A very disturbing article from the upcoming issue of the New York Times magazine:

As Jenny lay on the obstetrician’s examination table, she was grateful that the ultrasound tech had turned off the overhead screen. She didn’t want to see the two shadows floating inside her. Since making her decision, she had tried hard not to think about them, though she could often think of little else. She was 45 and pregnant after six years of fertility bills, ovulation injections, donor eggs and disappointment — and yet here she was, 14 weeks into her pregnancy, choosing to extinguish one of two healthy fetuses, almost as if having half an abortion. As the doctor inserted the needle into Jenny’s abdomen, aiming at one of the fetuses, Jenny tried not to flinch, caught between intense relief and intense guilt.

“Things would have been different if we were 15 years younger or if we hadn’t had children already or if we were more financially secure,” she said later. “If I had conceived these twins naturally, I wouldn’t have reduced this pregnancy, because you feel like if there’s a natural order, then you don’t want to disturb it. But we created this child in such an artificial manner — in a test tube, choosing an egg donor, having the embryo placed in me — and somehow, making a decision about how many to carry seemed to be just another choice. The pregnancy was all so consumerish to begin with, and this became yet another thing we could control.”

For all its successes, reproductive medicine has produced a paradox: in creating life where none seemed possible, doctors often generate more fetuses than they intend. In the mid-1980s, they devised an escape hatch to deal with these megapregnancies, terminating all but two or three fetuses to lower the risks to women and the babies they took home. But what began as an intervention for extreme medical circumstances has quietly become an option for women carrying twins. With that, pregnancy reduction shifted from a medical decision to an ethical dilemma. As science allows us to intervene more than ever at the beginning and the end of life, it outruns our ability to reach a new moral equilibrium. We still have to work out just how far we’re willing to go to construct the lives we want.

Some quick thoughts: this trend confirms some of the church’s prescient fears regarding reproductive medicine. It’s disappointing, however, that the church really does not have any kind of influence on this debate, at least in this country. (Unlike the question of, say, end-of-life care, where its moral voice is strong.) Since church teaching prohibits any kind of intervention in the reproductive process, it cannot offer any moral guidance on how to regulate that process. The new book Unnatural, which was recently reviewed in the Times Literary Supplement, takes up this question. The author, Philip Ball, argues that by labeling IVF and other such procedures unnatural, or by heeding what Leon Kass calls “the wisdom of repugnance,” there is very little space to offer an ethical critique:

Ball’s point here is that such language and mythic invocations foreclose grown-up discussion and actual scrutiny of the technologies at hand; in short, they end up accounting for the laissez-faire attitude to regulating assisted conception in the United States. 

Tim Reidy

 

Tim Reidy is the deputy editor in chief of America Media.