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The Paradox of Altruistic Gamete Donation and Surrogacy

The various forms of artificial human reproduction are, all of them, problematic; not least because they present all sorts of complex moral and legal issues. And this blog touches on such issues but, before going into the complexity, let us first have a little simplicity.

Let us, therefore, consider what appears to many to be the least problematic forms of artificial human reproduction: altruistic gamete donation and altruistic surrogacy. They are called ‘altruistic’ because they are the freely given gifts of women who seek no profit; women who simply want to do good, and who are under no pressure to do so.

Such an altruistic woman is Anne, a healthy young woman who donates eggs so that an infertile couple can have children. Let's suppose that no monetary exchange is involved, not even in the form of compensation for expenses, which is still a subtle form of exchange. Anne, remember, expects nothing in return from the couple. This is altruism, not commerce. Some people would find her action morally acceptable, even laudable; and they would see no good reason why it should not be considered perfectly legal.

Another such altruistic woman is Marie. Like Anne, Marie is a healthy young woman and absolutely altruistic. Anne acts as a surrogate mother for a couple because the woman who wants to become a mother cannot carry a pregnancy. Again, let's suppose that no monetary exchange is involved, not even in the form of compensation for expenses. Marie allows the use of her womb for mere altruism and expects nothing in return from the couple. Some people would find her action, too, to be morally acceptable; even laudable. This, too, they believe, should be perfectly legal.

Certainly, appropriate forms of regulation would be necessary in the cases of both, Anne and Marie, to anticipate and avoid possible conflicts that just might arise between the parties involved. But, in general, there are not many people who would find the actions of either Anne or Marie to be, in any way, dreadfully, seriously, problematic.

Now, let us imagine another healthy, young, and exceptionally altruistic woman, whom we shall call, for obvious reasons, Annemarie. Annemarie, in this imaginary case, both donates her eggs to, and, acts as a surrogate mother for, a particular infertile couple, the woman of which cannot carry a pregnancy. Annemarie does the same, and is the same, as Anne and Marie. The same: but, different.

Yes, here is the paradox: while some people would approve of the actions of Anne, and of Marie, the actions of Annemarie seem to them to be very different. Because very few people would consider the practice of conceiving and gestating a child with the deliberate intention to give the child away to a commissioning couple, even for purely altruistic reasons, to be either morally or legally acceptable. So, with Anne and Marie: not problematic. Yet, with Annemarie: so problematic.

What is so wrong in the case of Annemarie that is not seemingly wrong in the cases of Anne or Marie? If two actions are individually good, why are they not good when combined together?

The paradox obviously does not arise for those who do not consider gamete donation – that is the donation of either eggs or sperm - or surrogacy, (or both,) to be in any way acceptable. For others, the paradox is there.

Ova are donated with a view to generating children; and if a surrogate mother is needed to complete the process why shouldn’t she be the very same woman who donates the eggs?

Similarly, if an altruistic surrogate mother is doing something good, isn’t she doing something even better if she is also the altruistic donor? Would it be different if Annemarie donates her ova to one couple and acts as a surrogate for a different couple?

We can easily imagine all sorts of permutations and combinations of roles, genders, relationships, number of people involved, etc., between the process of gamete donation and surrogacy. We can easily imagine just how complex and problematic the whole business can become.

In the reality of the world out there, cases are usually much more complicated that those presented here in such a simplified way. But, even as we discuss clear cut simplified cases, sooner or later some contradiction appears; and it points to something seriously wrong with splitting up the normal, and naturally composite, action of becoming the mother and the father of a child.

Those who would defend altruistic gamete donation and surrogacy should, if they are being logical, also defend the practice of generating children with the purpose of donating them to couples. For that is the logic of it all. Somehow, we feel that there is more to this than cold logic; this does not feel right and proper.

And those who have no problems with some form of compensation (be it a fee, or expenses, or whatever) for gamete donation and surrogacy, should have no problem with turning the bringing of a child into this world into a commercial business.

We demand to know: Since when has treating children as commodities to be given is progress?






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Euthanasia is promoted under the disguise of neutrality

Last week, a spokeperson for Fianna Fáil told the Medical Independent that they would not oppose the referral of assisted suicide to a Citizens’ Assembly for further discussion. Delegating the debate to an unelected body means that neither Fianna Fáil, nor any other major party, is not actively opposing the introduction of legislation that could legalise euthanasia and assisted suicide. (1)

In 2017 the Oireachtas Joint Committee on Justice and Equality considered possible recommendations on legislating in favour of euthanasia andassisted suicide. They heard from a number of experts, and the strongest opposition to the introduction of new liberalising laws came from the representatives of the medical profession and of disability advocacy groups. (2)

Des O’Neill, professor of medical gerontology at Trinity College Dublin, said “We have to send out a message to people of disability of whatever age that our impulse is to care, to cure sometimes, to relieve often and comfort always.” (3)

Dr Regina McQuillan of the Irish Association of Palliative Care said: “Suicide is rightly considered a blight on society and there are many efforts made to reduce it. That there are some people for whom suicide is considered appropriate may suggest that there are people whose lives are not deserving of the same level of protection.” (4)

At the end of the hearings, the Committee did not achieve a clear consensus. Accordingly, they did not recommend legislative change. Instead, they urged the Houses of the Oireachtas “to consider referring the issue to the Citizens’ Assembly for deliberation”. (5)

But why should a non-representative body, with no specific expertise, discuss and recommend vicariously, when there was no majority in the Oireachtas Committee in support of the change?

Political parties cannot stay neutral and delegate to others such a critical debate. Even small changes must be opposed or they will have catastrophic effects.

We can learn from the experience of other countries that the legislation on these issues is usually introduced on some limited ground (for terminally ill patients, for instance) but, with time, it becomes more and more liberal. Once the general principle that doctors should not participate in procuring death is eroded, it is difficult to change the trend and go back.

Psychiatrist Mark Komrad has said, “Several governments, in the last two decades, have invited and permitted physicians to transgress the prohibition against killing their patients. … Originally, the class who can be voluntarily killed or helped to suicide was limited to those at the very end of life. However, principles of justice have made it very difficult to limit such procedures to that category of people. The more experience a country has with such practices, the more the horizon of eligibility has expanded far beyond extreme end-stage cases. … The so-called “choice“ that is offered to the suffering to end their lives is a pseudo-choice, filtered through a physician’s own values, and commonly forced, by having very limited choices in other domains — economics, social support, healthcare, etc. It is unjust, and therefore impossible, in a democratic society, to limit these procedures to some — like the terminally ill — but refuse it to others — like those with chronic physical and psychiatric disabilities. Yet, it signals that chronic disability and its sufferings might constitute a “life not worth living.” (6)

The pressure on doctors to support and participate in euthanasia and assisted suicide is growing everywhere.

In October 2018, at the General Assembly of the World Medical Association (WMA), representatives from Canada and the Netherlands attempted to change the WMA code of ethics, which has always condemned the participation of physicians in procuring death through direct euthanasia or providing drugs for suicide. (7)

During the debate, all sort of euthanasic practices were rejected and eventually the proposal has been withdrawn, reiterating the WMA’s long-standing opposition to procuring death.

This debate, though, continues on national level.

The Royal College of Physicians (RCP), in the UK, has recently dropped its opposition to assisted dying in a surreptitious manner that has attracted strong criticism. They are now neutral on the issue and will not officially engage in public discussions but how they have arrived at this position appears to be despicable. (8)

In 2014, 57.6% of the RCP membership opposed a change in the law that would legalise assisted suicide. In January this year, after announcing the third poll on this topic among its members since 2006, it was decreed that a 60% majority was needed to stop changing the RCP position to non-opposition. This means that even if 59,9% were against the change, it would have occurred nonetheless. Such a majority was even more difficult to achieve as three options were given (yes, no or neutral), while the previous vote was binary (yes or no).

A group of members of the RCP have challenged them in court, arguing that “the use of a ‘super-majority’ vote on such issues is without precedent in professional organisations in the UK. They have said that it appears to be a tactical move to give a strong boost to the campaign to change the law on assisted suicide. The largest euthanasia lobby group in the UK has previously identified the opposition of medical bodies as a key obstacle to changing to law. Two well-known patrons of this organisation, and active campaigners for legalising euthanasia, are on the RCP Council – the internal body driving the RCP poll.” (9)

In spite of the robust protestation, the poll was carried out in February and found that 43.4 pc were opposed adopting a pro-assisted suicide policy, 31.6 pc were in favour and 25 pc were neutral. This means that even though the majority of the voters were against, the Royal College of Physicians will now be neutral on the matter.

In this case, as with the Joint Committee referral to the Citizens’ Assembly, we see that even when there is no clear majority in support for a significant change, certain issues are considered so important by a minority that they have to be promoted, under the disguise of neutrality, until they are accepted.





Notes
(1) medicalindependent.ie/ff-would

(2) ionainstitute.ie/assisted-suic

(3) ionainstitute.ie/oireachtas-co

(4) ionainstitute.ie/assisted-suic

(5)
data.oireachtas.ie/ie/oireacht

(6) alexschadenberg.blogspot.com/2

(7) ionainstitute.ie/world-medical

(8) bbc.com/news/health-47641766

(9) cmfblog.org.uk/2019/01/16/why-

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Naples, Marechiaro, air is so clear that feels like looking at the landscape in HD

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New law takes an axe to the natural ties

This week, the final parts of the Children and Relationship Act 2015 have come into operation. This legislation has changed profoundly the legal arrangement of family relationships but in a way that downgrades the importance of the natural ties. Part 2 and 3, which were delayed because of technical mistakes in the original Act, contain provisions relating […] familysolidarity.org/new-law-t

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FAFCE fully supports the appeal made by the Ukrainian Catholic Bishops to ban all forms of surrogacy

In recent days, a video has been widely spread online, published by a Ukrainian company devoted to the practice of surrogacy. The video shows around 46 crying babies in a hotel conference room converted into a nursery, explaining that these “babies are waiting for their parents” (sic). In fact, the foreigners who agreed a contract for the purchase […] familysolidarity.org/fafce-ful

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Hidden Facts: Domestic Abuse is at its Worst During the Pandemic

Most in the U.S. are on week 3 or more of “social distancing,” or perhaps even a mandated “shelter-in,” and the New York Times is now reporting on an unanticipated and tragic result of the pandemic-protection guidelines: a rise in domestic violence and child abuse. Domestic violence is up around the world, reports the story, leaving overstretched hotlines […] familysolidarity.org/hidden-fa

Jordan Peterson - Noah | J B P W A V E | VISUAL | MEANINGWAVE | Akira Th... youtu.be/BJHEaWfpFqA

CW Long post

How religious sisters are the real founders of modern nursing

We suffer from a big case of historical amnesia when it comes to the massive and positive Christian contribution to society down the ages. We are deluged by news of scandals, but the good news is left out.

This week, for example, we celebrated International Nurses’ Day, which coincides with the birthday of Florence Nightingale. It was mentioned at Tuesday’s press briefing headed by Dr Tony Holohan. Nightingale is regarded as a founder of modern nursing after she became famous for her work during the Crimean War of the 1850s (See picture). What has been largely forgotten is that she took inspiration from the works of medical nuns, who are really the founders of modern nursing. In fact, she has a strong connection both to the Mercy Sisters here in Ireland, and with the Religious Sisters of Charity and St Vincent's hospital, which they have just handed over to a trust.

For centuries, the monasteries had offered medical and nursing services but with the Reformation, and particularly after King Henry VIII closed them down in 1536, this tradition was practically lost in England and Ireland.

During the Crimean War (1854-56) it became evident that while the French soldiers were being attended by the French Sisters of Charity, the British troops had no equivalent assistance. And this is when Florence Nightingale, who had observed nursing from the Sisters of Charity in France and Egypt, re-established a proper professional service for them. Among the small initial group that served the Scutari hospital in Crimea led by her there were ten Catholic nuns and ten Anglican nuns, plus about ten lay-women.

When the British War Office was looking for skilled nurses, it found them mostly among the Irish Sisters of Mercy operating in London. They were the first to depart for the Crimea and, when on their way, they were met by Florence Nightingale, with a second group of nurses. Nightingale became their director, in spite of the fact that she was less experienced than the nuns.

One of them was Mary Clare Moore, who had joined the Sisters of Mercy at their foundation. When in 1832 the first cholera epidemic hit Dublin, Mary Clare Moore worked along with Catherine McAuley, the founders of the Sisters of Mercy, and received an intensive nursing training. She continued to assist the poor in the tenements and workhouses of Dublin and London, and she brought her professional experience to Crimea when she joined Florence Nightingale in 1854 and together went to Scutari.

The two worked in concert and when Mary Clare had to return to England due to illness, Florence wrote to her: “You were far above me in fitness for the General Superintendency, both in worldly talent of administration, and far more in the spiritual qualifications which God values in a superior.”

The Irish nun was a great source of inspiration for Florence Nightingale and they remained intimate friends for the rest of their lives. There were other Sisters of Mercy operating in Crimea with the British troops.

When Mother Vincent Whitty, the superior at Baggot Street, responded to the call for nurses by the British War Office, she wrote: “We know it must be difficult, if not impossible, to procure for our country- men engaged as soldiers in the East, the skilful nurses speaking their own language and sympathising with their habits and feelings, and that care and attention in a strange land which would be so well supplied at home.

“Attendance on the sick, as you are aware, is part of the work of our Institute, and sad experience amongst the poor has convinced us that even with the advantages of medical aid, many valuable lives are lost for want of careful nursing.”

The tradition of “careful nursing” the Sisters of Mercy belong to, goes back to the beginning of Christianity. The first Christian woman recorded as dedicating herself to the care of the sick was Phoebe, mentioned by Saint Paul to his letter to the Romans.

A Roman noblewoman, Fabiola, a Christian, is recorded as having founded the first civilian hospital in the history of the Roman Empire in the 4th century.

This tradition lasted for centuries and it was reestablished in Ireland by the works of Catherine McAuley and her congregation, but also of Mary Aikenhead and her Irish Sisters of Charity, who set up the first hospital run by nuns in the English speaking world, in 1834, namely St Vincent’s hospital, which was originally on St Stephen’s Green in Dublin and later moved to Blackrock. The Sisters have now relinquished control of the hospital to a trust.

It is this tradition that Florence Nightingale relied on and, in celebrating her achievements, we should also remember the nuns who preceded her. They are the real mothers of modern nursing.

(Dr Therese C. Mehaan, who has formed generations of nurses in UCD, runs the website Careful Nursing , containing interesting articles on the history of this profession and its Christian roots. Much of this article is drawn from that).

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Religious practice reduces ‘deaths from despair’

A new study from Harvard University has found that the frequent attendance of religious services dramatically reduces so-called ‘deaths from despair’, such as suicide, and drug or alcohol abuse. This finding seems more relevant than ever given the current pandemic that has resulted in untold job losses and a very uncertain future for many people. Economic slumps are always associated with a rise in ‘deaths from despair’, so if religion acts as a protective against this, then we need to pay attention.

The study followed a large cohort of more than 100,000 health care professionals in the US, over a long period of time (1999 -2016).

The investigators started with the hypothesis that a weakening in traditional social support systems such as marriage and the family, leads to an increasing sense of hopelessness in many, leading in turn to a rise in “deaths of despair”.

One of the leading examples of such a weakened support system is the decline in religious participation, and therefore the investigators wanted to establish the link between despair and the declining attendance of religious services.

They found that nurses and physicians who attend a religious service at least weekly are less likely to die as a result of suicide or drug or alcohol abuse than their peers who do not attend.

The incidence of ‘deaths from despair’ among health professionals is more than double that of the general population, as a result of stress and trauma, but among those who attend a religious service at least once a week it drops by 68pc among women, and 33pc among men.

As the educational attainment of health professionals is higher than the average, despair in them is associated more with factors such as loss in meaning in life, rather than material deprivation.

Religion often fosters a sense of peace and positive outlook to life, it promotes social connectedness and encourages engagement in prosocial activities, such volunteering. “In the context of trauma, such resources may provide healthy stress-coping strategies and revive a sense of meaning in difficult times and thereby counteract various processes associated with despair.”, the study claims.

This is something to be pondered, particularly in the current difficult times when the general populations is experiencing unusual stress and trauma.

Even if churches are closed for public worship, people are still praying. A poll commissioned by the Iona Institute found that in Ireland 18pc said that they are praying more than they usually would.

Another new poll commissioned by Tearfund, a Christian relief and development agency and a member of the Disasters’ Emergency Committee, found that in the UK one in twenty (5pc) adults say they have started praying during the lockdown but they didn’t pray before.

Eighteen percent of UK adults have asked someone else to say a prayer for them and 19% say they have read a religious text during lockdown. Prayer is a vital part of life for the public, and among those who pray a third say that they have prayed since the COVID-19 lockdown because they believe it makes a difference.

There is a solid body of evidence highlighting the benefit of religion for mental health and the new Harvard study confirms that.

Professor Patricia Casey produced for the Iona Institute a paper called “The Psycho-Social Benefits of Religious Practice”, showing how a large number of scientific papers have established that religious practice reduces the risk of depression, suicide, marital breakdown, alcohol and drug abuse, pregnancy among teenagers. It also helps cope with bereavement effects.

Worship is, for those who believe, a source of consolation and hope, strength and motivation. A church is also a place where they can experience the support of a community and are encouraged to engage in activities that are useful to themselves and to others.

This new Harvard study shows that believers often respond better to the struggles of life, and it brings further evidence to fact that both their religious beliefs and the enhanced social connection that worshiping involves, are good for our health. This is something that secularists often forget.

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