Dignitas personae

Conference of Cardinal William Levada
Prefect of the Congregation for the Doctrine of the Faith

Uniwersytet Kardynała Stefana Wyszyńskiego & the Diocese of Radom
Radom, 16 May 2009

Introduction

It gives me great pleasure to join His Excellency, the Most Reverend Zygmunt Zimowski, and the many other participants in the International Symposium on “God the Font of Life” at the Major Seminary in Radom. I thank him and the authorities of the Cardinal Stefan Wyszinski University of Warsaw who joined in giving me this welcome invitation.

To my thanks, of course, I must add a word of congratulations. Now he is bishop emeritus of Radom, and Archbishop President of the Pontifical Council for Health Pastoral Care at the Holy See. Perhaps I can be the first of his new colleagues at the Vatican to welcome him to his new work. Ad multos annos!

In the Catechism of the Catholic Church the third “pillar” of catechesis in the Catholic faith, the section on morality, is entitled “Life in Christ”. God of course is “fons vitae,” the font of all life itself, as we profess in the Creed with the words, “We believe in God … Creator of heaven and earth.” The dignity of the human person rests on the foundation of our creation “in his image and likeness.” Through our faith we come to see our new dignity as children of God: by divine grace we are called to model our lives on the new man Jesus Christ, revealed as Way, Truth and Life for us and all humanity.

The task assigned to me today is to present one small, but not unimportant, part of this “Life in Christ.” The recent Instruction of the Congregation for the Doctrine of the Faith addresses certain bioethical issues at the beginning of life. But happily the title of document, taken from its first two words in Latin, is Dignitas personae. The title recalls for us how all life finds its origin in God. Indeed, God sent his Son to be “fons vitae” – a living spring of new life welling up for us in word and sacrament. Dignitas personae reminds us of the greatness of our vocation – “life in Christ” – as it proposes for our consideration how the dignity of the human person ought to be recognized and protected even in the tiny, microscopic forms in which every human life finds its beginning.

Setting the Scene

It seems every week the press carries a new article about some development in the area of biomedical technology. Allow me to cite just three examples:

This past December, the International Herald Tribune published a significant article on the problem of frozen embryos. “For nearly 15 years, Kim and Walt Best have been paying about $ 200 a year to keep nine embryos stored in a freezer at a fertility clinic at Duke University – embryos that they no longer need, because they are finished having children, but that Kim Best cannot bear to destroy, donate for research or give away to another couple. The embryos were created by in vitro fertilization, which gave the Bests a set of twins, now 14 years old. Although the couple… have known for years that they wanted no more children, deciding what to do with the embryos has been a dilemma. He would have them discarded; she cannot. ‘There is no easy answer’, said Kim Best, a nurse. ‘I can’t look at my twins and not wonder sometimes what the other nine would be like. I will keep them frozen for now. I will search in my heart…” (IHT, 5 December 2008).

A second story which received much press attention concerned embryonic stem cells as a new form of colonialism. Recently, Bishop Joseph Tlhagale, President of the South African Episcopal Conference, said: “In the majority of African countries, both the Maputo Protocol and the Convention, ostensibly aimed at the elimination of all forms of discrimination against women, actually seek the legalization of abortion and the legitimization of in vitro fertilization. While in Great Britain it is illegal to use the ova of English women for research, these new norms make possible the exploitation of the ova of African women in order to satisfy the needs of research into embryonic stem cells in industrialized countries. Biological colonialism is at the gate” (L’Osservatore Romano, 25 January 2009).

The third story refers to a recent and rather notorious case of in vitro fertilization: “After receiving in vitro fertilization…, Nadya Suleman, 33, gave birth to two girls and six boys… the babies, who now range in weight from 1 ½ pounds, or 680 grams, to 3 ¼ pounds, are in incubators and feeding on nutritional supplements and donated breast milk. They are breathing on their own… Suleman’s six other children are two girls and four boys, aged 2 to 7, and they all live with Suleman and her parents… It was not clear how the first six children were conceived, but Suleman’s mother… told… that they also resulted from in vitro fertilization and that Suleman used the remaining embryos to conceive the octuplets. Nadya Suleman, her mother said, has been ‘obsessed’ with having children since her teenage years… Suleman divorced in January 2008, but the filing indicates her ex-husband is not the father of any of the children…” (International Herald Tribune, 5 February 2009).

These three examples show the urgent need for calm ethical reflection on the questions connected to recent developments in reproductive science. The Church is not opposed to scientific progress, but seeks to ensure that the dignity of the human person is safeguarded. In this regard, the new Instruction of the Congregation for the Doctrine of the Faith entitled Dignitas personae (published in 2008) affirms: “The Church, by expressing an ethical judgment on some developments of recent medical research concerning man and his beginnings, does not intervene in the area proper to medical science itself, but rather calls everyone to ethical and social responsibility for their actions… The intervention of the Magisterium falls within its mission of contributing to the formation of conscience, by authentically teaching the truth which is Christ and at the same time by declaring and confirming authoritatively the principles of the moral order which spring from human nature itself” (n. 10).

This new document serves as an update of the Instruction Donum vitae, published by the Congregation for the Doctrine of the Faith in 1987. Today I would like to highlight some of the fundamental principles articulated in Dignitas personae.

Two Fundamental Ethical Criteria

Addressing itself to all those who seek the truth, the new Instruction “draws upon the light both of reason and of faith and seeks to set forth an integral vision of man and his vocation, capable of incorporating everything that is good in human activity, as well as in various cultural and religious traditions which not infrequently demonstrate a great reverence for life” (n. 3).

Two fundamental ethical criteria by which new biomedical questions should be evaluated are recognizable as true by human reason. They concern the dignity owed the human person, and the personal nature of the act which transmits life. The first criterion is presented in this way: “The human being is to be respected and treated as a person from the moment of conception; and therefore from that same moment his rights as a person must be recognized, among which in the first place is the inviolable right of every innocent human being to life” (n. 4). The second criterion is as follows: “The origin of human life has its authentic context in marriage and in the family, where it is generated through an act which expresses the reciprocal love between a man and a woman. Procreation which is truly responsible vis-à-vis the child to be born must be the fruit of marriage” (n. 6).

These two criteria are further consolidated and reinforced by faith. Faith teaches us that God has created every person in his own image. In the incarnate Son the human person can himself become a son of God, possessing “an eternal vocation and…called to share in the Trinitarian love of the living God” (n. 8). Furthermore, faith assists us in better understanding how the acts by which human beings come into existence “are a reflection of trinitarian love. God, who is love and life, has inscribed in man and woman the vocation to share in a special way in his mystery of personal communion and in his work as Creator and Father… The Holy Spirit who is poured out in the sacramental celebration offers Christian couples the gift of a new communion of love that is the living and real image of that unique unity which makes of the Church the indivisible Mystical Body of the Lord Jesus” (n. 9).

New Problems In Procreation

The Instruction Dignitas personae examines some new difficulties created by recent developments in reproductive science. Certainly the desire of a couple to have a child is legitimate: does this fact, however, justify turning to any technical means available to satisfy this desire?

The conjugal act involves the spouses totally and reciprocally: it is precisely in this interpersonal relationship that a new human life should be “pro-created”. It is in and through their bodies that spouses are united in the matrimonial act and may become fathers and mothers. It is from the mutual gift of themselves that the gift of life is born. The technique of artificial fertilization substitutes the conjugal act with a technical one. It introduces a division in the conjugal union of the spouses, and new life becomes the result of a technical procedure. Even though such procedures can be perfected from the technical point of view and perhaps also legalized by the State, they remain inexorably impersonal. It is not the parents that give life, but a doctor or biologist.

It is important to specify that the Church does not refuse artificiality in general, but only the artificiality of an intervention that distorts or cancels the most personal of human acts, procreation. Nor is artificiality understood as simply any employment of a technique. In fact, numerous techniques to assist fertility are judged acceptable. The stimulation of ovulation and microsurgery to remove areas of endometriosis or to remove a blockage in the fallopian tubes are examples of technical intervention which have as their only goal the restoration of functionality which would otherwise be impossible (cf. n. 13). As Dignitas Personae states: “The doctor is at the service of persons and of human procreation. He does not have the authority to dispose of them or to decide their fate. A medical intervention respects the dignity of persons when it seeks to assist the conjugal act either in order to facilitate its performance or in order to enable it to achieve its objective once it has been normally performed” (n. 12).

There is no doubt that difficulty in having children can be a source of great suffering for a couple. Before all else, attention should be given to the prevention of infertility which may result from risky personal behavior or environmental factors. Today, a significant factor leading to infertility is the advanced age at which women seek to become pregnant. To this end, number 13 of Dignitas personae states: “Research and investment directed at the prevention of sterility deserve encouragement”.

Even when great effort is made to diagnose and cure sterility, not every couple is able to realize their legitimate aspirations to have children. In such cases a response must not violate the essential right to life of the unborn or undermine the true significance of marriage. In many cases, one must help the couple discover a new sense of “generativity”. As Dignitas Personae notes: “In order to come to the aid of the many infertile couples who want to have children, adoption should be encouraged, promoted and facilitated by appropriate legislation so that the many children who lack parents may receive a home that will contribute to their human development” (n. 13).

“The desire for a child cannot justify the ‘production’ of offspring, just as the desire not to have a child cannot justify the abandonment or destruction of a child once he or she has been conceived” (n. 16). This is the central point for the ethical evaluation of techniques of artificial fertilization. Another factor which must be taken into consideration include the high rate of abortion associated with many techniques of artificial fertilization. This elevated number of abortions has not been reduced with the passage of time but rather is the fruit of the technique itself. More than 80% of embryos created in methods of artificial fertilization are subsequently destroyed. In addition to the destruction of embryos inherent in the fertilization process, there is also the willed destruction of certain embryos in a selective process during the period of pre-implantation. Here the overall number of fertilized embryos is reduced in order to favor the successful implantation in utero of some. These cases are clear examples of elective abortion. Additionally, not all the embryos created through artificial fertilization are either implanted or destroyed, giving rise to a further issue of creating a “reserve” of fertilized embryos to be used at some later date. “This sad reality, which often goes unmentioned, is truly deplorable: the various techniques of artificial reproduction, which would seem to be at the service of life and which are frequently used with this intention, actually open the door to new threats against life” (n. 15).

Two further issues which arise from modern techniques of artificial fertilization which take on particular importance are the cryo-preservation of embryos and “embryo reduction” in the pre-implantation phase.

The practice cryo-preservation or the freezing of embryos is judged by the Instruction as “incompatible with the respect owed to human embryos; it presupposes their production in vitro; it exposes them to the serious risk of death or physical harm, since a high percentage does not survive the process of freezing and thawing; it deprives them at least temporarily of maternal reception and gestation; it places them in a situation in which they are susceptible to further offense and manipulation” (n. 18). Often enough these frozen embryos are abandoned, as so there arises the question of what to do with them. On one hand, there are those who would argue in favor of simply emptying or eliminating the massive stocks of frozen embryos. On the other hand there are those who, conscious of the grave injustice against innocent human life, seek some acceptable solution to the existence of so many frozen embryos. The instruction Dignitas personae excludes the use of abandoned embryos for medical or therapeutic research, the thawing of frozen embryos, as well as donating them to infertile couples. This last case would result in a form of heterologus artificial fertilization and surrogate maternity, whose morally negative character is described in Donum Vitae (cf. n. II, A, 3). In addition, so-called “prenatal adoption”, while being “praiseworthy with regard to the intention of respecting and defending human life, presents however various problems not dissimilar to those mentioned above” (n.19). It should be evident, therefore, that the only true solution is to cease creating these embryos. As Pope John Paul II affirmed, “there seems to be no morally licit solution regarding the human destiny of the thousands and thousands of ‘frozen’ embryos which are and remain the subjects of essential rights and should therefore be protected by law as human persons” (n. 19).

Many techniques used in artificial fertilization give rise to a significant number of multiple pregnancies. Often in these cases, a process of embryo reduction is proposed: this is a procedure to reduce the number of embryos present in the womb by directly destroying some of them. In view of this practice, one must affirm: “From the ethical point of view, embryo reduction is an intentional selective abortion. It is in fact the deliberate and direct elimination of one or more innocent human beings in the initial phase of their existence and as such it always constitutes a grave moral disorder” (n. 21).

Another issue arising from modern methods of artificial fertilization is pre-implantation diagnosis. This technique is directly connected to “the elimination of an embryo suspected of having genetic or chromosomal defects, or not being of the desired sex, or having other qualities that are not wanted. Preimplantation diagnosis – connected as it is with artificial fertilization, which is itself always intrinsically illicit – is directed toward the qualitative selection and consequent destruction of embryos, which constitutes an act of abortion” (n. 22). This is really a form of eugenics “which leads to the non-recognition of the ethical and legal status of human beings suffering from serious diseases or disabilities” (ibid.).

New Proposed Therapies That Require The Manipulation Of The Embryo

The Instruction Dignitas personae also offers an ethical evaluation of recent developments in biomedical research, some of which carry great hope for treating infertility, while others pose grave ethical problems.

As regards gene therapy, that is, the application of genetic engineering to the human person for a therapeutic purpose, the Instruction notes a fundamental distinction. Genetic therapy may be applied on two levels: somatic cell gene therapy and germ line cell therapy. Somatic cell gene therapy which seeks to reduce or eliminate genetic defects present in somatic cells of an individual person is, in principle, morally legitimate. Germ line cell therapy, which involves the genetic modification of the germ line cells of a human subject and which would therefore entail the transmission of these modifications to any future descendants, is not morally permissible. At least at the current state of this research, the risks associated with such genetic manipulation are significant and unable to be adequately controlled (cf. n. 25-26).

One issue that has garnered much public comment is human cloning. The type of manipulation necessary for cloning is profound and tests the limits of the laws of biology itself. Cloning involves asexual or agametic reproduction of the entire human organism achieved through what has been called twinning or, more commonly, nuclear transfer. Reproductive cloning, which so far has been employed only for zoological or botanical aims, would be applied to human beings for several reasons: to exercise control over human evolution, to pre-select the sex of offspring, or even to substitute a deceased loved one with a near “copy”. In reproductive cloning, a preordained genetic identity is imposed on the cloned subject which is itself a sort of “biological slavery” and therefore “represents a grave offense to the dignity of that person as well as to the fundamental equality of all people” (n. 29). Therapeutic cloning, that is, the production of embryos with the intention of destroying them, even when that intention is in view of helping the sick, “is completely incompatible with human dignity, because it makes the existence of a human being at the embryonic stage nothing more than a means to be used and destroyed. It is gravely immoral to sacrifice a human life for therapeutic ends” (n. 30).

The use of and experimentation on stem cells purports to be the most promising recent discovery, inaugurating a new phase of medicine. This new area of medical research uses stem cells extracted from the human body that are able to self-replicate, even outside the organism itself, and that are capable of differentiating into various types of human tissue. Once transplanted into damaged tissue, these cells promote cell growth and can therefore regenerate the damaged tissue. The Instruction Dignitas personae lists the various sources from which these stem cells can be collected, namely from certain tissues in the adult human body, from umbilical cord blood and amniotic fluid, and from the human embryo and aborted fetuses. There is a significant difference between embryonic stem cells and somatic stem cells collected from an adult body, a difference which carries with it profound ethical implications since the collection of embryonic stem cells necessarily involves the destruction of the embryo. Although a certain research priority was accorded to embryonic stem cells as opposed to adult stem cells, this research has, in fact, not offered significant results in terms of the regeneration of damaged tissue. Rather, the research into somatic or adult stem cells has produced results both at the experimental level and in clinical application. For this reason, the new Instruction concludes: “Research initiatives involving the use of adult stem cells, since they do not present ethical problems, should be encouraged and supported” (n. 32).

Recently, hybrid cloning has been proposed, in which the oocytes of animals are reprogrammed in order to produce human somatic stem cells from the resulting embryos without having to use human embryos. The Instruction states: “From the ethical standpoint, such procedures represent an offense against the dignity of human beings on account of the admixture of human and animal genetic elements capable of disrupting the specific identity of man” (n.33).

Conclusion

The new Instruction begins with the programmatic words Dignitas personae—the dignity of the person—which is to be recognized in each and every human being form conception to natural death. The document encourages biomedical research which respects this dignity of the person and the dignity of procreation, hoping “that the results of such research may also be made available in areas of the world that are poor and afflicted by disease, so that those who are most in need will receive humanitarian assistance” (n. 3). At the same time, the Church feels the duty to give voice to the voiceless, and so the Document excludes as ethically illicit several forms of biomedical technology. “The fulfillment of this duty implies courageous opposition to all those practices which result in grave and unjust discrimination against unborn human beings, who have the dignity of a person, created like others in the image of God. Behind every “no” in the difficult task of discerning between good and evil, there shines a great “yes” to the recognition of the dignity and inalienable value of every single and unique human being called into existence” (n. 37). One may hope that the faithful and all men and women of good will, in particular physicians and medical researchers, will be open to dialogue and desire to perceive the truth of human dignity and so find themselves in agreement with the fundamental principles of the Instruction “which seek to safeguard the vulnerable condition of human beings in the first stages of life and to promote a more human civilization” (n. 37).