Wednesday, June 21, 2006

Archived embryos

I just read an article at Lifeissues by Fr. Alain Mattheeuws, S.J. about The Freezing, Implantation, and Adoption of Embryos. While I'm generally in agreement, and I'm not really in a good position to criticize Fr. Mattheeuws' work, I'd like to emphasize a few things he didn't, and demur on a few related things I've seen elsewhere. You can sort them out for yourself if I'm ambiguous at any point; fair warning.

The first question he covers is whether embryos may be frozen. Donum Vitae appears to be pretty clear:

The freezing of embryos, even when carried out in order to preserve the life of an embryo - cryopreservation - constitutes an offence against the respect due to human beings by exposing them to grave risks of death or harm to their physical integrity and depriving them, at least temporarily, of maternal shelter and gestation, thus placing them in a situation in which further offences and manipulation are possible.

The first part of this argument is, I think, contingent more on the limits of technology than on the limits of moral behavior. We now induce hypothermia in adults for certain medical procedures, and the risk of dying therefrom is quite small, especially next to the benefits to be gained by surgery.

I'm not condoning, however, any experimentation like what the Nazis did to bring us what we know about hypothermia today. I'm only saying that medical technology has gotten us this far, and in the future, something mundane, safe, and materially identical to the cryosleep featured in the Alien and 2001 movies might be feasible for a human at any point in development.

Justifying the extraction and preservation in the first place is another matter. If it's not disproportionately dangerous--which is a big if, one our state of the obstetric art can't yet practically answer, and no valid reason for which I can even think of--then I'm not sure how the deprivation of "maternal shelter" would be materially different from having your five year old spend a weekend in the hospital (which, I can personally attest, is sometimes necessary). We don't think that much of a kid getting homesick. Technical problems aside, would an extraction and reimplantation be significantly different? I'm not asking rhetorically. While there can be no tangible emotional trauma if there's no differentiated neural tissue, there are still spiritual matters that might be significant, and I'm less qualified to judge those than I am Fr. Mattheeuws' article (and less qualified to judge them than he is).

(I'm not sure if I'm using such words as "material" in the proper philosophical way, but I trust you'll take my meaning. Feel free to correct me where appropriate; there are, I'm sure, other places where I mean ontology when I say reality...)

I've piled high quite a few contingents, though, so don't think I'm actively dissenting from Donum Vitae. Outside of the unlikely confluence of a successor of Peter saying I can do so and some incredibly bizarre medical condition developing in my wife, none of my unborn kids is going to take a detour through the freezer section.

What about embryonic children who have already been cryopreserved? Let me address a few excerpts directly:

[Parents] cannot relinquish the responsibility that they have taken on in conceiving these embryos, even if it was with the help of doctors....

Here he's saying that parents cannot store or give them away like mere objects. Entirely true, but there is such a thing as adoption, and it is legitimate. Giving up only the second of five children for adoption in order to keep the bills low would be an unconscionable breach of the family, but it only demonstrates that the appropriateness of adoption would depend on the circumstances.

[T]hey should bring their embryonic children back to the dimension of time and take them out of their frozen state. It is in their hands to avoid adding one evil on top of another: to create a surplus of embryos and freeze them is one evil, to keep them in this state is another. To decide to make them material for science is also an evil.

Okay: in vitro fertilization sinful? Check. Freezing them evil? Check, but not necessarily with more advanced technology; DV prohibits risky operations and zygote-affecting operations that are experimental for the sake of experiment, and not all medical intervention across the board. Leaving them indefinitely on ice sinful? Check: they're placed in an unnatural and isolated state, most often for no primary reason. Harvesting for stem cells or cloning sinful? Check. All things we need not cooperate in. Keeping these points in mind, we move on...

But are they to be expected to implant every embryonic child in the body of its mother in view of bringing it into the world? I don't think this should be a 'moral obligation' for them....The only possibility open to them is implantation and gestation in the uterus of a woman. This possibility moreover does not automatically assure their survival.

If it weren't for the idea that a couple doesn't have to have every child they could possibly have, then NFP would be on the rocks; but on the other hand, they have already conceived children, and if parents weren't obligated to make at least a reasonable effort to bring their unborn children to term, then we wouldn't be opposing abortion, either. We don't have to guarantee success to make an effort; God only expects us to be faithful. How many miscarriages happen in the first week of pregnancy, anyway? Are we to sit on our hands because we haven't yet brought the failure rate well below these natural levels? If we do forsake every possible solution, then we are automatically assuring their death.

"What is more, can we really speak of adoption in a strict sense?...I do not believe that this would be a realistic 'response.'

First, yes we can, if we put our minds to it. The age of the child need not matter, and kids don't exactly come with 18-year warranties, let alone nine-month ones. Second, no, the way things are, it's not the most realistic response. No matter how many willing couples we'd be able to find, at this rate we'd never be able to give every embryonic child a chance at development and birth. It's possible that IVF could lose popularity or be banned, but unless such unlikely events transpire, embryo adoption will never be sufficient. Let me know if sufficiency becomes the primary moral consideration for an act.

Certain moralists consider that adopting embryonic children merely consists in moving a piece of a complex and absurd puzzle within a system that does not respect the origin of human life. It is a delicate question of a material cooperation with a technique which, in itself, is a means disrespectful of man. Others think that a massive and visible adoption of these embryonic children would testify to the respect we owe them and would favor, in the long run, a recognition of the evil that has been done to them and thus of the deadly character of these diverse techniques.

I think we're at the crux of the biscuit. By accepting the final act in a process that on the whole is immoral, are we formally cooperating with the evil? Not necessarily. Hearken back to the hypothermia example I gave earlier. Would it be immoral for me today to use that knowledge to save someone's life? No. What about my doctor in saving mine? Perhaps I'd be biased, but I'd again say no. What about the first doctor to read journal articles on the effects of prolonged cold on the human body, based on Nazi research? Not if that doctor is truly--primarily--interested in helping a patient keep his life or regain his health.

Where are we left when it comes to embryonic children? The science is not mature, and the technology is not what I'd like to call robust, but saving the life of a child is prima facie a good thing.

If I had to pay an open clinic to get an embryo and have it implanted, I'd probably pass because payment would constitute material cooperation, in the form of financially enabling an embryo mill to continue its work. If I felt an embryo mill were just another resource for fertility treatment, one that let me keep a little distance from the obviously immoral activity, then I'd still share the culpability.

If, however, I knew that there were frozen children--children who shouldn't exist, but God permitted to bring to the world anyway--and that they would definitely die if I did nothing, eventually discarded during an inventory purge or donated for ESCR or lost during a power failure or natural disaster; then I would really be inclined to give them something they could still have. They may have been denied a natural conception, but technically it wouldn't be too late to give them a chance at an otherwise normal gestation, and hopefully a full life.

Fr. Mattheeuws himself makes what is to me the same point in another part of the article, pointing out that adopting a child conceived by rape does not make one in any way complicit with the rape.

The personal conditions of [embryo adoption]--her condition as a woman, as a mother, as a spouse--seem little considered. With the 'rescue' option, the ethical illusion is profound: a sign of this is that even outside of the conjugal connection, the body of the woman can serve to this end.

Generally agreed. We can't just have lone people going around adopting embryonic children any more than we can have them adopting air-breathing children. Children are more than pets, and women are more than baby-making machines. Marriage provides for the procreation and raising of children, but it too is more. However, I'm still not seeing a durable difference between the goodness of a married, conjugally active, yet childless couple adopting an air-breather and a married, conjugally active, yet childless couple adopting an embryo. A woman's condition as a person, as a spouse, as a mother, should be considered along with her teleology even in the intent of conceiving her own children normally. I won't be so quick as to say these considerations for embryonic adoption are illusory, but it would be possible to commodify motherhood if we follow that path.

I still don't think it's enough to condemn the idea, though. It's not like the "right becomes obligation" argument against euthanasia, where a bad thing gives way to something worse. We just have something that could be very good, which is vulnerable to exploitation. Maybe weighing the quality of the technology, the likelihood of success, against the degree of moral vulnerability should be a judgment of prudence, but the possibility of exploitation doesn't make the matter different from anything else; it makes it just like everything else.

Donum vitae tells us 'surrogate' motherhood is not morally licit. It is contrary "to the unity of marriage and to the dignity of the procreation of the human person."

I submit, however, that embryo adoption is not surrogacy. Fr. Mattheeuws permits the distinction from traditional surrogacy, but insists that the similarity in the substitutiveness of both EA and surrogate motherhood are definitive and thus morally prohibitive. Let’s let DV define surrogate motherhood for us:

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.

DV explicitly leaves room for technical assistance to conception for conjugating spouses (see question #6 under Homologous Artificial Insemination), we can obviously distinguish IVF itself from surrogacy, and we can see that surrogacy as here defined is a commoditization of the woman’s childbearing capacity, a reduction of it to a mere social service.

I’m not trying to argue that the only problem with surrogacy is the objectifying aspects of the practice. Children have a right to be conceived in love by their parents and carried to term by their mothers. Surrogacy deliberately deprives children of at least one and often all of these things.

Embryonic adoption, on the other hand, does not. It bears little similarity outside of some technological aspects, which DV does not prohibit just for being technological. Embryonic children have already been conceived; the likelihood of their conception having been in vitro, while probable, is moot. If it were merely a matter of being something between regular adoption and custom-genotype surrogacy, then it would be a bad thing. Embryonic adoption won’t save every child, even if we found an adoptive mother for every one, but again, we shouldn’t refuse to try saving any lives just because we can’t save all of them.

Doesn’t saving lives often require the tolerance of lesser “evils?” A woman in a car accident requires a leg amputation. A man having a heart transplant receives an organ cut from another’s corpse, is given a highly addictive narcotic to alleviate the pain. A child is removed from an abusive household. Dangerous mentally ill people are institutionalized against their wills. In all such cases “adding one evil on top of another” really doesn’t suit. All the evils are already added up and piled on top of the child. The child was already conceived by IVF; any siblings have already been implanted or killed or are also awaiting adoption; the genetic mother is not coming back; the child has probably already been archived in a fancy freezer somewhere. The only variable is setting the Petri dish out on a counter and letting the children die today, or waiting until next week for the adoptive parents to come in for implantation. I don’t know about spiritually, but biologically, even an adult who could be successfully frozen would not notice the passage of time. Given sufficient scientific advancement, it might be no more violent than general anesthesia.

DV spells out how we shouldn’t procure children. It does not say there is some point during the accretion of material evils against a child that a third party is morally obligated to throw up his hands, refuse to take part in anything even tangentially related, and let the child die. This attitude strikes me as little different from one where a parent treats a child drinking some under-the-counter chemical the same way he’d treat his keys dropped in lava.

“Shouldn’t we call the Poison Control Center?”
“Don’t bother; he’s as good as gone.”
“This stuff might only be a slow toxin!”
“I said don’t bother.“

If I were a zygote stashed in a freezer somewhere, I’d be pretty hard pressed to come up with a course of action that would be worse than nothing. I’d also be pretty hard pressed to overlook the suggestion that I should die because I would be starting life deprived of too many good things.

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