In Vitro

In Vitro Fertilization: Moral or Immoral? by Dr. Richard C. Eyer Is in vitro fertilization morally acceptable or not?”
One of the increasing number of questions asked about reproductive technologies by parishioners is, “Is in vitro fertilization morally acceptable or not?” Since in vitro (Latin: in glass referring to a petri dish) fertilization is a process involving issues within issues there is often confusion resulting from attempts to answer that question. In this brochure we will attempt to identify the separate issues and their moral standing so that the reader can evaluate the moral acceptability or unacceptability of in vitro fertilization.
The current process of attempting pregnancy through in vitro involves the making of as many as seven, eight, or more embryos in the laboratory. Only two or three of those embryos might actually be used to achieve a pregnancy. It is not surprising that morally concerned people ask, “What happens to the rest of the embryos?” and, “Why is such an excessive number of embryos formed to begin with?” The answer is that no one knows beforehand how many attempts and therefore how many embryos are needed to achieve a pregnancy. If a couple wants only two children and are able to accomplish this in one or two attempts, they don’t “need” the rest, and the problem of leftover embryos occurs. Because of this cavalier attitude toward human embryos and their uncertain future, morally concerned people are inclined to reject the idea of in vitro altogether.
There are other moral issues as well. It must be said that clinicians who bring together sperm and egg in a petri dish do not generally concern themselves with questions of morality since the tradition of medical practice is to remain objectively amoral. It is a society that must decide, either by tacit consent or by legislation, the moral limitations, if any, to be placed on those things that threaten human life. As we all know by now, the placing of any limits on reproductive freedoms has, in recent years, been followed by the charge of violating the freedom of the individual. It also happens that some couples using in vitro simply do not think ahead to the possibility of leftover embryos. So absorbed are they in the prospect of parenthood, and committed to their goal of pregnancy, that they will do whatever it takes, even at the risk of leftover embryos. Other couples simply fail to realize the moral nature of their actions until the dilemma of leftover embryos becomes a reality, and then they feel guilty about it. They sometimes attempt to justify themselves by claiming a morality expressed as “the end justifies the means.” If married couples were to pursue in vitro fertilization at all, a morally responsible solution to the dilemma of leftover embryos might be to allow only the formation of a limited number (i.e. two, three, or four), having decided beforehand how many attempts at pregnancy they will permit, thus not ending up with any leftovers. In reality, however, this is rarely done because of the great expense involved and because of the failure rate of implantation.¹

Fertilized Human Egg	Human Embryo - Day 3	Human Blastocyst -Day 5
But even if we were to limit the number of embryos formed, the nature of in vitro fertilization itself raises further moral issues for Christians. For example, due to the controlled nature of the procedure, it is difficult to see that we are leaving much to God in the matter of having a child. It is surely the most any human effort can exercise to take control of infertility by means of placing sperm and egg together, implanting the resulting embryo in the uterus, and repeating the process until a pregnancy is accomplished. Some might say the mystery of procreation and the giving of children by God as a gift is compromised in the process.
We may look back collectively at in vitro fertilization as the point at which procreation gave way to reproduction as described in Huxley’s Brave New World written seventy years ago. In the new reproductive paradigm, the next step would be cloning human beings, eliminating the need for spouse or partner. This would be the ultimate step of separation of the biological from the relational. It seems that each new reproductive technology moves us deeper in the direction of separating marriage and conception as two distinct and unrelated human activities.
		Preborn baby seven weeks from conception
Another moral issue is sometimes raised about the loss of embryos where implantation fails to succeed. This loss of embryos seems to some to be treating embryos as too easily dispensable. But it must be remembered that this happens even in normal circumstances far more than couples realize. Even apart from the common occurrence of a miscarriage, it appears that in the normal course of procreation embryos do not always implant and are lost. The intentional destruction of embryos is unacceptable, but there is no intention to do that with in vitro embryos when the number is limited to those implanted. In fact, the aim and hope is for the opposite, so that a pregnancy may be achieved. There is always the risk of losing an embryo, as there is the risk of losing life in other medical procedures.
A more serious moral issue arises if, in the making of embryos through in vitro, donor sperm or eggs are used. A husband may consent to the use of another man’s sperm and the wife to the use of another woman’s eggs, but consent does not lessen the moral culpability in the issue. Children are the blessing God gives to the One Flesh union of husband and wife in marriage.2 The entrance of a third party donor into the process of conceiving a child may well be thought of as adulterous, since attention turns from that which our spouse cannot provide to someone else outside the marriage who can. This is a clear violation of the biblical theme of the One Flesh union of husband and wife understood as the mystery of marriage. There appears to be no moral acceptability to a pregnancy achieved by a married couple through the use of donor sperm or egg no matter how consensual the act.
Yet another moral issue confronts us in the matter of a single woman seeking pregnancy through in vitro fertilization. It has been argued that since no physical contact is made between the woman and the sperm donor (other than the sperm itself), there is therefore nothing immoral about achieving pregnancy in this way. But God did not intend procreation to take place in a vacuum, that is, outside of marriage. The fact that it often does cannot make it acceptable. Rather, God intends procreation to be the giving of a child (or sometimes not given) through the love-making of a husband and wife. In the Christian’s worldview, children are begotten, not made. They are the summation of their parent’s substance, and not another’s, as part of the mystery of conception. Being a single parent is not an easy life for parent or child. And even apart from the maternal hardships and potential deficits for the child in the absence of a father, children ought not to be treated as commodities, made-to-order to satisfy one’s needs.
Conclusion: We have considered some of the moral issues involved with in vitro fertilization such as the dilemma of leftover embryos, the loss of embryos that do not implant, the unmarried woman seeking pregnancy, the use of donor sperm or egg, and, perhaps most importantly of all, the increasing separation of the biological from the relational inherent in reproductive technologies. Someone might ask, “But what if the number of embryos formed is limited, a couple is married, and donors are not used?” If these things are possible it does appear to overcome those particular moral issues, leaving us with the one issue of the separation of the biological from the relational. This is no small matter in the range of reproductive technologies. Various reproductive technologies reduce the bond of the biological and the relational to a greater or lesser degree. The use of artificial insemination (with the qualifications identified above) seems a lesser degree and perhaps therefore morally acceptable. Surrogate motherhood or human cloning, on the other hand, are clearly of the greatest degree of disconnect and therefore morally unacceptable. In vitro fertilization (with qualifications as listed above) seems to lie somewhere between the two ends of this spectrum. It may be that a married couple will conclude that, having followed the qualifications, they still wish to make use of in vitro fertilization. Such a couple would do well to seek pastoral counsel and care before concluding their considerations, for there are other spiritual issues. Spiritually, infertility is an opportunity to examine one’s understanding of the ways of God revealed in the Scriptures. It is a time to examine oneself and one’s faith as the willingness to deny self and take up one’s cross, rather than taking matters into one’s own hands. Finally, if a couple has already made use of in vitro fertilization in morally unacceptable ways, pastoral care and the availability of Individual Confession and Absolution needs to be considered. These are difficult and complicated times, but they are times for growth in faith and trust in God even in the face of on-going infertility. God will always provide for our needs even when His ways are not our ways.
(Footnotes) ¹ The question of what to do with leftover embryos that do exist requires a second article. ² In adoption, children are not intentionally created by illicit means as in the use of donors, but are handed over to others to care for when a biological parent cannot or will not do so.
Rev. Dr. Richard Eyer (LCMS), now retired, was Assistant Professor of Philosophy, Director of Counseling, and Director of the Concordia Bioethics Institute, Concordia University, Mequon, Wisconsin.
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