Interview With Doctor and Moral Theologian, Father Requena Meana
By Carmen Elena Villa
ROME, 8 DEC. 2010 (ZENIT)
When Robert Edwards receives the Nobel Prize for Medicine this Friday, an implicit approval of an ideology that sees children as products will be taking place.
Edwards pioneered the process of in vitro fertilization, making it possible for the first "test-tube baby," Louise Joy Brown, to be born July 25, 1978.
ZENIT spoke about this with Father Pablo Requena Meana, a physician and moral theologian, who explained that at the heart of in vitro fertilization is an outlook that understands children as a "right" — something a couple can produce when they wish.
This is the problem with in vitro fertilization, says Father Requena. And the moral condemnation of the process has nothing to do with a mistrust of science or disdain for artificial techniques.
ZENIT: How many embryos are lost for every baby born by in vitro fertilization?
Father Requena: It's impossible to know exactly, in part because it depends very much on the technique used and on the protocols of every country, but the number is certainly high. Some data can help us understand the extent of this loss of human beings. In 2009 a European study was published regarding 30 countries, which mentioned 418,111 cycles of assisted reproduction, with a rate of pregnancy — not of babies born — that oscillated for the most efficient techniques between 30.3% and 30.9%. If one takes into account the fact that the common practice implies hyper-ovarian stimulation in every cycle, from which are obtained between 10 and 20 ovules, many of which will be fertilized, one can easily conclude that the embryos that have not seen the light in Europe in 2005, the year to which the study refers, are several million.
Today 1% or 2% of the babies born in Europe or in North America are test-tube babies. C. Hogg, of the Nobel Committee for Medicine, said that "it is a safe and effective treatment, it follows rigorous rules. The studies carried out in the course of these years state that test-tube babies are as healthy as all others."
ZENIT: Is this true? Do we know if persons born by in vitro fertilization are at greater risk of having congenital diseases?
Father Requena: It's not surprising that clinics dedicated to assisted reproduction hold that the health of babies born of test tubes is the same as that of those conceived naturally: Much money is at stake — a 2010 scientific article states the costs in Australia and New Zealand hover around $27,000 for women between 30 and 33 years and around $187,000 for those between 42 and 45. Unfortunately, assisted fertilization has become a business, like furniture that can be custom made, with all the standards proper to industrial production and the pertinent quality controls. This business is increasingly moving away from the original idea, born in the clinical ambit, that sought to resolve the problem of infertility. People continue to go to clinics, and the equipment continues to be that which is proper to medicine, but the relationship is not the traditional one of doctor and patient, but that of technician-seller and client. Returning to the question, clearly sellers must speak well of their "products." What is more surprising is that persons of science, very rigorous in their analyses and their technical appreciation, then make such unscientific comments for the purpose of ensuring these techniques.
It's true that the babies born by in vitro fertilization are, in the majority of cases, healthy and normal, but it is also true that they have a greater possibility of developing malformations of various types. It's not an opinion or a theoretical hypothesis, but an affirmation that stems from data published in the scientific literature.
Three examples: published in 2004 in the Journal of Assisted Reproduction and Genetics was a meta-analysis that collected data from 19 previous studies, and concluded that 29% of babies born by in vitro fertilization had some type of malformation, more or less severe: from hare lips to serious cardiac malformations. In another report, promoted by the Ministry of Health of New Zealand in 2005, which gathers an international bibliography from countries where in vitro fertilization is done, points out that babies born through the ICSI (intracytoplasmic sperm injection) technique, at present one of the most common, have a three to four times higher risk of chromosomal anomalies as compared to babies conceived naturally, to a large extent due to paternal genetic problems that are transmitted with this technique. The last example stems from an article published recently in the Human Reproduction review. It is a study carried out on more than 90,000 babies, and one of its conclusions is that cerebral palsy, which is normally found in one child born out of 400, in babies born in vitro is verified in one case out of 176.
ZENIT: Leaving to one side the question of the health of "test-tube babies," why is in vitro fertilization morally unacceptable?
Father Requena: The problem of infertility is very serious and has serious repercussions in the life of many couples, causing great suffering. In this connection, it's logical that couples who do not succeed in having children take recourse to technical help to succeed. The moral issue of in vitro fertilization is not from the artificiality of the techniques, and much less from a mistrust of science. In an important Holy See document on these questions, it is affirmed among other things that the Church "looks with hope to scientific research, hoping that many Christians will dedicate themselves to the progress of biomedicine and to witness their faith in this ambit" (Dignitas Personae, No. 3). Medicine constantly uses artificial instrumentation, and we don't say it is bad. Think, for example, of the replacement of a damaged cardiac valve by a mechanical one, which can save a patient's life: Not only do we say that it does not present ethical problems, but that from the moral point of view it's something that is very good, and hence should be done when it's possible.
What is the difference with techniques of artificial insemination? The fundamental problem here is that a human being, a child, is considered as a "product," as something that in some way belongs to me and which I can program, select, manipulate ... and destroy. But this isn't right for human beings: It can be so for machines, it can be so — in some cases — for animals, but never for man. He is too important to be able to be "fabricated." That's why we say that the only appropriate place to give origin to a human being is the act of love of the parents.
This certainly does not mean that the dignity of children conceived in vitro, as those who might proceed from violence, is less than that of children of a married couple. And it is precisely because of their great dignity, that these ways of "calling them into existence" are inadequate.
Moreover, not to be forgotten is the great quantity of lives that are lost along the way, and the innumerable frozen embryos that at present fill the storerooms of assisted fertilization clinics. And this reason is not only valid for people of faith, but for all those who want to protect human life in society in all its forms.
ZENIT: How much is this influenced by the ideology of maternity and paternity as a right and not as a gift?
Father Requena: In today's society the perception of a child has changed very much. For a long time a child was considered a gift. This view is very united to a religious conception of existence, which sees parents as collaborators of God, and in a certain sense as his ministers in the task of looking after and educating the children. In any case, the child was certainly not seen as a right, as some now consider it, because it cannot be so. No person has the "right" to possess another: One can possess a house, a car, but never a person. This is why slavery is an evil, because no man can be the "owner" of another. If it was affirmed that there is a right to a child, one would be saying that someone — the community — has the duty, the obligation, to give me that, and one would also be saying to the child that he is the "product" of a right of his parents. But this implies taking away from the child his dignity of person, and the right to be conceived through an act of love.
ZENIT: As a doctor, priest and professor, what would you say to a married couple that wants to have a family and cannot do so naturally?
Father Requena: In the first place, I would tell them to go to a center of help for procreation, such as the Gemelli here in Rome, where they can do an in-depth study of the problem, to see if there are morally appropriate therapeutic possibilities for their situation. In not a few cases, they do exist, without the need to take recourse to in vitro fertilization.
However, on other occasions, the spouses will discover that their desire to have children, so legitimate and good, cannot be fulfilled. In that case, with the help of the whole ecclesial community, they can discover that this possibility is not foreign to their Christian vocational journey. The Church has always taught that "spouses who are in this painful situation are called to discover in it the occasion to participate particularly in the cross of the Lord, source of spiritual fertility" (Donum Vitae, No. 8). It certainly is not an easy path, but we know well that "the gate is narrow and the way is hard, that leads to life" (Matthew 7:14).
Perhaps time will be necessary, a long time, to understand the way to live God's call to paternity and maternity in a different, but no less effective and happy, way. There are many examples of parents who have never been able to have children, and who feel very united and very fulfilled in their marriage.
ZENIT: Finally, do you think Robert Edwards deserves this prize?
Father Requena: Personally, I would not have given it [to him] because, although he is a great technician and without a doubt the objective of helping couples that cannot have children is very laudable, the means he has used are not adequate. Moreover, Edwards himself has expressed on occasions support for using these techniques in a eugenic sense, something that it seems to me is very negative on the social level. I believe that good will and technical successes should not be sufficient to earn this type of prize, but of course not everyone thinks this way.