Donum Vitae
II. Interventions upon Human Procreation
By "artificial procreation" or " artificial
fertilization" are understood here the different technical
procedures directed towards obtaining a human conception in
a manner other than the sexual union of man and woman. This
Instruction deals with fertilization of an ovum in a test-tube
(in vitro fertilization) and artificial insemination
through transfer into the woman's genital tracts of previously
collected sperm.
A preliminary point for the moral evaluation of such technical
procedures is constituted by the consideration of the circumstances
and consequences which those procedures involve in relation
to the respect due the human embryo. Development of the practice
of in vitro fertilization has required innumerable
fertilizations and destructions of human embryos. Even today,
the usual practice presupposes a hyperovulation on the part
of the woman: a number of ova are withdrawn, fertilized and
then cultivated in vitro for some days. Usually not
all are transferred into the genital tracts of the woman;
some embryos, generally called "spare ", are destroyed
or frozen. On occasion, some of the implanted embryos are
sacrificed for various eugenic, economic or psychological
reasons. Such deliberate destruction of human beings or their
utilization for different purposes to the detriment of their
integrity and life is contrary to the doctrine on procured
abortion already recalled. The connection between in vitro
fertilization and the voluntary destruction of human embryos
occurs too often. This is significant: through these procedures,
with apparently contrary purposes, life and death are subjected
to the decision of man, who thus sets himself up as the giver
of life and death by decree. This dynamic of violence and
domination may remain unnoticed by those very individuals
who, in wishing to utilize this procedure, become subject
to it themselves. The facts recorded and the cold logic which
links them must be taken into consideration for a moral judgment
on IVF and ET (in vitro fertilization and embryo transfer):
the abortion-mentality which has made this procedure possible
thus leads, whether one wants it or not, to man's domination
over the life and death of his fellow human beings and can
lead to a system of radical eugenics.
Nevertheless, such abuses do not exempt one from a further
and thorough ethical study of the techniques of artificial
procreation considered in themselves, abstracting as far as
possible from the destruction of embryos produced in vitro.
The present Instruction will therefore take into consideration
in the first place the problems posed by heterologous artificial
fertilization (II, 1-3), * and subsequently those linked with
homologous artificial fertilization (II, 4-6 ) .** Before
formulating an ethical judgment on each of these procedures,
the principles and values which determine the moral evaluation
of each of them will be considered.
* By the term heterologous artificial fertilization or
procreation, the Instruction means techniques used to
obtain a human conception artificially by the use of gametes
coming from at least one donor other than the spouses who
are joined in marriage. Such techniques can be of two types
a) Heterologous IVF and ET: the technique used to
obtain a human conception through the meeting in vitro
of gametes taken from at least one donor other than the two
spouses joined in marriage.
b) Heterologous artifical insemination: the technique
used to obtain a human conception through the transfer into
the genital tracts of the woman of the sperm previously collected
from a donor other than the husband.
** By artificial homologous fertilization or procreation,
the Instruction means the technique used to obtain a human
conception using the gametes of the two spouses joined in
marriage. Homologous artificial fertilization can be carried
out by two different methods:
a) Homologous IVF and ET: the technique used to obtain
a human conception through the meeting in vitro of
the gametes of the spouses joined in marriage.
b) Homologous artificial insemination: the technique
used to obtain a human conception through the transfer into
the genital tracts of a married woman of the sperm previously
collected from her husband.
A. Heterologous Artificial Fertilization
1. Why Must Human Procreation
Take Place in Marriage?
Every human being is always to be accepted as a gift and
blessing of God. However, from the moral point of view a truly
responsible procreation vis-à-vis the unborn child must be
the fruit of marriage.
For human procreation has specific characteristics by virtue
of the personal dignity of the parents and of the children:
the procreation of a new person, whereby the man and the woman
collaborate with the power of the Creator, must be the fruit
and the sign of the mutual self-giving of the spouses, of
their love and of their fidelity.(34)
The fidelity of the spouses in the unity of marriage involves
reciprocal respect of their right to become a father and a
mother only through each other. The child has the right to
be conceived, carried in the womb, brought into the world
and brought up within marriage: it is through the secure and
recognized relationship to his own parents that the child
can discover his own identity and achieve his own proper human
development. The parents find in their child a confirmation
and completion of their reciprocal self-giving: the child
is the living image of their love, the permanent sign of their
conjugal union, the living and indissoluble concrete expression
of their paternity and maternity, (35)
By reason of the vocation and social responsibilities of the
person, the good of the children and of the parents contributes
to the good of civil society; the vitality and stability of
society require that children come into the world within a
family and that the family be firmly based on marriage. The
tradition of the Church and anthropological reflection recognize
in marriage and in its indissoluble unity the only setting
worthy of truly responsible procreation.
2. Doe Heterologous Artificial
Fertilization Conform to the Dignity of the Couple and to
the Truth of Marriage?
Through IVF and ET and heterologous artificial insemination,
human conception is achieved through the fusion of gametes
of at least one donor other than the spouses who are united
in marriage. Heterologous artificial fertilization is contrary
to the unity of marriage, to the dignity of the spouses, to
the vocation proper to parents, and to the child's right to
be conceived and brought into the world in marriage and from
marriage.(36) Respect for
the unity of marriage and for conjugal fidelity demands that
the child be conceived in marriage; the bond existing between
husband and wife accords the spouses, in an objective and
inalienable manner, the exclusive right to become father and
mother solely through each other.(37)
Recourse to the gametes of a third person, in order to have
sperm or ovum available, constitutes a violation of the reciprocal
commitment of the spouses and a grave lack in regard to that
essential property of marriage which is its unity. Heterologous
artificial fertilization violates the rights of the child;
it deprives him of his filial relationship with his parental
origins and can hinder the maturing of his personal identity.
Furthermore, it offends the common vocation of the spouses
who are called to fatherhood and motherhood: it objectively
deprives conjugal fruitfulness of its unity and integrity;
it brings about and manifests a rupture between genetic parenthood,
gestational parenthood and responsibility for upbringing.
Such damage to the personal relationships within the family
has repercussions on civil society: what threatens the unity
and stability of the family is a source of dissension, disorder
and injustice in the whole of social life. These reasons
lead to a negative moral judgment concerning heterologous
artificial fertilization: consequently fertilization of a
married woman with the sperm of a donor different from her
husband and fertilization with the husband's sperm of an ovum
not coming from his wife are morally illicit. Furthermore,
the artificial fertilization of a woman who is unmarried or
a widow, whoever the donor may be, cannot be morally justified.
The desire to have a child and the love between spouses who
long to obviate a sterility which cannot be overcome in any
other way constitute understandable motivations; but subjectively
good intentions do not render heterologous artificial fertilization
conformable to the objective and inalienable properties of
marriage or respectful of the rights of the child and of the
spouses.
3. Is Surrogate Motherhood Morally
Licit?
No, for the same reasons which lead one to reject heterologous
artificial fertilization: for it is contrary to the unity
of marriage and to the dignity of the procreation of the human
person. Surrogate motherhood represents an objective failure
to meet the obligations of maternal love, of conjugal fidelity
and of responsible motherhood; it offends the dignity and
the right of the child to be conceived, carried in the womb,
brought into the world and brought up by his own parents;
it sets up, to the detriment of families, a division between
the physical, psychological and moral elements which constitute
those families.
* By "surrogate mother" the Instruction means:
a) the woman who carries in pregnancy an embryo implanted
in her uterus and who is genetically a stranger to the embryo
because it has been obtained through the union of the gametes
of "donors". She carries the pregnancy with a pledge
to surrender the baby once it is born to the party who commissioned
or made the agreement for the pregnancy.
b) the woman who carries in pregnancy an embryo to whose
procreation she has contributed the donation of her own ovum,
fertilized through insemination with the sperm of a man other
than her husband. She carries the pregnancy with a pledge
to surrender the child once it is born to the party who commissioned
or made the agreement for the pregnancy.
B. Homologous Artificial Fertilization
Since heterologous artificial fertilization has been declared
unacceptable, the question arises of how to evaluate morally
the process of homologous artificial fertilization: IVF and
ET and artificial insemination between husband and wife. First
a question of principle must be clarified.
4. What Connection is Required
from the Moral Point of View Between Procreation and the Conjugal
Act?
a) The Church's teaching on marriage and human procreation
affirms the "inseparable connection, willed by God and
unable to be broken by man on his own initiative, between
the two meanings of the conjugal act: the unitive meaning
and the procreative meaning. Indeed, by its intimate structure,
the conjugal act, while most closely uniting husband and wife,
capacitates them for the generation of new lives, according
to laws inscribed in the very being of man and of woman".(38)
This principle, which is based upon the nature of marriage
and the intimate connection of the goods of marriage, has
well-known consequences on the level of responsible fatherhood
and motherhood. "By safeguarding both these essential
aspects, the unitive and the procreative, the conjugal act
preserves in its fullness the sense of true mutual love and
its ordination towards man's exalted vocation to parenthood".(39)
The same doctrine concerning the link between the meanings
of the conjugal act and between the goods of marriage throws
light on the moral problem of homologous artificial fertilization,
since "it is never permitted to separate these different
aspects to such a degree as positively to exclude either the
procreative intention or the conjugal relation" (40)
Contraception deliberately deprives the conjugal act of its
openness to procreation and in this way brings about a voluntary
dissociation of the ends of marriage. Homologous artificial
fertilization, in seeking a procreation which is not the fruit
of a specific act of conjugal union, objectively effects an
analogous separation between the goods and the meanings of
marriage. Thus, fertilization is licitly sought when it
is the result of a "conjugal act which is per se suitable
for the generation of children to which marriage is ordered
by its nature and by which the spouses become one flesh".(41)
But from the moral point of view procreation is deprived of
its proper perfection when it is not desired as the fruit
of the conjugal act, that is to say of the specific act of
the spouses' union.
b ) The moral value of the intimate link between the goods
of marriage and between the meanings of the conjugal act is
based upon the unity of the human being, a unity involving
body and spiritual soul. (42)
Spouses mutually express their personal love in the "language
of the body ", which clearly involves both "sponsal
meanings" and parental ones.(43)
The conjugal act by which the couple mutually express their
self-gift at the same time expresses openness to the gift
of life. It is an act that is inseparably corporal and spiritual.
It is in their bodies and through their bodies that the spouses
consummate their marriage and are able to become father and
mother. In order to respect the language of their bodies and
their natural generosity, the conjugal union must take place
with respect for its openness to procreation; and the procreation
of a person must be the fruit and the result of married love.
The origin of the human being thus follows from a procreation
that is "linked to the union, not only biological but
also spiritual, of the parents, made one by the bond of marriage".(44)
Fertilization achieved outside the bodies of the couple remains
by this very fact deprived of the meanings and the values
which are expressed in the language of the body and in the
union of human persons.
c) Only respect for the link between the meanings of the
conjugal act and respect for the unity of the human being
make possible procreation in conformity with the dignity of
the person. In his unique and irrepeatable origin, the child
must be respected and recognized as equal in personal dignity
to those who give him life. The human person must be accepted
in his parents' act of union and love; the generation of a
child must therefore be the fruit of that mutual giving (45)
which is realized in the conjugal act wherein the spouses
cooperate as servants and not as masters in the work of the
Creator who is Love. In reality, the origin of a human person
is the result of an act of giving. The one conceived must
be the fruit of his parents' love. He cannot be desired or
conceived as the product of an intervention of medical or
biological techniques; that would be equivalent to reducing
him to an object of scientific technology. No one may subject
the coming of a child into the world to conditions of technical
efficiency which are to be evaluated according to standards
of control and dominion. The moral relevance of the link
between the meanings of the conjugal act and between the goods
of marriage, as well as the unity of the human being and the
dignity of his origin, demand that the procreation of a human
person be brought about as the fruit of the conjugal act specific
to the love between spouses. The link between procreation
and the conjugal act is thus shown to be of great importance
on the anthropological and moral planes, and it throws light
on the positions of the Magisterium with regard to homologous
artificial fertilization.
5. Is Homologous 'In Vitro' Fertilization
Morally Licit?
The answer to this question is strictly dependent on the
principles just mentioned. Certainly one cannot ignore the
legitimate aspirations of sterile couples. For some, recourse
to homologous IVF and ET appears to be the only way of fulfilling
their sincere desire for a child. The question is asked whether
the totality of conjugal life in such situations is not sufficient
to ensure the dignity proper to human procreation. It is acknowledged
that IVF and ET certainly cannot supply for the absence of
sexual relations (47) and cannot
be preferred to the specific acts of conjugal union, given
the risks involved for the child and the difficulties of the
procedure. But it is asked whether, when there is no other
way of overcoming the sterility which is a source of suffering,
homologous in vitro fertilization may not constitute
an aid, if not a form of therapy, whereby its moral licitness
could be admitted. The desire for a child - or at the very
least an openness to the transmission of life - is a necessary
prerequisite from the moral point of view for responsible
human procreation. But this good intention is not sufficient
for making a positive moral evaluation of in vitro
fertilization between spouses. The process of IVF and ET must
be judged in itself and cannot borrow its definitive moral
quality from the totality of conjugal life of which it becomes
part nor from the conjugal acts which may precede or follow
it.(48)
It has already been recalled that, in the circumstances in
which it is regularly practised, IVF and ET involves the destruction
of human beings, which is something contrary to the doctrine
on the illicitness of abortion previously mentioned.(49)
But even in a situation in which every precaution were taken
to avoid the death of human embryos, homologous IVF and ET
dissociates from the conjugal act the actions which are directed
to human fertilization. For this reason the very nature of
homologous IVF and ET also must be taken into account, even
abstracting from the link with procured abortion. Homologous
IVF and ET is brought about outside the bodies of the couple
through actions of third parties whose competence and technical
activity determine the success of the procedure. Such fertilization
entrusts the life and identity of the embryo into the power
of doctors and biologists and establishes the domination of
technology over the origin and destiny of the human person.
Such a relationship of domination is in itself contrary to
the dignity and equality that must be common to parents and
children.
Conception in vitro is the result of the technical
action which presides over fertilization. Such fertilization
is neither in fact achieved nor positively willed as the expression
and fruit of a specific act of the conjugal union. In homologous
IVF and ET, therefore, even if it is considered in the context
of 'de facto' existing sexual relations, the generation of
the human person is objectively deprived of its proper perfection:
namely, that of being the result and fruit of a conjugal act
in which the spouses can become "cooperators with
God for giving life to a new person".(50)
These reasons enable us to understand why the act of conjugal
love is considered in the teaching of the Church as the only
setting worthy of human procreation. For the same reasons
the so-called "simple case", i.e. a homologous IVF
and ET procedure that is free of any compromise with the abortive
practice of destroying embryos and with masturbation, remains
a technique which is morally illicit because it deprives human
procreation of the dignity which is proper and connatural
to it. Certainly, homologous IVF and ET fertilization is not
marked by all that ethical negativity found in extra-conjugal
procreation; the family and marriage continue to constitute
the setting for the birth and upbringing of the children.
Nevertheless, in conformity with the traditional doctrine
relating to the goods of marriage and the dignity of the person,
the Church remain opposed from the moral point of view
to homologous 'in vitro' fertilization. Such fertilization
is in itself illicit and in opposition to the dignity of procreation
and of the conjugal union, even when everything is done to
avoid the death of the human embryo. Although the manner
in which human conception is achieved with IVF and ET cannot
be approved, every child which comes into the world must in
any case be accepted as a living gift of the divine Goodness
and must be brought up with love.
6. How Is Homologous Artificial
Insemination to be Evaluated from the Moral Point of View?
Homologous artificial insemination within marriage cannot
be admitted except for those cases in which the technical
means is not a substitute for the conjugal act but serves
to facilitate and to help so that the act attains its natural
purpose.
The teaching of the Magisterium on this point has already
been stated.(51) This teaching
is not just an expression of particular historical circumstances
but is based on the Church's doctrine concerning the connection
between the conjugal union and procreation and on a consideration
of the personal nature of the conjugal act and of human procreation.
"In its natural structure, the conjugal act is a personal
action, a simultaneous and immediate cooperation on the part
of the husband and wife, which by the very nature of the agents
and the proper nature of the act is the expression of the
mutual gift which, according to the words of Scripture, brings
about union 'in one flesh' ".(52)
Thus moral conscience "does not necessarily proscribe
the use of certain artificial means destined solely either
to the facilitating of the natural act or to ensuring that
the natural act normally performed achieves its proper end".(53)
If the technical means facilitates the conjugal act or helps
it to reach its natural objectives, it can be morally acceptable.
If, on the other hand, the procedure were to replace the conjugal
act, it is morally illicit. Artificial insemination as a substitute
for the conjugal act is prohibited by reason of the voluntarily
achieved dissociation of the two meanings of the conjugal
act. Masturbation, through which the sperm is normally obtained,
is another sign of this dissociation: even when it is done
for the purpose of procreation, the act remains deprived of
its unitive meaning: "It lacks the sexual relationship
called for by the moral order, namely the relationship which
realizes 'the full sense of mutual self-giving and human procreation
in the context of true love' ".(54)
7. What Moral Criterion Can Be
Proposed with Regard to Medical Intervention in Human Procreation?
The medical act must be evaluated not only with reference
to its technical dimension but also and above all in relation
to its goal which is the good of persons and their bodily
and psychological health. The moral criteria for medical intervention
in procreation are deduced from the dignity of human persons,
of their sexuality and of their origin. Medicine which
seeks to be ordered to the integral good of the person must
respect the specifically human values of sexuality.(55)
The doctor is at the service of persons and of human procreation.
He does not have the authority to dispose of them or to decide
their fate.
A medical intervention respects the dignity of persons when
it seeks to assist the conjugal act either in order to facilitate
its performance or in order to enable it to achieve its objective
once it has been normally performed",(56)
On the other hand, it sometimes happens that a medical procedure
technologically replaces the conjugal act in order to obtain
a procreation which is neither its result nor its fruit. In
this case the medical act is not, as it should be, at the
service of conjugal union but rather appropriates to itself
the procreative function and thus contradicts the dignity
and the inalienable rights of the spouses and of the child
to be born. The humanization of medicine, which is insisted
upon today by everyone, requires respect for the integral
dignity of the human person first of all in the act and at
the moment in which the spouses transmit life to a new person.
It is only logical therefore to address an urgent appeal to
Catholic doctors and scientists that they bear exemplary witness
to the respect due to the human embryo and to the dignity
of procreation. The medical and nursing staff of Catholic
hospitals and clinics are in a special way urged to do justice
to the moral obligations which they have assumed, frequently
also, as part of their contract. Those who are in charge of
Catholic hospitals and clinics and who are often Religious
will take special care to safeguard and promote a diligent
observance of the moral norms recalled in the present Instruction.
8. The Suffering Caused by Infertility
in Marriage
The suffering of spouses who cannot have children or who
are afraid of bringing a handicapped child into the world
is a suffering that everyone must understand and properly
evaluate.
On the part of the spouses, the desire for a child is natural:
it expresses the vocation to fatherhood and motherhood inscribed
in conjugal love. This desire can be even stronger if the
couple is affected by sterility which appears incurable. Nevertheless,
marriage does not confer upon the spouses the right to have
a child, but only the right to perform those natural acts
which are per se ordered to procreation.(57)
A true and proper right to a child would be contrary to
the child's dignity and nature. The child is not an object
to which one has a right, nor can he be considered as an object
of ownership: rather, a child is a gift, "the supreme
gift" (58) and the most
gratuitous gift of marriage, and is a living testimony of
the mutual giving of his parents. For this reason, the child
has the right, as already mentioned, to be the fruit of the
specific act of the conjugal love of his parents; and he also
has the right to be respected as a person from the moment
of his conception.
Nevertheless, whatever its cause or prognosis, sterility
is certainly a difficult trial. The community of believers
is called to shed light upon and support the suffering of
those who are unable to fulfill their legitimate aspiration
to motherhood and fatherhood. Spouses who find themselves
in this sad situation are called to find in it an opportunity
for sharing in a particular way in the Lord's Cross, the source
of spiritual fruitfulness. Sterile couples must not forget
that "even when procreation is not possible, conjugal
life does not for this reason lose its value. Physical sterility
in fact can be for spouses the occasion for other important
services to the life of the human person, for example, adoption,
various forms of educational work, and assistance to other
families and to poor or handicapped children".(59)
Many researchers are engaged in the fight against sterility.
While fully safeguarding the dignity of human procreation,
some have achieved results which previously seemed unattainable.
Scientists therefore are to be encouraged to continue their
research with the aim of preventing the causes of sterility
and of being able to remedy them so that sterile couples will
be able to procreate in full respect for their own personal
dignity and that of the child to be born.
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