Spotlight on Prenatal Diagnosis : Vatican Points Up Moral Fudging Over Abortion Implications

The Vatican has roused a storm of controversy with its unstinting condemnation of the evolving medical techniques intended to assist the growing number of couples who would like to have children but find themselves unable to do so.

Through technologies such as embryo transfer, artificial insemination, in vitro fertilization and surrogate mothering, countless thousands of children are born each year to people whose infertility was not readily correctable by drugs or surgery. These procedures are widely available in hospitals in the United States, Canada, Australia and Western Europe.

Viewed in light of these facts, the Vatican’s statement of doctrine “on the dignity of procreation” seems a bit tardy. It is a bit late in the game to commence arguments aimed at putting the genie of artificial reproduction back into its bottle.

Viewed in another way, however, the statement is not so much new as it is a reaffirmation of the Roman Catholic Church’s longstanding teaching against sexual conduct outside the realm of marriage and procedures, including contraception, that separate sex from procreation. Add to these views the Vatican’s recent statements on the moral illicitness of homosexuality, and there should have been no doubt in anyone’s mind about what would ensue when the Congregation for the Doctrine of the Faith turned its collective mind to evaluating technologically assisted forms of reproduction.

A more relevant question is: What difference will the statement make in influencing those who might consider seeking treatment for infertility or the willingness of health-care professionals to provide it? The answer is: Not much.

The striking fact about couples who want to have children is that they will do almost anything to accomplish this goal. For many infertile couples no price is too high, no drug too dangerous, no surgical intervention too uncomfortable to dissuade them.

It is doubtful that such desperate people, be they Catholic or not, will pay any more attention to religious proscriptions of the necessary techniques than those who are desperate to avoid having children have paid to religious proscriptions of contraception.

Moreover, unlike like those who disagree with church teaching on matters such as abortion or contraception, these couples are strongly pro-life and pro-family. It is hard to imagine a political frenzy developing to prohibit techniques that are intended to make birth possible for families who yearn to have babies.

Nor is moral grousing likely to have much effect on the supply side of a field in which the demand is so great and growing.

Oddly enough, the Vatican’s statement is likely to have its greatest effect for one section that, at least initially, has commanded little interest or attention: the four paragraphs on prenatal diagnosis.

Prenatal diagnosis includes a wide variety of medical techniques such as amniocentesis, ultrasound imaging, blood tests and the analysis of cells withdrawn from the placental tissue of a developing fetus. These can help to determine the presence of a variety of congenital diseases or physical malformations that range from mildly to severely disabling, such as Down’s syndrome, spina bifida, anencephaly and other neural tube defects.

California’s Department of Health recently required health-care providersto give every pregnant woman a state-prepared brochure that discusses birthdefects and the availability of Medi-Cal-reimbursed testing and counseling. In the first four months of the program, 50,000 women underwent prenatal testing. State officials hope to test up to 385,000 women each year.

There is one catch: For most congenital diseases and abnormalities, the only option is termination of the pregnancy.

The Vatican statement says that anyone who provides or seeks such testing with the intent of inducing an abortion depending on the results is committing a “gravely illicit act.” It further condemns any civil or health authorities who in any way favor a link between prenatal diagnosis and the option of abortion.

Religious groups have already demonstrated their ability to affect public policy where very young children are concerned. Those who espouse a sanctity-of-life standard have been influential in enacting state and federal “Baby Doe” laws that require aggressive medical care for all newborns except those born dying. There is every reason to believe that the Vatican statement may encourage efforts to end all forms of prenatal diagnosis on similar moral grounds.

Unfortunately, those who have been the most aggressive in the promotion of prenatal testing during the past decade have exhibited the least moral courage in justifying their efforts. Those who do prenatal testing claim to do so in a manner that is “value-free.” Health authorities sheepishly insist that they do not tell patients what to do when a problem is discovered. They merely report medical facts and let the patient take matters from there.

This moral fudging makes prenatal diagnosis, rather than artificially assisted reproduction, the area most likely to be affected by the Vatican’s pronouncement. It is much easier to rouse public sentiments against abortion than it is against efforts intended to produce babies. Those who believe that it is morally correct as well as sound public policy to offer prenatal testing to pregnant women had best get their ethical arguments in order in a hurry.