Editor’s Note: The Interim is publishing excerpts from Dignitatis Personae: On Certain Bioethical Questions, the Vatican’s new instruction on bioethics. The instruction, released Dec. 12 by the Congregation for the Doctrine of the Faith, is considered the most significant document treating biomedical issues in over 20 years, updating Donum Vitae, addressing the scientific advances of the past two decades. The excerpts we are publishing relate to the issue of in-vitro fertilization and the status of frozen embryos, but Dignitatis Personae also addresses other bioethical and reproduction technology issues, including cloning, the creation of hybrids and the use of embryonic stem cell research.
1. The dignity of a person must be recognized in every human being from conception to natural death. This fundamental principle expresses a great “yes” to human life and must be at the centre of ethical reflection on biomedical research, which has an ever greater importance in today’s world. The Church’s Magisterium has frequently intervened to clarify and resolve moral questions in this area. The Instruction Donum vitae was particularly significant. And now, 20 years after its publication, it is appropriate to bring it up to date.
The teaching of Donum vitae remains completely valid, both with regard to the principles on which it is based and the moral evaluations which it expresses. However, new biomedical technologies which have been introduced in the critical area of human life and the family have given rise to further questions, in particular in the field of research on human embryos, the use of stem cells for therapeutic purposes, as well as in other areas of experimental medicine. These new questions require answers. The pace of scientific developments in this area and the publicity they have received have raised expectations and concerns in large sectors of public opinion. Legislative assemblies have been asked to make decisions on these questions in order to regulate them by law; at times, wider popular consultation has also taken place.
These developments have led the Congregation for the Doctrine of the Faith to prepare a new doctrinal instruction, which addresses some recent questions in the light of the criteria expressed in the instruction Donum vitae and which also examines some issues that were treated earlier, but are in need of additional clarification.
2. In undertaking this study, the Congregation for the Doctrine of the Faith has benefited from the analysis of the Pontifical Academy for Life and has consulted numerous experts with regard to the scientific aspects of these questions, in order to address them with the principles of Christian anthropology. The encyclicals Veritatis splendor and Evangelium vitae of John Paul II, as well as other interventions of the Magisterium, offer clear indications with regard to both the method and the content of the examination of the problems under consideration.
In the current multi-faceted philosophical and scientific context, a considerable number of scientists and philosophers, in the spirit of the Hippocratic Oath, see in medical science a service to human fragility aimed at the cure of disease, the relief of suffering and the equitable extension of necessary care to all people. At the same time, however, there are also persons in the world of philosophy and science who view advances in biomedical technology from an essentially eugenic perspective.
3. In presenting principles and moral evaluations regarding biomedical research on human life, the Catholic church draws upon the light both of reason and of faith and seeks to set forth an integral vision of man and his vocation, capable of incorporating everything that is good in human activity, as well as in various cultural and religious traditions, which not infrequently demonstrate a great reverence for life.
The Magisterium also seeks to offer a word of support and encouragement for the perspective on culture which considers science an invaluable service to the integral good of the life and dignity of every human being. The church, therefore, views scientific research with hope and desires that many Christians will dedicate themselves to the progress of biomedicine and will bear witness to their faith in this field. She hopes moreover that the results of such research may also be made available in areas of the world that are poor and afflicted by disease, so that those who are most in need will receive humanitarian assistance. Finally, the church seeks to draw near to every human being who is suffering, whether in body or in spirit, in order to bring not only comfort, but also light and hope. These give meaning to moments of sickness and to the experience of death, which indeed are part of human life and are present in the story of every person, opening that story to the mystery of the Resurrection. Truly, the gaze of the church is full of trust because, “Life will triumph: this is a sure hope for us. Yes, life will triumph because truth, goodness, joy and true progress are on the side of life. God, who loves life and gives it generously, is on the side of life.”
The present instruction is addressed to the Catholic faithful and to all who seek the truth …
Anthropological, theological and
ethical aspects of human life
4. In recent decades, medical science has made significant strides in understanding human life in its initial stages. Human biological structures and the process of human generation are better known. These developments are certainly positive and worthy of support when they serve to overcome or correct pathologies and succeed in re-establishing the normal functioning of human procreation. On the other hand, they are negative and cannot be utilized when they involve the destruction of human beings or when they employ means which contradict the dignity of the person or when they are used for purposes contrary to the integral good of man.
The body of a human being, from the very first stages of its existence, can never be reduced merely to a group of cells. The embryonic human body develops progressively according to a well-defined program with its proper finality, as is apparent in the birth of every baby.
It is appropriate to recall the fundamental ethical criterion expressed in the instruction Donum vitae in order to evaluate all moral questions which relate to procedures involving the human embryo: “The human being is to be respected and treated as a person from the moment of conception; and therefore, from that same moment his rights as a person must be recognized, among which in the first place is the inviolable right of every innocent human being to life.”
5. This ethical principle, which reason is capable of recognizing as true and in conformity with the natural moral law, should be the basis for all legislation in this area. In fact, it presupposes a truth of an ontological character, as Donum vitae demonstrated from solid scientific evidence, regarding the continuity in development of a human being …
Although the presence of the spiritual soul cannot be observed experimentally, the conclusions of science regarding the human embryo give “a valuable indication for discerning, by the use of reason, a personal presence at the moment of the first appearance of a human life: how could a human individual not be a human person?” Indeed, the reality of the human being for the entire span of life, both before and after birth, does not allow us to posit either a change in nature or a gradation in moral value, since it possesses full anthropological and ethical status. The human embryo has, therefore, from the very beginning, the dignity proper to a person.
6. Respect for that dignity is owed to every human being, because each one carries, in an indelible way, his own dignity and value. The origin of human life has its authentic context in marriage and in the family, where it is generated through an act which expresses the reciprocal love between a man and a woman. Procreation which is truly responsible vis-à-vis the child to be born “must be the fruit of marriage …”
Thus, husband and wife, through the reciprocal gift of themselves to the other – something which is proper and exclusive to them – bring about that communion of persons by which they perfect each other, so as to co-operate with God in the procreation and raising of new lives. In the fruitfulness of married love, man and woman “make it clear that at the origin of their spousal life there is a genuine ‘yes,’ which is pronounced and truly lived in reciprocity, remaining ever open to life … The transmission of life is inscribed in nature and its laws stand as an unwritten norm to which all must refer.”
7. It is the church’s conviction that what is human is not only received and respected by faith, but is also purified, elevated and perfected. God, after having created man in his image and likeness (cf. Gen 1:26), described his creature as “very good” (Gen 1:31), so as to be assumed later in the Son (cf. Jn 1:14). In the mystery of the Incarnation, the Son of God confirmed the dignity of the body and soul which constitute the human being. Christ did not disdain human bodiliness, but instead fully disclosed its meaning and value: “In reality, it is only in the mystery of the incarnate Word that the mystery of man truly becomes clear …”
8. By taking the inter-relationship of these two dimensions, the human and the divine, as the starting point, one understands better why it is that man has unassailable value: he possesses an eternal vocation and is called to share in the trinitarian love of the living God.
This value belongs to all without distinction. By virtue of the simple fact of existing, every human being must be fully respected … In short, human life is always a good, for it is a manifestation of God in the world, a sign of his presence, a trace of his glory.
9. These two dimensions of life, the natural and the supernatural, allow us to understand better the sense in which the acts that permit a new human being to come into existence, in which a man and a woman give themselves to each other, are a reflection of trinitarian love. “God, who is love and life, has inscribed in man and woman the vocation to share in a special way in his mystery of personal communion and in his work as Creator and Father.”
Christian marriage is rooted “in the natural complementarity that exists between man and woman, and is nurtured through the personal willingness of the spouses to share their entire life-project, what they have and what they are: for this reason, such communion is the fruit and the sign of a profoundly human need …”
10. The church, by expressing an ethical judgment on some developments of recent medical research concerning man and his beginnings, does not intervene in the area proper to medical science itself, but rather calls everyone to ethical and social responsibility for their actions. She reminds them that the ethical value of biomedical science is gauged in reference to both the unconditional respect owed to every human being at every moment of his or her existence, and the defence of the specific character of the personal act which transmits life …
New problems concerning procreation
11. In light of the principles recalled above, certain questions regarding procreation which have emerged and have become more clear in the years since the publication of Donum vitae can now be examined.
Techniques for assisting fertility
12. With regard to the treatment of infertility, new medical techniques must respect three fundamental goods: a) the right to life and to physical integrity of every human being from conception to natural death; b) the unity of marriage, which means reciprocal respect for the right within marriage to become a father or mother only together with the other spouse; c) the specifically human values of sexuality, which require “that the procreation of a human person be brought about as the fruit of the conjugal act specific to the love between spouses.” Techniques which assist 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.”
In light of this principle, all techniques of heterologous artificial fertilization, as well as those techniques of homologous artificial fertilization which substitute for the conjugal act, are to be excluded. On the other hand, techniques which act as an aid to the conjugal act and its fertility are permitted …
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.
In order to come to the aid of the many infertile couples who want to have children, adoption should be encouraged, promoted and facilitated by appropriate legislation so that the many children who lack parents may receive a home that will contribute to their human development. In addition, research and investment directed at the prevention of sterility deserves encouragement.
In-vitro fertilization and the deliberate destruction of embryos
14. The fact that the process of in-vitro fertilization very frequently involves the deliberate destruction of embryos was already noted in the instruction Donum vitae. There were some who maintained that this was due to techniques which were still somewhat imperfect. Subsequent experience has shown, however, that all techniques of in-vitro fertilization proceed as if the human embryo were simply a mass of cells to be used, selected and discarded.
It is true that approximately a third of women who have recourse to artificial procreation succeed in having a baby. It should be recognized, however, that given the proportion between the total number of embryos produced and those eventually born, the number of embryos sacrificed is extremely high. These losses are accepted by the practitioners of in-vitro fertilization as the price to be paid for positive results. In reality, it is deeply disturbing that research in this area aims principally at obtaining better results in terms of the percentage of babies born to women who begin the process, but does not manifest a concrete interest in the right to life of each individual embryo …
Embryos produced in-vitro which have defects are directly discarded. Cases are becoming ever more prevalent in which couples who have no fertility problems are using artificial means of procreation in order to engage in genetic selection of their offspring. In many countries, it is now common to stimulate ovulation so as to obtain a large number of oocytes which are then fertilized. Of these, some are transferred into the woman’s uterus, while the others are frozen for future use. The reason for multiple transfer is to increase the probability that at least one embryo will implant in the uterus. In this technique, therefore, the number of embryos transferred is greater than the single child desired, in the expectation that some embryos will be lost and multiple pregnancy may not occur. In this way, the practice of multiple embryo transfer implies a purely utilitarian treatment of embryos. One is struck by the fact that, in any other area of medicine, ordinary professional ethics and the healthcare authorities themselves would never allow a medical procedure which involved such a high number of failures and fatalities. In fact, techniques of in-vitro fertilization are accepted based on the presupposition that the individual embryo is not deserving of full respect in the presence of the competing desire for offspring which must be satisfied.
This sad reality, which often goes unmentioned, is truly deplorable: the “various techniques of artificial reproduction, which would seem to be at the service of life and which are frequently used with this intention, actually open the door to new threats against life …”
18. One of the methods for improving the chances of success in techniques of in-vitro fertilization is the multiplication of attempts. In order to avoid repeatedly taking oocytes from the woman’s body, the process involves a single intervention in which multiple oocytes are taken, followed by cryopreservation of a considerable number of the embryos conceived in-vitro. In this way, should the initial attempt at achieving pregnancy not succeed, the procedure can be repeated or additional pregnancies attempted at a later date. In some cases, even the embryos used in the first transfer are frozen because the hormonal ovarian stimulation used to obtain the oocytes has certain effects which lead physicians to wait until the woman’s physiological conditions have returned to normal before attempting to transfer an embryo into her womb.
Cryopreservation is incompatible with the respect owed to human embryos; it presupposes their production in-vitro; it exposes them to the serious risk of death or physical harm, since a high percentage (do) not survive the process of freezing and thawing; it deprives them at least temporarily of maternal reception and gestation; it places them in a situation in which they are susceptible to further offence and manipulation.
19. With regard to the large number of frozen embryos already in existence, the question becomes: what to do with them? Some of those who pose this question do not grasp its ethical nature, motivated as they are by laws in some countries that require cryopreservation centres to empty their storage tanks periodically. Others, however, are aware that a grave injustice has been perpetrated and wonder how best to respond to the duty of resolving it.
Proposals to use these embryos for research or for the treatment of disease are obviously unacceptable because they treat the embryos as mere “biological material” and result in their destruction. The proposal to thaw such embryos without reactivating them and use them for research, as if they were normal cadavers, is also unacceptable.
The proposal that these embryos could be put at the disposal of infertile couples as a treatment for infertility is not ethically acceptable for the same reasons which make artificial heterologous procreation illicit as well as any form of surrogate motherhood; this practice would also lead to other problems of a medical, psychological and legal nature.
It has also been proposed, solely in order to allow human beings to be born who are otherwise condemned to destruction, that there could be a form of “prenatal adoption.” This proposal, praiseworthy with regard to the intention of respecting and defending human life, presents however various problems not dissimilar to those mentioned above.
All things considered, it needs to be recognized that the thousands of abandoned embryos represent a situation of injustice which in fact cannot be resolved. Therefore John Paul II made an “appeal to the conscience of the world’s scientific authorities and in particular to doctors, that the production of human embryos be halted, taking into account that there seems to be no morally licit solution regarding the human destiny of the thousands and thousands of ‘frozen’ embryos which are and remain the subjects of essential rights and should therefore be protected by law as human persons.”
The full text of Dignitatis Personae: On Certain Bioethical Questions, is available at www.lifesitenews.com/ldn/2008/dec/08121201