Date post: | 01-Jan-2016 |
Category: |
Documents |
Upload: | imogene-montana |
View: | 30 times |
Download: | 1 times |
Assisted Reproductive
Technology:
Progress or Peril?
Ashley K. Fernandes, MD, PhDWright State University School of Medicine, Dayton, Ohio
Earl K. Fernandes, STD, MdivMt. St. Mary’s Seminary, Cincinnati, Ohio
Blessed are they who did not see, and yet believed. (John 20:29)
Purpose
To outline the science and philosophy behind a pro-life position on Assisted Reproductive Technology (ART)
To show that the philosophy behind the Catholic Church’s view is something reasonable
To answer some common objections to this view along the way
What This Talk Is
An acknowledgment of brotherly help!
A brief outline of the epidemiology and science of some assisted reproductive techniques (ARTs)
An articulation of the ethical and social problems involved in ART
A decidedly Catholic-Christian enterprise—no apologies! (except in the Greek sense)
Dr. Fernandes
Fr. Fernandes
What This Talk is NOT
An apology (except in the Greek sense!)
A defense of Christianity itself
An attempt to present all arguments in favor of, or against, ART
A “bashing” of the proponents or users of ART
In the Image of God
“…is central to the identity of every man and woman. This identity consists in the capacity to live in truth and love…the need of truth and love as an essential dimension of the life of the person.”
--John Paul II, Letter to Families (1994)
The Human Person
In his reflections on the family, John Paul II sees the family as a communio personarum, bound in love
The fundamental unit of value is the human person
But what is his nature?
The Human Person
‘Extrapolations of science’s materialist premises produces a bioethics measured by the good of the body or the species, for that is all there is. Mind, soul, emotion, spirit—all are simply epiphenomena of mater…There is no reality beyond what we can touch, see, feel, or smell.’
--Edmund Pellegrino, describing the positivist-empiricist model
The Christian personalist model
A person is an individual substance of a rational nature (persona est rationalis naturae individua substantia)
A person is a being created in the image and likeness of God
The positivist-empiricist model
The Right to Truth and Love Individualism
People are free to decide for themselves what to do with their bodies and themselves
Caring is non-interference with the desires of another
The obliteration of the person as one who thinks, acts, loves, and lives in community with another
Personalism Freedom transcends choice
(actus hominis) Freedom is choosing the
truth in love (communion) with/for self and another (actus humanus)
A person becomes (actualizes himself) what he was created to be when he chooses the good
The Relationship Between Faith and Reason
Are Faith and Reason Incompatible?
Does Reason Have Limits?
Can tenets of Faith legitimately contradict reason?
Epistemological Theories
Scientism: There are no valid forms of knowledge outside the scientific method; religion, metaphysics, theology etc. are generated by emotions, or biologic processes
Eclectisism: blending of different methods of reason, philosophy, theology without attention to internal coherence
Pragmatism: Religion is useful to humans, but not necessary; makes no claims on its origins
Nihilism/Marxism etc: Religion and spirituality, like human existence, are absurd or harmful
Fides et Ratio: A Unity of Knowledge in Christianity
“[The Christian notion of the Resurrection] is the reef upon which the link between faith and philosophy can break up, but it is also the reef beyond which the two can set forth upon the boundless ocean of truth. Here we see not only the border between reason and faith, but also the space where the two may meet.”
Fides et Ratio, Sect 21, 1998
“In an age when scientific developments attract and seduce with the possibilities they offer, it's more important than ever to
educate our contemporaries' consciences so that science does not become the criteria for goodness…
[Scientific investigation should be accompanied by] research into anthropology, philosophy and theology to give insight into man's own mystery, because no science can say who man is, where he comes from or where he is going… Man is not the fruit of chance
or a bundle of convergences, determinisms or physical and chemical reactions…”
Pope Benedict XVI, address to the Paris Academy of Sciences and the Pontifical Academy of Sciences, January 28, 2008
Science has a Purpose “Thus science and technology require, for their
own intrinsic meaning, an unconditional respect for the fundamental criteria of the moral law: that is to say, they must be at the service of the human person, of his inalienable rights and his true and integral good according to the design and will of God.” (DV , n. 2)
The Infertility Crisis Infertility is a real and growing problem in
contemporary society. 7.4% of married women of childbearing age are infertile; 2% had
sought some kind of medical treatment (CDC, 2007) 1/3 female-cause; 1/3 male cause; 1/3 both or unknown
Reasons: Delayed age of marriage Oligospermia or azoospermia in men Ovulation disorders Physical defects (blocked fallopian tubes, endometriosis) Increased sexual activity (increased STDs and PID) Undiagnosed STDs Genetic factors
The Infertility Crisis More than 3 million IVF
babies have been born worldwide (56% in Europe)
Only 5% of US Catholics use some form of Natural Family Planning Source: National Survey
of Family Growth
Fertilization TechniquesFertilization Techniques:
Extra-Corporeal (outside the body) IVF-ET ICSI ZIFT
Intra-Corporeal (inside the body) GIFT IUI/AI
Extracorporeal: IVFIn Vitro Fertilization (IVF)
1% of all live births in the US (doubled over decade)
29% of IVF cycles led to a live birth; 18% of IVF pregnancies did not
Number of embryos transferred varies from country to country (e.g., UK/NZ/Australia: 2; Greece: 3)
ASRM: age-dependent (2-5), but no limit to # conceived
Source: CDC website: http://www.cdc.gov/art/ART (accessed 5/2010)
The Use of ART is Increasing
Source: CDC website: http://www.cdc.gov/art/ART (accessed 5/2010)
Transfer of Embryos
Source: CDC website: http://www.cdc.gov/art/ART (accessed 5/2010)
Use of ICSI
Intracorporeal: IUI/AI
Intrauterine Insemination/Artificial Insemination Used for male factor, nondonor sperm, or unexplained
infertility
GIFT (Intracorporeal) & ZIFT (Extracorporeal)
Gamete Intrafallopian Transfer 25-35% success rate
Zygote Intrafallopian Transfer 65% success rate
Ooplasmic Transfer and SCNT
Ooplasmic Transfer: combines sperm, egg, and cytoplasm from a third party donor egg to create an embryo
Human Reproductive Cloning Broad consensus against
this (for now) in US, BUT…
Other Important Terms
Surrogate Motherhood (Gestational surrogate vs Surrogate Mother)
Pre-implantation Diagnosis
Heterologous vs Homologous Embryo Transfer Homologous: The sperm and egg originate from
spouses. Heterologous: The sperm or egg is from a donor who is
not a spouse
"You will know the truth, and the truth will make you free." (Jn 8:32)
ART: The Philosophical Arguments
2. The Right to Parenthood
NO: But, that doesn’t mean that facilitating one’s desires isn’t a good thing
NO: People should accept what they have; not all desires should be fulfilled if they may lead to ethical problems
YES: A negative right—they have a right not to be interfered with
YES: A positive right—someone has a duty to facilitate a person’s desire to have children
3. The Social Impact of ART Multiple gestations have quadrupled over the last 25 years
preterm labor and birth PIH (3 x the risk) Anemia (2 x the risk) birth defects (2 x the risk) miscarriage twin-to-twin transfusion syndrome abnormal amounts of amniotic fluid cesarean delivery postpartum hemorrhage
3. The Social Impact of ART
The Frozen Embryo Question Embryo Adoption
200, 000+ in the US Embryonic Stem Cell
Research—does ART lead to a “positive good?” Or, does ESR “resolve” an ethical dilemma?
4. Eugenics and Pre-Implantation Diagnosis
Fewer children being born with cystic fibrosisGlobe and Mail, Friday, October 28, 2005
The number of children born with cystic fibrosis has fallen sharply since Canadian researchers discovered the genetic cause of the debilitating disease in 1989.New research, published in The Journal of Pediatrics, shows that one in 3,608 babies is born with CF, down from one in 2,714 before a genetic test existed. "Our hypothesis is that pregnancies are being terminated," Dr. Mary Corey, a senior scientist at the Hospital for Sick Children in Toronto, said in an interview.
5. The Technological Imperative
‘Without tools [man] is nothing; with them he is all.’
---Thomas Carlyle (1841)
Summary
The Catholic Church insists on both the primacy and dignity of the human person
There is no contradiction between faith and reason
Given the rapid pace of technological advancement, there are at least some prima faciae reasons for critiquing ART.
Donum Vitae (1987)Technology at the Service of the
Person
Those techniques are acceptable in which one simply has the transfer of the egg into a more favorable place in which to encounter the sperm which is deposited after a normal sexual union, without other medical interventions.
E.g., LTOT
Donum Vitae:Pastoral Note
Every child which comes into the world must in any case be accepted as a living gift of the Divine Goodness and must be brought up with love.
21st Century Questions
1. Why does the Church care about MY choices and MY freedom?
2. Doesn’t the Church encourage children? Isn’t ART is very “pro-life,” and “pro-family?”
3. Why is the Catholic Church always AGAINST everything?
Dignitas Personae (2008): Fundamental Principles
1. “The human being is to be respected and treated as a person from the moment of conception; and therefore from that same moment his rights as a person must be recognized, among which in the first place is the inviolable right of every innocent human being to life” (n. 4).
All Human Life is Sacred
Every human embryo should be treated as a person with an immutable nature.
DP asserts that every human embryo is a person with dignity.
An embryo should not be treated as an object for experimentation, research, or even to “fulfill” the wishes of prospective parents.
1. Why does the Church care
so much about MY choices
and MY freedom?Because authentic freedom involves not just choosing—but choosing the good.
IVF establishes the “domination of technology over the origin and destiny of the human person” (n.
17).
Dignitas Personae (2008): Fundamental Principles
2. “The origin of human life has its authentic context in marriage and in the family, where it is generated through an act which expresses the reciprocal love between a man and a woman.
Procreation which is truly responsible vis-à-vis the child to be born must be the fruit of marriage” (n. 6).
The Outcome Does Not Justify the Action
Evil is not to be done that good may come of it. (Romans 3: 8)
Tomb of St. Paul, Rome
An act should be good through and through
“’As for acts which are themselves sins (cum iam opera ipsa peccata sunt) …who would dare affirm that, by doing them for good motives (causis bonis), they would no longer be sins, or, what is even more absurd, that they would be sins that are justified?“ Pope John Paul II, quoting
Augustine, Veritatis Splendor, para. 81
St. Augustine of Hippo
2. Doesn’t the Church
encourage children? Isn’t ART
very “pro-life,” and “pro-
family?”
Objectionable ART techniques justify the means via the ends Techniques such as IVF inevitably lead to embryo destruction and the violation of dignityIVF dissociates procreation from its personal context and replaces it with a technical procedure (n.16).
Dignitas Personae (2008): Fundamental Principles
3. DP outlines five categories of procedures :
1. Techniques of heterologous artificial fertilization (n. 12)
2. Techniques of homologous artificial fertilization (n. 12)
3. Techniques which act as an aid to the conjugal act and its fertility (n. 12).
4. Techniques aimed at removing obstacles to natural fertilization (n. 13).
5. Adoption (n. 13).
Dignitas Personae (2008): Not “Anti-Everything!”
Techniques are morally permissible if they respect:
“the right to life and to physical integrity of every human being”,
“the unity of marriage” “the specifically human values of sexuality” (n. 12)
Procreation results from the conjugal act specific to the love between a husband and wife.
“Techniques which act as an aid to the conjugal act and its fertility are permitted” (n. 12).
Dignitas Personae (2008): Not “Anti-Everything!”
“Certainly, techniques aimed at removing obstacles to natural fertilization… are licit” (n. 13).
Hormonal treatments for infertility Surgery for endometriosis Unblocking/surgical repair of the fallopian tubes NaPro Technology/Creighton CCL
Dignitas Personae (2008): Not “Anti-Everything!”
“Adoption should be encouraged promoted and facilitated…”(n. 13).
Primacy of the child’s welfare (n. 19).
DP’s position on embryo adoption: Is not definitive As a treatment for infertility?: NO Prenatal adoption?: ambiguous
3. Why is the
Catholic Church
always AGAINST
everything?The Church supports the aiding of the conjugal actThe Church supports the removal of barriers to conceptionThe Church supports adoption
(Not (Not everything, everything, just bad just bad things)things)
Catholic and Protestant Differences
Catholic (Donum Vitae)
Approves of: Depends on the measure
in which they respect the constitutive dimensions of human procreation and the integrity and dignity of the embryo.
Proscribed: procedures which obscure
the sense of the dignity of procreation and its relationship with the incarnate, conjugal love of the spouses.
Protestant (CMDA)
Approves of: AI by husband Homologous IVF with
transfer to uterus ZIFT GIFT Cryopreservation with
intent to implant
Ambivalent Heterologous IVF
What Must We Do As Christians?
Have faith [The Apostles after Pentecost] "did not come down
from the mountain carrying, like Moses, tablets of stone in their hands; but they came down carrying the Holy Spirit in their hearts... having become by his grace a living law, a living book". (Saint John Chrysostom)
Have hope, which never fades "With God all things are possible" (Mt 19:26)
Have charity and love for all “Love takes up where knowledge leaves off.” (St.
Thomas Aquinas)