Assisted Reproductive Technologies

Commentators have taken widely differing positions on the appropriateness of having children through ARTs. Some commentators embrace these technologies with few reservations, emphasizing the benefits they offer both infertile couples and women who want to reproduce without a partner of the opposite sex. Supporters of ARTs argue that society should defer to individual decisions about reproductive matters, citing the legal and ethical principle of individual autonomy and the absence of evidence that ARTs result in tangible harm (Robertson 1994).

Other commentators, although generally supportive of at least some forms of ARTs, have expressed concerns about certain aspects of these technologies. Some commentators worry that, as the use of ARTs becomes more routine, children will come to be seen as products to be manufactured according to parents' specifications, rather than as unique individuals to be accepted and loved unconditionally (Murray 1996). As an example of this phenomenon, some gamete donation programs that allow prospective parents to select donors based on personal characteristics like SAT scores, athletic ability, or physical appearance. Similarly, some disability rights activists worry that technologies designed to avoid the birth of children with genetic disorders send a negative message about the value of people with disabilities who are already alive (Asch 1989). Many commentators express particular concern about the prospect of germ-line modification, particularly if it is used for nondisease related reasons, such as controlling a child's hair or eye color or enhancing athletic ability or other personal characteristics (Mehlman 2000).

The danger that ARTs will change the way that children are valued also underlies some commentators' objections to the increasing commercialization of reproductive services. For example, some commentators decry the high fees paid to egg donors and surrogate mothers, based partly on their fear that purchasing an individual's reproductive capacity inappropriately commodifies the process of reproduction—in other words, that it turns reproduction into a commodity for sale in the market, rather than a private activity motivated solely by love. Some commentators find it difficult to distinguish between paid surrogate parenting and baby selling, as both practices involve the payment of money to obtain a child (New York State Task Force on Life and the Law 1998).

For some commentators, the acceptability of ARTs turns in part on the environment in which the resulting child will be raised. Thus, some commentators support the use of ARTs by married couples unable to reproduce through sexual intercourse but object to the provision of IVF to single women or lesbian couples (Lauritzen 1993). Others oppose the use of egg donation in postmenopausal women, given the possibility that older women might die while their children are still young (Cohen 1996). By contrast, many commentators believe that children can thrive in a variety of environments, and that efforts to restrict reproduction to young married couples are motivated primarily by ignorance or bias (Murphy 1999).

The use of third-party participants in ARTs— particularly egg donors and surrogate mothers— has generated significant controversy. These women undergo significant medical and psychological risks, often at young age, and usually for a considerable amount of money. Many commentators have expressed concern about the potential for exploitation as young women in need of money undergo risks to benefit older, wealthier couples who want to reproduce (Rothman 1989). With surrogate parenting, commentators also argue that a birth mother cannot make an informed and voluntary decision to give up her child before she has gone through pregnancy and childbirth (Steinbock 1988).

Feminist commentators disagree about many of the ethical issues surrounding ARTs (Warren 1988). Some feminists believe that ARTs are a positive development for women because they give women greater control over the timing and manner of reproduction. Others, by contrast, maintain that the increasing medicalization of infertility reinforces the view of women as primarily mothers, making it more difficult for women to choose to remain childless.

Feminists are particularly divided over the practice of surrogate parenting. Some believe that surrogacy, especially paid surrogacy, exploits women by treating them as mere "incubators" (New York State Task Force on Life and the Law 1988, p. 85). Others maintain that efforts to restrict surrogate parenting are based on misguided paternalism, and that women have a right to use their bodies as they see fit.

Religious perspectives on ARTs are as varied as the positions of secular commentators. At one extreme, the Roman Catholic Church has consistently opposed all forms of ARTs, based on its belief that reproduction must remain inextricably linked to sexual intimacy within a marital relationship (Congregation for the Doctrine of the Faith 1987). The Church has expressed particular concern about ARTs that result in the creation of multiple embryos, as some of these embryos will ultimately be destroyed. Because the Church believes that embryos are persons from the moment of conception, it regards the destruction of an embryo as morally equivalent to killing a person who has already been born.

In most other religious traditions, however, the use of at least some forms of ARTs is considered ethically acceptable (New York State Task Force on Life and the Law 1998). Most Protestant denominations, as well as Jewish, Islamic, Hindu, and Buddhist authorities, support the use of ARTs using gametes from a married couple. Indeed, some Jewish and Islamic theologians suggest that infertile married couples have a duty to use ARTs, given the importance of procreation in these religious traditions. Many of these religions, however, are opposed to the use of donor gametes.