The Catholic Church and modern science
Arguments that IVF 'commodified' procreation cut little ice with infertile couples and with all who sympathised with them, including most Catholics.
A recent intervention by the Archbishop of Sydney, Anthony Fisher, OP, was both unremarkable and, paradoxically, significant.
In a letter to the Prime Minister on August 20th, co-signed by the Anglican Archbishop of Sydney, Dr Glenn Davies, and the Greek Orthodox Primate, Archbishop Makarios, Archbishop Fisher suggested that the projected use of the Oxford AstraZeneca vaccine might cause a crisis of conscience for some potential recipients because cell lines derived from a 1973 aborted foetus were involved in its production.
This intervention was unremarkable because it was all too predictable.
Archbishop Fisher, more inclined to find fault with and to condemn modern scientific developments than to welcome and encourage them.
But the intervention was, nonetheless, significant because it was of a piece with a series of stances which the Vatican authorities have adopted over the past fifty years.
These stances, pitting the Church over against the world, represent a retreat from the hopes and aspirations expressed in that most progressive decree of the Second Vatican Council: 'Gaudium et Spes: The Church in the Modern World'.
Whereas the Vatican II document sought to engage with, and to respect, the autonomy of the modern world and its science, only too many of the Vatican's official statements over the past fifty years have effectively resiled from that commitment.
It is no secret, of course, that the Vatican II decree was a step too far even for some of the more progressive theologians advising the bishops at the Council, notably among them, Joseph Ratzinger.
Although the assembled bishops did approve the decree, there were rumblings even at the Council, and these have reverberated over the years especially among the more conservative elements in the Church.
Joseph Ratzinger, too, was to become in time the Cardinal Prefect of the Congregation of the Doctrine of the Faith and the custodian of doctrinal 'orthodoxy'.
Some commentators have remarked that not only did Ratzinger distance himself at the time from 'Gaudium et Spes', but also that the student riots of 1968 and the general unrest that accompanied them reinforced his fears that hitherto unquestioned absolute principles were under sustained attack from rampant progressivism.
Hence his retreat from the more liberal theology of his earlier years.
The first test for the Church was the debate over artificial contraception.
Pope Paul VI withdrew the issue from discussion at the Second Vatican Council but subsequently appointed two committees to investigate the arguments.
The first committee was composed exclusively of bishops and cardinals.
By a narrow majority it reported that the use of artificial contraceptives might be permissible for married couples in some restricted circumstances.
The second committee, composed of sixty clerical and lay members, also reported in the affirmative, but this time by a large majority, reputedly 56:4 in favour.
This committee justified their recommendation as a development from the Church's traditional stance, which opposed all forms of artificial contraception, by viewing marriage as a relationship rather than a series of conjugal acts, giving priority to the unitive over the procreative dimensions of marriage.
The relationship should certainly be procreative in intent, but not each and every act of conjugal intercourse had to be open to the possibility of procreation.
There were circumstances in which couples could intentionally regulate their births not only by natural, but also by artificial, contraceptive methods.
The majority and minority reports of the second committee were leaked to the media.
Paul VI hesitated and deferred.
But in July, 1968, in the encyclical, Humanae Vitae (Of Human Life), he finally sided with the minorities, declaring that each and every conjugal act had to be open to the possibility of procreation, effectively ruling out the use of artificial contraceptives.
Commentators have speculated that what finally swayed him was the fear that if he accepted the recommendations of the majorities, he would seem to be reversing the negative judgment of his predecessor, Pius XI, in his 1930 encyclical, Casti Connubii' (Of Chaste Marriage).
This reversal, he believed, would have had the effect of undermining papal authority.
Paradoxically, of course, nothing more effectively undermined papal authority than the publication of Humanae Vitae.
Not only did the laity reject it, but even a series of bishops' conferences, notably the Canadians and Germans, provided commentaries on the encyclical that suggested that it should not be taken as the definitive word but interpreted according to each married couple's consciences and circumstances
The next test for the Church in its engagement with the modern world and its science was its reaction to the developments associated with in-vitro fertilisation.
It all started off well. One month after the birth of Louise Brown, the first 'test tube baby', in July, 1978, the newly-elected Pope, Albino Luciani, Pope John Paul I, was asked for a reaction.
After a moment's reflection he responded: 'I bless the mother; I bless the baby'. It seemed the appropriate response for a Church that was generally perceived as pro-natalist.
The pontificate of John Paul I lasted only 33 days. He was succeeded by Pope John Paul II, under whose pontificate Cardinal Ratzinger presided as Prefect of the Congregation of the Doctrine of the Faith. It was on his watch that the Church published in February, 1987, its definitive teaching on in-vitro fertilisation, Donum Vitae (The Gift of Life).
Once again, as with Humanae Vitae, the response was negative. Not even the so-called 'simple case' of IVF between husband and wife with all the embryos transferred back to the maternal uterus was permitted.
Harking back to the 1968 encyclical, just as 'lovemaking' without the possibility of 'baby making' was interdicted in Humanae Vitae, so in Donum Vitae 'baby making' without 'lovemaking' was proscribed.
The indissoluble link which Humanae Vitae had proclaimed to exist between conjugal relations and openness to procreation operated both ways.
No procreation was permitted unless it was continuous with preceding conjugal relations, even for infertile couples. 'Procreation which is truly responsible vis-à-vis a child to be born', it proclaimed, 'must be the fruit of the marriage act'.
But again, as with Humanae Vitae, infertile couples, even 'good Catholics' were unlikely to be persuaded by a papal instruction denying them even the 'simple case' of IVF.
Many may have shared the instruction's concerns about cryopreserved banks of 'surplus' embryos and the liability that these embryos would be exposed to scientific experimentation.
But when a remedy for infertility was becoming available, why did it matter so much where the union of the zygotes took place — in the fallopian tube (back to which the in-vitro embryo was swiftly implanted in any case) or temporarily in a petri dish? 'Location, location', why was it so important?
Arguments that IVF 'commodified' procreation cut little ice with infertile couples and with all who sympathised with them, including most Catholics.
When Pius XII in statements in 1949 and 1956 had not ruled out the possibility of medical interventions subsequent to intercourse to promote sperm motility and to facilitate the union of the zygotes — dilation of the vagina and the use of a syringe to spray the ejaculate further into the cervical canal were the preferred interventions — why were these manipulations morally licit while that associated with IVF was unacceptable?
'Tainted' cell lines
The third test for the Church's biological scruples concerned the derivation of cell lines from aborted foetuses. It was to this question that the recent interventions of the Sydney Archbishops and the Greek Orthodox Primate were directed.
In 2003, Debra Vinnedge from Florida in the United States sent a letter to Cardinal Ratzinger at the Congregation of the Doctrine of the Faith seeking a clarification about 'the liceity of vaccinating children with vaccines prepared using cell lines derived from aborted human foetuses'.
She was concerned primarily with a vaccine for the Rubella virus whose production involved a cell line derived from foetuses surgically aborted in the 1960s and 1970s.
The Vatican took over two years to reply and apparently consulted widely before providing its response. Archbishop Fisher has belatedly acknowledged that he was one of the consultants.
In an eight page reply the Pontifical Academy for Life emphasised the evil of abortion and the responsibility of medical scientists who used cell lines derived from surgically aborted foetuses to distance themselves generally from abortifacient procedures.
It would never be acceptable to effect an abortion in order to generate a productive cell line.
That would be so-called 'formal cooperation', where the medical scientist would be adjudged to share the evil intention of the abortionist.
But over and above formal cooperation there is also so-called 'material cooperation', and it is mainly the degree of immediacy or remoteness of the cooperation that respectively condemns or may legitimise the material cooperation.
Generally speaking, the more remote the medical science use of the cell lines is from the original abortion, the more legitimate morally it is likely to be.
It would be better, the Academy advised, to use cell lines not derived from aborted foetuses, but where these are not available or where their efficacy is limited or compromised, then the use of the aborted foetal cell lines may be acceptable, especially if they are very efficacious and there is an urgent need for a protective vaccine. Its response concluded as follows:
As regards the diseases against which there are no alternative vaccines which are available and ethically acceptable, it is right to abstain from using these vaccines if it can be done without causing children, and indirectly the population as a whole, to undergo a significant risk to their health.
However, if the latter are exposed to considerable dangers to their health, vaccines with moral problems pertaining to them may be used on a temporary basis. The moral reason is that the duty to avoid passive material cooperation is not obligatory if there is a grave inconvenience.
Moreover, we find in such a case a proportional reason in order to accept the use of these vaccines in the presence of the danger of favouring the spread of the pathological agent due to the lack of vaccination of children.
Even the subsequent 2008 Vatican Instruction, Dignitas Personae (The Dignity of the Person), while emphasising once again the evil of any formal cooperation with the original abortion, acknowledged that:
Grave reasons may be morally proportionate to justify the use of such 'biological material'. Thus, for example, danger to the health of children could permit parents to use a vaccine which was developed using cell lines of illicit origin, while keeping in mind that everyone has the duty to make known their disagreement and to ask their healthcare system to make other types of vaccines available.
These Vatican pronouncements were the source on which Archbishop Fisher and his co-signers drew in their letter to the Prime Minister.
They admitted that: 'Some will have no ethical problem with using tissue from electively aborted foetuses for medical purposes'. But the burden of their letter was to alert the Prime Minister to what they called the 'ethically tainted' status of the Oxford AstraZeneca vaccine.
They did not, however, directly acknowledge that many quite orthodox Catholic moral theologians would have seen the use of the vaccine as so remote from the original abortion that it was morally acceptable to use the vaccine, and it was not necessary to wait for an alternative vaccine, particularly during a pandemic.
Nor did the signatories even advert to the arguments that have also been advanced that the use of foetal material to develop a life-saving vaccine may, at least to some degree 'redeem' or mitigate the original abortion.
Certainly one may not induce an abortion with the intention of developing a cell line from the foetus — that would be formal cooperation — but once the abortion has in fact taken place, isn't it better, with the mother's permission, for a medical researcher, independent of the abortionist, to use the foetus to develop the cell line rather than to consign it to hospital waste?
Although we abhor the Nazi human experimental programmes, we have used some of their results for further research.
Although we deplore slavery, there are nations and cultures that now accept that their very foundations were built on slave labour.
If a suicide has donated his body to medical research, should we refuse to use it? And in traditional Christian theology, the price of our redemption was the obscenity of Christ's passion and death — the felix culpa of the Easter liturgy.
Certainly these subsequent beneficial uses or effects do not justify the original immoral actions, but there is a sense in which they 'redeem' or mitigate the original evil.
In each of the three aforesaid instances — contraception, in-vitro fertilisation and 'tainted' cell lines — in which the Vatican has engaged with modern medical science, there has been an underlying fear that has inspired the doctrinaire, hard-line response of the Roman authorities.
With Humanae Vitae and contraception, it was the fear that accepting the majority report and allowing the use of artificial contraceptives in some circumstances would reverse the universal prohibition of Casti Connubii' of Pius XI and thus undermine papal authority.
With Donum Vitae and in-vitro fertilisation, there was the fear that extra-corporeal fertilisation of embryos would result — as, indeed, it did — in the generation of thousands of 'surplus' embryos, which, inevitably, would be cryo-preserved in suspended animation or used for medical experimentation. So, even the 'simple case' of IVF was proscribed.
With Dignitas Personae and the use of cell lines derived from induced abortions, it was the fear that this would result in a lessening of the horror of abortion and even the possibility of the formal cooperation of the 'medical science industry' with the 'abortion industry'.
So, even though in terms of traditional moral theology the use of these so-called 'tainted' cell lines would be justified as an instance of remote material cooperation, Archbishop Fisher and his co-signers, in deference to his Vatican patrons, have written to the Prime Minister to recommend that a cell line alternative to AstraZeneca be made available.
In each of these cases, too, to overcome these fears, it might have been possible for the Vatican to engage more positively with modern medical science.
In the contraception debate it would have meant accepting the majority report's recommendation that there had been over the thirty years since Casti Connubii' a development of doctrine in respect of the theology of marriage — that marriage should be viewed primarily not through the lens of procreation, the Victorian 'producing a son and heir', but in terms primarily of a personal relationship.
While the whole relationship should be procreative in intent, it was not necessary that each and every conjugal act of intercourse should be open to the possibility of procreation.
After all, this is what human biology dictates.
Why cannot modern science enable married couples to regulate their biology so that artifice enhances nature and avoids unwanted births?
In the IVF debate, while abhorring the production of surplus embryos and their availability for experimentation, these abuses should not necessarily infect the 'simple case' of the use of IVF for infertile married couples where all the embryos generated are returned to the maternal uterus.
Why is the location where the zygotes are united so important that it condemns some couples to lifetime infertility?
Could not the afterthought of Pope Pius XII in 1949 and 1956, when addressing the debate among moral theologians on the legitimacy of homologous (husband/wife) artificial insemination as a remedy for infertility, be invoked?
Although one may not exclude new methods for the sole reason that they are new: nevertheless, as regards artificial insemination, there is not only reason for extreme reserve, but it must be entirely rejected.
To say this is not necessarily to proscribe the use of certain artificial means designed to facilitate the natural act, performed in a normal manner, to attain its end.
Indeed, a clinic in San Antonio, Texas, at the height of the IVF debate acted on this advice to extract semen after intercourse and inject it into the fallopian tube adjacent to a maturing ovum follicle.
Such a procedure was brought to the attention of the Vatican as a 'Catholic' form of IVF. It was neither approved nor condemned. But it is difficult to see that this is less 'artificial' than the simple case of IVF.
Finally, of course, as I have indicated and the co-signers have — reluctantly — agreed, the use of the 'tainted' cell lines from the 1960/1970s abortions is so remote (and material, rather than formal, cooperation) that it is quite morally acceptable to use these lines to develop the AstraZeneca Covid vaccine and to use the lines in other medical applications.
On this understanding the intervention of the Archbishop and his subsequent cautionary comments, while potentially winning him plaudits in some of the more conservative Roman dicasteries, may well be construed as unnecessary and alarmist rather than genuinely pastoral.
Bill Uren SJ AO is a Jesuit Priest, Scholar in Residence at Newman College at the University of Melbourne and Former Rector of the College, Jesuit Theological College and former Provincial of the Australian Jesuits. He is a graduate of the Universities of Melbourne, Sydney, Oxford and the Melbourne College of Divinity. He has lectured in moral philosophy and bioethics at the Universities of Melbourne, Murdoch and Queensland, and has served on over a dozen clinical and research ethics committees in universities, hospitals and research institutes.