Saturday, March 9, 2013

Can Nature be a Conscientious Objector?

It is a standing Catholic doctrine that the conception of human beings should take place only in the context of acts of intercourse between married, opposite-sex partners.  Maybe some Catholic practitioners can find some wiggle room in the Church’s declarations, but that usually requires some creative interpretation of texts such as Donum Vitae (1987) which declares the “right of every person to be conceived and to be born within marriage and from marriage.” (The emphasis here is in the original.)  If we go with the spirit of these texts, the Church declares that the front line of fertility treatments offered today are sinful. Inasmuch as the Church makes a case that there is a separate, philosophical basis for these declarations, these fertility treatments are also supposed to be immoral as well.

What’s a conscientious physician to do, if he or she finds that they want to observe this interpretation? Some commentators and physicians now declare that the pathway to fertility lies through Natural Procreative Technology (NPT). These commentators and physicians advise that clinicians be look-out for underlying causes of fertility and treat those rather than deploy donor gametes, IVF, embryo transfer, and other treatments in order to give people the child they want. NPT is, therefore, a call to treat underlying disorders insofar as they stand in the way of conception through acts of intercourse between married, opposite-sex partners. 
Advocates of NPT don’t simply offer this approach to infertility as one option among others. They assert the desirability of identifying and reversing the causes of infertility as the only approach that is consistent with the rights of children to be conceived in marriage as well as the rights of men and women to become fathers and mothers only through one another and only through acts that are unitive of body and soul.  

There are no guarantees, of course, that these approaches must succeed. Not all treatment will lead to success in having a child. For those people who pursue this approach, they can either accept their fertility as a kind of spiritual opportunity for religious growth or they will face anew the question of whether to seek out donated gametes, IVF, embryo transfer, or whatever other techniques will help them have a child.

Advocates of NPT invokes ‘personalism’ as one basis for their objection to most assisted reproductive treatments, but there is no reason to accept their interpretation as the one and only interpretation of what it means to be married or to have a child. Advocates of NPT fall back on one interpretation of human relationships and treat that interpretation as somehow an expression of human nature as such. 

Most people who are looking for help in having children do not seek out clinicians for lessons in the metaphysics of human nature. They hope to enrich their lives by having a child, upon whom they can confer benefits. For most people these ethical reasons outweigh the metaphysical interpretations of others. People are free, of course, to interpret their infertility – even if it continues after treatment to restore fertility – as religiously and morally valuable. Physicians are also generally free to decline to offer certain treatments altogether. Treating these freedoms as concordant with nature itself, however, goes too far since we cannot know nature except as an interpretation.  And when it comes to having children and entering into relationships, one interpretation does not fit all.

See:  B.E. Jemlka, D.W. Parker, R. Mirkes, “NaProTECHNOLOGY and Conscientous OB/GYN Medicine,” Virtual Mentor – American Medical Association of Ethics,  2013 (15): 213-219.