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Reflections on Ethics 57
God's Will in Assisted Reproduction

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Early last month, Canada's first sextuplets were born in British Columbia. While still rare, this type of multiple birth is on the increase worldwide due to the increasing use of IVF by those unable to conceive naturally. Multiple embryos are implanted to increase the odds that at least one or two of them will survive in the womb through to birth.[1]

Sometimes this natural attrition does not occur, and more embryos than expected develop into foetuses. If all continue to develop normally, then the outcome is almost certain that they will be born extremely prematurely (at 25 weeks in the Canadian case,) they will require extraordinary and costly neo-natal care, they will have a far higher mortality rate than other newborns and they will be likely to have developmental problems affecting their future lives. And because of the amount of testing required while in intensive care, they will probably require blood transfusions.

What IVF specialists recommend in the case of a potential multiple birth is a reduction in the number of foetuses - OK, it is abortion they are recommending - to bring the number down to two. This will give those two a solid chance of staying in the womb for the full nine months and of being born healthy.

These facts are explained to prospective parents who undergo IVF. It should not come as a surprise to them that they will be presented with such decisions. It makes me wonder why people who are opposed to abortion or opposed to blood transfusions would undergo such a procedure. Surely, their objective is a healthy child with a full life expectancy.

The Canadian couple who produced the sextuplets are Jehovah's Witnesses. They refused to consider reducing the number of foetuses in the womb in full knowledge of the potential consequences. Soon after the six were born, two died. God's will, they said. Of the four remaining, three required blood transfusions to survive. That is against God's will, they said. The province stepped in and ordered the transfusion. The parents are now suing to prevent future transfusions. Meanwhile the four surviving babies remain in neo-natal intensive care receiving the full panoply of medical care - all of which except for blood transfusions are apparently OK with God. If the babies die because they do not get transfusions - well, that is God's will.

People manage to read into the Bible a directive from God against abortions. A smaller minority manage to read into the Bible a directive from God against blood transfusions. I find it a stretch to do either. But I find it far easier to read into the Bible that according to God's will the only place a man can morally deposit his sperm is in a woman's vagina - and that woman must be one of his wives, one of his concubines, his wife's servant, his dead brother's wife, or a prostitute (particularly if she is his dead son's wife.)[2] That effectively rules out test tubes and plastic cups.

If God's will is the basis of morality, then those couples who believe in God and who are unable to conceive naturally might consider that God has given them a clear indication of His will and their parenting possibilities. To use IVF suggests either that the parents do not agree with God's will, or that they consider the availability of IVF to be God's will. But if IVF is God's will, then logically that means the entire package with all its implications.

As is usual with those who use God for their morality, the interpretation of God's will is extremely selective - and can lead to profoundly immoral consequences. Unfortunately, the fate of children is in the balance here - and they are the losers solely because of their parents' interpretation of God's will.

Footnote:

  1. Conventional medical wisdom is slowly changing on this. Gradually IVF clinics are coming round to the idea of just implanting one or two. [note added Nov 09]
  2. An argument can be made that teenage daughters can be added to the list, but they are required to get their father drunk first so he can pretend he did not know what he was doing. [Lot & his daughters]