Artificial Insemination 4

Fernando P. Andrada II, PTRP, RN May 13, 2009 BIOETHICS ARTIFICIAL INSEMINATION A. Historical Milleu of the development of the bioethical issue The reproductive revolution is upon us. The past half-century has seen the development of reproductive technologies previous generations could not even imagine. The term reproductive technology refers to various medical procedures that are designed to alleviate infertility, or the inability of a couple to produce a child of their own. These include artificial insemination, in vitro fertilization (or â€Å"test-tube† babies), and surrogate motherhood. These technologies have radically expanded human control over the biological process, and have been designed both to prevent and to achieve successful pregnancy. When successful, these technologies are the miracle of life for couples who have often spent years trying to have a child, and who have exhausted all other avenues for conceiving a child of their own. We are so often amazed how science and medicine have brought human reproduction to new heights. It is not uncommon for us to hear news about a mother giving birth to multiple babies, national geographic and discovery channels showing the process of human reproduction in a laboratory, and the likes, that leave us in awe â€Å"Nakakabilib, and galing naman† is what we often say . But should we accept these technologies as it is. What we often see is already the end of a means. Have we dared assessing the morality of such means? While this new reproductive technologies give great hope to infertile couples and make many new reproductive arrangements possible, they also raise many difficult and complex moral issues and questions. What is the morality of these procedures? What does it mean to separate conception from the act of sexual union? To whom should these technologies be made available? What is the moral status of the fertilized embryos? Those who dismiss these questions as irrelevant or inconsequential show disrespect for human dignity and human life. B. Presentation of the bioethical issue and other related ideas/ issue Definition and Types of Artificial Insemination Artificial Insemination – refers to an assisted method of reproduction in which a man’s semen is deposited into the woman’s reproductive tract through the use of instruments to bring about conception unattained or unattainable by natural fertile intercourse. Two basic types of A. I. 1. Homologous insemination/ AIH – semen is obtained from the husband a. 2 methods employed: i. Homologous artificial insemination – a technique used to facilitate human conception through the transfer into a woman’s vagina of the sperm previously extracted from her husband ii. Homologous in vitro fertilization (IVF) and embryo transfer(ET) – a technique used to facilitate human conception through in vitro fertilization of the generative cells (sperm and ovum) of couple followed by transfer of the newly conceived embryo into the wife’s uterus for gestation. b. Justification for AIH: i. Husband’s impotence ii. Anatomical defects of husband’s urethra iii. Oligospermia – deficient sperm count iv. Some types of spinal injury, and certain physical and psychological problems that hinder normal intercourse. v. Husbands with previous vasectomy for contraceptive purposes who decides to have a child using his stored semen vi. Physiological obstruction in the genital apparatus in virtue of which sperm cannot the ovum in the oviduct 2. Heterologous Insemination /AID –a technique in which the semen is acquired from a donor other than the husband a. 2 methods i. Heterologous artificial insemination – obtain human conception through the transfer into the genital tracts of the wife of a sperm previously extracted from a donor other than the husband. ii. Heterologous IVF and ET – a technique used to obtain human conception through in vitro fertilization of the generative cells (sperm and ovum) taken from at least one donor other that the two spouses in marriage b. Justification for AID i. Husband is sterile ii. Husband carrier of a hereditary disease iii. Wife’s oocytes are defective or also a carrier of a hereditary dse. The Issues 1. Is it morally permissible to procreate outside marriage? 2. Is it morally permissible to separate conception from the act of sexual union? 3. Is it morally permissible to allow fertilization outside the womb? 4. Is it morally permissible to allow a couple to use AI as justification for childlessness? C. Application of Ethical Theories a. Pro-ideas regarding Artificial Insemination Situational Ethics (Fletcher 1954) endorses AI as â€Å"our right to overcome childlessness. Marital Fidelity is more than a legal requirement or a sexual monopoly. It is rather a personal agreement nourished by love for each other which is fulfilled in ensuring that a child born into this world by whatever means. Under Utilitarianism, AIH and AID may promote more good than harm, more happiness than unhappiness, more pleasure than pain for a childless couple. The eugenic justification of AIH (i. e. to prevent the birth of potentially defective child, thus improving the human race) is in conjunction with the principle of greatest happiness for the greatest number. To minimize suffering instead of aggravating it seems to be the rationale in AIH. For a moral pragmatist, AI is the most practical, beneficial, and useful technique to be undertaken by spouses who are beset with the problems of impotence, hereditary disorders, defective genes, and anatomical defects. The decision however must be optional and volitional. What is practical and workable to one individual may not be the case to another. Its practicality must be gauged on a case –to – case basis. b. Anti- ideas regarding Artificial Insemination According to Natural law Ethics, artificial insemination, whether it is within the bounds of marriage or not, is considered immoral. AI is immoral within marriage. More so, if when it is done outside marriage. Worst is when AI is done by a donor. Natural ethicians consider AI to be immoral, insofar as the AI child is not the fruit of the conjugal act as an expression of personal love. Fertilization is more than a mere union of to germs, the sperm and egg, which can be brought about artificially. And that the conjugal act which is planned and willed by nature needs a personal cooperation of both spouses who are joined together in marriage. In marriage, AI by a donor is substantially an adulterous procedure. The element of adultery technically resides in the use and placement of semen into the body of a woman from a man who is not her lawfully wedded husband. This procedure is detrimental to the unitive property of marriage. Only marriage partners have mutual rights over their bodies for the procreation of a new life, and these rights are exclusive, non-transferable and inalienable. Moreover, the husband has neither a moral nor a legal right to give anyone permission to inseminate his wife. Nature imposes on whoever gives life to an infant the task of its preservation and education. Impotency and sterility are also not excusable reasons for the moral justification of artificial insemination. Morally, no amount of good intention and surrounding circumstance however great can make an objectively evil act good. The end does not justify the means. D. Personal Critique on Artificial Insemination The Church’s teachings are reflected in my stand on this bioethical issue of Human Artificial Insemination (A. I. ). While you may say that choosing it is a convenient way for me to justify my stand, because we know that using these teachings silence many of other reasons. On the contrary, I used this as my guide in deciding on difficult moral issues because I believe that these teachings truly demonstrate great reverence for life. Procreation must be within the bounds of marriage. And procreation is the fruit of a conjugal act which is an act of love in which two people are united â€Å"in one flesh. † It is from this act which expresses it that human procreation is meant to result. This is God's design for human procreation. Marital love is essential to human procreation and thus they are inseparable. It is not just an act by which two life germs are united. In artificial insemination procreation is separated from this conjugal act and thus it what makes A. I. morally not permissible even within marriage. Separating human procreation from conjugal love and reducing it to the union of two germ cells also depersonalizes and dehumanizes it. Artificial insemination by a donor is more immoral than homologous insemination. So-called donor insemination was not considered morally acceptable since it involved an invasion of the marriage bond. Techniques that use eggs or sperm from someone outside the married couple are unacceptable as they do not respect the marriage bond and also deny the child the right to be born of a mother and father known to him. Impotency and sterility are also not excusable reasons for the moral justification of artificial insemination. Morally, no amount of good intention and surrounding circumstance however great can make an objectively evil act good. The end does not justify the means. The desire for a child — a completely legitimate desire of the married people — does not prove that artificial insemination is legitimate because it would satisfy such a desire . A defect of nature may be corrected. But, if the defect is beyond the possibility of correction as it is irreversible, nothing can be done but to just leave it to its own course. Spouses who find themselves in this situation must not forget that even when procreation is not possible, conjugal life does not for this reason lose its value. It can be the occasion for other important services to the life of people, for example adoption, various forms of educational work, and assistance to other families and to poor handicapped children. During the process of in vitro fertilization, because of a great number of failures, women seeking pregnancy by this means receive multiple embryos to ensure its occurrence. Some of these embryos maybe found weaker or with defects are discarded or simply aborted in a process called pregnancy reduction. Such process is plain and simple abortion and therefore has no regard whatsoever on the importance of life. Hence this is definitely morally unacceptable. To summarize, Artificial Insemination is immoral on the following grounds: 1. Arbitrary exclusion of the Marital Act from Procreation – the naturally devised means of transmitting life is no other than the marital act. Now, by AI, the said act is deliberately excluded from procreation and replaced with a medical means ,that is, the insertion of a thin and soft catheter containing sperm into the wife’s reproductive tract – a procedure enormously contrary to nature. . Usurpation of God’s Creative power of Authorship over Life – by its very procedure AI usurps God’s authorship over life through the employment of artificially concocted means other than His designed way of transmitting life. It is also an expression of man’s abusive and manipulative act of going beyond the border of his power of stewardship by , more or less, assuming that which exclusively belongs to God – the power of authorship over life. 3. Against Human Dignity – the claim of a right to the baby’s life implies that the child is an object to own and to possess which reduces him/her to a mere biological property over which one has right thereby violating his/her human dignity, value, and worth. E. Summary and Conclusion: I have nothing against the advances in reproductive technology. Technologies can actually assist nature, or even supply for the deficiencies of nature, and when used for these purposes, they can be commendable rather than objectionable. It is not because technologies are artificial that they are condemned. It is only when they go contrary to moral requirements. In examining technologies for their morality, our interest is not whether they are natural or artificial, but whether they are in violation of God’s design for procreation. The Church recognizes the legitimacy of the desire for a child and understands the suffering of couples struggling with problems of fertility. Such a desire, however, should not override the dignity of every human life to the point of absolute supremacy. The desire for a child cannot justify the â€Å"production† of offspring, just as the desire not to have a child cannot justify the abandonment or destruction of a child once he or she has been conceived. A child is not something owed to one, but is a gift† (No. 2378). It is not a mere piece of property, and, likewise, there is no â€Å"right to a child. † Points that provide a useful orientation in the midst of constant scientific developments. In these cases, there need be no intention of intrauterine monitoring (although there could b e) with a view of abortion should the child conceived suffer from any abnormality. Nor need there be, in these cases, the use of immoral means (masturbation) to obtain the husband's sperm, since it can be retrieved in morally acceptable ways. In these cases there is, apparently, only the intent to help a couple, despite their physical incapacity (either by reason of the husband's low sperm production or the wife's blocked Fallopian tubes) to have a child with whom they ardently desire to share life and to whom they are willing to give a home. Do not such couples have a â€Å"right† to have a child of their own? Why, many people reasonably ask, is it morally bad–indeed a sin, an offense against God Himself–to make use of artificial insemination by the husband and homologous in vitro fertilization in such cases? Is not the Church's position here too rigid, too insensitive to the agonizing plight of involuntarily childless couples who are seeking, by making good use of modern technologies, to realize one of the goods of marriage? Do not married couples in this situation have a right to make use of these methods so that they can have a child of their own? It is definitely true that married men and women have rights (and responsibilities) that nonmarried men and women do not have. They have the right, first of all, to engage in the marital act, that is not simple a genital act between two persons who happen to be married but is an act of interpersonal communion in which they give themselves to one another as husband and wife. In direct contrast to genital sex between an unmarried man and woman which merely joins two individuals who are in principle replaceable, substitutable, disposable, the marital act unites two persons who have made one another absolutely irreplaceable and nonsubstitutable by giving themselves to one another in marriage. In addition, husbands and wives, by giving themselves to one another in marriage, have capacitated themselves, as St. Augustine put it, â€Å"to receive life lovingly, to nourish it humanely, and to educate it religiously,† i. e. , in the love and service of God (cf. De genesi ad literam, 9. 7 PL 34:397). Unmarried men and women to the contrary have not so capacitated themselves. God, in short, wills that human life be given in the marital embrace of husbands and wives not through the random copulation of fornicators and adulterers. pic][pic] [pic] Husbands and wives, thus, have a â€Å"right† to the marital act and to care for life conceived through this act, but they do not have a â€Å"right† to a child. A child is not a thing to which husbands and wives have a right. It is not a product that, by its nature, is necessarily inferior to its producers, rather a child, like its parents. And this is the moral problem with the laboratory generation of human life, in cluding artificial insemination by the husband and the â€Å"simple case† of in vitro fertilization. When a child comes to be in and through the marital act, it is not a product of their act but is â€Å"a gift supervening on and giving permanent embodiment to† the marital act itself (cf. Catholic Bishops [of England and Wales] Committee on Bioethical Issues, In Vitro Fertilization: Morality and Public Policy [London: Catholic Information Services, 1983], n. 23). When human life comes to be through the marital act, we say quite properly that the spouses are â€Å"begetting or procreating,† they are not â€Å"making† anything. The life they receive is â€Å"begotten, not made. â€Å"