A week after the Nobel Prize went to Robert Edwards for his accomplishments in developing in vitro fertilization as a treatment for infertility—and more than thirty years after Edwards’ first successful IVF procedure in 1978—IVF still looks like an amateur lab experiment. The same ethical matters that troubled science when Edwards created his first test-tube baby remain unresolved, even in the wake of winning the world’s most prestigious prize.
Aimed at creating fertilized embryos, IVF destroys many more than it creates. Aimed at producing successful pregnancies, IVF results in twice as many failed attempts as successes. Aimed at healing the traumatic experience of infertility for many women, IVF brings with it a multitude of traumatic experiences for women—including years of failed attempts, miscarriages, and the difficult choice of which baby to abort when a prospective mother finds she has conceived more embryos than she could bring to term.
As the Nobel website itself clearly states: with IVF, “20-30 percent of fertilized eggs lead to the birth of a child.”
Yes, that means that for nearly one in every three couples, IVF can bring a much-wished-for child into the world. No one can deny that babies are priceless, and, for infertile women especially, it means the world just got better, to finally have a baby of one’s own. Studies have shown that the depression many women experience from infertility is similar to that experienced by people with heart disease or cancer. Sure IVF brings a rocky road of hormones and failed attempts, but the relief and joy that comes with the baby can make it all seem worth the costs.
So certainly a discovery that relieves women of the burden of infertility is worthy of a Nobel prize, right? Right.
But that’s not what Edwards’ development of IVF has achieved. IVF hasn’t cured infertility. If it had, all women who undergo IVF would no longer be infertile. Instead, Edwards has developed a procedure that costs more than $10,000 and rarely is covered by insurance, that comes with significant physical suffering, risks, and psychological burdens of its own, and that is marketed as the only option available to thousands of vulnerable, infertile women today—even though it offers no guarantee of success, and comes with a two-to-one risk of failure.
Of course, it has grown increasingly difficult to criticize IVF, because many of us now know a child who was conceived with IVF; and who could suggest that child shouldn’t be alive? To do so would be truly wrong. No other medical innovation has ever led so directly to the creation of human life. This represents a real, seemingly prize-worthy breakthrough in the history of medicine.
But, like most medical breakthroughs, it comes with a host of ethical ramifications. Even if we put aside the issue of what it means to be able to create people for whatever use we’d like—which is indeed ethically worrisome—there are other, equally troubling costs we can measure. For instance, we know IVF destroys many embryos in the process of seeking to bring one embryo to term. Doesn’t this matter just as much to medical practitioners as the creation of life?
Well, let’s consider that while looking at a recent example of scientific research. Last Friday we heard the horrifying report that during the 1940s American researchers in Guatemala willfully infected hundreds of people with STDs in an effort to find out if penicillin could be used to stop the spread of STDs. This is obviously an ethical and scientific disaster on the face of it; just last week President Obama publicly apologized for this decades-old scandal, since the U.S. government is responsible for funding the research.
Imagine if researchers found a cure for AIDS today; what an amazing achievement that would be! But if, in the process of reaching that cure, researchers infected several participants with AIDS, it would be not praiseworthy but abhorrent. Here’s the difference: The ethical scientist who discovered a cure for AIDS would win a Nobel Prize in Medicine; but the other one—who discovered a cure by using unethical procedures—it would be the journalist who blew the whistle on him who would win the Pulitzer Prize.
With science, as with everything, how we do something is just as important as the result we’re hoping to reach. It’s not okay to find cures to diseases by testing on voiceless people in developing countries. And, as Alfred Nobel well knew, it’s not justifiable to create peace in one place by bombing civilians in another. No matter how worthy a goal, it’s not legitimate to try to achieve peace at any cost. As humans, we are bound by reason and ethics to be humane.
With IVF, the worthy desire to help infertile couples conceive a baby can be so great that it can be tempting to overlook the ethical and human costs: the embryos destroyed in the process that are just as human as the ones created alongside them that come to full term and walk among us; the years of pain and struggle that many women undergoing IVF experience with the assurance that it will lead to a child, when often it doesn’t.
And that is why this year’s Nobel Prize for the discovery of IVF represents a failure. It fails humanity because it overlooks the human costs of IVF; it fails women because it overlooks their suffering that, even thirty years later, is still routine in the procedure; it fails science because it does nothing to encourage ingenuity and research for better treatments to the condition of infertility; and, in perhaps its greatest irony, it fails the legacy of the Nobel Prize itself.
Mary Rose Somarriba is managing editor of First Things.
Comments:
That's about as ethically illuminating as saying "slavery produced cotton."
If not, my point is not dispelled with a simple scientific statement. Your dispute is based on the premise that some humans aren't human until some arbitrary point. Or maybe, your contention is that no amount of destruction is worth worrying about if the end result is some number of births. You're free to hold whatever ethical or philosophical positions you like on those things, but don't confuse them with simple scientific logic.
C.S. Lewis, "That Hideous Strength"
In other words, the vast majority of fertilized eggs are not viable human beings, and discard themselves by failing to mature to embryos, failing to attach to the wall of the womb, or by miscarrying very early.
We don't know about those, because the mother doesn't even know it's going on. Nature does with natural fertilization what it does with IVF. With IVF we just happen to be watching it through a microscope. But it's still nature that does the choosing.
The ethical problem with IVF comes when multiple VIABLE embryos result from the process. If more than 2 or 3 are implanted, bringing them all to term will be problematic. Will the extras be aborted. Clearly, that would be a moral failure.
The extras can be frozen, but will the couple choose to have those thawed and implanted later, or just discard them? Discarding the extras would also be a moral failure, similar to abortion.
I'm not a doctor, but have 2 sons, thanks to IVF.
The view of the Magisterium is easy for libertines to deride. But I am (naively, perhaps) surprised at the ludicrous way they justify the manufacture of embyos—unique human offspring, which if allowed to follow their natural course can be anticipated to mature to whatever arbitrary degree one may choose recognize as human. And the author seems blind to the tens of millions of "could have beens" that "were not" due to the obscene spread of abortion.
As you point out, those born of this process were only one of many siblings that the process created and destroyed. They are obviously God's children—as was King Solomon, despite his origin, and even the most amoral libertines, despite their ultimate destinies, which only God knows—but, as mentioned by GL, the process (reflecting, I think, a profound unwillingness to accept God's will) does remind one of C.S. Lewis' story, or of (Tolkien's) Saruman and his creation of the uruk-hai.
Scientists derive often very substantial advantage, as in the case at hand, by cutting corners and ignoring morality (as we all may do at times), but very often at terrible cost, to society and to their own souls.
IVF technology has much potential for good, as the author writes. It's just one cure for several types of infertility. Calling it a failure is incorrect. IVF can be used within much more ethical bounds than it is currently used today in the US. How the technology is implemented is a gray area and the government has left regulation up to private interests....which of course will be mostly interested in money.
Good can come out of an evil act. The cotton in your underwear was grown on soil tilled by slaves 200 years ago. Please do not accuse this site of hateful talk, there was not a drop in the original post, just arguments.
IVF kids alive today have siblings not of this world, and most every IVF parent has more children awaiting in the next life.
Russell K, Thanks for being a father to your two sons who were brought into the world by IVF. They are much more precious than some here would have you believe. (Children fabricated by vile arts in a secret place by the libertine establishment). Such hateful talk for a religious site.'
First, I was quoting C.S. Lewis. Liberal Christians who admire Lewis must come to understand that he opposed their agenda.
Second, the ends do not justify the means. No one here believes Russell K's sons are anything other than children made in the image of God. Their existence is no less valued than anyone elses. That, however, does not justify IVF, any more than it justifies fornication, adultery or rape, all of which can and have resulted in the procreation of children made in the image of God and all of which, undoubtedly, have resulted in many of our own ancestors, just as it did our Lord's human ancestors. That David's adultery with Bathsheba led to the birth of Solomon and, later, Nathan, both direct ancestors of our Lord, does not justify David's act of adultery. Let's not confuse the issues.
EVERY child is precious. That is exactly the point. The ones lost in the process are as precious as the ones who survive, so it's hard to justify the expected and intended loss of some of the little ones, by the survival and flourishing of others.
And yet, even though the surviving children themselves are precious, it is still possible that the means by which they are brought into the world cause moral harm. Truly, the outcome (even an outcome as good as the birth of healthy, loved children) does not justify the means. Is that hard to grasp, or is this situation somehow an exception to that principle?
If someone were to solve their infertility problem by raping someone else, would it lessen the value of the life of the child born if we were to speak of the rape in the ugly language it deserves? I am not "equating" IVF with rape; I am simply pointing out that speaking of a morally suspect process in accurate but negative language does not devalue anyone's life, it simply places an accurate moral perspective on the process itself.
Imagine if our lives were so desperate that we went on the websites that turn his crankshaft and critiqued what they say...not that many of us would have the stomach for such pursuits.
IVF kids are absolutely priceless as they are children of God.
Survivors of abortion or other forms of attempted murder are absolutely priceless as they are children of God.
Description of Hasty Generalization
This fallacy is committed when a person draws a conclusion about a population based on a sample that is not large enough. It has the following form:
1. Sample S, which is too small, is taken from population P.
2. Conclusion C is drawn about Population P based on S.
I can only speculate why the mainstream medical community has not been interested in Dr. Hilger's research. One reason is ignorance about modern NFP. Old methods of NFP, such as the rythmn method were not effective. I was not taught about fertility awareness systems in medical school, and contemporary students I have spoken with also know very little about fertility awareness methods. Secondly, as I mentioned in my previous post, there is a tendency in academia to scoff at anything in any way connected with religion. The Creighton Model is not exclusively for Catholics, but NFP is strongly associated with the Catholic church. Additionally, Dr. Hilgers is a devout, orthodox Catholic physician (He named his research institute after Pope Paul VI, in honor of Humane Vitae) Last, but not least, there is big money to be made in the IVF clinics. The current tendency among infertility specialists is, unfortunately, to do a cursory investigation of the causes of infertility and, then to proceed swiftly to IVF. There is, I believe, a little bit of arrogance involved here. Why should we (Reproductive Medicine specialists) bother with trying to fix what's wrong with a woman's reproductive system-----we can just make a baby ourselves in our petri dishes! Again, the above is just speculation. Eventually, some of the academics will start to test out and try to reproduce some of Hilger's work. Woman's health will be better when that happens----naprotechnology can treat many conditions other than infertility, such as irregular cycles, PCOS, PMS, abnormal bleeding, ovarian cysts, etc.
IVF has become mainstream, and no one grapples with the moral damage done to those who undergo it.
But even if IVF could be rid of its embryo-destroying aspect (and I don't see any incentive for that at present), it would still be wrong.
It's wrong to conceive a baby outside of the mother's womb.
Even a great longing for a child can't justify bringing it to life this way. There are many desires man has that can't be fulfilled. That's just our human condition.
Also, many doctors are sold (no pun intended) on the idea that the Pill is a panacea for just about any ailment that afflicts women. During a routine gyn visit, I was brow-beaten by the doc for NOT being on the pill. I was given a rather uncomfortable exam following our exchange, during which she became so upset she had to leave the room. Even when I reasonably told her that I was not willing to experiment on my body and my mind with the 60+ different formulations on the market (numerous physical and mental side effects to the Pill), she could not believe that I was would stand up to her and say no.
Sadly, many women never get the chance to say no, and are offered the Pill to "regulate" if they do not want to concieve, and clomid if they do. If it appears to women that these are their only options (and these were the only ones offered to me when I faced infertility), then it's no wonder IVF has become the choice for many women.
Wouldn't it be great if you could treat your PMS/PCOS/PMDD/infertility/anovulation and NOT affect your fertility? That's what makes the Creighton method so awesome. It doesn't look at women as if they are just men with ovaries and a uterus.
