|AVOID A PRACTICE THAT REFUTES HUMAN DIGNITY|
University's Institute of Bioethics on heterologous assisted fertilization techniques
the last few years, the use of heterologous assisted fertilization techniques with an
element that does not belong to the couple applying for it (spermatozoa, egg cells,
embryo), has become more and more frequent and has been supported and legalized by laws in
several countries (Great Britain, Spain, Sweden, etc.).
After the initial enthusiasm, encouraged by the ideology that anything technically possible should be made available to whoever might need or request it, there has been increasing perplexity regarding assisted fertilization in general, but particularly heterologous assisted fertilization, even in those who had previously legalized its use.
The illicitness of heterologous assisted fertilization has intrinsic motivations, since this practice is contrary to the unity of marriage, to the dignity of the couple and to the right of the conceived child to be able to recognize a father and a mother united in marriage at the origin of his life; but in the biomedical field, the use of these techniques can also lead to extreme consequences.
Heteronomous assisted fertilization: medical consequences
There are, by now, several studies that point out the risks connected to the use of assisted fertilization techniques, and these risks are generally in addition to those of a natural conception: for example, the maternal risk connected to the pharmacological treatment used to obtain multiple ovulation, which can provoke the so-called "ovarian hyper-stimulation syndrome", or connected to peritoneal infections following laparoscopic procedures performed in order to collect egg cells. But even multiple pregnancies, whose incidence has increased with the use of assisted fertilization techniques, cause both maternal and foetal risks and at the same time lead to an ethically unacceptable practice: embryo reduction (see our previous document "Against so-called embryo reduction").
Morever, among the infants obtained with assisted fertilization techniques, and in particular with in vitro fertilization, there is an increased incidence of premature births (24-29.3 per cent versus 4-6 per cent of normal pregnancies), low birth weight (13-26.2 per cent versus 6 per cent of natural pregnancies for weights less than 2,500 gr.), perinatal mortality (22.8-26.6 per cent versus 9.8-13 per cent with natural pregnancies) and pathology. In fact, prematurity and low weight are in turn associated with the increased risk of compromising growth and psychomotor and mental development, and often with neurological damage.,
Together with these medical problems, common to heterologous and homologous assisted fertilization techniques, there are also other specific problems regarding heterologous assisted fertilization, including the request to select the donors of gametes.
It is well-known by people who run the so-called "semen banks" that the donors are selected in order to exclude the possibility of transmitting infective or genetic diseases.
This selection, carried out with eugenic aims, and therefore intrinsically illicit, is also illusive and deceptive. At the moment it is certainly possible to identify in the donor the presence of altered genes, responsible for the outbreak of a genetic disease in the unborn child. It is also possible to identify a vast range of pathological pre-dispositions, from diabetes to arteriosclerosis and other diseases. In order to be valid, according to eugenic logic, these examinations that can be performed on the donor, should also be performed on the receiving woman. This is a prospect that would involve a very high cost and because of the range of examinations, it would also be unrealistic. Once the diagnosis of a future disease or pathological predisposition has been made, there would then arise the problem of whether or not to use this certain semen to fertilize one or more women. But apart from the eugenic selection nature of this decision, who should decide: the manager of the centre? The receiver? The willing husband? A commission of experts?
Heterologous assisted fertilization: psychosocial consequences and further ethical implications
Among the consequences of using heterologous assisted fertilization techniques, one has to remember the proposal of the anonymity of the donors of gametes and embryos.
Granted that the so-called "donation of gametes" is a rather doubtful form of generosity, when one considers the total exemption of the genetic parent from any responsibility that burdens all other parents, it is our opinion that not being able to know one's genetic parent is contrary to the unborn child's right.
And it is absolute nonsense, in a time in which anyone can find out his genetic origin through an examination of his DNA, that this possibility could be conditioned by judicial authorities. One can certainly prohibit by law the failure to acknowledge paternity by the husband who has agreed to heterologous fertilization, but it is inconceivable to prohibit a child from knowing his own genetic father. Without then considering the fact that the anonymous donor is granted what is not officially granted to anybody: to be the father of many children born of different women and to remain "hidden", with the risk that the children may, unknowingly, marry their own stepbrothers and sisters.
The fact that minimum attention is given to the interests of the unborn is also shown by the way their fundamental right to life is continuously violated. This is what happens with the very act of obtaining conception in a way that is separated from the conjugal act, but it is made even more obvious by the multiple in vitro fertilization procedures and by obtaining so-called "extra-embryos", which are not transferred to the mother's uterus but are used for experimentation or cryo-preserved.
Among the possible destinies of cryo-preserved embryos there is also the donation to another sterile couple and this procedure is inevitably connected with the selection of the embryos through a pre-implantation diagnosis.
Doubtless, the discovery of one's sterility and the impossibility of achieving paternity or maternity cause great suffering to the couple. The aspiration to maternity and paternity is "physiologically" related to conjugality. This is why one should have the maximum human appreciation for the desire for a pregnancy. And where science identifies a situation of sterility, there should be the maximum commitment in diagnosis and treatment. When, however, this kind of treatment does not allow the sterile couple to achieve their aspiration to paternity/maternity, this desire should be directed towards a "social fertility" rather than allowing a practice that is contrary to both the personal dignity of the unborn child and of the parents, and contrary to the very nature of marriage and family.
Weekly Edition in English
6 August 1997, page 9
Romano is the newspaper of the Holy See.
The Cathedral Foundation
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