From Dr M. Asciak

The Vatican’s much-awaited update on the 1987 Bioethics instruction Donum Vitae (The Gift of Life) was finally published on 12 December. It is called Dignitatis Personae, as reflected in the title of this article, and I find it to be an extremely positive document.

Essentially it has not changed any of the previous instruction’s moral content. Medical interventions in the field of fertilisation procedures remain intrinsically immoral for several reasons, the basic problem of which today, remains the separation of the sexual conjugative unitive act from the procreative act during the said procedures. The beginning of human life remains identified as “the moment the zygote has formed” in the process of fertilisation, and this human being should be treated as a person from this very moment.

To the moral evaluations found in Donum Vitae, however, are added instructions on a number of new developments. With the usual condemnation of the freezing of embryos, one now also finds the underlined immorality of inserting too many embryos during the procedure, called multiple transfer, as a “purely utilitarian treatment of embryos”. In actual fact, the state-of-the-art in IVF today dictates that no more than two embryos, at most three, should be inserted. Many procedures in many countries insert only one embryo. With the possibility of the freezing of eggs rather than embryos, this has become a very attractive prospect. The dangers of pre-implantation and prenatal diagnosis are highlighted, with the consonant threat of abortion implied in both cases, as is that of many morning-after pills.

The new forms of genetic engineering are wisely differentiated from one another. Somatic (normal body) cell gene therapy is praised as a way of curing inheritable or acquired diseases and the concomitant temptation and danger of eugenic enhancement therapy is pointed out. Genetic change can be used not only to cure disease but also to make one physically stronger and more beautiful, mentally wiser and for enhancing other physical characteristics one may like to choose. Germ line gene therapy is ruled out morally, as it passes on these known and unknown changes to future generations with all the dangers this involves at this stage of medical proceedings, many effects of which are still unknown. Human cloning in all its forms, especially to obtain embryonic stem cells, is morally forbidden as referred to as a form of biological slavery. The participation in commodifying the use of embryonic stem cell lines, even at the demand side of the market, is also labelled as complicity in this form of immorality and cooperation with evil. The use of adult stem cells and their lines, on the other hand, are highly extolled as being extremely positive.

Having read through the recent instruction, I felt a sense of satisfaction, because the recommendations of the Social Affairs Committee and the Bioethics Consultative Committee issued three years ago on Biotechnology, reflect most of these very principles. One should, of course, distinguish between the position of the Church as a teacher and the position of the State. The State ought to regulate procedures of IVF and Biotechnology in order to preserve the common good. In Malta, this would mean the preserving of human life from conception and the preserving of family values, in a procedure that may be open to abuse and which has taken place behind closed legal doors for the past 20 years. The Church has expressed its moral position, as it has a right and duty to do, but the State cannot expect that these procedures are not allowed to be accessed by infertile couples subject to the legislation of concepts of the common good which it wants to promote. This was confirmed by Cardinal Ratzinger in a book published with the leader of Italy’s Senate, Marcello Pera (Senza Radici – also available in English) wherein the present Pope expressed the importance of civil society enforcing legislation in selecting procedures of IVF that are friendly to the family and human life.

I believe that it would not be right to impose the whole Catholic morality on IVF on the whole of civil society, especially in an area where personal informed decisions need to be allowed their own space and freedom of conscience within the special relationship of the couple involved. One ought to keep in mind, however, that the main structural precepts essential to our civilised society should be maintained. One ought also to keep in mind that as science evolves safer techniques in biotechnology, so the Church may evolve its teachings in the future as it has done now. The sexual concepts of conjugative unity and procreation remain but may not be found to be enough to account for complications involving the whole moral sexual relationship between a couple. As new psychological, sociological and medical information is discovered everyday, concepts such as sexual identity, mutuality and communication may have to find their place alongside unity and procreation. Notwithstanding all this, the State has been dormant for too long and it is now time to act.

Michael Asciak MD