Religious response to assisted reproductive technology
Religious response to assisted reproductive technology (ART) deals with the new challenges for traditional social and religious communities raised by modern assisted reproductive technology (ART). Because many religious communities have strong opinions and religious legislation regarding marriage, sex and reproduction, modern fertility technology has forced religions to respond.
Both for male factor testing and in order to use sperm for IUI or IVF the couple must first collect a sperm sample. For many religious groups this creates a challenge due to a prohibition on masturbation.
- Religious waivers due to the sperm being used for procreation.
- Post-coital testing.
- Seminal Collection Device (SCD) — a non-spermicidal condom used during intercourse.
The Roman Catholic Church opposes all kinds of ART and artificial contraception because they separate the procreative goal of marital sex from the goal of uniting married couples. The Roman Catholic Church permits the use of a small number of reproductive technologies and contraceptive methods like Natural family planning, which involves charting ovulation times. The church allows other forms of reproductive technologies that allow conception to take place from normative sexual intercourse, such as a fertility lubricant.
In Vitro Fertilization
Pope Benedict XVI has publicly re-emphasized the Catholic Church's opposition to in vitro fertilization (IVF), claiming it replaces love between a husband and wife. In addition, the church opposes IVF because it might cause disposal of embryos; Catholics believe an embryo is an individual with a soul who must be treated as a such.
This particular doctrine, often expounded by the magisterium of the Church, is based on the inseparable connection, established by God, which man on his own initiative may not break, between the unitive significance and the procreative significance which are both inherent to the marriage act.
The reason is that the fundamental nature of the marriage act, while uniting husband and wife in the closest intimacy, also renders them capable of generating new life—and this as a result of laws written into the actual nature of man and of woman. And if each of these essential qualities, the unitive and the procreative, is preserved, the use of marriage fully retains its sense of true mutual love and its ordination to the supreme responsibility of parenthood to which man is called. We believe that our contemporaries are particularly capable of seeing that this teaching is in harmony with human reason.
According to the Catechism of the Catholic Church,
Techniques involving only the married couple (homologous artificial insemination and fertilization) are perhaps less reprehensible, yet remain morally unacceptable. They dissociate the sexual act from the procreative act. The act which brings the child into existence is no longer an act by which two persons give themselves to one another, but one that "entrusts the life and identity of the embryo into the power of doctors and biologists and establishes the domination of technology over the origin and destiny of the human person. Such a relationship of domination is in itself contrary to the dignity and equality that must be common to parents and children."
The Catholic Church maintains that it is not objectively evil to be infertile, and advocates adoption as an option for such couples who still wish to have children:
The Gospel shows that physical sterility is not an absolute evil. Spouses who still suffer from infertility after exhausting legitimate medical procedures should unite themselves with the Lord's Cross, the source of all spiritual fecundity. They can give expression to their generosity by adopting abandoned children or performing demanding services for others.
Gamete intrafallopian transfer (GIFT) is not technically in vitro fertilisation because with GIFT, fertilisation takes place inside the body, not on a Petri dish. The Catholic Church nevertheless is concerned with it because "Some theologians consider this to be a replacement of the marital act, and therefore immoral."
Some of the more liberal Protestant denominations support ART. Many Evangelicals, however, especially Calvinists, position themselves similarly to Catholics.
IVF and similar technologies are permissible as long as they do not involve any form of third-party donation (of sperm, eggs, embryos, or uteruses). Regarding third-party donation there is a debate between the Sunni and Shia streams of Islam. The Sunni community, following the Al-Azhar fatwa, does not allow third-party donations. In 1999, Ayatollah Khamenei, the authority for the Shi'a Muslims, issued a fatwa stating that is was permitted to use third-party donors.
The conclusions of Gad El-Hak Ali Gad El-Hak's ART fatwa are as follows:
- Artificial insemination with the husband’s semen is allowed, and the resulting child is the legal offspring of the couple.
- In vitro fertilization (IVF) of an egg from the wife with the sperm of her husband and the transfer of the fertilized egg back to the uterus of the wife is allowed, provided that the procedure is indicated for a medical reason and is carried out by an expert physician.
- Since marriage is a contract between the wife and husband during the span of their marriage, no third party should intrude into the marital functions of sex and procreation. This means that a third party donor is not acceptable, whether he or she is providing sperm, eggs, embryos, or a uterus. The use of a third party is tantamount to zina, or adultery.
- Adoption of a child from an illegitimate form of medically assisted conception is not allowed. The child who results from a forbidden method belongs to the mother who delivered him/her. He or she is considered to be a laqid, or an illegitimate child.
- If the marriage contract has come to an end because of divorce or death of the husband, medically assisted conception cannot be performed on the ex-wife even if the sperm comes from the former husband.
- An excess number of embryos can be preserved by cryopreservation. The frozen embryos are the property of the couple alone and may be transferred to the same wife in a successive cycle, but only during the duration of the marriage contract. Embryo donation is prohibited.
- Multifetal pregnancy reduction (i.e., selective abortion) is only allowed if the prospect of carrying the pregnancy to viability is very small. It is also allowed if the health or life of the mother is in jeopardy.
- All forms of surrogacy are forbidden.
- Establishment of sperm banks with "selective" semen threatens the existence of the family and the "race" and should be prevented.
- The physician is the only qualified person to practice medically assisted conception in all its permitted varieties. If he performs any of the forbidden techniques, he is guilty, his earnings are forbidden, and he must be stopped from his morally illicit practice.
Within the Orthodox Jewish community the concept is debated as there is little precedent in traditional Jewish legal textual sources. Non-legal sources such as medrash and aggadah provide stories that have been used to draw conclusions regarding ART by modern Jewish legal decisors. In general, traditional Judaism views medical intervention positively. Regarding ART, the positive view of medicine is challenged by the Jewish religious legal system which has numerous laws regarding modesty and sexuality and a strong emphasis on verifiable lineage.
In Orthodox Judaism, insemination with the husband’s sperm is permissible if the wife cannot become pregnant in any other way.
Regarding laws of sexuality, religious challenges include masturbation (which may be regarded as “seed wasting”), laws related to sexual activity and menstruation (niddah) and the specific laws regarding intercourse. Additional issues arise regarding the restrictions of the Sabbath (Shabbat) and Jewish holidays.
An additional major issue is that of establishing paternity and lineage. For a baby conceived naturally, the father’s identity is determined by a legal presumption (chazakah) of legitimacy: rov bi'ot achar ha'baal - a woman's sexual relations are assumed to be with her husband. Regarding an IVF child, this assumption does not exist and as such Rabbi Eliezer Waldenberg (among others) requires an outside supervisor to positively identify the father. Doctors or laboratory workers present at the time of the fertility treatment are not considered supervisors due to a conflict of interest and their pre-occupation with their work.
As such, supervisory services are required for all treatments involving lab manipulation or cryopreservation of sperm, ovum or embryos.
While a range of views exist, both egg donation and surrogacy are permitted according to many Orthodox decisors, pending religious fertility supervision. (In Israel, the "Embryo Carrying Agreements Law" was formulated to ensure that surrogacy agreements between Jewish Israelis do not conflict with Jewish laws concerning incest and adultery and that the child born of the arrangement will be recognized as a Jew.)
The official halachic legal authority for American Conservative Judaism is the Rabbinical Assembly's Committee on Jewish Law and Standards. They vote on proposed responsa. A responsa may be approved by either a majority or a minority vote, and individual Rabbis may rely on even minority-approved responsa for their rulings.
Artificial insemination: AI is permitted whether the donor is the husband of the woman to be impregnated or not, although it is preferable to use the husband's sperm whenever possible. The sperm donor is considered the father for purposes of determining the child's tribal status and for issues of ritual consanguinity, therefore, the use of anonymous donors is strongly discouraged.
Egg donation/Surrogacy: Surrogacy and egg donation are permissible and the birth mother, rather than the genetic mother, is considered the mother of the child, therefore conversion may be necessary if a non-Jewish woman acts as a gestational surrogate. A maximum of 3 embryos may be implanted at a time. Freezing and donation of embryos is permitted.
The Conservative movement's position on "family purity" practices, reducing the amount of time after a woman's period during which she is prohibited to have sex, may also work as a pro-fertility measure. As part of its treatment of Tohorat HaMishpahah, the Conservative Assembly in 2006 accepted a position of eliminating the requirement for seven white days after the cessation of menses and establishing this as an optional custom. This is offered as a solution for women dealing with ovulation before mikvah by reducing the number of days with sexual relations being forbidden from an average of 12 to 5. Mid-cycle staining during ovulation, while ordinarily would prevent sexual relations by being considered zavah, is to be considered a result of ancillary circumstances (diet, medical treatment, physical exertion, or illness) and as such the emission is considered permissible, and the woman would not become a zavah. Drug therapies to avoid mid-cycle staining are deemed unnecessary with the risks of the drug side-effects outweighing the prohibition of zavah due to the commandment of hai bahem, ("[you shall] live by them").
- "Pope Benedict XVI Declares Embryos Developed For In Vitro Fertilization Have Right To Life", Medical news today.
- Reconciling religion and infertility By Alina Dain. July 30, 2009
- Pope Paul VI (25 July 1968). "Humanae Vitae: Encyclical of Pope Paul VI on the Regulation of Birth, sec 12". Rome: Vatican. Retrieved 25 November 2008.
- "Catechism of the Catholic Church. Section 2377". Rome: Vatican. 1993. Retrieved 25 November 2008.
- "Gamete". Sexuality. Loras. Retrieved 22 May 2012.
- Haas, John M. "Begotten Not Made: A Catholic View of Reproductive Technology". United States Conference of Catholic Bishops.
- Inhorn 2006.
- Goodwin, Jan (Winter 2008), "Faith & Fertility", Conceive (My virtual paper).
- Shulchan Aruch, Yoreh Deah 336: 1
- Tzitz Eliezer 9 p. 247
- Rav Sholom Eliashiv: “Even if I were to be the lab worker I couldn’t be a valid witness for this matter”.
- Haredi widow to become surrogate mother. Nissan Shtrauchler, Yediot Acharonot
- Teman, Elly. 2010. Birthing a Mother: the Surrogate Body and the Pregnant Self. Berkeley: University of California Press. See also Kahn, Susan Martha. 2000. Reproducing Jews: A Cultural Account of Assisted Conception in Israel. Durham: Duke University Press.
- Dorff, Rabbi Elliott. "Artificial Insemination, Egg Donation, and Adoption," Committee on Jewish Law and Standards of the Conservative Rabbinical Assembly. Approved 20 in favor, 1 abstention, in 1994
- Mackler, Rabbi Aaron L. "In Vitro Fertilization," Committee on Jewish Law and Standards of the Conservative Rabbinical Assembly. Approved 20 in favor, 1 abstention, in 1995.
- Grossman, Susan (September 13, 2006). Mikveh And The Sanctity Of Being Created Human.
- Inhorn, MC (December 2006), "Making Muslim babies: IVF and gamete donation in Sunni versus Shi'a Islam", Cult Med Psychiatry 30 (4): 427–50, doi:10.1007/s11013-006-9027-x, PMC 1705533, PMID 17051430.
- Hirsh, Anthony, "Post-coital sperm retrieval could lead to the wider approval of assisted conception by some religions" (PDF), Hum Rep (reprint) (Oxford journals).