Technology and The Womb

By Richard N. Ostling

A child must never be "desired or conceived as the product of an intervention of medical or biological techniques; that would be equivalent to reducing him to an object of scientific technology." With those stern words of admonition, the Vatican, acting with the full endorsement of Pope John Paul II, last week denounced virtually all the rapidly spreading methods of artificial procreation, deeming them to be violations of both the rights of man and the laws of God.

That strongly conservative stand was proclaimed in a 40-page document issued by the Congregation for the Doctrine of the Faith, the Vatican agency that is responsible for monitoring orthodoxy. Said West Germany's Joseph Cardinal Ratzinger, head of the congregation, at a Rome press conference: "What is technologically possible is not also morally admissible." The document is being termed "Ratzinger's catechism" because of its substantial use of a question-and-answer format. Clinical in tone, the text bears the title Instruction on Respect for Human Life in Its Origin and on the Dignity of Procreation: Replies to Certain Questions of the Day.

The Instruction is not published as an infallible pronouncement but carries definitive authority as an exercise of the church's teaching power. The document, however, does more than insist that Catholics submit to its instructions; it also calls on governments to pass laws prohibiting a number of the controversial reproductive techniques. The Pope clearly expects his bishops to lobby for such statutes. The day after the text was published, the Italian bishops urged their nation's legislators to create a "legal order conforming to the needs of moral law."

The Vatican is not only boldly resisting trends in biological research and medicine but, in the case of a few practices commonly in use, also rejecting the opinions of numerous Roman Catholic moral theologians. The document's release quickly provoked widespread debate not only on the ethics of the reproductive techniques it discusses but on the propriety of the Vatican's attempt to influence public policy on a medical issue, particularly in pluralistic societies. Many Americans claimed the words from Rome would have little impact on daily practices.

To theological experts, the text contained no major surprises, since there has been a long development of consistent papal teaching on reproductive technology. But the statement is dramatic because it collects points from scattered pontifical addresses and other church pronouncements into a strong, coherent policy about medical techniques that have become widespread.

The major practices condemned:

ARTIFICIAL INSEMINATION. This is the oldest and by far the most common of the techniques prohibited. The Instruction not only opposes the introduction into a womb of sperm from a "third party" donor other than the husband but rejects the use of a husband's sperm. The first condemnation of artificial insemination came in a 1949 speech by Pope Pius XII, but the teaching has been ignored by many Catholic couples and disputed by some theologians.

IN VITRO FERTILIZATION. In this technique, eggs are fertilized outside the womb in laboratory vessels, and the resulting embryo is implanted in a womb. Since Louise Brown of England became the first test-tube baby nine years ago, 1,992 babies have been born this way, according to one reliable estimate. As with artificial insemination, Rome opposes the use not only of eggs or sperm from "third parties" but of implanted embryos, even if the eggs were fertilized by the husband's sperm. This marks the first definitive church denunciation of the practice, although the prescient Pope Pius XII criticized the in vitro concept as early as 1956.

SURROGATE MOTHERHOOD. This method involves a woman bearing a child on behalf of others, often for payment, through artificial insemination or the implantation of a fertilized egg. The practice has caused a widely publicized and anguishing struggle between two New Jersey couples in the so-called Baby M. case; a decision by Judge Harvey Sorkow is soon expected. Harold Cassidy, a Catholic lawyer representing the surrogate mother of Baby M., who wants to keep her child, thinks the Vatican teaching helps his case. Opposing Lawyer Gary Skoloff scoffs at that but agrees with Rome that laws are needed. "No one wants any more Baby M. cases," he asserts.

EMBRYO EXPERIMENTS. The Instruction allows medical treatment of human embryos or fetuses within the womb only if it is therapeutic for the new life. Experimental interventions for the sole purpose of advancing medical knowledge are forbidden. Prenatal diagnosis is allowed, but not if the intention might be abortion rather than treatment. The Instruction rules out the use of human fetuses for experiments or for obtaining biochemical products.

In a broad attack on reproductive technology, the document denounces a number of theoretical scientific advances, such as human births from artificial wombs, gestation of human embryos within animals, and hybrids formed by crossing humans with animal species. Also prohibited: asexual human reproduction, whether by cloning (creation of genetically identical individuals from a single cell), parthenogenesis (reproduction from unfertilized eggs) or twin fission (surgical splitting of an embryo to produce twins).

Pope John Paul, who was profoundly involved in the preparation of the document, believes the techniques must be halted because they threaten the respect for human life that is fundamental to Christianity. To John Paul, who lived for years under Nazi rule, human beings must never be treated as "objects" that are available for scientific manipulation.

Though the techniques in question may be complex, Rome's doctrinal opposition to them stems from two simple, if controverted, principles. The first, which also undergirds the church's stance against abortion, holds that from the point when sperm and egg unite, a fertilized egg or embryo must be accorded, in the words of the document, the "unconditional respect that is morally due to the human being." That rules out the embryo manipulations that are often necessary in the research and application of a number of the reproductive techniques. This view provides an argument against the in vitro technique because in that process unused fertilized eggs are discarded. However, Dr. Martin Quigley, a Cleveland fertilization expert, denies that any U.S. IVF program "would routinely destroy" an embryo. Claiming the Vatican has been misinformed, he insists that most "spare" embryos are kept for later attempts at pregnancy.

The second principle is that reproduction should occur, as the Instruction says, only "in marriage through the specific and exclusive acts of husband and wife," that is, normal sexual intercourse. In the Vatican view, couples must combine the "unitive" (sexual) and the "procreative" aspects of marriage. Artificial methods of producing children consider only procreation, says Rome, while artificial methods of birth control consider only the sexual aspect. Since artificial insemination and in vitro fertilization bypass the normal "conjugal act," neither method is allowed.

On this point some Catholic theologians question the Instruction. Notable among them is Jesuit Father Richard McCormick of the University of Notre Dame, who thinks the in vitro passage is the "weakest part" of the entire statement. In his view "the child should be the product of a loving act. That doesn't necessarily translate as a result of an act of sexual intercourse." McCormick agrees that the "unitive" and "procreative" spheres need not be combined in every act of a married couple.

Many Protestants share the Vatican's alarm over the ever braver worlds of human reproduction that advanced biomedical techniques have made possible. Clinics are now assisting in fertilizations involving donor sperm, donor eggs, donor embryos, single women and lesbian couples. Lawyer George Annas, professor of health law at Boston University's School of Medicine, notes the possibility that a child could have five different parents: the father who donates sperm, the mother who produces the ovum, the mother who provides the womb, and the mother and the father who raise the child.

The Pope and his doctrinal watchdogs find these developments violations of the dignity of the nascent human life, transgressions of the child's right to be born into a natural family, interference with natural sexual reproduction between husband and wife, or attempts at sinister scientific "control and domination" over the human person. In addition, the Instruction expresses fears that reproductive technology invites discrimination among human beings, weakened protection for vulnerable people, and eugenic schemes to fashion a more desirable super-race.

Even though it was armed with earlier papal speeches on biological ethics, Rome decided to prepare a formal document in response to requests from many bishops as the new techniques were becoming more widespread. In fact, some worried Catholics think the Vatican has been too cautious, rather than too bold, by waiting so long to speak out. The Pontifical Council for the Family has received letters from scores of couples, most of them American, asking for guidance or expressing concern about the technologies. The doctrinal congregation spent 20 months writing the text, consulting some 60 moral theologians and 22 scientists from various nations.

One of the experts consulted, Catholic Neurosurgeon Robert J. White of Cleveland, finds the resulting document "ultraconservative." Patrick Steptoe, the British doctor who delivered Louise Brown, called the teaching "rather ridiculous," adding, "Our experiments may benefit a great deal of people in the future. I think it is perfectly moral to conduct them."

One sharp critic within church circles is Daniel Maguire, a liberal theologian at Marquette University, who opposes official teaching on abortion. "It's a document born into obsolescence. Rome is speaking to the Catholic right wing and from the Catholic right wing." Edward Marut, a Chicago-area Catholic doctor and fertility expert, says childless Catholics are "incensed" at the church's tough line. Two days after the Vatican's prohibition was issued, Susan Fitter, 33, of Lawton, Okla., who has been trying to have a child for four years, went ahead with her decision to use in vitro fertilization with her husband's sperm for later implantation in a surrogate carrier. She has decided that she would leave the church rather than submit to the teaching. Says she: "I simply will not remain a Roman Catholic. Children are the No. 1 priority of my husband and me, and we're willing to sacrifice a lot for it."

At the Rome press conference introducing the Instruction, Cardinal Ratzinger indicated he had anticipated negative reactions. He said the church sympathizes with the desire of couples to have children and of researchers to extend knowledge. "However, honesty of the aim and goodness of intentions are not sufficient," he insisted. "The no to certain experimentations and to certain reproductive techniques is actually a yes to man, a witness to the dignity and deliverance of man."

With reporting by Cathy Booth/Rome and Michael P. Harris/New York