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A Global By-Pass of the Heart

In vitro fertilization is not therapy because “it does not treat whatever pathologies are at the root of couples’ infertility,” writes Tim Muldoon on the Patheos website, taking issue with the Nobel Prize in Medicine awarded to Robert Edwards for his work in developing the techniques of human in vitro fertilization. “Infertility is not a medical condition, but rather the result of other medical conditions” that IVF does not heal. One might argue, he suggests, noting that IVF has become a lucrative industry despite its low (30 percent) success rate, that IVF has allowed the medical community to ignore these underlying pathologies and focus instead on achieving successful pregnancies.

Muldoon, who teaches at Boston College, is suitably and humanely moved by the plight of couples experiencing the trial and trauma of infertility, and he acknowledges that we give thanks for the people who have come into the world through IVF, but he does not allow the brush of modern sentimentalism to blur lines and prettify the truth.

And the truth, as uncomfortable as it may make us, is that on both a physical and a spiritual level, in vitro fertilization—difficult and costly as it is—creates an easier and (spiritually) cheaper way for human beings to focus solely on themselves, and what they want, while ignoring those insights into sacrifices they may indeed be called to.

“It interrupts,” he writes, “the transformative process—the conversion, if you will—experienced by many families who ultimately are led to seriously consider adoption. It feeds the natural desire of parents to be genetically related to their children, but it does not raise the question of whether this desire serves a larger good.”

What Muldoon is describing here is a kind of Global By-Pass of the Heart: we increasingly talk about the “global community” and the need for humanity to get past geographical boarders and boundaries, yet we take every opportunity to circumvent our own heartbreak, our own spiritual challenges by any means necessary. In the case of infertility, it seems we first-worlders hold the needs of third-world global communities—like those with children who desperately need to be adopted—in abeyance, only bringing them into focus once our self-reliant technological options have been exhausted. Their needs finally pierce our awareness when our own desires force us to look their way.

Perhaps this is a mystery of love—that our reaching out to others is always rooted in a both a subconscious desire to acquire, and a surrender of sorts. But if this is so, doesn’t it indicate that there is something wrong, on a primary and instinctive level, when our first yielding—our first act of surrender—is directed, not to God or to a human being in need, but to technology and procedure?

This is no treatise against medical treatment or science, and Muldoon obviously is not making an argument against either, but there is an odd parallel at play here and it involves love and God and surrender. Life is good. We seek it out, and wish to hold on to it.

But lately we find ourselves unable to discern how to live and how to die, because our technological options are so varied, the force for life so inherent and the culture so techno-dependent. Instrumentation is coming between our desires and our gut-instincts—our self-knowledge. When that happens we are delayed in understanding our roles and our callings; we are delayed in understanding who we are.

To want a child of one’s own is a perfectly understandable human sentiment. Our biology is designed for reproduction, and our longing for our husband or wife is oriented toward creating the fruit of children. But when we can’t have children, we ought to consider the notion of “calling,” and ask whether playing Creator via petrie dish serves to distort our understanding of our roles and places in this world, and perhaps in the next as well.

Our reliance on procedure indicates that we have conferred upon science an almost unthinking precedence over spiritual or moral considerations. But morality—a notion more acceptable when pronounced from a position of political correctness—is still a consideration.

So why aren’t the environmental morality police decrying IVF?

God aside, when the standard line among the credentialed gentry is that the world already has too many people on it and “globalists” like Ted Turner are publicly suggesting that one-child policies should be instituted in order to “save the planet” and its “dwindling resources,” can IVF be considered “moral”? And if not, then isn’t there something oddly ironic in the Nobel Committee’s awarding a prize for a procedure that attempts to further populate a world widely asserted to be overpopulated?

Maybe it makes sense, if we think the world is overpopulated with other sorts of people living elsewhere, and that it needs more people like us. Then we can ignore the global community we claim we value, and turn to technology rather than adoption to create our families. If that is the case, what a stinging indictment it makes against us and all of our presumed better angels. That sentiment has nothing to do with love, or surrender, at all.

Adoption is already a complicated, arduous and emotional process; having to look beyond national borders for a child to welcome into your life and home is more complicated still, and while stable couples exhaust their resources to invest in the emotional crapshoot of IVF before finally “giving in” to the possibility that they may, in fact, be called to adoption, countless children grow older and become more difficult to place.

All of which makes me want to go study Pope Paul VI’s encyclical Humanae Vitae once more, and dwell on this: the Church “urges man not to betray his personal responsibilities by putting all his faith in technical expedients.” For those suffering infertility—and no one should underestimate the deep pain of being unable to conceive a child with your loved one—one of those personal responsibilities may be to surrender, and reach out and gather the global community together, one child at a time.

Elizabeth Scalia is a contributor to First Things where she blogs as The Anchoress. Her previous articles for "On the Square" can be found here. Tim Muldoon's IVF column may be read here at the Patheos website, whose Catholic portal Scalia edits.

Comments:

12.14.2010 | 4:53am
Supernova says:
It's such a cynical look at a science that has not been seen in the past as controversial.

There's nothing wrong with adoption, but you hold it to a standard greater than IVF without explaning the difference. You mention IVF as difficult and costly - as is adoption. It doesn't treat the pathologies at the root of a couples' infertility - nor does adoption.

You make it sound as if science has given up on making pregnancy more successful by surrendering to IVF - IVF is the answer to a more successful pregnancy. But it's not perfect, nor is it the apex of pregnancy creation, so it's likely that scientists are still working on a better solution (in the same way that scientists worldwide didn't give up on childbirth after developing the Cesarean Section).

There is a true problem of children needing adoption, and there is coincidentally a new solution to the problem that's being overlooked - gay couples want to adopt children. And because there are more gay couples than ever before, there is a greater need for adopted children. Because of this greater need, this problem doesn't have to be an either/or proposition. IVF can supplement this greater demand for kids. If only it wasn't so hard for gays to adopt...
12.14.2010 | 7:30am
Degu says:
Yeah, let's solve one problem by making another. Good thinking.
12.14.2010 | 9:18am
David Nickol says:
There may be much that is true in this post, but I am disturbed by the implication that in order to be "therapy" a medical intervention must "treat whatever pathologies are at the root" of a given problem. It seems to me this would rule out pain medication, insulin for diabetes, dialysis, tube feeding, hospice care for the dying, antihistamines for allergies, prosthetic limbs, and a whole host of other treatments.
12.14.2010 | 9:28am
olivia says:
"to want a child of one’s own is a perfectly understandable human sentiment." no, i think is THE MOST understandable human feeling, it's in our nature..imagine the frustration of the ones who can't naturally have children.
12.14.2010 | 9:35am
Adoptive Dad says:
Supernova-

I am not sure if naivete is not a worse problem than cynicism. As the parent of two children, one adopted and one "traditional," (in that order) I think I have a perspective on this that others may not.

We were heavily encouraged by the medical professionals to undergo IVF at tens of thousands a clip, most of which insurance would have picked up. It was my wife who managed to frame the question in a manner that made brutal sense:

"Who, in their right mind, enters into an arrangement with a car dealer who promises that, 'if you plunk down $20K, there is a 20% chance you'll drive off the lot with the car of your dreams'?"

So we opted to to adopt.

People need to keep a few facts in mind that they would rather not. First, the technical name for an "unsuccessful" IVF treatment is a miscarriage. A human life ends.

Second, there is a reason there is an epidemic of infertility in the developed world: The over reliance on technical expedients, specifically oral contraceptives and abortion.

Third, ever notice that the abortion clinics are in the poor neighborhoods and the fertility specialists have tonier addresses? Probably just a coincidence.

Also- a nice red herring about homosexual adoptions. Given the fact that homosexuals are a relatively small portion of the population (far less than Kinsey's 10%) and of that group, a small percentage wish to live in monogamous relationships and be a "family," the number of children helped is small, and could be easily dealt with families doubling up. The only reason we did not adopt again is the fact it was too expensive and there was no help as there would have been with IVF.

The final, and perhaps largest issue to be dealt with is the fact that no woman is owed the pregnancy of her dreams nor any parent the perfect child.
12.14.2010 | 10:44am
Supernova makes reasonable points, but I think is discussing something slightly different. The post is about individual decisions and calling, and about the granting of cultural approval, not about whether we should allow scientists to develop new techniques. We treat IVF as an unqualified good when it is essentially neutral. I don't want to push the comparison too far, but IVF is a bit like cosmetic surgery. The techniques are not condemnable, they are certainly beneficial in many instances, but there is some element of people resorting to it who should perhaps not.

We have five, BTW, two traditional, two adopted from Romania, and one nephew taken in because of parental irresponsibility. I don't know how much that skews my view.
12.14.2010 | 10:48am
BTW, the dynamic of the "wrong sort of people being born" driving some political, environmental, and cultural debate is quite real. People say what they really mean if you let them talk long enough, and the dark underside of some supposedly enlightened beliefs reveals itself
12.14.2010 | 11:20am
Heather King says:
The desire to get together with another human being and create something new that is bigger than either of us is part of our glory. But it seems that when the desire becomes so great that we're willing to resort to technology, the desire is no longer so much about giving life to a child as about giving life to the parents. We hear a lot about the "right" to have a child, but what about the right of a child to not be conceived in a Petri dish? What about the right of the child not to come into the world as as chattel that has been engineered, bought and sold? The schizophrenic culture that on the one hand supports abortion and on the other supports IVF is basically saying: We don't want just any human being: we want OUR human being.

In fact, the whole notion of the "right" to have a child is abhorrent--shouldn't it be more the mystery of participating in the miracle of a child, if and when the event should occur? The deeper point is that IVF--like all the myriad ways we try to "take the shortcut," whether reproductively, sexually, psychologically, financially, or spiritually-- bypasses the true crucifixion of abandoning ALL IDEA THAT WE GET TO SEE OUR LIVES BEAR FRUIT THE WAY WE WANT THEM TO, the way we envision, the way we think they should, the way our hearts long to the point of death for. This is the scandal of the Cross. The scandal of a Savior who died in the prime of his life without issue, his beautiful body butchered, his life and work an apparent failure. Nothing to show for all his love. Nothing to "show", for the life he was offering up--except us...

So it's not that we don't welcome with open arms all children, however conceived. It's not that we don't fully acknowledge the sacrifice, suffering and love of the parents of chidren who have been conceived by IVF. But it is that we're bound by truth to acknowledge that the full Cross has been bypassed...
12.14.2010 | 12:23pm
J Shelton says:
After going through infertility for ten years and then being dropped from the only round of IVF I ever did because I didn't respond to the drugs at all, I feel uniquely qualified to respond to this argument. As Christians, you are missing the point. Do you really believe that anything we puny humans do to ourselves or for ourselves will thwart the will of the living God? If God does not want you to have a child then you never will. If God wants you have a child then not even being well past childbearing age will be an obstacle. Will we never believe that he is God and we are just human sinners? By the way, after being dropped from IVF I conceived twins who are now healthy eight-year-old boys.
12.14.2010 | 12:47pm
I've wondered if God has allowed so many wonderful and good people to be unable to bear children lately so that they may be brought around to providing steady and loving homes to the many children that would not have them otherwise. It is an opportunity for a tranformation within all hearts involved.
12.14.2010 | 12:52pm
Mr. Graves says:
I can't let this opportunity pass to share a link I found the other day. It seems that UNICEF is making international adoptions more difficult.

Here's a quote: "In brief: UNICEF has been at the forefront of pressuring national governments to set up so many hurdles as to make international adoption rare and extremely time-consuming. The result is that children languish in miserable, hellish orphanages for years. During the critical early months and years in which interaction with loving parents is essential to a child’s normal brain development, the children are neglected and left in squalor."

http://tiny.cc/f5srv
12.14.2010 | 1:30pm
Bender says:
**What about the right of the child not to come into the world as as chattel that has been engineered, bought and sold?**

___________

This, of course, is the linchpin of the entire issue -- the objectification of the human person. Treating persons as things, as objects of commerce, and advancing a utilitarian mechanization of human sexuality, rather than a humanization of sexuality.
12.14.2010 | 1:40pm
Grace says:
I went to China to adopt our 5th child, after 4 bios. I went with a dozen infertile couples. All of them had been married for many years and had gone through many treatments, including IVF. I wondered at the wasted years of their lives, when I saw each of them holding their new beautiful chinese daughters. That was parenthood right there, that had eluded them for so long. I agree with the author, that they had tried to get what they wanted through technology and painful treatments. All along what they wanted was waiting for them in a concrete orphanage on the other side of the world.
Just writing about it makes me desperately want another!!!
12.14.2010 | 3:00pm
Jessica says:
Wonderful comments all. As a physician, I've spent a great deal of time thinking about what are legitimate treatments for actual physical illnesses (ie. what treatments are truly attempts to restore health) and which are, what I term, "lifestyle medicine." IVF and, indeed, much of reproductive health centers around the idea of infertility as a disease which it is in some cases but not in all. Infertility, after a certain age, is physiologically normal. It is normal for it to become harder to conceive as one ages. So IVF is not necessarily a treatment for disease at all. In so many cases, it seems to be a response to a society that demands the right to fertility.

In a side note, as Adoptive Dad's wife stated, why would anyone pay so much for so little return? Furthermore, why would insurance cover this? Insurance regularly fails to pay for actual medical treatments with greater success rates than IVF, so I'm frankly surprised that it covers a risky procedure costing tens of thousands of dollars with low chances of success.
12.14.2010 | 3:15pm
Spencer says:
Nothing happened for many months. At the Christmas Eve children's mass in 1990, I looked around me at all of the happy families with children, and prayed that if we weren't successful in the next few months we would seek a private adoption. We were both too old for the long waiting lists at Catholic Social Services or our local Children's Home Society. Little did I know that God had already taken care of the problem. We would soon discover that our baby had been successfully conceived only a few days before my prayer!

Our OB/GYN declared our son to be a miracle, and we were oh so careful over the next nine months. As of now, he has successfully completed his first semester at college.

Through God's good graces, we were able to thank him in January 2001 by bringing home a beautiful baby girl from China. She just turned eleven this month. I didn't think it possible, and it did take a little time, but now I love this child as much as my biological child. I believe that most couples worry about two things when they adopt. First, they worry that the adoption will be dissolved by some court action. There are many stories about these situations. This is why so many go to international adoptions. In our case, we knew from the day we received our referral that our daughter was truly abandoned and that no one knew who her biological parents were, and they knew not what happened to her. Second, prospective parents worry that they won't feel as attached, committed, bonded, etc., as they would if the child were biological. Although everyone is different, my experience, along with a large support group of adoptive families with Asian children, leads me to believe that familial love is the likely positive outcome.

Maybe the uncertainty of adoption drives couples to deal with the uncertainty of technology first. Maybe it's easier to have faith in technology.
12.14.2010 | 4:34pm
Robert Moody says:
And what about all the "extra" embryos produced by IVF only to be discarded like trash or (perhaps worse) frozen for indefinite periods of time?
12.14.2010 | 6:07pm
MomProf says:
As one who has actually PLACED a child for adoption, I do not agree with the glorification of it by so many people. Placing a child for adoption is in many ways like a death - except without the community comfort that one receives at wakes, funerals, etc. A huge piece of your life, your body, your soul, is gone. And yes, I prefer it to abortion, heaven knows. But glossing over it does an enormous disservice to those of us who have been through it.

And so I detect a bit of first-world sanctimoniousness is Elizabeth Scalia's blithe critique of IVF as being less worthy than adopting children from third-world nations. Frankly, I am a little tired of Hollywood celebrities proving their compassionate bona fides by going and getting "little brown babies" (to quote Agatha Christie) from poor nations. And I think it is every bit as legitimate to be concerned about the potential for exploitation in first-worlders seeking to adopt (and pay for!) children from developing countries, as it is to question the wisdom of people going to elaborate medical lengths to have their own biological children.
12.14.2010 | 8:59pm
Adoptive Dad says:
MomProf-

Thank you so much for your sacrifice. There is not a day that goes by that I do not think about the tremendous gift given our family by our daughter's birth mother. I hope and pray somewhere a family does that for you. Many years ago I heard Stanley Hauerwas declare that that one cannot do a moral act without someone getting hurt. I can only imagine. As someone pointed out to me, we often deserve that moment of vindication, that billboard on I95, but we never get it. I grieve for your loss and give thanks for your gift. And know that some vindication is eschatological.
12.15.2010 | 12:23am
Scott S says:
For goodness sake! God created man with a free will, and an intelligence and a thirst for learning. I see absolutely no problem with parents using whatever means are available to have children. If you disagree with this, where would you draw the line? Would you censor news reports that wearing briefs raise the temperature of the testis and thus can lead to fertility problems?

I am an ardent environmentalist, and I do believe that overpopulation is the greatest environmental threat existent today. That's why I support family planning and the liberal use of contraceptives (though I generally oppose abortion).

To deny otherwise healthy people the gift of parenthood is baffling to me.
12.15.2010 | 1:24am
Ben says:
I'm with Scott S here. First, let's acknowledge that the Biblical injunction to take up one's cross is not a command to seek out suffering for its own sake--it is a command to risk anything, even a sentence of capital punishment, in the service of Christ. If adoption really is a sacrifice relative to IVF (and I'm not so sure it is), that does not automatically grant it superior moral status. Scalia says her essay is no treatise against technology, but I think her argument says otherwise. The assertion that "we find ourselves unable to discern how to live and how to die, because our technological options are so varied, the force for life so inherent and the culture so techno-dependent. Instrumentation is coming between our desires and our gut-instincts—our self-knowledge" is far broader than issues of conception. The same could easily (and probably more truly) be said of information technology and labor-saving devices. Yet I don't see anyone advocating doing all the dishes by hand because God calls us to that sacrifice. Quite frankly, I found this article to be a bit of romantic but misplaced hogwash.
12.15.2010 | 4:45am
Bender says:
"Science and technology are valuable resources for man when placed at his service and when they promote his integral development for the benefit of all; but they cannot of themselves show the meaning of existence and of human progress. . . . It would on the one hand be illusory to claim that scientific research and its applications are morally neutral; on the other hand one cannot derive criteria for guidance from mere technical efficiency, from research's possible usefulness to some at the expense of others, or, worse still, from prevailing ideologies. Thus science and technology require, for their own intrinsic meaning, an unconditional respect for the fundamental criteria of the moral law: that is to say, they must be at the service of the human person, of his inalienable rights and his true and integral good according to the design and will of God.(7) The rapid development of technological discoveries gives greater urgency to this need to respect the criteria just mentioned: science without conscience can only lead to man's ruin. . . . Applied biology and medicine work together for the integral good of human life when they come to the aid of a person stricken by illness and infirmity and when they respect his or her dignity as a creature of God. No biologist or doctor can reasonably claim, by virtue of his scientific competence, to be able to decide on people's origin and destiny. . . . These interventions [in procreation] are not to be rejected on the grounds that they are artificial. As such, they bear witness to the possibilities of the art of medicine. But they must be given a moral evaluation in reference to the dignity of the human person, who is called to realize his vocation from God to the gift of love and the gift of life."
--Donum Vitae (Instruction on respect for human life in its origin and on the dignity of procreation), Congregation for the Doctrine of the Faith (Joseph Cardinal Ratzinger, Prefect)(1987)
12.15.2010 | 10:11am
catherine says:
I have a close childhood friend who used in vitro more than a decade ago and got three baby girls. She still has seven frozen embryos in test tubes in lab somewhere--and she pays yearly rent to keep them that way! I don't know what happens if she stops paying rent to keep those tiny children on ice. It's horrific. I suppose she thinks one day she'll have more children, but she's in her late fifties and her husband just lost his job. There is something called Snowflake to adopt embryos but she says that due to her husband's genetics and age of the embryos they wouldn't be accepted. What to do with all the frozen children? That's an ethical dilemma........
12.16.2010 | 1:38am
TXW says:
Wojtyla's Love and Responsibility categorizes the misuse of sexuality into hedonism and rigorism. Contraception falls into hedonism, IVF falls into a form of rigorism. That is, the pleasure of sex is removed from the act and the intent is only procreation. Call it scientific puritanism, if you will. IVF conception does not occur from an act of love, but from a machine; albeit a life is created, but we know good can arise from an evil act. Infertile couples are desperate, and the fertility clinics take advantage. Dr. Hilger's PPVI institute has a higher fertility rate than IVF clinics, but reportedly the two IVF clinics in Omaha do not refer to him. His method, Naprotechnology (a sappy name), is cheap, has few if any side effects, doesn't create sibling guilt (why was I born and my siblings are frozen?), and will never be promoted by the secular world because it is run by a crazy Catholic and named after a maligned Pope. If you are an infertile couple reading this, I suggest you check out their website.
12.18.2010 | 1:30am
Don Roberto says:
God loves you, but if you listen for His voice He will tell you that IVF is wrong. Think about it: Whether you look at it from a natural law perspective or a utilitarian one, it cannot be justified. To create unique human embryos, knowing they will die without the chance to reach their potential, violates natural law and the revealed law. To spend great sums of money gambling on a child of ones own when myriad children cry out for mercy is like any other act of pure self love. It is idolatrous narcisism. I don't see how we can face God after supporting this kind of behavior. But then again we also readily spend thousands on other frivolities—to treat the ailments of our pets, to live in unnecessary luxury, to eat unusual foods, to travel far and wide, etc.—while our neighbors suffer. It's hard to be a saint. That is, however, our purpose in life.

12.20.2010 | 12:25pm
I will stress again, because the same leap was made by Scott S and Ben as was made by Supernova. This is not about forbidding the technology. I have to wonder why folks think that others injecting spiritual caution into a discussion means they are a short step from forbidding something.

I raise the question, not because of any knowledge of your characters, but simply because of the repetition: is there some projection going on? Do you yourself move rapidly from identifying spiritual diciness to outlawing a practice? Check your environmental and criminal justice views first, as those are where it shows up first these days.
8.28.2011 | 11:37am
There may be much that is true in this post, but I am disturbed by the implication that in order to be "therapy" a medical intervention must "treat whatever pathologies are at the root" of a given problem. It seems to me this would rule out pain medication, insulin for diabetes, dialysis, tube feeding, hospice care for the dying, antihistamines for allergies, prosthetic limbs, and a whole host of other treatments. "Who, in their right mind, enters into an arrangement with a car dealer who promises that, 'if you plunk down $20K, there is a 20% chance you'll drive off the lot with the car of your dreams'?"
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