Tuesday, March 13, 2012

The Ethics of IVF

One of the most controversial aspects of modern medical ethics is the use of in vitro fertilisation (IVF). Ethical views appear, in general, to have changed considerably in western countries since the birth of the first test tube baby, Louise Brown, in Britain in 1978 - so much so that it is now largely accepted that homosexual couples can seek IVF treatment and the sex of a baby may be determined prior to pregnancy.

Most religious groups seem to have given IVF qualified acceptance. The Anglican Church, for instance, allows IVF within marriage, but forbids the donation of eggs and sperm. The Hindu religion allows IVF, but only if the gametes used in the procedure come from a married couple seeking pregnancy. Hindus may also donate sperm, but the donor must be a close relative of the infertile husband. Buddhists have a very liberal attitude towards assisted pregnancy - it is permitted for both married and unmarried couples and men are free to donate sperm. While Islam allows IVF treatment, it must be within the bounds of marriage. After divorce or death of one of the spouses, preserved sperm or eggs are not permitted to be used, since the Muslim marriage contact would be seen to have been broken. My understanding of Jewish Law is that since the scriptures direct Jews to procreate, if this is not possible via a normal pregnancy, it is acceptable for this to be achieved by artificial means. There does not appear to be a clear consensus among rabbis over some aspects of IVF such as the implantation of multiple embryos (some of which may of course not result in a viable pregnancy).

Of the major world religions, Catholicism appears to take the most authoritarian and conservative stance, in line with its absolutist take on morality and ethics. It accepts that Catholic couples may seek medical treatment for infertility, but does not permit the use of IVF or the donation of eggs or sperm. The Vatican's position is that it is immoral to separate sex and procreation. In June 2006 Pope Benedict XVI made a series of statements to clarify his view of IVF treatment:
  • The human being has the right to be generated, not produced, to come to life not in virtue of an artificial process but of a human act in the full sense of the term: the union between a man and a woman. 
  • Never before in history has human procreation, and therefore the family, which is its natural place, been so threatened as in today's culture. 
  • Procreation must always take place within the family.
  • ...true love is only that which comes from the union of a man and a woman.
  • A true family comes from the union of two people from different sexes.

Robert Winston is a pioneer of some techniques of IVF and is currently professor of Science and Society at Imperial College, London. He was an advisor to the World Health Organisation as part of their programme on human reproduction between 1975 and 1977, and is now a celebrity after presenting numerous science documentaries on British television. He currently sits in the House of Lords on the side of the Labour Party and therefore also has political affiliations. In the following podcast he sets out his views on the ethics of IVF treatment:

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