The wrong cure for infertility

Turning baby-making into a technology can have devastating results. 
Bill Muehlenberg | Jun 16 2009 | comment  



For some men and women, IVF can seem like a godsend. Inability is always felt as a grievous loss for loving couples. But the clinics which offer IVF and other "assisted reproductive technology" techniques are businesses, and offer services, not love. They make mistakes which devastate lives.

The latest blunder comes from the UK. The Daily Mail’s headlines speak for themselves: "'In ten seconds our world was shattered': Distraught IVF couple discover their last embryo was given to the wrong woman -- and then aborted".

The story continues: "A couple's last hopes of having another child have been shattered after an appalling blunder at an NHS fertility clinic led to their final usable embryo being implanted into the wrong patient. The error was made by an overworked trainee doctor who failed to carry out strict checks that require all fertility procedures to be witnessed and verified. The woman who mistakenly received the couple’s embryo was told of the devastating error shortly after it occurred and agreed to have a termination. It was the only remaining embryo of nine the distraught couple had created using IVF. The blunder at IVF Wales, part of Cardiff and Vale NHS Trust, was rated category A, the most serious level, by the Government’s fertility regulator, the Human Fertilisation and Embryology Authority (HFEA)."

A number of ethical issues are raised here. It is clear, for example, that these technologies are often running at cross purposes. The same hospital that performs fertility treatment in one room, may well be dealing with contraception, sterilization and abortion in another. On the one hand we want to be fertile, even where it is socially, morally or biologically impossible or undesirable. On the other hand we want the ability to cut off the possibility of new life. This schizophrenic mentality is all part of a society that has lost its moorings and is confused about the nature of sexuality and reproduction.

But this can only get worse. As we move down the road of sex selection, selective breeding, designer babies, and grand promises of eliminating present disease and weeding out future illnesses, we will more and more make utilitarian decisions about which babies should be allowed to enter the world and which should not. The range of what is acceptable life will continue to narrow, and the pressure will mount to restrict conception and parenthood to that which is socially desirable.

But problems in medical ethics are the least of the concerns for these distraught parents. Their reality is quite obvious: their last child was killed. As the grieving mother said: "I kept thinking, 'They’ve killed our baby! Killed our baby!' The hospital offered us private counselling on the spot, but we couldn’t get out of there fast enough. Even our worst fears didn’t prepare us for the devastating news that our embryo had actually been placed in another woman, and that it had to be taken out and destroyed for 'medical reasons'."

Many similar problems such as this have occurred over the years, mostly due to human error. Numerous IVF mix-ups have occurred. Sperm, eggs, or embryos, are somewhere along the line mixed up, resulting in the wrong children given to the wrong parents. A recent example took place in Britain when a white couple had black twins following an IVF mix-up. A study later found that this was due to mistakes, overworked staff and poor management. The report found a "catalogue of serious mishaps" at IVF clinics.

And the various medical concerns continue to make news. Also in the UK, a recent study found that IVF twins are at a much greater risk of illness or early death. As the Times reported last month, "Twins born as a result of fertility treatment are at greater risk of serious illness or dying in the first three years of their life than those who are conceived naturally, a study suggests. Siblings born together after in vitro fertilisation (IVF) stay an average of four days longer in hospital after birth and are far more likely to be admitted to a neo-natal intensive care ward. They are more than twice as likely to die just before or just after birth, although the reasons for this are not clear, researchers at the universities of Western Australia and Oxford said."

The desire for children is normal and deep-seated. But sometimes we must be willing to accept what nature has dealt to us, if the remedy becomes worse that the ‘illness’. Indeed, one can ask if it is even right to speak of infertility as in illness.

One thing is certain, assisted reproductive technology does nothing to cure the condition. The infertile individual continues to be infertile after treatment. Perhaps we should put more money into the causes of infertility. Research should be aimed at solving or relieving these problems, instead of pouring money into treating the symptoms. And other options, like adoption, should be explored more fully.

Indeed, one can also ask whether IVF is good medicine. Bioethicist Donald De Marco reminds us that reproductive technologies "represent a deviation from the traditional aims of medicine inasmuch as they treat a desire rather than a disease".

And as fertility expert Roger Gosden notes, "The desire to bear a child can become obsessive, and the costs of infertility treatment are often heavy. Infertility patients are willing to accept considerable discomfort as they undergo a roller coaster of emotions and medical procedures that would be considered humiliating or even dangerous in other circumstances."

Commenting on this newest story of IVF mix-ups, Bel Mooney offers some helpful insights: "The toll on her physical and mental health (and that of her husband) has been immense and one wonders what the knock-on effect of that on her existing child will be. After all, Mum is always sick or in tears ... Desperate couples on the IVF carousel think: 'Next time we will be lucky' and perhaps say silent prayers as the cycle starts once more. As I said earlier, who can blame them?

"Yet it's impossible not to worry that we have reached an unhealthy state when too many people believe they have a divine right to a child. When you have women in their 50s and 60s living by that misplaced conviction and conceiving babies artificially, something is very wrong. These are fiendishly difficult issues, and any government (and its watchdog) owes it to the public to legislate fairly, to be vigilant, to take responsibility and to warn.

"Many of us have doubts that the HFEA is living up to those standards. But beyond that, perhaps women themselves need to rethink their attitudes to motherhood. I would suggest that any young woman in her twenties, in a serious loving relationship, would be wiser not to postpone trying for a baby. That she should think of fertility as a privilege, not a right. And that -- whisper it -- childlessness might be a fate which (like so many of the other sorrows which afflict our lives) sometimes has to be accepted."

Quite so. And this is not mere wishful thinking. I know of infertile couples who have embraced their infertility. Sure, they still ache for a child, but they have learned to accept their lot in life, and have learned to be grateful for the many mercies and blessings they do experience in a less than ideal world.

Perhaps the desire for a child has becomes that much stronger in a world where we expect everything to be handed to us on a silver platter. Living in an age of entitlements simply compounds the problem here. Perhaps it is time we started looking at life in all its fullness as a gift, instead of an entitlement.

Bill Muehlenberg is a lecturer in ethics and philosophy at several Melbourne theological colleges and a PhD candidate at Deakin University.



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