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A Hard Truth: IVF is Not Moral

In the past days, several news outlets have noted [1] the “demographic bomb [2]” facing much of Europe. With below-replacement rates of fertility, many European countries risk an acute shortage of workers and tax-payers needed to sustain their economies and the welfare state. Of course, Europe is hardly alone in this situation, as evidenced by the United States [3] and Japan [4], among others. In one notable policy, Hungary will soon provide free [5] in vitro fertilization treatments (IVF [6]), already offering [7] tax incentives and loan forgiveness to larger families.

Of course, many people utilize IVF not to bolster sagging demographics but simply to have a child. IVF is a highly effective option [8] for “heterosexual and same sex couples experiencing infertility and even single women pursuing parenthood.” Like other medical procedures, there are risks involved, and many are aware of the moral issues entailed in the storing and disposal [9] of “excess” embryos as well as the exploitation [10] and manipulation [11] of some “egg donors,” especially the poor.

Still, IVF is a common practice, deemed morally acceptable [12] by most, covered by many health insurance plans, and viewed as a miracle for many unable to have children. The pain of infertility can be traumatic, the experience and joy of having a child life-changing—why should “moral” concerns limit that joy or increase that pain?

But is IVF morally acceptable?

I’m not asking whether the storing and disposal of unused embryos is moral, nor whether it is acceptable to cull “excess” or unhealthy implanted embryos. Those issues are akin to the debates surrounding the morality of abortion. I’m asking a different question, one I recognize is painful to ask. Namely, even if no embryos were discarded or culled, is IVF morally acceptable? Even if every fertilized egg resulted in a happy and healthy birth for eager and loving parents, is IVF morally permissible?

The answer is a hard one, I’ll admit. IVF is not as unproblematic as it seems.

I understand how counter-intuitive this appears. A loving married couple, say, desperately wants a child, loves that child when it is born, and intends only good—how can that be wrong?

A primary principle of ethics is that persons ought never be instrumentalized, that is, ought never be treated as a mere means or tool to some other end. Persons have unalienable dignity, in other words. But personhood is not some attribute distinct from the body; it is not that I have a body but am a person. Rather, my body is coterminous with my person, and the parts and acts and operations of my body are at the very same time aspects and acts and operations of my person. Obviously, we don’t think of some bodily operations as voluntary or the result of personal choice or responsibility—like respiration or the heart beating, say—and yet it is a person who breathes and a person’s heart who beats. There are no parts or acts or operations of a human body which are sub-personal or impersonal, because the body and the person are coterminous.

Genetic material is not simply raw material, nor are children “products.” This non-fertilized egg is not just undifferentiated bodily stuff, for this egg is Samantha’s egg, generated of her ovary, her body, that is, of her. The egg is not just from her, but rather of her [13]. In the same way, semen and sperm are not just stuff which happens to carry genetic information, for it is of Tom, the person, not just produced by Tom’s body.

Children, too, are persons, not products or composed of products. Instead, children are generated by the bodies, acts, and operations of their parents, that is, by the systematic coordination of persons. (This, as an aside, is one reason why sexual violence is so unjust, for such violence causes not just bodily harm but additionally violates the moral autonomy of persons.)

As a result, if we act as if our bodies and their operations simply contribute parts towards a product we treat our bodies as sub-personal, thus instrumentalizing our bodies, and our person, but also treating the body and person of another (the reproductive partner) as likewise a mere tool or instrument.

Further, once we treat persons as objects and products in this way, it shouldn’t surprise us to discover that a host of other problems emerge, such as wrongful birth [14] lawsuits (I only wanted one child through IVF, but I got three!), custody battles [15] over frozen embryos, designer babies [16] (and culling of “ordinary” babies), and embryonic-destructive scientific research. Once a child is considered a product, the logic of buying and selling, owning and disposing of “property” kicks in—but persons aren’t property.

Obviously, it may not feel like this. A couple using IVF may have no intention of treating themselves or their bodies in this way. They may wish to have a child together for the very best of reasons, to express love for each other, to enjoy new life together, to love a child thoroughly. Those are lovely and commendable motivations, of course.

Still, when it comes to ethics, our good intentions don’t determine everything about the morality of an action, although certainly intentions matter a whole lot. The goals of our “heart” may make us less or more blameworthy, but some acts are wrong in and of themselves, objectively, whatever our other desires and intentions.

Many, perhaps most people who use IVF have the very best of intentions. Yet, it’s worth pausing for a moment to consider the morality of the action itself, that is, to think about the persons involved in their full humanity.