The United States has a cultural obsession with families created with assisted reproductive technologies, or ARTs—think of Nadya Suleman who gave birth to octuplets or the feuding Gosselins of television’s “Jon and Kate Plus 8.” Yet few insurance plans cover these services and there is little regulation of this field. This contrast is striking and speaks to the stigma still attached to infertility—a stigma that is often informed by traditional religious teachings.
There is a vital role for faith leaders to play in creating intentional dialogue about the effectiveness and safety of ARTs, the relative lack of regulation, and the moral dimensions of their use. This is why the Religious Institute has just released A Time to be Born: A Guide to Assisted Reproductive Technologies for Faith Communities.
Over 3 million babies have been born using ARTs worldwide, and approximately 12 percent of women of child-bearing age in the United States have used an infertility service. Our society still operates under the assumptions that biological children are the correct way to form a family and that achieving pregnancy is effortless. The reaction to those who have high-order multiple births highlights our cultural ambivalence about biological childbearing, sophisticated technologies, and notions of restraint or responsibility in childbearing.
An important component of this ambivalence stems from traditional religious teachings about fertility and childbearing, which often reinforce the view that a woman’s value lies primarily in her reproductive capacity, and that a heterosexual marriage is only fulfilled by bearing children. These teachings about women, childbearing, and heterosexual parenting can be hurtful and exclusionary. Some religions have historically presented infertility as a punishment and suggest that people without children are somehow less faithful. These teachings may cause great pain to individuals; they may also deter people who use ARTs from engaging in moral decision making within the context of their faith community.
The lack of government regulations and the sporadic, often biased insurance coverage of ARTs compound the harm caused by stigma and silence. Fertility clinics currently self-regulate through membership in the American Society of Reproductive Medicine, although the Centers for Disease Control report that 8 in 10 clinics do not strictly follow ASRM guidelines. Many insurance companies, fertility clinics, and state laws limit access to ARTs based on marital status, sexual orientation, and socio-economic standing.
Unfortunately, technology is outpacing the theological and moral response to assisted reproduction. The Religious Institute’s new resource is intended to help clergy and religious professionals join the much-needed public conversation and provide informed counsel and ethical reflection on the use of reproductive technologies. A Time to be Born is the first multifaith resource to address the scientific and ethical complexities of reproductive technologies from a religious perspective and to provide practical advice to religious leaders to help the people they serve who struggle with these issues.
We must commit to an ongoing conversation that respects the desire for biological children while honoring reproductive justice. Faith communities can take the lead in this conversation by promoting values that can guide moral and ethical decision making on the use of ARTs. Many faith communities have come to value nontraditional family structures, uphold the dignity and diversity of human beings, articulate a principle of communal responsibility, and witness against social injustices that perpetuate inequalities based on race, gender, economic class, sexual orientation, age, and ability. Faith communities can guide ethical exploration, inform compassionate counseling, and promote justice-based advocacy through an expanded understanding of creativity, generativity, and family formation.
As the Religious Institute stated in the Open Letter to Religious Leaders on Assisted Reproductive Technologies, calls for increased regulation can best address disparities in ART practice if they “promote research to determine the risk of ARTs and raise questions about the use of resources for ARTs that are high risk and low success.” In addition, insurance coverage “for effective and safe ARTs should respect the diversity of family structure and not exclude on the basis of partner status, economic circumstances, or sexual orientation.”
Use of ARTs is sure to grow as these technologies continue to develop. We urgently need a public dialogue—involving physicians, theologians, ethicists, clergy, health advocates, and the scientific community—that responds to the social, moral, and medical issues raised by the use of ARTs. Neither silence in the health care industry nor media-driven tabloid gossip will provide the desperately needed ethical response that respects the desire to have children while calling for accountability and equity in how ARTs are used.
A Time to Be Born is available for download at www.religiousinstitute.org. Dr. Kate M. Ott is associate director of the Religious Institute and the author of A Time to be Born.