IVF is different

[Note: I edited this post substantially on March 8, 2024]

You may have heard of the recent Alabama Supreme Court case that identifies embryos, created through the in-vitro fertilization process (IVF) and then frozen, as children. At least, that's how the Washington Post describes the decision [paywall]. I haven't read the actual case and am prepared for it to have said something a little different. But the gist appears to be that the court recognizes IVF embryos as human and states people can be sued for wrongful death if they mishandle the embryos.

With that decision comes the usual concern about the courts' ever stronger restrictions against abortion rights. I understand that concern. But I see an important distinction here. In cases of unwanted pregnancies, the zygote/embryo is enmeshed with the body of the woman. Whether it is a human life or not, its existence is so implicated with the woman's body, that it is a part of her body. 

I believe someone can accept that view and can believe that therefore the woman has the moral prerogative to abort and ought to have the legal right to do so--all the while believing, as I do, that life begins at conception. One can hold both those views consistently.

IVF is different.

With IVF, people are creating embryos, on purpose, that they know, beforehand, will probably have no chance at life. From the embryos' creation, they're separate from any body. The above linked Washington Post article explains:

To give a patient the best chance at a pregnancy, Sussman [Dana Sussman, MD] said, multiple embryos are created in the hopes that a patient can try again if an attempt at a pregnancy fails. As a result, as many eggs as possible are often fertilized and kept frozen. After a patient becomes pregnant, what to do with the remaining embryos can be an agonizing choice.

(I'll pause here to note that I understand there are different approaches to IVF. I've heard that some IVF procedures don't involve creating multiple embryos. Some procedures create only one at a time. In this post, I am speaking only about processes that involve creating multiple embryos. )

If you believe that human life begins at conception, you can still consistently wish to outlaw IVF and yet also wish to affirm the moral and legal prerogative to choose abortion. Again, I believe abortion involves an entity that is so tied up with the woman's body that it very well may be a part of her body. Even though I do believe human life begins at conception, I believe the woman's interest in her own autonomy and in her own bodily integrity forbid others to prohibit her to choose to abort or even to condemn a decision to abort.

And yet I believe IVF should be outlawed. To me, creating life just to destroy it is wrong. That's not the intention behind IVF, which is to create and foster life. But it is the foreseeable result of IVF.

Even if you support IVF, you have to recognize that the slogan often used to rally support for abortion--that abortion is about "a woman's right to do what she wants with her own body"--no longer applies. Or at least it doesn't apply in the same way. (I'll add as an aside that once the embryo is implanted, then my argument requires me to admit the woman has the prerogative even then to abort. What I object to is the process that creates the multiple embryos in the first place.)

All that said, I admit to some reservations about my own position.

Take the Alabama court decision. Again, my understanding of that decision comes only from that Washington Post article. The article says that "a patient who mistakenly dropped and destroyed other couples’ frozen embryos could be held liable in a wrongful-death lawsuit." I'm not quite willing to go so far if the action really was a simple mistake as opposed to, err, a complex mistake that involves reckless disregard. [see note 1 below] I'm also uneasy with what I take to be the logical conclusion to which that decision might lead, namely that the same person could be found guilty of murder.

My unwillingness to accept that logical extreme highlights my ambivalence about my own position on IVF. If I believe IVF kills human life, then I shouldn't be surprised if courts and lawmakers treat IVF embryos as human lives.

I come to my belief that human life begins at conception through a process and argument that I cannot expect will convince anyone who doesn't already agree with me. I won't discuss that here other than to say that I expect to convince no one that my basic belief is right.

I'll add that my certainty that human life begins at conception is more like 51% and not, say, 80% or 90%. As an example, recall that I write above that many embryos created in the IVF process "will probably have no chance at life." I almost deleted that because it can be read to suppose I don't in fact believe already existing embryos are "alive." But I decided to let that in in order to be open about my uncertainty. (I'll also note "chance at life" can mean--and I intended it to mean--"chance at continued life.") I'm not quite ready to use my 51% certainty to extend the crime of murder to such cases, and I'm very hesitant to allow it to extend to wrongful death claims.

My 51% certainty probably somehow enters the picture for my pro-choice abortion views. In theory, I should be believe abortion is a woman's moral prerogative and should be legal even if I were 100% certain that life begins at conception. But the fact that I'm only 51% certain makes it so much easier to hold that pro-choice view.

Departing from existential and meaning of life arguments, I also realize that I live in the real world. No matter how reasonable I believe the distinction between abortion and IVF to be, the Alabama decision will almost certainly be a substantive step in denying access to legal abortion in the United States. If more an more courts recognize the unborn as human life, that empowers the pro-life policies even more than they're already empowered. (And yet maybe that concern isn't so pressing. Pro-life advocates who would limit access to abortion seem (at least some of them) to support legalizing IVF.)

One final reservation about my position. I have no urgent desire to have children. I don't really know what it's like to want children, and I don't know the depths of anxiety or unhappiness that comes with wanting children and having difficulty bearing them. It's easy for me to set my position against a practice that I would never want to avail myself of. I don't think any of that means I'm wrong. But it does serve as a reminder that there's a lot I don't know.

I also know at least two people who (probably) did IVF. I'd like to say I don't judge them. That's true in an overarching "who am I to judge another's soul?" sense. But I do realize that by calling an action wrong, I am also saying that others who perform that action are doing wrong. Sometimes (or often, or most of the time), it's hard to distinguish between discerning wrong and judging others. I am conflicted. I don't wish to denigrate my acquaintances' decisions or the love they obviously feel for their children even as I claim that the decisions they made are deeply wrong. The best I can do is hold my tongue and acknowledge that I'm not perfect either.

 

 

Note 1: How and why a patient might have access to another couples' embryos and therefore be in a position to accidentally destroy those embryos mystifies me. Unless there's something I'm missing,the malfeasance and mismanagement would be on the part of the medical practice that allows patients to handle other patients' embryos. I strongly suspect the Washington Post article was poorly written and failed to capture the case's fact pattern. But again, I haven't read the decision and don't know.