What is the Church’s position on prenatal diagnosis and fetal research?

Before approaching fetal research per se, we must first be clear about what– or better who– the fetus is.  The Catholic Church has continually asserted that a human being must be respected as a person from the moment of conception, the very first instance of existence.  The Declaration on Procured Abortion stated, “From the time that the ovum is fertilized, a new life is begun which is neither that of the father nor of the mother; it is rather the life of a new human being with his own growth.  It would never be made human if it were not human already.  To this perpetual evidence… modern genetic science brings valuable confirmation.  It has demonstrated that, from the first instant, the program is fixed as to what this living being will be:  a man, this individual-man with his characteristic aspects already well determined.  Right from fertilization is begun the adventure of human life, and each of its great capacities requires time… to find its place and to be in a position to act” (#12-13).  Moreover, we believe that almighty God creates and infuses an immortal soul, which truly gives each of us that identity of one made in His image and likeness.  Therefore, we must respect the unborn child as a person whose life is sacred and whose rights must be protected.

Given this perspective, we can now address issues and the governing principles concerning prenatal diagnosis and fetal research.  The Sacred Congregation for the Doctrine of the Faith addressed these issues in its Instruction on Respect for Human Life in Its Origin and on the Dignity of Procreation (Donum vitae), released in 1987.  (These principles are affirmed in the Catechism, #2274-75.)  First, prenatal diagnosis provides information about the health of the fetus still in the womb, and thereby may enable physicians to anticipate and to correct more readily and earlier any problems.  Various methods of fetal diagnosis currently exist:  Amniocentesis involves withdrawing some of the amniotic fluid from the womb and then doing an analysis which can identify certain genetic problems, such a cystic fibrosis.  Sonography allows physicians to see the child in the womb.  Many new techniques using biochemical, cytogenic, or molecular biologic means have been developed which permit early fetal diagnosis.  Prenatal diagnosis is morally acceptable “if it respects the life and integrity of the embryo and the human fetus and is directed towards its safeguarding or healing as an individual…” (Donum vitae, I, 2).  However, prenatal diagnosis is not moral if it is performed with the intention of aborting a child if some malformation or hereditary illness is detected:  “A diagnosis must not be the equivalent of a death sentence” (Ibid).

The new Ethical and Religious Directives for Catholic Health Care Services (1994) present these principles succinctly:  “Prenatal diagnosis is permitted when the procedure does not threaten the life or physical integrity of the unborn child or the mother, and does not subject them to disproportionate risks; when the diagnosis can provide information to guide preventive care for the mother or pre- or postnatal care for the child; and when the parents, or at least the mother, give free and informed consent.  Prenatal diagnosis is not permitted when undertaken with the intention of aborting an unborn child with a serious defect” (#50).

The real problem occurs when prenatal diagnosis reveals an abnormality in the child, such as Down’s Syndrome or some physical malformation.  The temptation in our world then becomes “Terminate the pregnancy.  Abort the child.”  Actually, since the 1973 Supreme Court decision Roe v. Wade which legalized abortion, pressure upon physicians to make accurate prenatal diagnoses has grown and consequently has increased the legal penalties and settlements for failure to accurately diagnose and report any abnormality.  Obstetricians regularly use prenatal diagnosis and then inform parents of the findings to protect themselves from malpractice suits.  Many health care plans insist on prenatal diagnosis, and then in the case of an abnormality, apply pressure to terminate the pregnancy, which is more “cost effective” than treating the abnormality for perhaps a prolonged period of time after birth.  Nevertheless, despite this knowledge, we must not lose sight that each person remains an unique individual made in the image and likeness of God.  Moreover, the criterion of what is normal versus abnormal can be very subjective, depending upon who is in control.

Without question, parents must agonize when the prenatal diagnosis reveals an abnormality.  Suddenly, this information about the baby they wanted so much now sparks a host of questions:  “What will happen to my child?  What kind of life will he have?  What will the treatments entail?  How could this happen to us?  How can we possibly care for this child?”  Especially in our world today, the temptation to abort may enter the parent’s mind.  However, to succumb to such a temptation and take the life of the child would leave the parents with tremendous grief, hurtful memories, and guilt.

To give the child with an abnormality life is a generous and heroic act of love.  Surely, our Lord will give His grace to the couple to sustain their decision.  Moreover, each member of the Church must also assist these families through prayers and charitable assistance.  We must remember always that whatever we do for the least of our brethren, we do for Christ Himself (Matthew 25:40).  We cannot simply give exhortations about the right to life, or talk or sing songs about good works; each of us must take responsibility for these children and support their families.

What then can we do morally when an unborn child is diagnosed with a medical problem?  Medical interventions on unborn children are judged moral as long as they respect the life and integrity of the child, do not involve “disproportionate risks,” and are directed to the child’s healing, improvement of health, and survival.  Here, the free and informed consent of parents is required, who must act in the best interests of their child.  For instance, a procedure to correct a health problem from a hereditary disease is morally permissible even while the child is still in the womb.  The more serious the problem and the greater urgency to correct it determines how much risk can be accepted.  However, experimental treatment must not be performed on an unborn child just for the sake of experimentation; rather, any experimental treatment should be therapeutic to the child with, as best as possible, a moral certainty of not causing harm to his life and integrity.  (Cf. Donum vitae, I, 4.)

However, we have moved from the realm of therapeutic treatment to experimental research on unborn children.  The danger here is that we can lose sight of the unborn child as a person and view him as a laboratory research animal.  We have slipped into this mentality primarily because our civil law, as stated in Roe v. Wade, does not consider the unborn child a “person.”  Moreover, the present capabilities of in vitro fertilization have compounded the problem, reducing a conceived child to “genetic material” isolated in a petri dish.  Nevertheless, here again the Church asserts clear moral guidance concerning fetal research:

—  Any production of human beings for the sake of experimentation, research, or the harvesting of organs is morally wrong.  Such actions reduce a human being to simply disposable biological material.  (Cf. Donum vitae, I, 5.)

—  Any medical research or observation which jeopardizes the health or life of the unborn child is morally wrong.  (Cf. Donum vitae, I, 5.)

—  Procedures designed to influence the genetic inheritance of a child, which are not therapeutic, are morally wrong.  To try to correct a genetic disorder, such as cystic fibrosis, is morally permissible, whereas to manipulate the genetic structure to produce human beings selected by sex or some other quality is wrong.  Attempts to produce a “breed” of humans through cloning, twin fission, or parthenogenesis outside the context of marriage or parenthood is immoral.  Such procedures violate the dignity of the human being, attacking his personal integrity and identity.  (Cf. Donum vitae, I, 6.)

—  “The corpses of human embryos and fetuses, whether they have been deliberately aborted or not, must be respected just as the remains of other human beings” (Donum vitae, I, 4).  Any kind of commercial trafficking of corpses or organs in morally wrong.

These teachings reflect “Catholic common sense.”  If we say, “Yes, the unborn child at the moment of conception is an unique individual, made in God’s image and likeness, with a body and a soul,” then these principles make sense.  If we say, “No,” then we will permit uncontrolled research and plunge ourselves into the realm of genetic manipulation, organ harvesting and trafficking, human breeding, and unrestrained experimentation.  A few recent cases demonstrate what happens when we choose the latter answer.

In 1991, Anissa Ayala, a 19 year-old suffering from leukemia, received a bone marrow transplant from her 13 month old sister, Marissa, who was purposefully conceived to be a bone marrow donor.  While still in the womb, physicians analyzed Marissa’s tissue and determined that she would be an acceptable donor for her older sister.  What if her tissue had not been compatible with that of her sister?  Would she have been aborted, and would the parents then try to conceive another compatible donor?  Dr. Robert Levine at Yale University School of Medicine commented, “It seems to me that when a primary motive for conceiving a child is to produce tissue or an organ, we are getting very close to seeing this new being as a means to another end.”

Take this a step further.  Currently, fetal brain tissue is used to treat patients suffering from Parkinson’s disease, an incurable neurodegenerative disease.  Fetal brain cells are extracted and transplanted to supply the needed brain chemical Dopamine, a neurotransmitter.  Tissue harvests of at least 14 fetal brains are required for best results.  This procedure is still very much experimental, and the benefits still inconclusive.  However, the fetal brain tissue is suctioned out while the fetus (13 to 18 weeks old) is still living; so the transplantation does not come from a clinically dead person, but from a clinically alive person.  Obviously, the procedure kills the unborn child.  Researchers are finding other ways in which “parts” of unborn children may be beneficial to those born.  This research questions parameters concerning producing babies and aborting them simply to sell fetal tissue.

Take it a step further.  Although current federal law prohibits the sale of human organs, abortion clinics regularly receive a processing fee of $50 to $150 per child from research laboratories.  Here lies the beginning of a very lucrative business.

Take it a step further.  The success of organ transplants depends upon the freshness and, in the case of a fetus, the developmental stage of the organ.  Therefore, one can easily predict later abortions for the sole purpose of harvesting organs for transplantation.  With the legalization of partial birth abortions, this practice may soon become easier.

And in the end, the more one propagandizes the use of fetal tissue, the easier it is to think of this procedure as a good, which justifies abortion and looks at the unborn child simply as a blob of tissue.  As Catholics, we must courageously defend the basic respect for all human life, born and unborn.  All forms of prenatal diagnosis or fetal research must proceed from this stance.  The unborn, innocent, defenseless child cries out for our protection.