1. Introduction
The problem of infertility among married couples is a recurring decimal in this contemporary era. ( Glaser, 2010 ) Marriage is vital for the propagation of human species. So, it is a very tragic for couples not to have any issue or off-spring years after their marriage. Such anomaly may kill the love they have for each other which can result to infidelity or divorce. In some cases, if the problem is from the woman, some African men will leave their wives to marry another wife which causes serious psychological trauma of depression for the woman that might lead to suicide. According to Raphael Olisa Maduabuchi, childlessness is one of the major factors that can precipitate depressing feeling which leads to suicide. ( Maduabuchi, 2009: p. 1 ) The great value is placed on a male child in African thought and culture especially Igbo people of Southeastern, Nigeria has driven some men to leave their marriage and marry another wife in a bid to beget a male child. In other cases, it has resulted to one man marrying many wives. The negative impact of polygamous instinct in some people from polygamous family may militate against good human relationship with others in the society.
Alternatively, some couples may resort to adoption in order to avoid the social stigma of infertility or people tagging them as divorcee. But, adopting children for some people may not be a way out of this problem. Apart from the fact that some of these children may bear some bad traits of their biological parents who gave birth to them before marriage and become social deviants in the society later. Adoption has its own peculiar problems in this our contemporary African society today. Africans practice communitarian lifestyle of extended family system unlike the Westerners which functions mainly among people with blood family relationship. In some cases, the adopted may be segregated and treated with disdain especially in the sharing of properties and other privileges. This problem becomes peculiar when the couples beget their own biological children. Some couples may not like their elderly adopted child to enjoy the rights and privileges of first son or daughter over their own biological children. This might lead to abuse. Sometimes the couple in an attempt to send them away secretly may expose them to human trafficking and other inhuman practices.
However, some woman who may still like to bear their own children may resort to immoral practice of cheating or going out of their marriage secretly in order to beget children. It is unfortunate that some women are bearing another man’s children for their husband in order to save their marriage. But this practice has dangerous consequences for the couples when it is detected later.
Today scientific advancement in the area of biotechnological sciences has made it possible for parents to dictate the gene of their biological children through DNA test. Many couples have killed themselves or left their marriages when it is proven through DNA test that children they are having in their family is not their biological children. Other couples who might like to have biological children of their own without adoption will resort to in vitro fertilization (IVF) which may have some challenges associated with it. The advancement and exploration in the biotechnological sciences and medicine have given rise to assisted reproductive technologies to facilitate reproduction.
As one of the assisted reproductive technologies, IVF militates against the natural means of reproduction. St. Thomas Aquinas was one of the greatest proponents of natural law theory who advocates for copulation of male and female gametes as a natural design of procreation. Even though in vitro fertilization is geared towards self preservation of the biological or genetic traits of the couples, it is against natural design for man. Nature has designed sexual intercourse for the reproduction of offspring. Thus, this work tends to carry out a comparative analysis of in vitro fertilization (IVF) vis-à-vis St. Thomas Aquinas’ Natural Law Theory. In attempt to carry out this study, this work will look into the basic or key concepts associated with this work, analyse the main issues associated with IVF and St. Thomas Aquinas’ Natural Law Theory, juxtapose IVF with St. Thomas Aquinas’ Natural Law Theory and critically examine their strength and weak point.
Conceptual Clarification of Key Terms
The basic or key concepts that are associated with this study are: in vitro fertilization and natural law. Both of them are at par with each other. It is good at this juncture to clarify these two terms that have to do with this study.
In vitro fertilization is one of the assisted reproductive technologies designs for infertile couples to beget the biological children of their own. According to American Society of Reproductive Medicine (ASRM), “IVF is a method of assisted reproduction in which a man’s sperm and a woman’s eggs are combined outside of the body in a laboratory dish. One or more fertilized eggs (embryos) may be transferred into the woman’s uterus, where they may implant in the uterine lining and develop”. ( American Society of Reproductive Medicine, 2022 ) It is evident from this definition that IVF has to do with artificial insemination which is quite distinct from the natural method of sexual reproduction. In other words, in vitro fertilization is the mixture of the human reproductive cells outside the body in a scientific apparatus. In this procedure, drugs are injected to get many eggs in the woman’s ovaries to maturation which are surgically removed and fertilized with the husband’s sperm in a test tube. ( Maduabuchi, 2016: p. 85 ) The fertilized egg is then transferred into the woman’s uterus after a few days for pregnancy to occur. The child conceived and born by means of in vitro fertilization is sometimes regarded as ‘test tube babies’. ( Maduabuchi, 2016: p. 85 )
But, in vitro fertilization militates against the natural design for man. Natural law is derived from nature which is designed for ordering the activities of rational creatures. According to Encyclopedia Britannica, “natural law, in philosophy, system of right or justice held to be common to all human and derived from nature rather than from rules of society, or positive law”. ( The Editors Encyclopedia Britannica, 2023 ) One can infer from this definition that natural law is derived from nature which is common to all human beings.
St. Thomas Aquinas was one of the great forerunners of natural law who developed natural law extensively in his philosophy. Hence, St. Thomas Aquinas defines natural law as the “participation of the eternal law in the rational creature”. ( Aquinas, 2020: p. 1334 ) In the view of St. Thomas Aquinas, God governs the whole universe through the eternal law. So, natural law for him is the aspect of eternal law (which God uses to govern the whole universe) as it pertains to man as a rational creature. In other words, it is the participation of rational creature (man) in the eternal law.
However, in vitro fertilization (IVF) is an artificial method of reproduction which contravenes the natural process of reproduction designed for man by the law of nature. Even though St. Thomas’ Aquinas’ natural law condemns IVF as evil, in vitro fertilization is geared towards self preservation of the natural, biological or genetic traits of the couples and removing its obstacles towards achieving this feat. ( Aquinas, 2020: p. 1351 ) The fact that IVF is not prohibited legally by Federal Republic Nigeria and other countries of the world implies that IVF seems not to be bad in its entirety. This work tends to juxtapose IVF with St. Thomas Aquinas’ natural law.
2. In Vitro Fertilization (IVF)
Fertility treatment is as old as man which does not start with in vitro fertilization. Different forms of fertility treatments have been in practice right from time immemorial. Hence, different societies have their own method of fertility treatment. In Vitro Fertilization (IVF) is one of the modern forms of fertility treatment which emanates as a result of advancement and sophiscation in biotechnological science through which egg is released and fertilized outside the womb.
The procedure of IVF requires the intervention of a medical team who will examine the medical history of the reproductive capacity of the couples. Then, fertility drugs are administered to the woman to make her produce as many eggs as possible. These eggs are fertilized with the healthy sperm of the husband and inseminated into a woman’s womb. A good number of fertilized egg or pre-embryos are required to boost the likelihood of pregnancy. Other eggs that are not transferred to a woman’s uterus are frozen, destroyed or used for research purposes. This is what is known as pregnancy reduction. Pregnancy reduction which also includes research on embryo has generated ethical controversy. The serious controversial issue in IVF and abortion borders on the issue of when life begins. This problem has not been resolved up till this moment since there are different conceptions with regard to the personhood of the embryo. ( Goldworth, 2020 )
In this contemporary era, in vitro fertilization is sometimes associated with gamete donation and surrogacy. Gamete donation can be applicable in some situation where the man is unable to produce a healthy sperm or elderly women who may wish to have their own children will procure or buy sperm or egg from gamete donors in fertility hospitals. IVF gives room for collaborative reproduction through sperm or egg donation, surrogate motherhood parenting and so on. Surrogate motherhood is a provision for a woman to carry another woman’s child conceived by in vitro fertilization. Some couples who may not be willing to undergo the pain of pregnancy can pay the surrogate mother who will carry the pregnancy of their biological children for them.
In addition, egg freezing or banking is an emergent sector in IVF for women who may want to extend their fertility. This is so because child bearing and taking care of babies is time consuming which can make women not to attain satisfactory level of achievement in their job or career. Nature has made it that women fertility decline with age. The quality of egg production that will give rise to fertilization in women declines in late thirties and forties so egg freezing or banking gives women the opportunity for them to pursue their education and career without losing their fertility.
Also, egg freezing or banking can serve as a remedy by way of donation or sale of unused eggs for women nearing menopause by using younger donor gamete. But, women need accurate and sufficient information so that they can make informed consent or choice on egg freezing in order to avoid abuse. This is so because the right of women to egg freezing is faced with the problem of having the correct information. Individual providers of this service or company in some cases may not provide the precise data concerning the success rates either on a general scale or specific success rate of their own company. Thus, there is the need for them to provide accurate and sufficient information fitted to women situation. Imogen Goold admonishes that public education or awareness is necessary to help women understand the best time to freeze their eggs whether it is better doing it sooner or later. ( Gold, 2017 )
Notwithstanding the prospects of IVF and other reproductive technologies, philosophers never condemn the natural or coital reproduction. They see the need for people to continue to work towards clearing the barriers to natural conception earlier in life for those women who would choose to do so.
3. St. Thomas Aquinas’ Natural Law
St. Thomas Aquinas’ natural law theory was one of the philosophical ventures in clearing the barriers to natural reproduction. Aquinas develops his natural law theory extensively in the medieval period whose influence is still reflected in the modern and contemporary era. Natural law functions in the light of natural reason to discern what is good and avoid evil. Aquinas buttresses that God has certain natural inclination for men which is directed towards their ends. The precepts of natural law in his view are ways through which men come to know the natural law. These precepts of natural law according to him are classified into three categories.
The first precept of natural law is that “good is to done and pursued, evil is to be avoided”. ( Aquinas, 2020: p. 1354 ) It is implied by this precept that “all those things to which man has a natural inclination, are naturally apprehended by reason as being good, and consequently as objects of pursuit, and their contraries are evil, and objects of avoidance”. ( Aquinas, 2020: p. 1354 ) Man shares this inclination to good in accordance with nature in common with all substances. For example, self preservation is a natural inclination which man has in common with all substances. Other precepts are derived from the first precept as most general precept.
The second precept of natural law is an inclination that pertains to man’s nature which he shares in common with other lower animals such as sexual intercourse, education of offspring and so forth. Aquinas defines sexual intercourse as that “which nature taught to all animals”. ( Aquinas, 2020: p. 1354 ) Nature taught animals to mate and take care of their young. On this note, homosexuality or lesbianism (unisexual lust) is unnatural crime which militates against sexual intercourse which is natural to all animals.
Finally, the third precept of natural law is the inclination to good in accordance with nature which pertains to man alone as a rational creature. For example, the natural inclination to know the truth about God and to live in the society belong to man alone as a rational being. Thus, F. Kerr avers that ‘it is a matter of the natural law that we have an inclination, for instance, to avoid ignorance, not to offend those with whom one ought to live amicably, and other such related matter’. ( Kerr, 2009: p. 77 )
Although the second and third precepts are derived from the first precepts as conclusion following from its premises, these three precepts are the general principles of natural law. Natural law is a universal principle which is binding on all men. It is promulgated in the heart of men. In the words of St. Thomas Aquinas, “God instills this law in the mind of men to be known by them naturally”. In other words, the general precepts of natural law are self evident (innate) in human heart. For Aquinas, it is apprehended or known by “synderesis”. It is the view that man has the natural disposition to grasp and know these general precepts or principles of natural law that ought to guide rational creatures. The role of conscience for Aquinas is to apply these principles to particular situations. ( Omoregbe, 1991: p. 153 )
4. Comparative Analysis of St. Thomas Aquinas’ Natural Law on Procreation and IVF
The natural or coital reproduction and IVF share in the common act of procreation. But, the modern scientific exploration in the area of in vitro fertilization and other assisted reproductive technologies contravene the natural design for procreation. On this note, W. Jerome Bracken uses Rahner’s theology of symbol and St. Thomas Aquinas’ theory of soul and body to distinguish IVF from coital reproduction. He buttresses that Rahner’s theology of symbol sees the body as not just a symbol of human soul but a human person in its entirety. In the same manner, he draws from St. Thomas Aquinas’ teaching that the soul is the substantial form of the body. From these two analogies, human body is a symbol of the whole person, there is an intrinsic connection between the body and person. So, the couples share in this intrinsic connection or expression existing between the body and soul when they use their body to procreate. By so doing, they make themselves present in each other and to the act of procreation. But, this is lacking in the act of using scientific instrument or apparatus in vitro fertilization because there is no intrinsic connection between the reproductive technology and the spouses.
Unlike the case of spouses’ bodies where the direction is evolving directly from “the intrinsic principles of the bodily members of the persons themselves”, the direction in the case of in vitro fertilization is coming from the agents extrinsic to the spouses. Sexual intercourse in this view differs so much from reproductive technologies in that the causes of the direction are formal ones. But, the cause of direction in reproductive technologies is an efficient one. Thus, in the case of sexual reproduction the direction is coming from the human form (soul) of the spouses and natural inclinations which are “vital, sexual and intellectual” which is very different from reproductive technologies. ( Bracken, 2020 )
Again, the analogy of Catholic Church is applied to explain this connection that marriage bond is symbolized by sexual intercourse, which becomes “absolutely indissoluble”. The Catholic theology frowns so much at in vitro fertilization because it is quite contrary to sexual intimacy or conjugal union of the couple. Hence, the Church believes that there is a link in sexual pleasure, the communication of love and desire for children. Since reproduction takes place through love making, couple can show their love for other as they make offspring together.
But, looking at in vitro fertilization from the other dimension, Apart from other practices that may be associated with IVF like embryo research, sperm or egg donation, surrogacy and so on which involves collaborative reproduction that may be abused, the aim of IVF seem to gear towards the self preservation of the natural, biological or genetic traits of the couples. And this is somehow in line with St. Thomas Aquinas’ first precept of natural law which stipulates that self preservation is a natural inclination which man has in common with all substances.
Contrary to this fact, IVF militates against sexual reproduction which falls within the second precept of St. Thomas Aquinas’ natural law that man shares in common with other lower animals. It is evident from nature that coital reproduction is the best form of reproduction for the propagation of human species. One may not be able to compare artificial with natural things because the distinction is obvious. Experience has shown that anything artificial is bound to some complications no matter how scientists present its efficiency.
Nevertheless, the problem of infertility is a physical evil which many couples are contending in this contemporary period. The stand of Catholic teachings on using natural process to procreate is the ideal. On the other hand, life is larger than logic. Some couples passing through the psychological trauma of childlessness can do anything possible to surmount this problem including IVF. It is always advisable for people to seek for spiritual and medical solution to this problem of infertility. Experience has shown that some of the problem of infertility emanates as a result of infection or sexually transmitted diseases which can be treated in the hospital. In addition, there are some cases of miraculous healing for some infertile couples. Even though IVF is sanctioned legally in Nigeria and other countries of the world for infertile couples to beget biological related children of their own, it has to be applied with reason. Human beings are the only animal endowed with rationality. The third precept of St. Thomas Aquinas’ natural law conceives that acting with reason is in line with nature which pertains to man alone as a rational creature.
5. Evaluation
The moral issue endemic in IVF and natural or coital reproduction revolves around when human life begins. Philosophers down through the ages have different conceptions with regard to the issue of when human life begins. In one hand, some philosophers uphold that spiritual soul is attributed three months after conception. Aristotle envisages that embryo attains ensoulment or personhood forty days after conception for the male fetus and eighty days for fetus. On this note, Peter Singer conceives that the nervous system of fetuses less than four months has not started functioning. ( Maduabuchi, 2016: p. 61 ) Even Islamic religion believes that hominization or personhood take place fourteen days after fertilization.
Going by above argument, the philosophers who are propagating for IVF see the destroyed embryos that are not transferred to woman’s womb as protoplasm so for them there is nothing wrong in destroying or freezing them. Thus, Peter Singer is radical in supporting this view by saying “that the potential of a human embryo in the laboratory is not the same as the one who is already implanted in the endometrium of the uterus”. ( Howard, 2005 ) For him, there is nothing wrong in pregnancy reduction and embryo research associated with IVF. He further asserts that the argument of potentiality cannot be applied to embryo in the laboratory. The human embryo generated from in vitro fertilization cannot develop into persons unless they are inseminated into uterus. Sometimes even when they are transferred into the uterus, they may not develop into persons. He thereby denies the potential of embryo as a ground for according it moral status of human person since egg and sperm existing separately has no moral status. It is justifiable for him to use human embryo for research until it reaches a stage when the embryo is capable of feeling pain (when the brain and nervous system develop). In his view, research in human embryo is useful in averting fertility problems.
For the traditional Christian moralists or pro-lifers, on the other hand, the spiritual soul is attributed to the fetus at the moment of conception when the sperm fertilizes the ovum. Hence, they consider pregnancy reduction i.e. the process of destroying, freezing or using other fertilized eggs that are not transferred to a woman’s uterus in IVF for research as evil. In other words they consider this act as abortion or willful murder of innocent unborn children.
Evaluating these two arguments, there is a point in what they are saying because infertility is a physical evil which no couple may want to experience. But, the argument of the pro-lifers seems to be more tenable because it is based on the natural process of reproduction. Even the same modern science that supported IVF has proven that the human pre-embryo or embryo can be identified as human by its DNA that is formed when the sperm fertilizes the ovum at conception. In other words, it is only at fertilization that the important genetic transfer from parents to offspring which makes the embryo a full fledge human being emanates or takes place. So, Karen Dawson postulates from the point of view of scientific perspective that it is at fertilization that important genetic changes take place like genotype which determines the moral status of the early embryo. ( Dawson, 1987: pp. 173-178 )
Using the artificial means to reproduce which Peter Singer and other philosophers are advocating for may be bound to complication because it is based on human artificial means. Man is a fallible being who can make mistake. Sometimes, children conceived by IVF may have some deformities. Amnon Goldworth laments that some of the drugs injected in IVF to women to stimulate the production of eggs may give rise to certain birth defects like “spina bifida and transposition of the great vessel” ( Goldworth, 2020 ) or heart defect. Even though IVF makes provision for parents who run the risk of having children with disease to be given Preimplantation genetic diagnosis (PGD) to beget healthy children, ( Tannsjo, 2008 ) the natural means of conceiving children stands a better option of producing better children than IVF. Moreover, transplanting multiple embryos to woman’s uterus in IVF constitute risks both for the woman and child. For instance, if implantation fails to take place, another treatment cycle is needed to evacuate the eggs is required at the expense of financial, bodily discomfort and health risk or hazard to the patient. IVF has disastrous consequences on women. The drug given to women to produce many matured eggs has some dangerous effects on women like enlargement of ovaries, ovarian cysts, bleeding, even ovarian cancer etc. Even the system of extracting eggs from the ovary causes internal bleeding; it has “adverse reaction to anesthesia and infection”. And the implantation of fertilized eggs back to the uterus or womb can give rise to “infection, physical damage, or ectopic pregnancies” including miscarriage or still birth in some cases. ( Steinbock, 1995: pp. 543-551 )
Again, IVF is very costly such that it is not every couple that can afford it. The cost of IVF in Nigeria for instance runs in millions. In the advanced countries of Europe and America, IVF may cost 5000 to 7000 US Dollars per cycle and it may require two or more cycle for pregnancy to occur according to this work. But, the chance of giving birth to a ‘viable baby’ in IVF is minimal. ( Steinbock, 1995: pp. 543-551 ) Thus, it is only the rich that can afford the high cost of IVF and other assisted reproductive treatments.
Many scholars, philosophers or scientists who are arguing strongly on the side of IVF seem to be doing so on the basis of utility. The huge economy benefits in IVF cannot be comparable with the value of human life. Considering these challenges in IVF, coital or sexual reproduction is a better option without any challenge or problem. It is a natural process designed by nature for the propagation of human species.
6. Conclusion
This work has examined the modern scientific invention of IVF vis-à-vis Thomas Aquinas’ natural law theory. The problem of genetic inheritance outside marriage has generated the modern scientific invention IVF in the area of genetic engineering which is geared to assist nature in the propagation of human species. It has a good prospect of collaborative reproduction by giving room for surrogacy, egg or sperm donation for infertile couples or people who are unable to conceive their own children. But, IVF cannot serve to substitute human procreation. Taking cognizance of the risk in IVF and other practices (collaborative reproduction) associated with it; adoption is a better option than the use of donor eggs or sperm because the genetic parents are still someone outside the marriage as in the case of adoption. It is also important to employ the natural scientific research or knowledge which will assist couple to know the best possible time to engage in sexual intercourse to beget children. In addition to this, there is the need for the infertile couples to diagnose the cause of infertility and go for medical treatment. Most of the problem of infertility is caused by infection or sexual transmitted diseases. People ought to take proper care of their body by not engaging in illicit sexual activity. Sexually transmitted diseases can be treated to promote fertility. Aristotle conceives that the proper care of the body is very important for fertilization to occur in copulation for the generation of human species. Thus, proper dieting and nutriment are indispensable to ameliorate this problem of infertility. St. Thomas Aquinas’ natural law theory has contributed so much in resolving the bio-ethical issues revolving around natural procreation and sanctity of human life which serves as one of the ethical theories that guide the morality of human action especially in the aspect of generation of human life.