Research Paper
These new questions require answers. The pace of scientific developments in this area and the publicity they have achieved have raised expectations and concerns in large sectors of public opinion. Legislative assemblies have been asked to make decisions on these questions in order to regulate them by law; at times, wider popular consultation has also taken place.
These developments have led the Congregation for the Doctrine of the Faith to prepare a new doctrinal Instruction which addresses some recent questions in the light of the criteria expressed in the Instruction Don vitae and which also examines some issues that were treated earlier, but are in need of additional clarification. 2. In undertaking this study, the Congregation for the Doctrine of the Faith has benefited from the analysis of the Pontifical Academy for Life and has consulted numerous experts with regard to the scientific aspects of these questions, in order to address them with the principles of Christian anthropology.
The Encyclicals Verities splendor] and Evangelism vitae[3] of John Paul II, as well as other interventions of the Magisterial, offer clear indications with regard to both the method and the content of the examination of the problems under consideration. Len the current multifaceted helicopters and scientific context, a considerable number of scientists and philosophers, in the spirit of the Hippocratic Oath, see in medical science a service to human fragility aimed at the cure of disease, the relief of suffering and the equitable extension of necessary care to all people.
At the same time, however, there are also persons in the world of philosophy and science who view advances in biomedical technology from an essentially eugenic perspective. 3. In presenting principles and moral evaluations regarding biomedical research on human life, the Catholic Church draws upon the light tooth of reason and of faith and seeks to set forth an integral vision of man and his vocation, capable of incorporating everything that is good in human activity, as well as in various cultural and religious traditions which not infrequently demonstrate a great reverence for life.
The Magisterial also seeks to offer a word of support and encouragement for the perspective on culture which considers science an invaluable service to the integral good of the life and dignity of every human being. The Church therefore views scientific research with hope and desires that many Christians will dedicate homeless to the progress of biomedicine and will bear witness to their faith in this field. She hopes moreover that the results of such research may also be made available in areas of the world that are poor and afflicted by disease, so that those who are most in need will receive humanitarian assistance.
Finally, the Church seeks to draw near to every human being who is suffering, whether in body or in spirit, in order to bring not only comfort, but also light and hope. These give meaning to moments of sickness and to the experience of death, which indeed are part of human life and are present in the story of very person, opening that story to the mystery of the Resurrection. Truly, the gaze Of the Church is full Of trust because “Life will triumph: this is a sure hope for us. Yes, life will triumph because truth, goodness, joy and true progress are on the side of life.
God, who loves life and gives it generously, is on the side of present Instruction is addressed to the Catholic faithful and to all who seek the truth. [5] It has three parts: the first recalls some anthropological, theological and ethical elements of fundamental importance; the second addresses new problems regarding procreation; the hired examines new procedures involving the manipulation of embryos and the human genetic patrimony. First Part:Anthropological, Theological and Ethical Aspects of Human Life and Procreation 4. In recent decades, medical science has made significant strides in understanding human life in its initial stages.
Human biological structures and the process of human generation are better known. These developments are certainly positive and worthy of support when they serve to overcome or correct pathologies and succeed in re-establishing the normal functioning of human procreation. On the other and, they are negative and cannot be utilized when they involve the destruction of human beings or when they employ means which contradict the dignity of the person or when they are used for purposes contrary’ to the integral good of man . The body of a human being, from the very first stages of its existence, can never be reduced merely to a group of cells.
The embryonic human body develops progressively according to a well-defined program with its proper finality, as is apparent in the birth of every baby. Let is appropriate to recall the fundamental ethical criterion expressed in the Instruction Don ate in order to evaluate all moral questions which relate to procedures involving the human embryo: “Thus the fruit Of human generation, from the first moment of its existence, that is to say, from the moment the zygote has formed, demands the unconditional respect that is morally due to the human being in his bodily and spiritual totality.
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 This ethical principle, which reason is capable of recognizing as true and in conformity with the natural moral law, should be the basis for all legislation in this area. [7] In fact, it presupposes a truth of an ontological character, as Don vitae demonstrated from solid scientific evidence, regarding the continuity in development of a human being. F Don vitae, in order to avoid a statement of an explicitly philosophical nature, did not define the embryo as a person, it nonetheless did indicate that there is an intrinsic connection between the ontological dimension and the specific value of every unman life. Although the presence of the spiritual soul cannot be observed experimentally, the conclusions of science regarding the human embryo give “a valuable indication for discerning by the use of reason a personal presence at the moment of the first appearance off human life: how could a human individual not be a human person? ‘. [8] Indeed, the reality Of the human being for the entire span of life, both before and after birth, does not allow us to posit either a change in nature or a gradation in moral value, since it possesses full anthropological and ethical status. The human embryo has, Hereford, from the very beginning, the dignity proper to a person . 6. Respect for that dignity is owed to every human being because each one carries in an indelible way his own dignity and value.
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 visit–visit the child to be born “must be the fruit of marriage”. [9]Marriage, present in all times and in all cultures, “is in reality something wisely and providently instituted by God the Creator with a view to carrying out his loving plan in human beings.
Thus, husband and wife, through the reciprocal gift of themselves to the other – something which is proper and exclusive to them -? bring about that communion of persons by which they perfect each other, so as to cooperate with God in the procreation and raising of new In the fruitfulness of married love, man and woman “make it clear that at the origin of their spousal life there is a genuine ‘yes’, which is pronounced and truly lived in reciprocity, remaining ever open to life…
Natural law, which is at the root of he recognition of true equality between persons and peoples, deserves to be recognized as the source that inspires the relationship between the spouses in their responsibility for begetting new children. The transmission of life is inscribed in nature and its laws stand as an unwritten norm to which all must 1]7. It is the Church’s conviction that what is human is not only received and respected by faith, but is also purified, elevated and perfected. God, after having created man in his image and likeness (CB.
Gene 1:26), described his creature as ‘Were good” (Gene 1 131), so as to be assumed later in he Son (CB. JNI 1:14). In the mystery of the Incarnation, the Son of God confirmed the dignity of the body and soul which constitute the human being. Christ did not disdain human bodiless, but instead fully disclosed its meaning and value: “In reality, it is only in the mystery of the incarnate Word that the mystery of man truly becomes becoming one of us, the Son makes it possible for us to become “sons of God” (JNI 1:12), “sharers in the divine nature” (2 Pet 1:4).
This new dimension does not conflict with the dignity of the creature which everyone can recognize by the use of reason, UT elevates it into a wider horizon of life which is proper to God, giving us the ability to reflect more profoundly on human life and on the acts by which it is brought into respect for the individual human being, which reason requires, is further enhanced and strengthened in the light of these truths of faith: thus, we see that there is no contradiction between the affirmation of the dignity and the affirmation of the sacredness of human life. The different ways in which God, acting in history, cares for the world and for mankind are not mutually exclusive; on the contrary, they support each other ND intersect. They have their origin and goal in the eternal, wise and loving counsel whereby God predestines men and women ‘to be conformed to the image of his Son’ (Room By taking the interrelationship of these two dimensions, the human and the divine, as the starting point, one understands better why it is that man has unassailable value: he possesses an eternal vocation and is called to share in the Trinitarian love of the living God.
This value belongs to all without distinction. By virtue of the simple fact of existing, every human being must be fully respected. The introduction of scarification with regard to human dignity based on biological, psychological, or educational development, or based on health-related criteria, must be excluded.
At every stage of his existence, man, created in the image and likeness of God, reflects “the face of his Only-begotten Son… This boundless and almost incomprehensible love of God for the human being reveals the degree to which the human person deserves to be loved in himself, independently of any other consideration – intelligence, beauty, health, youth, integrity, and so forth.
In short, human life is always a good, for t ‘is a manifestation of God in the world, a sign of his presence, a trace of his glory’ (Evangelism vitae, 34)”. [15]9. These two dimensions of life, the natural and the supernatural, allow us to understand better the sense in which the acts that permit a new human being to come into existence, in which a man and a woman give themselves to each other, are a reflection of Trinitarian love. God, who is love and life, has inscribed in man and woman the vocation to share in a special way in his mystery of personal communion and in his work as Creator and 6]Christian marriage is rooted “in the natural implementation that exists between man and woman, and is nurtured through the personal willingness of the spouses to share their entire life- project, what they have and what they are: for this reason such communion is the fruit and the sign of a profoundly human need.
But in Christ the Lord, God takes up this human need, confirms it, purifies it and elevates it, leading it to perfection through the sacrament of matrimony: the Holy Spirit who is poured out in the sacramental celebration offers Christian couples the gift of a new communion of love that is the living and real image of that unique unity which makes of the Church the indivisible Mystical Body of the Lord 7]10.
The Church, by expressing an ethical judgment on some developments of recent medical research concerning man and his beginnings, does not intervene in the area proper to medical science itself, but rather calls everyone to ethical and social responsibility for their actions. She reminds them that the ethical value of biomedical science is gauged in reference to both the unconditional respect owed to every human being at every moment of his or her existence, and the defense of the specific character of the personal act which transmits life.
The intervention of the Magisterial falls within its mission of contributing to the formation of conscience, by authentically teaching the truth which is Christ and at the same time by declaring and confirming authoritatively the principles of the moral order which spring from human nature itself. [1 8] Second Part:New Problems Concerning Procreation 1 1. In light of the principles recalled above, certain questions regarding procreation which have emerged and have become more clear in the years since the publication of Don vitae can now be examined. Techniques for assisting fertility.
With regard to the treatment f infertility, new medical techniques must respect three fundamental goods: a) the right to life and to physical integrity of every human being from conception to natural death; b) the unity of marriage, which means reciprocal respect for the right within marriage to become a father or mother only together with the other 9] c) the specifically human values Of sexuality which require “that the procreation of a human person be brought about as the fruit of the conjugal act specific to the love between Techniques which assist procreation “are not to be rejected on the grounds that they are artificial.
As such, they bear witness to the possibilities of the art of medicine. But they must be given a moral evaluation in reference to the dignity of the human person, who is called to realize his vocation from God to the gift of love and the gift of light of this principle, all techniques of heterozygous artificial as well as those techniques of homologous artificial fertilization[23] which substitute for the conjugal act, are to be excluded.
On the other hand, techniques which act as an aid to the conjugal act and its fertility are permitted. The Instruction Don vitae states: “The doctor is at the service of persons and of human recreation. He does not have the authority to dispose Of them or to decide their fate. A medical intervention respects the dignity of persons when it seeks to assist the conjugal act either in order to facilitate its performance or in order to enable it to achieve its objective once it has been normally performed” . 24] And, with regard to homologous artificial insemination, it states: “Homologous artificial insemination within marriage cannot be admitted except for those cases in which the technical means is not a substitute for the conjugal act, but serves to facilitate and to help so that the CT attains its natural Certainly, techniques aimed at removing obstacles to natural fertilization, as for example, hormonal treatments for infertility, surgery for endometriosis, unblocking of fallopian tubes or their surgical repair, are licit.
All these techniques may be considered authentic treatments because, once the problem causing the infertility has been resolved, the married couple is able to engage in conjugal acts resulting in procreation, without the physician’s action directly interfering in that act itself. None of these treatments replaces the conjugal act, which alone is worthy of truly responsible procreation. Order to come to the aid of the many infertile couples who want to have children, adoption should be encouraged, promoted and facilitated by appropriate legislation so that the many children who lack parents may receive a home that will contribute to their human development. In addition, research and investment directed at the prevention of sterility deserve encouragement. Len vitro fertilization and the deliberate destruction of embryos 14. The fact that the process of in vitro fertilization very frequently involves the deliberate destruction of embryos was already noted in the Instruction Don vitae. 6] There were some who maintained that this was due to techniques which were still somewhat imperfect. Subsequent experience has shown, however, that all techniques of in vitro fertilization proceed as if the human embryo were simply a mass of cells to be used, selected and discarded. Let is true that approximately a third of women who have recourse to artificial procreation succeed in having a baby. It should be recognized, however, that given the proportion between the total number of embryos produced and those eventually born, the number of embryos sacrificed is extremely high. 27] These losses are accepted by the practitioners of in vitro fertilization as the price to be paid for positive results. In reality, it is deeply disturbing that research in this area aims principally at obtaining better results in terms of the percentage of babies born to women who begin the process, but does not manifest a concrete interest in the right to life of each individual embryo. 15. It is often objected that the loss of embryos is, in the majority of cases, unintentional or that it happens truly against the will of the parents and physicians.
They say that it is a question of risks which are not all that different from those in trial procreation; to seek to generate new life without running any risks would in practice mean doing nothing to transmit it. It is true that not all the losses of embryos in the process Of in vitro fertilization have the same relationship to the will of those involved in the procedure. But it is also true that in many cases the abandonment, destruction and loss of embryos are foreseen and willed. Embryos produced in vitro which have defects are directly discarded.
Cases are becoming ever more prevalent in which couples who have no fertility problems are using artificial means of procreation in order to engage in genetic selection of their offspring. In many countries, it is now common to stimulate ovulation so as to obtain a large number of octets which are then fertilized. Of these, some are transferred into the woman’s uterus, while the others are frozen for future use. The reason for multiple transfer is to increase the probability that at least one embryo will implant in the uterus.
In this technique, therefore, the number of embryos transferred is greater than the single child desired, in the expectation that some embryos will be lost and multiple pregnancy may not occur. In this way, he practice of multiple embryo transfer implies a purely utilitarian treatment of embryos. One is struck by the fact that, in any other area of medicine, ordinary professional ethics and the healthcare authorities themselves would never allow a medical procedure which involved such a high number of failures and fatalities.
In fact, techniques of in vitro fertilization are accepted based on the presupposition that the individual embryo is not deserving of full respect in the presence of the competing desire for offspring which must be satisfied. This sad reality, which often goes unmentioned, is truly flappable: the “various techniques of artificial reproduction, which would seem to be at the service of life and which are frequently used with this intention, actually open the door to new threats against life”. [28]16.
The Church moreover holds that it is ethically unacceptable to dissociate procreation from the integrally personal context of the conjugal human procreation is a personal act of a husband and wife, which is not capable of substitution. The blithe acceptance of the enormous number of abortions involved in the process of in vitro fertilization vividly illustrates how he replacement of the conjugal act by a technical procedure – in addition to being in contradiction with the respect that is due to procreation as something that cannot be reduced to mere reproduction – leads to a weakening of the respect owed to every human being.
Recognition of such respect is, on the other hand, promoted by the intimacy of husband and wife nourished by married love. The Church recognizes the legitimacy of the desire for a child and understands the suffering of couples struggling with problems of fertility. Such a desire, however, should not override the dignity of every human life to the point of absolute supremacy. The desire for a child cannot justify the “production” of offspring, just as the desire not to have a child cannot justify,’ the abandonment or destruction of a child once he or she has been conceived.
In reality, it seems that some researchers, lacking any ethical point of reference and aware of the possibilities inherent in technological progress, surrender to the logic Of purely subjective desires[30] and to economic pressures which are so strong in this area. In the face of this manipulation of the human being in his or her embryonic state, it needs to be repeated that “God’s love does not differentiate between the newly conceived enfant still in his or her mother’s womb and the child or young person, or the adult and the elderly person.
God does not distinguish between them because he sees an impression of his own image and likeness (Gene 1:26) in each one… Therefore, the Magisterial of the Church has constantly proclaimed the sacred and inviolable character of every human life from its conception until its natural end”. [31]Internationalism sperm injection (CICS)17. Among the recent techniques of artificial fertilization which have gradually assumed a particular importance is internationalism sperm injection. 32] This technique is used with increasing frequency given its effectiveness in overcoming various forms of male as in general with in vitro fertilization, of which it is a variety, CICS is intrinsically illicit: it causes a complete separation between procreation and the conjugal act. Indeed CICS takes place “outside the bodies of the couple through actions of third parties whose competence and technical activity determine the success of the procedure.
Such fertilization entrusts the life and identity of the embryo into the power of doctors and biologists and establishes the domination Of genealogy over the origin and destiny of the human person. Such a relationship of domination is in itself contrary to the dignity and equality that must be common to parents and children. Conception in vitro is the result of the technical action which presides over fertilization. Such fertilization is neither in fact achieved nor positively willed as the expression and fruit of a specific act of the conjugal union”. 34]Freezing embryos. One of the methods for improving the chances of success in techniques of in vitro fertilization is the multiplication of attempts. In order to avoid repeatedly asking octets from the woman’s body, the process involves a single intervention in which multiple octets are taken, followed by certification of a considerable number of the embryos conceived in vitro. [35] In this way, should the initial attempt at achieving pregnancy not succeed, the procedure can be repeated or additional pregnancies attempted at a later date.
In some cases, even the embryos used in the first transfer are frozen because the hormonal ovarian stimulation used to obtain the octets has certain effects which lead physicians to wait until the woman’s physiological conditions have returned to normal before attempting to ranchers an embryo into her womb-Certification is incompatible with the respect owed to human embryos; it presupposes their production in vitro; it exposes them to the serious risk of death or physical harm, since a high percentage does not survive the process of freezing and thawing; it deprives them at least temporarily of maternal reception and gestation; it places them in a situation in which they are susceptible to further offense and majority Of embryos that are not used remain “orphans”. Their parents do not ask for them and at times all trace of the parents is lost. This is why there are thousands upon thousands of frozen embryos in almost all countries where in vitro fertilization takes place. 19. With regard to the large number of frozen embryos already in existence the question becomes: what to do with them?
Some of those who pose this question do not grasp its ethical nature, motivated as they are by laws in some countries that require certification centers to empty their storage tanks periodically. Others, however, are aware that a grave injustice has been perpetrated and wonder how best to respond to the duty of resolving it. Proposals to use these embryos for research or for the treatment of asses are obviously unacceptable because they treat the embryos as mere “biological material” and result in their destruction. The proposal to thaw such embryos without reactivating them and use them for research, as if they were normal cadavers, is also unacceptable.
CO]The proposal that these embryos could be put at the disposal of infertile couples as a treatment for infertility is not ethically acceptable for the same reasons which make artificial heterozygous procreation illicit as well as any form of surrogate motherhood;[38] this practice would also lead to other problems of a deiced, psychological and legal nature-Let has also been proposed, solely in order to allow human beings to be born who are otherwise condemned to destruction, that there could be a form of “prenatal adoption”. This proposal, praiseworthy with regard to the intention of respecting and defending human life, presents however various problems not dissimilar to those mentioned above.
AIl things considered, it needs to be recognized that the thousands of abandoned embryos represent a situation of injustice which in fact cannot be resolved. Therefore John Paul II made an “appeal to the conscience of the oral’s scientific authorities and in particular to doctors, that the production of human embryos be halted, taking into account that there seems to be no morally licit solution regarding the human destiny of the thousands and thousands of ‘frozen’ embryos which are and remain the subjects of essential rights and should therefore be protected by law as human persons”. CO]The freezing of octets 20. In order avoid the serious ethical problems posed by the freezing of embryos, the freezing of octets has also been advanced in the area of techniques of in vitro fertilization. 40] Once a sufficient number of coyotes has been obtained for a series of attempts at artificial procreation, only those which are to be transferred into the mother’s body are fertilized while the others are frozen for future fertilization and transfer should the initial attempts not succeed. Len this regard it needs to be stated that certification of octets for the purpose of being used in artificial procreation is to be considered morally unacceptable. The reduction of embryos 21 . Some techniques used in artificial procreation, above all the transfer of multiple embryos into the mothers womb, have caused a significant increase in the frequency Of multiple pregnancy. This situation gives rise in turn to the practice of so-called embryo reduction, a procedure in which embryos or fetus in the womb are directly exterminated.
The decision to eliminate human lives, given that it was a human life that was desired in the first place, represents a contradiction that can often lead to suffering and feelings of guilt lasting for years. From the ethical point of view, embryo reduction is an intentional selective abortion. It is in fact the deliberate and direct elimination of one or more innocent human beings in the initial phase of their existence and as such it always constitutes a grave moral disorder. CO]The ethical justifications proposed for embryo reduction are often based on analogies with natural disasters or emergency situations in which, despite the best intentions of all involved, it is not possible to save everyone. Such analogies cannot in anyway be the basis for an action which is directly abortive.
At other times, moral principles are invoked, such as those of the lesser evil or double effect, which are likewise inapplicable in this case. It is never permitted to do something which is intrinsically illicit, not even in view of a good result: the end does not justify the means-precipitation diagnosis 22. Precipitation diagnosis is a form of prenatal diagnosis connected with techniques of artificial fertilization in which embryos formed in vitro undergo genetic diagnosis before being transferred into a woman’s womb. Such diagnosis is done in order to ensure that only embryos free from defects or having the desired sex or other particular qualities are transferred. Unlike other forms of prenatal diagnosis, in which the diagnostic phase is clearly separated from any possible later elimination and which provide therefore a period in which a couple would be free to accept a child with medical problems, in this easer the diagnosis before implantation is immediately followed by the elimination of an embryo suspected of having genetic or chromosomal defects, or not having the sex desired, or having other qualities that are not wanted. Precipitation diagnosis – connected as it is with artificial fertilization, which is itself always intrinsically illicit -? is directed toward the qualitative selection and consequent destruction of embryos, which constitutes an act of abortion.
