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GENERAL POLICY ON ASSISTED REPRODUCTIVE   TECHNOLOGIES (ART) 

 

Explanation of Terms and Procedures 

     The term assisted reproductive technology (ART) is used of  a medical technique which promotes or achieves fertilization.

  

Policy 

     Human procreation must always take place within marriage. 

     Using sperm or ova from a person outside the marriage to conceive a child is never permissible. 

     The conception of a child must be brought about as the result of an act of sexual intercourse between spouses.  The unitive and procreative aspects of the conjugal act should not be separated.  Fertilization should not occur as the direct result of a technical process which substitutes for the personal act of sexual intercourse between spouses. 

          The use by spouses of technological methods in reproduction is not entirely precluded, but such methods must meet the following condition to be permissible: the method must facilitate the natural act of sexual intercourse or assist that act to achieve its objective of conceiving a child once it has been naturally performed.

      Techniques of assisted reproduction may not be used which involve the deliberate destruction or wastage of human embryos.

 

Sources of Policy 

     The first four principles have been set forth in the Instruction on Respect for Human Life in its Origin and On the Dignity of Procreation (Donum Vitae), a 1987 document from the Vatican Congregation for the Doctrine of the Faith (1): 

...from the moral point of view a truly responsible procreation vis-a-vis the unborn child must be the fruit of marriage. ...The tradition of the Church and anthropological reflection recognize in marriage and in its indissoluble unity the only setting worthy of truly responsible procreation. (2)

    These reasons lead to a negative moral judgment concerning heterologous artificial fertilization: consequently fertilization of a married woman with the sperm of a donor different  from her husband and fertilization with the husband’s sperm of an ovum not coming from his wife are morally illicit. (3)

 

     The Church’s teaching on marriage and human procreation affirms the “inseparable connection, willed by God and unable to be broken by man on his own initiative, between the two meanings of the conjugal act: the unitive meaning and the procreative meaning.  Indeed, by its intimate structure, the conjugal act, while most closely uniting husband and wife, capacitates them for the generation of new lives, according to laws inscribed in the very being of man and woman.”  This principle, which is based upon the nature of marriage and the intimate connection of the goods of marriage, has well-known consequences on the level of responsible fatherhood and motherhood...

      Thus, fertilization is licitly sought when it is the result of a “conjugal act which is per se suitable for the generation of children to which marriage is ordered by its nature and by which the spouses become one flesh.”  But from the moral point of view procreation is deprived of its proper perfection when it is not desired as the fruit of the conjugal act, that is to say of the specific act of the spouses’ union...

     The moral relevance of the link between the meanings of the conjugal act and between the goods of marriage, as well as the unity of the human being and the dignity of his origin, demand that the procreation of a human person be brought about as the fruit of the conjugal act specific to the love between spouses. (4)

 

    Thus moral conscience “does not necessarily proscribe the use of certain artificial means destined solely either to the facilitating of the natural act or to ensuring that the natural act normally performed achieves its proper end.”  If the technical means facilitates the conjugal act or helps it to reach its natural objectives, it can be morally acceptable.  If, on the other hand, the procedure were to replace the conjugal act, it is morally illicit. (5)

      The second, third, and fourth principles are explicitly reiterated in the 1994 revision of the Ethical and Religious Directives for Catholic Health Care Services from the National Conference of Catholic Bishops (6):

 Heterologous fertilization (that is, any technique used to achieve conception by the use of gametes coming from at least one donor other than the spouses) is prohibited because it is contrary to the covenant of marriage, the unity of the spouses, and the dignity proper to parents and the child. (no. 40)

 Homologous artificial fertilization (that is, any technique used to achieve conception using the gametes of the two spouses joined in marriage) is prohibited when it separates procreation from the marital act in its unitive significance (e.g., any technique used to achieve extra-corporeal conception).  (no. 41)

 When the marital act of sexual intercourse is not able to attain its procreative purpose, assistance that does not separate the unitive and procreative ends of the act, and does not substitute for the marital act itself, may be used to help married couples conceive. (no. 38)

      The fifth principle is likewise presented in the Ethical and Religious Directives for Catholic Health Care Services of 1994:

 Those techniques of assisted conception that respect the unitive and procreative meanings of sexual intercourse and do not involve the destruction of human embryos, or their deliberate  generation in such numbers that it is clearly envisaged that all cannot implant and some are simply being used to maximize the chances of others implanting, may be used as therapies for infertility.   (no. 39)

 


____________________

 

     1. Congregation for the Doctrine of the Faith, Instruction on Respect for Human Life in its Origin and On the Dignity of Procreation (Donum Vitae) (Washington, DC: United States Catholic Conference, 1987).

      2. Ibid., I.A.1.

      3. Ibid., II.A.2.

      4. Ibid., II.B.4.

      5. Ibid., II.B.6.  The quote is from Pius XII, Discourse to those taking part in the 4th International Congress of Catholic Doctors, September 29, 1949.  The same principle was articulated by Pius XII in the address Christian Norms of Morality (September 29, 1949) and Fertility and Sterility (May 19, 1956).

      6. National Conference of Catholic Bishops, Ethical and Religious Directives for Catholic Health Care Services, Nov. 1994 (Washington, DC: United States Catholic Conference, 1995).

  

COMMENTARY

 GENERAL POLICY ON ASSISTED REPRODUCTIVE

TECHNOLOGIES (ART) 

      Section (I) of this commentary will present the rationale for the Church’s position on the use of assisted reproductive technologies.  Section (II)  will offer information relevant to counseling infertile couples who may be considering the use of assisted reproductive technologies.   

I. RATIONALE  FOR THE CHURCH’S POSITION ON THE USE OF ASSISTED       REPRODUCTIVE TECHNOLOGIES (ART) 

1) Human procreation must always take place within marriage. 

     First, this principle has to do with the very meaning of marriage.  A child is meant to be the sign of the mutual self-giving of the spouses.  He or she is meant to be the “living image” of the love of the spouses for each other and of their fidelity to each other. (1)  

     Second, a child needs a certain type of environment in which to develop and flourish.  Ideally, this is provided by the marital setting. (2)  Morever, it can be argued that family life based on marriage makes a positive contribution to the welfare of society. (3) 

2) Using  sperm or  ova  from  a  person  outside  the  marriage  to  conceive a child is never  permissible.                                                                                                                                                                         

     First of all, the use of donor sperm or ova violates the unity of the marriage. (4)  When a man and a woman marry, they give themselves exclusively to each other.  The selves they give are sexual and procreative beings.  A husband and wife violate their marital commitment if they give themselves to another in sexual union.  Similarly, they dishonor their marital covenant if they choose to exercise their procreative powers with someone other than their spouse. (5) 

     Second, the use of donor sperm or ova can seriously disrupt and confuse family relationships for the child. (6) For example, the sister or sister-in-law of the wife could donate ova, with that woman  subsequently being both the mother of the child from a biological point of view and the aunt of the child in terms of social relationships.  Or again, it is possible for a daughter to donate ova to her own mother so that her mother may have another child later in life.   In this case, the daughter would be the child’s mother biologically and the child’s sister in terms of social relationships.  The mother would be the child’s grandmother from a biological point of view and the child’s mother in terms  of social relationships. 

     Similarly, sperm might be donated by a brother or brother-in-law of the husband, with that man  subsequently being the child’s father from a biological point of view and the child’s uncle in terms of social relationships.  Further, it is not inconceivable that a father donate sperm to his biological son, so that he would be both the child’s father biologically and his/her grandfather in terms of social relationships.  Indeed, since sperm can be successfully frozen, a child could be conceived using sperm taken from a man who has already died. 

     These examples illustrate the rupture between biological parenthood and responsibility for upbringing that current reproductive technologies have made a possibility with the use of donor sperm or ova.  Such a confusion of  relationships is not fair to the child because it can adversely affect the child’s personal identity and relationships within the family. 

3) The conception of a child must be brought about as the result of an act of sexual intercourse  between spouses.  The unitive and procreative aspects of the conjugal act should not be separated.  Fertilization should not occur as the direct result of a technical process which substitutes for the personal act of sexual intercourse between spouses.   

     The inseparability principle, namely, that the unitive and procreative aspects of the act of sexual intercourse may not be separated, was articulated by Paul VI in Humanae Vitae. (7)  From the case of contraception, it was analogously applied to assisted reproduction in the Instruction on Respect for Human Life in its Origin and On the Dignity of Procreation: 

Contraception deliberately deprives the conjugal act of its openness to procreation and in this way brings about a voluntary dissociation of the ends of marriage.  Homologous artificial fertilization, in seeking a procreation which is not the fruit of a specific act of conjugal union, objectively effects an analogous separation between the goods and the meanings of marriage.  (8) 

     The rationale for the inseparability principle is found in natural law ethics: 

At this point, the Instruction presupposes a certain understanding of natural law that has played  an important role in Catholic moral analysis for centuries.  According to this view, the natural, biological functions of the human organism have definite purposes, which can be recognized  as such and which place moral parameters on human activity.  Traditionally, the sexual function was seen within this framework as having only one primary purpose, namely, the procreation of children.  However, in this century, Catholic theologians, and eventually, the magisterium itself, have acknowledged that the sexual act has two primary purposes, the unitive (that is, it serves to express and strengthen the personal relationship between the partners) and the procreative.  In distinction from the earlier view, these purposes are seen as equally fundamental, but at the same time, they are also held to be inseparable.  That is, any  exercise of the sexual function that is deliberately closed to either of these goods is morally prohibited, because such an action would directly contravene one of the purposes built into the structure of the act of sexual intercourse.  Such an action would not only be a violation of human nature, it would also be a transgression of the law of God, who is the author of human  nature. (9)  

     According to natural law theory, moral rightness and wrongness is grounded in our human nature.  The two purposes of sexual intercourse, the unitive and the procreative, are naturally found in the same act.  Methods of bringing about the conception of children apart from a personal act of sexual intercourse violate our God-given human nature.  For this reason, such methods are to be judged morally impermissible. 

     Some theologians have maintained that the inseparability of the unitive and procreative aspects of sexual intercourse applies to the marriage as a whole.  In other words, each marriage must be a loving union which is open to procreation, which may well be true even if the inseparability is not present in each individual act of intercourse.  However, the magisterium has consistently interpreted the inseparability principle as applying to individual acts of sexual intercourse as well as to the marriage as a whole. (10) 

     In an address at the University of Chicago, the late Joseph Cardinal Bernardin noted that human  sexual activity, unlike the sexual activity of animals, is part of human intimacy.  In other words, human sexual activity is part of our ability and our desire to enter into relationships with other people. (11 ) This dimension of human sexuality is taken away when purely technological procedures  are used to have a child.  Consider the comments of one couple who used a reproductive technology to have a child: 

...few, I believe, would have qualms about the sort of artificial insemination that Lisa and I have undertaken and yet perhaps the most difficult part of AIH for us has been the struggle to maintain a degree of intimacy in the process of reproduction in the midst of a clinical environment designed to achieve results. ...the ideology of technology that fuels this commodification...is a way of thinking of ourselves and our world in “mechanical, industrial terms,” terms that are incompatible with intimacy.  Interestingly, the Roman Catholic Church  has rejected AIH precisely because it separates procreation from sexual intercourse and the expression of love manifest in the conjugal act. ...there is an insight here that should not be overlooked.  Once procreation is separated from sexual intercourse, it is difficult not to treat  the process of procreation as the production of an object to which one has a right as a producer.  It is also difficult under these circumstances not to place the end above the means; effectiveness in accomplishing one’s goal can easily become the sole criterion by which decisions are made.

 

This, anyway, has been my experience.  Although Lisa and I tried for a time to maintain a degree of intimacy during the process of AIH by remaining together during all phases of the procedure as well as after the insemination, we quickly abandoned this as a charade.  The system neither encourages nor facilitates intimacy. ...A conception, if it takes place, will not be the result of an act of bodily lovemaking, but a result of technology.  We have come to accept this.  Yet, such acceptance comes at a price, for our experience of reproduction is discontinuous.  A child conceived by this method is lovingly willed into existence, but it is not conceived through a loving, bodily act. (12) 

     Regarding the Catholic Church’s rejection of certain reproductive technologies, Cardinal Bernardin pointed out that the Church “speaks against these procedures not because it is opposed  to the generation of life or to scientific knowledge and application, but because it seeks to protect what it sees as an essential connection between the creation of life and faithful, committed marital  intimacy.” (13)  

     Two more arguments are offered in the Vatican Instruction in support of the position that the conception of a child should be brought about as the result of a personal act of sexual intercourse between spouses rather than by a technological process which replaces that act.  The first is “rooted in the ‘theology of the body’ set forth by Pope John Paul II.” (14)  It is that purely technological means of reproduction apart from the  act of sexual intercourse between spouses “fails to respect the ‘language of the body’, ” that is, “the deep human significance of the personal gift, bodily and spiritual in nature, of husband and wife to one another in the marital act.” (15)     

     The second line of argument is that purely technological means of reproduction are offensive to the dignity of the child in reducing him or her to an “object” or “product.”  (16) This was noted by the aforementioned couple who used artificial insemination: “Once procreation is separated from sexual intercourse, it is difficult not to treat the process of procreation as the production of an object to which one has a right as a producer.” (17)   In the opinion of theologian William May, the fact that “bringing new human life into being in the laboratory is a form of production and depersonalizes  human life by treating it as if it were a product” is “the most straightforward argument against resorting to the laboratory generation of human life.” (18) 

4) The use by spouses of technological methods in reproduction is not entirely precluded, but such methods must meet the following condition to be permissible: the method must  facilitate the natural act of sexual intercourse or assist that act to achieve its objective of conceiving a child once it has been naturally performed. 

     A method of assisting reproduction which meets this condition would respect the natural connection between an act of sexual intercourse and the conception of children.  It would also respect the personal nature of the conjugal act and of human procreation. (19) 

5) Techniques of assisted reproduction may not be used which involve the deliberate              destruction or wastage of human embryos. 

     The Catholic tradition regards human life as beginning at the time of conception.  This view is based on biological evidence.  At the time of conception, the genetic instructions for a new individual are put together. These instructions determine that the new being who is developing is  a human being and underlie at least some of the individual characteristics this person will have. The fact that the identity of a new human individual is established at conception is taken as evidence that we have a complete human being---body and soul---present from the time of conception. (20) 

     Hence the new human being must be respected as a person from conception, and his or her life must be protected: 

Thus the fruit of human generation, from the first moment of its existence, that is to say from the moment the zygote is formed, demands the unconditional respect that is morally due to the human being in his bodily and spiritual totality.  The human being is to be respected and treated as a person from the moment of conception; and therefore from that same moment his rights as a person must be recognized, among which in the first place is the inviolable right of every innocent human being to life.

 

This doctrinal reminder provides the fundamental criterion for the solution of the various problems posed by the development of the biomedical sciences in this field; since the embryo  must be treated as a person, it must also be defended in its integrity, tended and cared for, to the extent possible, in the same way as any other human being as far as medical assistance is concerned. (21) 

     Destroying a zygote or embryo is not morally permissible because it is killing a human being.  It is the equivalent of abortion. (22) Similarly, it is not morally permissible to create a number of embryos to try to maximize the chances of achieving a pregnancy when it is unlikely that all of the  embryos will implant in the woman’s uterus and develop.  When someone knows in advance that some embryos will be wasted in the procedure, he or she knowingly engages in an action bringing about the death of the embryos. 

 

II. COUNSELING INFERTILE COUPLES 

     Infertility is defined as the inability to conceive after at least one year of trying to do so. (23)

It is not an uncommon problem.  In the United States, about one in twelve couples is affected by infertility. (24) 

     In counseling infertile couples it is essential to recognize that experiencing infertility is emotionally stressful, for both women and men. Persons faced with a diagnosis of infertility often “experience the same deep sense of loss that they would feel with the death of a loved one” (25), and they may go through stages similar to what is felt by persons dealing with a terminal illness. (26) Their shock and disbelief when learning of a diagnosis of infertility may be followed by denial of having a problem, finding excuses to rationalize why attempts to have a child have been unsuccessful.  They may go through a stage of isolation in which they withdraw from family and friends who have children.  The partner who has a physical problem causing infertility may feel guilty about depriving his or her spouse of children.  A couple may feel a sense of unfairness about their infertility, and react with anger. (27) In fact, “just looking at another pregnant woman, seeing a woman breast-feeding a baby, watching a baby pushed in a stroller, or running into a person buying disposable diapers in the market can create resentment.” (28) 

     The following anecdotal accounts illustrate the emotional trauma of married persons experiencing infertility: 

I remember going to a first birthday party for my best friend’s son.  My husband and I had been trying to conceive, but had met with no success.  I knew it was going to be uncomfortable at times, but I thought I could handle it.  After all I had been in worse situations.  Or so I thought.  As other one-year-old children filled her backyard, I found myself creeping toward  the corner.  When the cake was brought out, I looked into my friend’s eyes.  They were filled with joy.  It was one of the happiest moments of her life, and unfairly, one of my saddest.  After quickly sneaking out, I sat in my car and cried my eyes out, I’d never realized the intensity of my pain.  I hadn’t allowed myself to feel it, until it exploded out of me.

                                                                       ---Eileen, age 30 (29) 

I remember driving home from work on the freeway a couple of days after I learned that my  wife’s IVF procedure was not successful.  A news broadcast came on the radio.  Another baby  was found in a dumpster in New York.  I lost it.  I started screaming at the radio like a lunatic.  “Are you...kidding, you threw it away!”  It was incredible to me.  Here I was doing everything  I could in life to get my wife pregnant, and some sick person threw away their baby.  Their own flesh and blood.  How could it be that they could have it and discard it like a piece of trash, something we wanted more than anything in the whole world?  Preoccupied with the broadcast, I got too close to the car in front of me.  Fortunately, I still had a split second to slam on my brakes.  Otherwise, that little broadcast could have put me over the top.

                                                                ---Matthew, age 40 (30) 

     Such feelings may push infertile couples toward the use of assisted reproductive technologies.  In their desperation to have a child, some couples suffering from infertility may find it difficult to accept limitations on the methods of assisting reproduction which they can legitimately use.  Here one must be cautious about individuals falling into the mentality of saying that spouses have a “right” to a child by any means whatsoever: 

But is a married couple, in which one or both partners are infertile, justified in acquiring a child by any biological means?  Is the unremitting desire for a child a longing for personal fulfillment and marital wholeness, or is it an example of an inordinate desire?

 

...’On what rational ground is it urged that while sexual desires ought not to be indulged at will,  parental desires may be?...If we persuade ourselves that because we want a thing so much it must be right for us to have it, do we not thereby reject in principle...the very idea of limitation, acceptance, or a given natural order and social frame...the creatureliness of man?’  (31) 

Thus the Instruction reminds us that a child should be viewed “not as an object to which one has a  right” but  as “a gift, the ‘supreme gift’ and the most gratuitous gift of marriage.” (32) Concomitantly, as one theologian has pointed out, “each spouse should understand that the marriage covenant, ‘for better or for worse,’ encompasses also the unfortunate possibility that infertility may characterize their union.” (33) 

     Further, infertile couples need to recognize that, from a purely practical point of view, the use of assisted reproductive technologies will not guarantee them a child.  The failures, disappointments, and costs  which accompany the use of assisted reproductive technologies was described in a feature article in  Newsweek in 1995: 

Jodi Peterson, 36, still can’t believe it has come to this.  After eight months of failing to conceive right after her 1991 marriage, she found herself in the maw of the infertility machine.  She and her husband, who live in suburban Maryland, endured a year of tests, from semen analysis to injection of a dye to see if her fallopian tubes were blocked.  Their clean bill of health was, in the mirror world of infertility, perhaps the worst news they could have received: it meant the doctor had no idea why Peterson wasn’t conceiving.  So she went through months of daily infertility drugs.  She put up with nine intrauterine inseminations (IUIs), in which sperm are shuttled by catheter directly to the uterus.  Her bills had topped $40,000, and insurance covered nothing.  Then her doctor discovered that Peterson’s tubes, contrary to what she had been told, were hopelessly blocked: she had undergone a year of treatments that can work only with healthy tubes.  So Peterson tried in vitro fertilization (IVF), in which eggs are retrieved with an ultrathin needle, fertilized in the lab and inserted into the uterus, bypassing the tubes.  That resulted in a potentially fatal ectopic pregnancy.  She has now had three more  IVFs.  “Do I have second thoughts?” Peterson asks.  “You bet -- every time I write out a $2,500 check for fertility drugs.  Now I accept the fact that we’re not going to have biological children.  I’ve grieved enough.  I have to move on.”

 

First they live by the unbending rule of the calendar, keeping their doctor-ordered appointments for conjugal relations on the prescribed three days of every month...even though it now brings them all the joy of taking out the trash.  Then they become human pincushions, their rear ends sore from twice-a-day hormone shots that sometimes make their ovaries inflate  to the size of baseballs.  They spend at least $10,000, and as much as $100,000, on diagnostic  tests and fertility drugs and the crapshoot known as assisted-reproductive techniques -- a.k.a. test-tube babies.  They cringe when friends counsel them to “give it time” when time is their  relentless foe.  They fume at insurers who regard infertility treatments as experimental, or even as a frivolity on a par with a nose job.  They are childless.  And more and more of them are mad -- fighting, suing, e-mail flaming mad -- at an infertility industry that offers a lot of hype, a lot of hope and not enough babies.  After 20 years of scientific advances, nearly three out of four couples seeking assisted reproduction still go home to an empty crib. (34) 

     While experiencing infertility is psychologically stressful, so is the use of assisted reproductive technologies. Couples report feelings of  being on an “emotional roller coaster” because of the hopes held out to them and the disappointments which occur. (35) Couples can also experience grief over the loss of embryos.  This reaction is noted in the aforementioned  Newsweek article: “Carolyn and Craig May tried IVF in May.  When it failed, says Craig, ‘it was like losing a child you never really had.’” (36) As noted by Jodi Peterson in the same article, couples may eventually have to accept failure, which may also involve a grieving process: “Now I accept the fact that we’re not going to have biological children.  I’ve grieved enough.  I have to move on.” (37) 

     Counselors might well explore with  infertile couples the possibility that their unfortunate situation provides “the occasion for other important services to the life of the human person.” (38)  Here is a story from a priest in Wisconsin which illustrates this: 

I know such a couple who very much longed for children of their own.  After years of trying to conceive and unsuccessful attempts at corrective surgeries, they adopted two boys with severe disabilities.  It seems that the Lord has endowed them with the special gifts that they need to care for these boys.  Few people could care for them as they do.  Because they were unable to conceive, they discovered their unique vocation to share God’s life and love in a manner that few could.  Those unable to conceive have not been forgotten by God, rather they have a unique vocation that only they can fulfill.  May they listen to God’s voice as He calls them to share his life and love. (39)

 

 

___________________ 

     1. Congregation for the Doctrine of the Faith, Instruction on Respect for Human Life in it Origin and On the Dignity of Procreation (Donum Vitae) (Washington, DC: United States Catholic Conference, 1987): 

For human procreation has specific characteristics by virtue of the personal dignity of the parents and of the children: the procreation of a new person, whereby the man and the woman collaborate with the power of the Creator, must be the fruit and the sign of the mutual self-giving of the spouses, of their love and of their fidelity... 

The parents find in their child a confirmation and completion of their reciprocal self-giving: the child is the living image of their love, the permanent sign of their conjugal union, the living and indissoluble concrete expression of their paternity and maternity.  (II.A.1) 

     2. Ibid.: “The child has the right to be conceived, carried in the womb, brought into the world and brought up within marriage: it is through the secure and recognized relationship to his own parents that the child can discover his own identity and achieve his own proper human development.” (II.A.1)  Pastoral sensitivity is needed in applying this statement.  First, the number of single parent families has  increased since the Instruction was written in 1987.  Given the challenges already faced by single parents, one must be careful not to imply that they are intrinsically inferior parents or that their children are hopelessly disadvantaged.  Second, the strong claim that a child has the right to be brought up within marriage should not be misinterpreted to mean that aborting a child is preferable to him or her being born to a single parent.   

     3. Ibid., “By reason of the vocation and social responsibilities of the person, the good of the children and of the parents contributes to the good of civil society; the vitality and stability of society require that children come into the world within a family and that the family be firmly based on marriage.” (II.A.1) 

     4. Ibid.: 

The fidelity of the spouses in the unity of marriage involves reciprocal respect of their right to become a father and a mother only through each other. (II.A.1)

 

Respect for the unity of marriage and for conjugal fidelity demands that the child be conceived in marriage; the bond existing between husband and wife accords the spouses, in an objective and inalienable manner, the exclusive rights to become father and mother solely through each other.  Recourse to the gametes of a third person, in order to have sperm or ovum available, constitutes a violation of the reciprocal commitment of the spouses and a grave lack in regard to that essential property of marriage which is its unity.  (II.A.2) 

     5. William E. May, “Donum Vitae: Catholic Teaching Concerning Homologous In Vitro Fertilization” in Kevin William Wildes, S.J. (ed.), Infertility: A Crossroad of Faith, Medicine, and Technology (Boston: Kluwer, 1997), p. 74.  

     6. Congregation for the Doctrine of  the  Faith, Instruction: “Heterologous artificial fertilization violates the rights of the child; it deprives him of his filial relationship with his parental origins and can hinder the maturing  of his personal identity.  Furthermore, it offends the common vocation of the spouses who are called to fatherhood and motherhood: it objectively deprives conjugal fruitfulness of its unity and integrity; it brings about and manifests a rupture between genetic parenthood, gestational parenthood and responsibility for upbringing.  Such damage to the personal relationships within the family has repercussions on civil society: what threatens the unity and stability of the family is a source of dissension, disorder and injustice in the whole of social life.” (II.A.2)  

     7. Paul VI, On the Regulation of Birth (Humanae Vitae), 12 (Washington, DC: United States Catholic Conference, 1968).  Cited in Congregation for the Doctrine of the Faith, Instruction II.B.4. 

     8. Congregation for the Doctrine of the Faith, Instruction II.B.4.  A brief reference to the inseparability principle in the context of assisted reproductive technologies is given in John Paul II’s Evangelium Vitae (1995), 14.  

     9. Jean Porter, “Human Need and Natural Law” in Wildes (ed.), Infertility: A Crossroad of Faith, Medicine, and Technology, pp. 96-7. 

     10. Carol Tauer, “Donum Vitae: Dissenting Opinions on the ‘Simple Case’ of In Vitro Fertilization” in Wildes (ed.), Infertility: A Crossroad of Faith, Medicine, and Technology, p. 136.  

     11. Joseph Cardinal Bernardin, “Science and the Creation of Human Life,” Origins 17/2 (May 28, 1987):  21, 23-6 at 24. 

     12. Paul Lauritzen, “What Price Parenthood?” Hastings Center Report 20/2 (March/April 1990): 38-46 at 43.

     13. Bernardin, “Science and the Creation of Human Life,” p. 24. 

     14. May, “Donum Vitae: Catholic Teaching Concerning Homologous In Vitro Fertilization,” p. 77. 

     15. Ibid.  The Instruction states: “The moral value of the intimate link between the goods of marriage and between the meanings of the conjugal act is based on the unity of the human being, a unity involving body and spiritual soul.  Spouses mutually express their personal love in the ‘language of the body,’ which clearly involves both ‘sponsal meanings’ and parental ones.  The conjugal act by which the couple mutually express  their self-gift at the same time expresses openness to the gift of life.  It is an act that is inseparably corporal and spiritual.  It is in their bodies and through their bodies that the spouses consummate their marriage and are able to become father and mother.  In order to respect the language of their bodies and their natural generosity, the conjugal union must take place with respect to its openness to procreation; and the procreation of  a person must be the fruit and the result of married love.  The origin of the human being thus follows from a procreation that is ‘linked to the union, not only biological but also spiritual, of the parents, made one by the bond of marriage.  Fertilization achieved outside the bodies of the couple remains by this very fact deprived of the meanings and the values which are expressed in the language of the body and in the union of human persons.” (II.B.4)  

     16. Congregation for the Doctrine of the Faith, Instruction: “Only respect for the link between the meanings  of the conjugal act and respect for the unity of the human being make possible procreation in conformity with  the dignity of the person.  In his unique and irrepeatable origin, the child must be respected and recognized  as equal in personal dignity to those who give him life. ...He cannot 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.  No one may subject the coming of a child into the world to conditions of technical  efficiency which are to be evaluated according to standards of control and dominion.” (II.B.4) 

     17. Lauritzen, “What Price Parenthood?,” p. 43. 

     18. May, “Donum Vitae: Catholic Teaching Concerning Homologous In Vitro Fertilization,” p. 77. 

     19. Congregation for the Doctrine of the Faith, Instruction: “This teaching...is based on the Church’s doctrine concerning the connection between the conjugal union and procreation and on a consideration of the  personal nature of the conjugal act and of human procreation.  ‘In its natural structure, the conjugal act is a personal action, a simultaneous and immediate cooperation on the part of the husband and wife, which by the very nature of the agents and the proper nature of the act is the expression of the mutual gift which, according to the words of Scripture, brings about union ‘in one flesh’.”  Thus moral conscience ‘does not necessarily proscribe the use of certain artificial means destined solely either to the facilitating of the natural act or to ensuring that the natural act normally performed achieves its proper end.”  (II.B.6) 

     20. Congregation for the Doctrine of the Faith, Instruction 1.1.  The development of monozygotic (identical) twins from a single fertilized ovum and the biological phenomenon of natural wastage (wherein a significant number of fertilized ova never implant and are simply discharged from the woman’s body) are offered as objections to the contention that ensoulment takes place at the time of conception.  For discussion of these objections and attempts to answer them, see John Mahoney, Bioethics and Belief (London: Sheed & Ward, 1984), pp. 61-69; Benedict Ashley, O.P. and Albert S. Moraczewski, O.P., “Is the Biological Subject of Human Rights Present from Conception?” in Peter J. Cataldo and Albert S. Moraczewski, O.P. (Eds.), The Fetal Tissue Issue (Braintree, MA: Pope John Center, 1994), pp. 52-3. 

     21. Congregation for the Doctrine of the Faith, Instruction 1.1 

     22. Ibid., II.5. 

     23. Mayo Clinic Health Oasis, Treating Infertility, http://www.mayohealth.org/mayo/9609/htm/infertil.htm. 

     24. Ibid

     25.  Richard Marrs, M.D., Lisa Friedman Block, and Kathy Kirtland Silverman,  Fertility Book  (New York: Dell, 1998), p. 378. 

     26. Ibid

     27. Ibid., pp. 378-86. 

     28. Ibid., p. 384. 

     29. Ibid., p. 376. 

     30. Ibid., p. 385. 

     31. D. Gareth Jones, Brave New People (Grand Rapids, MI: Eerdmans, 1985), p. 127. 

     32. Congregation for the Doctrine of the Faith, Instruction II.B.8. 

     33.  Paul T. Jersild, “On Having Children: A Theological and Moral Analysis of In Vitro Fertilization” in Edward D. Schneider (ed.), Questions about the Beginning of Life (Minneapolis: Augsburg, 1985), p. 46. 

     34. Sharon Begley, “The Baby,” Newsweek (Sept. 4, 1995): 38-41, 43-7 at 38-40. 

     35.  Making Babies CBS 48 Hours (Sept. 1989). 

     36. Begley, “The Baby,” p. 40.

      37. Ibid., pp. 39-40.

      38. Congregation for the Doctrine of the Faith, Instruction II.B.8. 

     39.  Rev. John Doerfler (Diocese of Green Bay, Wisconsin), “In Vitro Fertilization and the Person.” Ethics and Medics 25/5 (May 2000): 3-4 at 4. 

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