMPLANTATION GENETIC DIAGNOSIS?

A new development in test-tube fertilization is called preimplantation genetic diagnosis. This involves genetically screening embryos and then selecting the one that is to be implanted into the uterus. Commenting on the implications of this technique, the book Choosing Assisted Reproduction​—Social, Emotional and Ethical Considerations explains:

“Soon [scientists] will be able to determine physical, intellectual, and perhaps emotional and social characteristics in an embryo. Thus in the not too distant future it will be possible for parents to select some of their offspring’s characteristics. And although many people would support the use of preimplantation genetic selection for couples who are carriers of a dreaded disease, many will not support this technology for couples who wish to have a child of a particular sex​—or in the future, for a child with blue eyes, or musical talent, or who will be tall.

“Preimplantation genetics, like many other technologies, raises the question of whether, because something can be done, it should be done. . . . The dilemma is where to draw the line​—if anywhere—​on this slippery high technological slope.”

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WHAT DOES THE BIBLE SAY?

The Bible, of course, makes no direct comments on modern-day assisted reproductive procedures. It does, however, enable us to know God’s view on certain key issues. And knowing the answers to two basic questions can guide true Christians in making decisions that are pleasing to God.

When does human life begin? The Bible indicates that life begins at conception. Note the words of the psalmist David, who was inspired to say of God: “Your eyes saw even the embryo of me, and in your book all its parts were down in writing.” (Psalm 139:16) Consider also Exodus 21:22, 23, where the original-language text indicates that a person would be held accountable for injury to an unborn child. The lesson to be learned is that our Creator views life as precious, even during the very early stages of development in the womb. In God’s eyes the willful destruction of an embryo would be viewed as abortion. *

Are there any restrictions as to how one’s reproductive powers may be used? God’s view can be found at Leviticus 18:20, which says: “You must not give your emission as semen to the wife of your associate to become unclean by it.” The underlying principle in that Scriptural decree is this: A man’s semen should not be used to inseminate anyone other than his wife, and a woman should not bear a child for someone other than her own husband. In other words, the reproductive powers are not to be used for someone other than one’s marriage mate. True Christians, therefore, avoid surrogate motherhood as well as any procedures that involve the use of donated sperm, eggs, or embryos. *

When making a decision involving assisted reproduction, true Christians must weigh carefully what the Bible reveals about God’s thinking. * After all, he is the Originator of marriage and family life.​—Ephesians 3:14, 15.

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Stored frozen embryos

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