Regarding the Instruction Dignitatis Personae - Second Part: New Problems Concerning Procreation - Techniques for assisting fertility

Among the procedures which respond to problems of fertility are the following: “techniques of heterologous artificial fertilization” (n. 12): that is, “techniques used to obtain a human conception artificially by the use of gametes coming from at least one donor other than the spouses who are joined in marriage” (footnote 22). “techniques of homologous artificial fertilization” (n. 12): that is, “the technique used to obtain a human conception using the gametes of the two spouses joined in marriage” (footnote 23). “techniques which act as an aid to the conjugal act and its fertility” (n. 12). “techniques aimed at removing obstacles to natural fertilization” (n. 13). “adoption” (n. 13). Techniques are morally permissible if they respect: “the right to life and to physical integrity of every human being”, “the unity of marriage, which means reciprocal respect for the right within marriage to become a father or mother only together with the other spouse” and “the specifically human values of sexuality” (n. 12), which require that the procreation of a new human person come about as a result of the conjugal act specific to the love between a husband and wife. Therefore, “techniques which act as an aid to the conjugal act and its fertility are permitted” (n. 12) In such procedures, the “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” (n. 12). “Certainly, techniques aimed at removing obstacles to natural fertilization… are licit” (n. 13). “Adoption should be encouraged, promoted and facilitated so that the many children who lack parents may receive a home… In addition, research and investment directed at the prevention of sterility deserve encouragement (n. 13).

The experience of recent years has shown that in all techniques of in vitro fertilization “the number of embryos sacrificed is extremely high” (n. 14). Even in the most technically advanced centers of artificial fertilization, the number is above 80% (cf. footnote 27). “Embryos produced in vitro which have defects are directly discarded”; a increasing number of couples “are using artificial means of procreation in order to engage in genetic selection of their offspring”; of the embryos which are produced in vitro “some are transferred into the woman’s uterus, while the others are frozen”; the technique of multiple transfer in which “the number of embryos transferred is greater than the single child desired, in the expectation that some embryos will be lost… implies a purely utilitarian treatment of embryos” (n. 15). “The blithe acceptance of the enormous number of abortions involved in the process of in vitro fertilization vividly illustrates how the replacement of the conjugal act by a technical procedure…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… 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 infant 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.. Therefore, the Magisterium of the Church has constantly proclaimed the sacred and inviolable character of every human life from its conception until its natural end” (n. 16).

Intracytoplasmic sperm injection is a variety of in vitro procreation in which fertilization in the test tube does not simply “take place on its own, but rather by means of the injection into the oocyte of a single sperm, selected earlier, or by the injection of immature germ cells taken from the man” (footnote 32). This technique, which is morally illicit, causes a complete separation between procreation and the conjugal act” (n. 17). It 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 technology over the origin and destiny of the human person” (n. 17).

“In order to avoid repeatedly taking oocytes from the woman’s body, the process involves a single intervention in which multiple oocytes are taken, followed by cryopreservation of a considerable number of the embryos conceived in vitro. 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” (n. 18) The freezing or cryopreservation of embryos “refers to freezing them at extremely low temperatures, allowing long term storage” (cf. footnote 35). “Cryopreservation 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 manipulation” (n. 18). With regard to the large number of frozen embryos already in existence the question becomes: what to do with them? All the answers that have been proposed (use the embryos for research or for the treatment of disease; thaw them without reactivating them and use them for research, as if they were normal cadavers; put them at the disposal of infertile couples as a “treatment for infertility”; allow a form of “prenatal adoption”) present real problems of various kinds. 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 world’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” (n. 19).

“In order avoid the serious ethical problems posed by the freezing of embryos, the freezing of oocytes has also been advanced in the area of techniques of in vitro fertilization” (n. 20). In this regard it needs to be stated that while the cryopreservation of oocytes is not in itself immoral, and is employed in other medical contexts which are not the subject of this document, when it takes place “for the purpose of being used in artificial procreation” it is “to be considered morally unacceptable” (n. 20).

“Some techniques used in artificial procreation, above all the transfer of multiple embryos into the mother’s 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 fetuses in the womb are directly exterminated” (n. 21). “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” (n. 21).

“Preimplantation 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” (n. 22). “Unlike other forms of prenatal diagnosis…, 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. Preimplantation diagnosis…is directed toward the qualitative selection and consequent destruction of embryos, which constitutes an act of abortion... By treating the human embryo as mere ‘laboratory material’, the concept itself of human dignity is also subjected to alteration and discrimination…Such discrimination is immoral and must therefore be considered legally unacceptable…” (n. 22).

There are methods of preventing pregnancy which act after fertilization, when the embryo is already constituted. “Such methods are interceptive if they interfere with the embryo before implantation” (n. 23); for example, the IUD (intrauterine device) and the so-called ‘morning-after pills’ (footnote 42). They are “contragestative if they cause the elimination of the embryo once implanted” (n. 23); for example, the pharmaceutical known commercially as RU-486 (footnote 43). Even if such interceptives may not cause an abortion every time they are used, also because conception does not occur after every act of sexual intercourse, it must be noted, however, that “anyone who seeks to prevent the implantation of an embryo which may possibly have been conceived and who therefore either requests or prescribes such a pharmaceutical, generally intends abortion”. In the case of contragestatives “what takes place in reality is the abortion of an embryo which has just implanted… the use of means of interception and contragestation fall within the sin of abortion and are gravely immoral” (n. 23).

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Regarding the Instruction Dignitatis Personae

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