A Defense of Dignity: Creating Life, Destroying Life, and Protecting the Rights of Conscience

Chapter Three: Equal Dignity and Equal Access to Fertility Treatments

Three equal Dignity and equal Access to Fertility treatments if all human beings have intrinsic dignity, this dignity extends to the very beginnings of human life and the procreation of human life itself . For this reason and others, the ethical response to infertility, including the risks of iVF to women and children,1 remains a topic of much discussion.2 An important contribution was published in 2009 by the ethics committee of the American Society for reproductive medicine (ASrm), entitled, “Access to fertility treatment by gays, lesbians, and unmarried persons.” the ASrm report addresses the question of whether those working in health care should assist individuals in reproducing, regardless of marital status or sexual orientation. obviously, if the conclusions reached thus far in this book are correct, unmarried people as well as gays and lesbians share equal basic dignity with every other human person and therefore also have equal basic rights. Based in part on this recognition , the summary conclusions of the ASrm report include the following, “there is no persuasive evidence that children are harmed or 27 D 28 A Defense of Dignity disadvantaged solely by being reared by single parents, unmarried parents , or gay and lesbian parents. . . . Programs should treat all requests for assisted reproduction equally without regard to marital status or sexual orientation.”3 Not only may health care workers assist in the request to reproduce , the report asserts that they must assist. “Although professional autonomy in deciding who to treat is also an important value, we believe that there is an ethical obligation, and in some states a legal duty, to treat all persons equally, regardless of their marital status or sexual orientation.”4 What justifies these conclusions? the report mentions shifting public standards such as increasing trends in society away from reproduction by married, opposite-sex couples and a greater acceptance of homosexuality. the committee also breaks down the ethical debate into three main points. First, the ASrm holds that unmarried persons as well as gays and lesbians have reproductive interests. Secondly, the committee believes that the welfare of children is not impeded by being reared in a nontraditional family. Finally, the report curtails the personal autonomy and conscience rights of health care workers in favor of a “duty not to discriminate on the basis of marital status or sexual orientation.”5 each of these points merits further investigation. the invocation of “societal standards” is remarkably inconsistent throughout the report. For example, shifts in social acceptance of single parenthood are noted as evidence in favor of assisting unmarried individuals in reproducing, but societal views of same-sex marriage are simply ignored as evidence against assisting same-sex couples in reproducing. As of 2009, when the ASrm report appeared, in thirty-one different states— including left-leaning california—same-sex marriage was put to a vote of the people, and in all thirty-one states a majority of the people voted against same-sex marriage. At the time it was written, the drafters of the report were not justified as claiming social acceptance of same-sex marriage . Neither voting nor polling indicated that society viewed oppositesex couples and same-sex couples as equivalent. the ASrm committee provides no evidence whatsoever that “society” approves of treating all requests for assistance in reproduction equally regardless of marital status or sexual orientation. Polls have found that society in general disapproves of adoption by same-sex couples of children already in existence and in need of parents, so how much more would society likely disapprove of creating equal Dignity and equal Access to Fertility treatments 29 a child specifically for same-sex couples? even if polling showed that most people support adoption by same-sex couples, the views of the majority do not determine what is ethically acceptable. the ASrm report, however , proceeds as if this were the case, at least when the majority supports the conclusions to which the committee is predisposed. When public opinion does not support the conclusions to which the committee is predisposed , public opinion is ignored. the committee asserts, “Given the importance to individuals of having children, there is no sound basis for denying to single persons and gays and lesbians the same rights to reproduce that other individuals enjoy.”6 Since the state does not criminalize single parenthood or constitutionally ban assisted reproduction by homosexuals or the unmarried, “moral condemnation of homosexuality or single parenthood is not itself an acceptable basis for...