The Dignity of Human Procreation and Reproductive Technologies: Anthropological and Ethical Aspects (Vatican City, 2004, 294 pages).,
The Dignity of Human Procreation and Reproductive Technologies is an edited volume of sixteen essays presented at the Pontifical Academy for Life in conjunction with the tenth anniversary of the Academy's foundation. These essays are directed to an academic audience and would be appropriate for study in bioethics or moral theology courses at an undergraduate or graduate level.
While the essays tackle a number of subjects and do not attempt to form a single argument, together they provide a profound reflection on the human implications of artificial reproductive technology. The contributors to this volume come from a variety of fields - they are psychologists and directors of fertility clinics, bioethicists and professors of law, theologians and medical doctors. At the time of its publication, they included the director of the Linacre Centre in Oxford (now the Anscombe Bioethics Centre), the founder of Naprotechnology at the Pope Paul VI Institute, and the Vice-President of the John Paul II Institute for Studies on Marriage and Family.
Broadly speaking, the volume is structured around three basic questions: what is the vision of human sexuality, childhood, and parenthood implied by artificial reproduction (anthropological); what authentic treatment is available for couples who long to find "in their child a confirmation and completion of their reciprocal self-giving" (Donum Vitae, II, 1) (therapeutic); and what is the proper response of a Catholic citizen, and especially a Catholic politician, in the face of unjust civil laws in the realm of human artificial reproduction (juridical). The remainder of this review will be organized around these three types of questions.
Taken as a whole, the essays of this volume paint a picture of two "logics" which are clearly alternatives at an anthropological level. For example, the reflection on the biblical understanding of human procreation (J. Lozano Barragán, pp. 21-32) stands in stark contrast to the dry and technical description of the history of ART, as it progressed from veterinary science to medicine (A. Bompiani, pp. 43-113). Rather than a vision of sexuality in which the gendered human body is seen to bear the inscription of the capacity to receive and to give love, with artificial reproduction "parents rightly perceive conception taking place in a way which excludes them as a couple," making superfluous their own act of bodily giving and receiving (Helen Watt, p. 33).
Along with these conflicting visions of human sexuality, Livio Melina (pp. 114-126) beautifully sketches how parenthood and childhood acquire different meanings under the logic of ART. "The essence of parenthood" - no longer seen as an obvious consequence of conjugal life, nor as an imploring waiting for a child - "...[is] made to lie in the decision to procreate" (p. 117). Accordingly, parenthood is burdened with a sense of forbidding responsibility, "the myth of total parenthood." As Melina puts it:
"As a result [of the separation of sexuality from procreation], sexuality has fallen into the field of irresponsibility... In contrary fashion, procreation appears as a burdensome responsibility, indeed a grave responsibility: too grave for a man and a woman, who feel that they are alone..." (p. 120)
On the other hand, "the overburden of responsibility involved in taking the direct and total decision to give life... is taken away when at the origins of procreation there is an act of conjugal union" (p. 125). Inseparably united to sexuality, parenthood recovers an element of joy and light-heartedness, even play, just as sexuality recovers an element of responsibility. Parenthood, then, is not first and foremost "a project imbued with huge and daunting responsibilities, but is an agreement to a task" that precedes the parents (p. 125). To this task parents entrust themselves, responsibly, with the help of their child's ultimate Creator.
Similarly, the child herself takes on an alternative logic within the realm of artificial reproduction: that of manufacture, or of "a project to be built" (p. 124). In this regard, the systematic rejection of children who are conceived with detectable illnesses in vitro is not "a somewhat unpleasant episode but rather the consistent consequence of a logic that from the outset does not acknowledge the full dignity of the person of the child" (p. 125). Alternatively, the logic of procreation stands firmly with the words of the philosopher Gabriel Marcel: the child "is never here for me," does not belong to me, "just as I myself do not belong to myself and do not have the possibility of giving existence to myself" (p. 119). One can wish for a child only by "bowing one's knee" (Eph. 3:14). Rather than a project to be built, a child is here seen as a gift to be welcomed - a gift "by which we are the first to be... surprised" (p. 126). Far from being neutral, artificial reproduction implies an alternative vision of what it meant by human sexuality, parenthood and childhood.
It should not be a surprise, then, that this anthropology is deeply felt by women and families who undergo artificial reproductive treatments. This perspective is poignantly provided in the essay of Peter Petersen (pp. 166-177), who spent his career in a reproductive clinic in northern Germany. First documenting the psychological symptoms he has often seen, the tremendous economic costs of ART (about €40,000 per pregnancy), and the problems associated with a physician unwittingly becoming the architect of destiny (such as the time a father of IVF triplets, not financially well off, returned to the doctor and shouted: "I ordered twins at the most! I demand that you pay maintenance!"), Dr Petersen then asks a keenly perceptive question: "[Within ART] how far are we justified in speaking of strong ties of love and an intimate personal relationship? Can the procreating and conceiving partnership of love be attained in the absence of physical aesthetics? I don't mean these questions metaphorically - these are questions of reality." Though he is not Catholic, Petersen's experiences in an IVF clinic lead him to articulate the very questions that the Church persistently proposes to our culture.
Several essays are also devoted to the possibility of real and authentic therapies for some situations of infertility (such as M. Di Pietro and A. Spagnolo, pp. 211-223; R. Marana, pp. 224-231; T. Hilgers, pp. 264-274). These therapies, unlike ART, seek to heal the organic problems associated with infertility; their goal is to repair rather than substitute. In a beautiful essay on the history and purpose of adoption, José Ruiz-Calderón (pp. 249-263) shows how the social institution of adoption has developed with a dual nature: to provide a home for a child and to allow a married couple to receive the gift of being able to offer their love. In sympathy with spouses who are still unable to find a medical solution, the essay shows how conjugal love is always fruitful when placed at the service of the very many human situations in need of generosity and love.
The juridical framework supporting the advancement of ART represents a unique challenge for Catholic citizens, and especially lawmakers, who seek to act according to their conscience. What is the proper response? In a profound reflection on Evangelium Vitae n. 73, Ángel Rodríguez Luño (pp. 199-207) shows that in a situation where "it is not possible to entirely abrogate an unjust law" it is good for a Catholic lawmaker to work for its "partial abrogation" (p. 201). To assure that one's act is a partial abrogation, however, several conditions are outlined, including that "with one's vote one does not become responsible for the unjust normative dispositions which will still be present in the more restrictive law" (p. 203).
Accordingly, the response based on a "principle of pluralism" is inadequate (see also A. Grzéskowiak, pp. 178-198). This principle states, in brief, that though Catholics are absolutely opposed to every instrumentation of human embryos, other citizens are not opposed; and given that everyone participates in the State, it would be unjust to demand that the law wholly admit either position, since the law must be a mediation. This logic fails because the value of life, when it is put to popular vote, is already relativized: deference to pluralism in the context of ART "always means that the law doubts the absolute value of the right to life or relativizes it" (p. 197). Such a compromise would "jeopardize the fundamentals of social life by putting them up for debate" (p. 205).
While the advance of manipulative medicine may at times seem inevitable, the counterweight of Catholic anthropology and ethics is all the more urgent for physicians and couples who seek a real alternative. There is no denying that artificial reproductive techniques constitute the powerful current of the day but, to paraphrase Solzhenitsyn, living fish swim against the current, dead fish merely float with it. This volume of essays represents a bold attempt to swim against the current.