Transcript Rebecca Davis-Mathias, Ph. D. - The Integritas Institute for Ethics

Integritas Institute Bioethics Symposium
April 5, 2014
Rebecca Davis Mathias, PhD
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Great burden for couples to bear
Especially when they so deeply desire to have
a child and live out their vocation to be
open to life and welcome the gift of
children from God
Infertility treatment must respect God’s
design for married love
The Church, with sincere compassion and
empathy . . . offers guidance and hope
through her teachings
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On how to understand and approach
infertility in a way that reverences and
protects the dignity of the human person
and respects God’s divine plan for married
love.
The challenge is to diagnose and address
problems so these bodies can function as
they should – and there is no moral
problem in doing this, any more than
there is in other medical treatments to
restore health. (Life Giving Love in an Age
of Technology)
Moral teachings flow principally from
the natural law, lex natualis,
understood in the light of the
revelation Christ has entrusted to
his Church
 Natural law is a law written in the
human heart, recognized by
reason, a law distinct from the
positive law of any State
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From this source, the Church has
derived its understanding of the
nature of:
1. The human person
2. Human acts
3. The goals that shape human
activity
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When the marital act of sexual
intercourse is not able to attain its
procreative purpose, assistance
that does not separate the unitive
and procreative ends of the act,
and does not substitute for the
marital act itself, may be used to
help married couples conceive.
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Those techniques of assisted conception
that respect the unitive and procreative
meanings of sexual intercourse and do
not involve the destruction of human
embryos, or their deliberate generation
in such numbers that it is clearly
envisaged that all cannot implant and
some are simply being used to maximize
the chances of others implanting, may
be used as therapies for infertility.
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Heterologous fertilization (that is, any
technique used to achieve conception by
the use of gametes coming from at least
one donor other than the spouses) is
prohibited because it is contrary to the
covenant of marriage, the unity of the
spouses, and the dignity proper to parents
and the child.
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Homologous artificial fertilization (that is, any
technique used to achieve conception
using the gametes of the two spouses
joined in marriage) is prohibited when it
separates procreation from the marital act
in its unitive significance (e.g., any
technique used to achieve extracorporeal
conception).
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A Catholic health care institution that
provides treatment for infertility should
offer not only technical assistance to
infertile couples but also should help
couples pursue other solutions (e.g.,
counseling, adoption).
1.
2.
3.
There is a moral order
This moral order can be
known
What it means to be human is
the basis of this
moral order
Act
2. Intention
3. Circumstances or
Consequences
1.
1.
2.
3.
Act
What?
Intention
Why?
Circumstances
Who & to Whom? When?
Where? How? Foreseeable
Consequences? Viable
Alternatives?
Pope Paul VI’s July 25, 1968
 Official, magisterial teaching of
the Catholic Church
 On the regulation of birth
 Issue ignited controversy
 Prior to Vatican II (1962 – 1965)
 Prominent Catholic theologians
raised questions
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Pope John XXII appointed a
commission to study the
subject
 It started with 6 men, mostly
scientists
 Grew to over 60 members
 Including 4 women
 Dialogic for 3 years
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At end of commission’s 3rd
meeting in 1964, Pope Paul
VI urged group to:
Continue its deliberations, listen
to the anxiety of so many souls,
and work diligently without
worrying about criticism or
difficulties.
Prophesies that contraception
would lead to:
1. Promiscuity
2. Sexual diseases [STIs]
3. Abortion
4. Divorce
5. Increasing anti-life mentality
and culture
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The question of human
procreation
cannot be limited to
mere scientific
analysis
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The Church demonstrates a commitment to
monitor and critique due respect for
human dignity and human flourishing as
technology progresses
For example, in Caritas in Veritate Pope
Benedict XVI advocates that the Church’s
mission is primarily a moral and
evangelical one and not a technical one of
medicine or economics
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Great defender of HV
Provides a personalist
understanding of sexuality
Theology of the Body
Familiaris Consortio
(1997)
(1981)
Promotes Natural Family
Planning (NFP)
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Fertility is offered to one’s
partner and lovingly
received
Fully human - it allows for
transcendence of desire
through self-control in the
service of a higher good
Fully giving and open to
acceptance of children
Blessed John Paul II claims that . . .
Science and faith are not foreign to
one another, but on the contrary,
both need and reciprocally
complement each other. . .
We are now touching upon the
autonomy of the sciences.
Today the postulate of unlimited
freedom in scientific research is
often defended. In this regard,
if on one hand [sic] it is
necessary to recognize the right
of the sciences to apply the
methods of research that are
proper to them;
on the other, one cannot agree
with the affirmation that the
field of research itself is not
subject to any limitations. The
boundary is, precisely, the
fundamental distinction
between good and evil. This
distinction takes place in [the
person’s] conscience.
Deep within the conscience men and
women discover a law which they
have not laid upon themselves but
which they must obey.
Its voice, ever calling them to love
and to do what is good and to avoid
what is evil, tells them inwardly at
the right moment: do this,
shun that.
For people have in their
hearts a law inscribed by God.
Their dignity lies in
observing this law,
and by it they will be judged.
Vatican Council II,
Pastoral Constitution on the Church in the Modern World
The ability to reason or discern well
the moral decisions we face in
our every day living
 Practical wisdom – well-informed
 Process of determining right from
wrong
 Not a magic voice in our heads
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This doctrine, often set forth by
the teaching authority, is
founded upon the inseparable
connection, willed by God, and
which man cannot break on his
own initiative, between the two
meanings of the conjugal act:
union and procreation.
For, by its intimate structure, the
conjugal act, while most closely
uniting the spouses, enables
them to procreate new lives
according to laws inscribed in
the very being of man and
woman.
It is by safeguarding these two
essential aspects,
union and procreation,
that the conjugal act preserves in
its fullness the sense of true
mutual love and its ordination
towards man’s most high calling
to parenthood.
From the moment of fertilization,
the new life is a human being
with unconditional respect and
moral rights
 Because the embryo must be
treated as a person, it needs to
be cared for as any other
human being
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Teachings allow for fertility
medication to encourage
ovulation (a source of many
higher-order multiple births)
 Surgery to correct conditions like
varicoceles and endometriosis
 Forbids procedures that
substitute medical
techniques for human
intercourse
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Certainly, techniques aimed at removing obstacles
to natural fertilization, as for
example, hormonal treatments for infertility,
surgery for endometriosis, unblocking of
fallopian tubes or their surgical repair, are licit. All
these techniques may be considered
authentic treatments because, once the problem
causing the infertility has been resolved, the
married couple is able to engage in conjugal acts
resulting in procreation, without the
physician’s action directly interfering in that act
itself. None of these treatments replaces
the conjugal act, which alone is worthy of truly
responsible procreation.
No biologist or doctor can reasonably claim, by
virtue of his scientific competence, to be able
to decide on people's origin and destiny.
This norm must be applied in a particular way
in the field of sexuality and procreation, in
which man and woman actualize the
fundamental values of love and life.
Pope Paul VI Institute - Omaha,
NE
 Founded by Thomas W. Hilgers in
1985
 Trains physicians to treat
infertility in harmony with
church teachings
 Adoption ?
 Infertility is not a problem to
overcome, but can be an
opportunity
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Embryonic stem cell research
opposition is clearly prohibited
 Often relies on “left over”
embryos from IVF
 Hormonal treatment with certain
drugs have side-effects
 http://www.ivpcare.com/patient/
Pharmacy/products/prod_inf.asp?
gclid=CLetqoWk3J0CFRYhDQodX
DqeMQ
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Use of perforated condom to
circumvent hypospadias
 LTOT – Low Tubal Ovum Transfer
 Moving sperm deposited in the
vagina, uterus, fallopian tube
 Temporary removal of sperm or
ova to “wash” or “capacitate”
for relocation in the
fallopian tube
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Accumulating sperm from a
series of marital acts and
introducing them into the
wife’s vagina
 Sperm is conserved, concentrated
and placed in wife’s generative
tract in association with
marital act
 SIFT (Sperm Intrafallopian Tube
Transfer
 GIFT (Gamete Intrafallopian Tube
Transfer)
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Some Catholic moral theologians
like McCarthy, Griese, Cataldo,
and Carlson defend GIFT
 Other Catholic moral theologians
like Doerfler, Seifert, Demarco,
Tonti-Filipini, Griesz, May and
Ashley-O’Rourke are against it
 TOTS (Tubal Ovum Transfer with
Sperm)
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Eventual success rate is roughly
50 – 70 % for all women
 Up to 86% for women under 35
 Church documents highlight GIFT
or ZIFT (Zygote Intrafallopian
Transfer)
 Rarely used due to medical
inferiority
 Reproductive Cycle can be
$12,400
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People who seek fertility
treatment often feel
vulnerable
 Goal = protect health and safety
of individuals
 Ensuring reproductive
techniques are safe and
affordable
 Able to make informed
decisions
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Morality - challenge about what
is most deeply human and
choices which are either lifeenhancing or life-diminishing
 Dignitatis Personae offers
reasoned argument in support
for the culture of modern
science as “an invaluable
service to the integral good of
life and dignity of every human
being.” (nos. 3 & 37)
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8. Implement
the Plan
http://www.irh.org/nfp.htm
 http://nfpandmore.org/nfphowt
o.shtml
 http://www.billingscentre.ab.ca/general/index.html
 http://familydoctor.org/online/f
amdocen/home/women/contrac
eptive/126.html
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US Conference of Catholic Bishops,
http://www.usccb.org/issues-and-action/marriageand-family/natural-familyplanning/resources/infertility.cfm
Paul VI, Humanae Vitae, no. 8,
http://www.vatican.va/holy_father/paul_vi/encyclicals/
documents/hf_p-vi_enc_25071968_humanaevitae_en.html
Congregation for the Doctrine of the Faith, Dignitas
Personae, nos. 6 and 9,
http://www.vatican.va/holy_father/paul_vi/encyclicals/
documents/hf_p-vi_enc_25071968_humanaevitae_en.html
US Conference of Catholic Bishops, Ethical and Religious
Directives for Catholic Health Care Services, 5th Ed.,
http://www.usccb.org/issues-and-action/human-lifeand-dignity/health-care/upload/Ethical-ReligiousDirectives-Catholic-Health-Care-Services-fifth-edition2009.pdf
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Congregation for the Doctrine of the Faith,
Donum Vitae, (February 22, 1987),
http://www.vatican.va/roman_curia/congregatio
ns/cfaith/documents/rc_con_cfaith_doc_198702
22_respect-for-human-life_en.html.
“Reproductive Technologies,” Natural Family
Planning Program, United Stated Conference of
Catholic Bishops, http://www.usccb.org/issuesand-action/marriage-and-family/naturalfamily-planning/catholicteaching/upload/Reproductive-technologies.pdf.
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Benedict XV1, Caritas in Veritate,
http://www.vatican.va/holy_father/benedict_
xvi/encyclicals/documents/hf_benxvi_enc_20090629_caritas-inveritate_en.html
Health Ethics Guide, (Ottawa, ON: Catholic
Health Association), 2000, 81.
John Paul II, Evangelium Vitae (March 25,
1995),
http://www.vatican.va/holy_father/john_paul
_ii/encyclicals/documents/hf_jpii_enc_25031995_evangelium-vitae_en.html,
nos. 18-20, 44-45.