“Be Fruitful and Multiply?” Ethical Takes on ART


Questions about assisted reproductive
technologies (ARTs) have been making major headlines with the California
octuplets.  Without sifting through the particularities of this
woman’s family story, a pressing problem surfaces:  the development
and use of these technologies has outstripped our ethical and regulatory
response.  As the Religious Institute’s just-released Open
Letter to Religious Leaders on Assisted Reproductive
Technologies
states, "The use of ARTs is always a serious moral
and medical decision."   Ethical deliberation is desperately
needed!   

Since the advent of these technologies
30 years ago, millions of women and men have used ARTs to try to have
children.  It is not a new story (although eight at once is
a rare occasion).  Yet the use of ARTs is a largely unregulated
practice in the United States.  Are they safe enough, effective
enough, affordable enough?  What are the ethical considerations
that should govern their use?  Moral judgments that take into consideration
medical, economic, and religious concerns will come to different conclusions
about artificial insemination than they might about in-vitro fertilization.  There is no easy answer, nor a single answer. 

We urgently need a public dialogue
– involving physicians, theologians, ethicists, clergy, health advocates
and the scientific community – that responds to the social, religious
and medical issues raised by the use of ARTs.  We need to assess
individual choice within a larger social context, so that we do not
divorce moral choices from moral responsibilities to one’s self, family
or the larger community.   In other words, the moral questions
not only involve the individual — health risk to self and potential
child(ren), ability to care for child(ren), religious belief/teaching,
partner’s desires, and personal motive.  But there are social
justice issues we as a community must weigh — medical effectiveness,
cost, and equal access.  We also must consider how ARTs reinforce
biological children as superior and women as valued only for childbearing.  

Medical Effectiveness and Economic
Cost

Not all ARTs are the same; they vary
in their cost and medical risk.  Some procedures have unknown long-term
health implications, not to mention high financial cost and limited
success.  There is a need for increased regulation to safeguard
health, additional research to determine the risks, and caution on the
use of high-risk, low-success technologies.  Medically effective
practices must be part of what determines the use of available technologies. 
With regard to in-vitro fertilization (IVF), for example, it is not
statistically effective to implant an excess of embryos
– and it could
increase health risks for the mother and children if multiple births
occur.  The high-financial cost also creates a class system of
those with access and those without. 

Equal Access and Non-Discriminatory Practices.

While religious and other cultural
beliefs will affect individual decisions about ARTs, no single religious
viewpoint should determine public policy or medical practice. 
We know from history that, when moral agency over reproductive choice
has been denied, marginalized persons and communities have been harmed
by forced sterilization, eugenics and medical experimentation in the
name of progress.  The right to make personal decisions about reproduction
should not be limited on the basis of marital status, sexual orientation,
gender identity, disability, class or race.   

‘Fruitfulness’ and Personal
Desire

I do not deny that many women and men
experience a yearning for biological children, or that women in particular
suffer in cultural and religious contexts that value them primarily
for childbearing.  Religious traditions have contributed to this
suffering.  From Jewish and Christian traditions, the Open Letter
calls for broader interpretations of texts such as "be fruitful and
multiply" and those that present infertility as a penalty for sin
or unfaithfulness.  Simultaneously, we must mine our religious
traditions’ rich sources of spiritual and moral support for various
understandings of creativity, generativity and family formation.    

As a society, and as faith communities,
we must commit to an ongoing conversation that respects an individual’s
desire to have biological children, holds medical professionals accountable
to nondiscriminatory and medically effective practices, and supports
reproductive justice for generations to come.    

The Religious Institute convened a
group of clergy, theologians, ethicists and health professionals to
create the Open Letter to Religious Leaders on Assisted Reproductive
Technologies.
Our intent was to help prepare religious leaders
to assist women and men seeking to become parents and to counsel individuals
and couples considering ARTs. I invite you into a discussion of the
moral and religious implications of these technologies.  The Open
Letter is available on our web site.  An accompanying guidebook, A Time
to Be Born
, will be published in May.

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To schedule an interview with contact director of communications Rachel Perrone at rachel@rhrealitycheck.org.

  • http://howtogetpregnantsite.info/4/3-secrets-how-to-get-pregnant invalid-0

    I never thought I would be against a woman having kids, but in this case it’s just crazy to want to have any more than the 6 she already has, living with her parents unmarried. Where did she get the money to do the procedure and get pregnant?

  • http://www.squidoo.com/earliest-possible-signs-of-pregnancy invalid-0

    Im not for government regulations but in an instance like this she should not have been able to get this procedure done to get pregnant.

  • invalid-0

    I would have to question the ethics of any ART doctor who assists people who already have more than 2 children to have more. It is irresponsible to society for doctors to assist families to grow well beyond the norm for the age. Doctors are health care providers first, and often not trained to think through decisions that will cause social change, like greatly increasing the average family size for certain sub-populations.

  • http://livingsexuality.com invalid-0

    If her parents and friends could not dissuade her from having more children, then the doctor definitely should have been the one to put a stop to this.

    It’s obviously a touchy subject because who wants the government or a doctor telling you how many kids you can have? No one… But this case points to the need for enforcement of regulations and ethical standards.

    Most of us will agree that 14 is simply too many… but what about the woman who has four and wants a fifth? Is that too many? Who decides how many is “too many”?

    I think the points made in the article need to be addressed, and soon. This won’t be the last time there is a case like this.

  • invalid-0

    I’m sorry, who died and made you god of the child bearing limitations and regulations department?
    Would people be questioning her mental health and credibility if she were married to a rich white man? Give me fricking break people.

  • therealistmom

    This woman is showing obsessive behavior, to the point of possibly diminishing her other childrens’ lives (6 children under 7? Does anyone really have the time and ability to truly be involved with each child?) and endangering the health of the eight she just gave birth to. It is a -fact- that the human body is not made to carry this many infants to term, and it is also a fact that infants born that early and at such low birth weights are at extremely high risk for various disabilities. When I first heard this story I had no idea about her ethnicity or her financial statues, but I still was very concerned about her mental state.

  • http://www.castlesteps.com invalid-0

    Who decides how many children you can have? I certainly don’t and I don’t judge anyone on how many children they have or want, PROVIDED that they have the means and ability to raise them well. Just because three quarters of the country have 2-3 children on average doesn’t mean that should be applied to everyone. If say, in another 10 years, the norm is to have 1 or no child, does that mean a person will be looked down upon if they have 2-3 children? My grandmother had 8 (in a space of 9 years) children, they were all poor and lived on a farm and every one of them turned out great. No washing machine, no car, no fridge, no flush toilet, no electricity and very basic education. Everyone of them is successful with families of their own. My grandparents had the ability to raise 8 great children – who are we to judge how this lady will raise hers when we don’t even know her? So she can’t afford disposable diapers for all of them – who cares? I didn’t have them either.

    The only thing I’d be concerned about is what the procedure does to the mother – if it does have any side effects on her and the children. Other than that, if this woman really loves her children and can bring them up, then leave her alone. Don’t judge her by the norm.

  • invalid-0

    This woman- the so-called octo mom- is on food stamps and gets federal disability for several of her younger children.Surely no one is surprised????
    So,your comments just don’t apply.

  • invalid-0

    This is scientific madness. I am pro-choice and pro natural. If two people can not accept the fact they are not fertile , than they are acting like spoiled kids-gimmie gimmie. If I can’t have it blah blah. Medical science has gone to far, they are cloning animals , plants,freezing embryo’s. This is sci-fi and Disgusting! Adopt a child if you truly want to be a parent. That is my opinion!

    This society has to stop treating women like damn incubators OK?

  • invalid-0

    What is so hard to understand? This octo-mom has a hoarding problem she is also not caring for her kids properly already! They are all going to wind up in foster care. Just wait!

  • http://thekissklimt.wordpress.com invalid-0

    For me the opportunity for appropriate couples to have their own child should always be supported. By appropriate i mean those who can support the children financially and emotionally. The child should have a good opportunity to contribute to the society into which they are born. My problem is where things go beyond simply have the child, as actually choosing its characteristics which should not be allowed. Things like choosing the sex or aesthetic characteristics of a baby is not what the techonology was initially designed for. Regulating this technology globally seems very difficult, and that problem needs to be addressed not just in the US, but everywhere.