Bioethics in Faith and Practice, Volume 4, Number 1

11 Bioethics in Faith and Practice ⦁ 2019 ⦁ Volume 4 ⦁ Number 1 IVF outcomes can also vary depending on whether one, two, or more embryos are transferred. 16 Transferring more embryos will increase the chances of a pregnancy, but is likely to result in twins or higher-order births. 17 Multiple birth is significantly more dangerous for the mother, with a high risk of complications and potential need for cesarean section delivery. 18 Other physical risks of IVF include side effects of hormonal treatment, ovarian hyperstimulation syndrome during pre-treatment for egg retrieval, 19 infection from retrieval or transfer procedures, 20 and risks associated with pregnancy and delivery especially for older mothers. This paper will briefly summarize some historical ethical criticisms of IVF as a practice in itself. The bulk of the paper will then address the ethical significance of issues adjacent to IVF, including the personhood of embryos, preimplantation genetic diagnosis, gamete donation, surrogacy, new gamete combinations, insurance incentives, and the role of biological children. IVF and ethical traditions Some observers may oppose IVF prima facie, seeing any application of this technology as inherently unethical, even when used under the most conservative circumstances -- say, a heterosexual married couple for whom no other infertility treatment options are available, who only extract a few eggs from the wife and implant all embryos that result from fertilization with the husband’s sperm. While this paper will primarily focus on adjacent issues of alternative applications, these objections are worth addressing at the outset. The most common opposition to IVF in principle is based in natural law theory, which holds that “reason recognizes intrinsic goods persons seek for human fulfillment.” 21 In other words, what is good can be logically deduced by observing what people naturally seek. This position was popularized by Thomas Aquinas and remains the predominant perspective of the Catholic church today. 22 The Dignitas Personae, a 2008 instruction from the Catholic Congregation for the Doctrine of the Faith, gives a representative overview of the Catholic natural law position on bioethical issues, including IVF. Like other Catholic documents (most notably the Donum Vitae ), this declaration condemns IVF because it separates reproduction from sexual intercourse between the husband and wife, bringing a deeply personal act into the 16 V. E. Klenov, "Live Birth and Multiple Birth Rates in US in Vitro Fertilization Treatment using Donor Oocytes: A Comparison of Single-Embryo Transfer and Double-Embryo Transfer," Journal of Assisted Reproduction and Genetics 35 (2018), 1657-1664. 17 Samer Tannus et al., "Cumulative Live Birth Rate Following Elective Single Blastocyst Transfer Compared with Double Blastocyst Transfer in Women Aged 40 Years and Over," Reproductive BioMedicine Online 35 (2017), 733- 738. 18 Ammon Goldworth, "The Ethics of in Vitro Fertilization," Pediatrics in Review 20 (1999), 28-31. 19 Wdowiak, "Improving the Safety of the Embryo and the Patient during in Vitro Fertilization Procedures," , 137- 143 20 Artur Wdowiak, Edyta Wdowiak and Iwona Bojar, "Improving the Safety of the Embryo and the Patient during in Vitro Fertilization Procedures," Wideochir Inne Tech Maloinwazyjne 11 (2016), 137-143. 21 N. Steffen, "Core Values in Bioethics: A Natural Law Perspective," Ethics, Medicine, and Public Health 2 (2016), 170-180. 22 D. A. Jones, "Christian Ethics, Roman Catholic," in Encyclopedia of Applied Ethics, Second Edition , ed. Ruth ChadwickElsevier, Inc., 2012), 435-444.