This article is reprinted from Ethics & Medics with the author’s permission.

In vitro fertilization (IVF) is by far the most common assisted reproductive technology used to treat infertility in the United States¹. In 2021, 2.3% of babies born in the U.S. (86,146 babies) were conceived using IVF and related technologies.

IVF entails the administration of medications to boost egg production in the prospective mother. This is followed by needle aspiration of eggs from the ovaries and mixing of the eggs and mixing them with the sperm of the prospective father in a laboratory. The fertilized eggs grow into embryos over several days and may be implanted surgically in the mother or frozen for future use.

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The embryos may be tested and sorted for genetic quality. Ordinarily the egg and sperm are from the couple seeking pregnancy, but third-party donor eggs or sperm may be used. The technique is routinely used to preserve fertility in young people with cancer who must undergo chemotherapy or radiation that would leave them sterile.

IVF has given rise to considerable controversy. Recently, the Alabama Supreme Court ruled that human embryos accidently killed in a clinic mishap were children under Alabama law and that their deaths could be the basis for civil litigation by their parents². This ruling caused considerable controversy³, although the U.S. Supreme Court recently rejected the IVF clinic’s appeal of the Alabama ruling⁴.

At issue in the debate about the ethics of IVF are fundamental questions of biology, morality and law. Are embryos produced by IVF human beings, persons worthy of moral respect and legal protection? Or are they merely human tissue, without moral or legal standing?

When does human life begin?

At the core of the debate about IVF is the question: when does human life begin? It is often treated as a metaphysical question — what does it mean to be human? Does being human mean having a heartbeat or brain waves, being sentient, being capable of feeling pain, being rational, achieving a certain stage of development or acquiring a certain set of skills?

Despite the ambiguity in public discourse about the definition of human life, the question “when does human life begin” has a clear biological answer with profound metaphysical implications.  From a biological perspective, life begins at fertilization. When the sperm fertilizes the egg, a new human being is present. From that time forward a unique living human being exists, grows and develops.

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This is not a matter of scientific debate; from the early 19^th century, when the biology of human reproduction was first understood in its basics⁵, the science has been clear and uncontroversial. Human life begins at fertilization.

Denial of this basic biological fact leads to absurdities. If human life begins sometime after fertilization (with sentience, heartbeat, or brain waves, etc.), then for a time, the embryo is either a part of the mother’s body or is a non-human organism of some sort. If the embryo is part of the mother’s body, then half of all pregnant women are hermaphrodites, with female and male body parts, and human beings reproduce by budding, in which new individuals emerge from tissue in the mother’s body (as some worms reproduce). If an embryo is a non-human organism distinct from the mother, then pregnancy is a parasitic disease, and speciation (the evolution from one species to another) takes place during each pregnancy. Of course, these assertions are scientific nonsense.

Profound metaphysical implications

This biological fact has profound metaphysical implications. Because human life begins at fertilization, it makes no sense to call an embryo a “potential human.” A potential human may be an individual spermatozoon and an individual ovum, prior to fertilization, but once fertilization occurs, the union of sperm and egg is an actual human being, not a potential human being.

The embryo has many actual and potential characteristics of course. He or she is actually alive, actually male or female, actually has a basic body structure, actually syntheses proteins, actually metabolizes carbohydrates, etc. He or she potentially has a heartbeat and brain waves, is potentially sentient, potentially capable of feeling pain, potentially rational, potentially of certain stages of development, can potentially acquire a certain set of skills such as feeling and thinking and loving, etc.

This composite human nature is not unique to human embryos — every human being at any age is a composite of actual and potential characteristics. I am actually many things — a man, a husband, a father, a doctor, a dog owner — and I am potentially many things — retired, an octogenarian, a lottery winner, a cat owner, etc. Every human being is a composite of actuality and potentiality—this is inherent to our nature. The younger we are, the more potential we have, but to have potential does not obviate what we actually are at every stage of our lives. We are all actually human beings, from fertilization until our last breath.

IVF embryos are human beings

Therefore, IVF embryos are human beings, every bit as human as their mother and father, every bit as human as each of the people working in the IVF facility, and every bit as human as people walking by on the sidewalk outside the facility. To be human is not to pass a test of age, size, or sentience. Each of us, from embryo to elder, is a human being.

Ethical questions about IVF embryos are ethical questions about real human beings, not metaphysical speculation about “potential life.”

What is a person?

In the debate over IVF, the questions “When does life begin” and “When does personhood begin” are usually conflated. But these are two separate questions, and the manner in which they are answered is central to the ethical issues around IVF. 

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As noted, the answer to “When does life begin” is clear and simple. At the moment of fertilization, human life begins. The second question “When does personhood begin?” is a subtler question. Yet the answers to the personhood question have implications that are not at all subtle.

Personhood is a moral judgment, a judgment about when a human being acquires rights and becomes worthy of respect and protection. Some rights are conferred according to age or ability: persons acquire the right to vote or to purchase alcohol or cigarettes at a legally specified age. Persons acquire the right to drive or to practice medicine or law according to ability demonstrated by training and licensure exams.

Independence is not a factor in personhood. The embryo is dependent on his mother, or on an IVF incubator, for sure, but dependence does not make the child less human. Each of us is dependent on others at every stage of life. We depend on others for food, shelter, protection, companionship, etc.

It is ironic that proponents of IVF who claim that the dependence of IVF embryos on technology makes them less than human eat food that is sown, grown, harvested, processed, delivered, and prepared by other people. We are all dependent on others, at every moment of our lives. None of us would survive long in a state of nature. Dependency is a feature, not a bug, of what it is to be human — a feral child lives on the margins of humanity.

Is there a criterion for personhood that supersedes and is morally prior to age and ability-dependent qualifications? Yes, there is. The fundamental right of persons, on which all other rights depend, is the right to life. If a human being has no right to life, the human being has no rights at all. Without the right to life, the right to vote, drive, or practice a profession is meaningless. If it were legal to kill a man if he votes, he would hardly have a “right to vote.”

A person is a human being with the right to life, and the right to life is the foundation for all human rights and the prerequisite for personhood.

The right to life?

Now we face the fundamental question: do all human beings have the right to life? Are all human beings persons? There are two possible answers to this question. 1) All human beings are persons from fertilization until natural death. 2) human beings acquire personhood at some point after fertilization, dependent on age, sentience, ability, etc.

The difficulty with option #2 is that it defines a class of human beings as disposable and instrumental, fit for purposes. Given that the fetus is undeniably a human being from the moment of conception, IVF technology inherently singles out one class of human beings — very young ones — for special treatment, in a highly negative sense. Embryos are frozen, tested, stored, and selected or discarded according to genetic endowment.

The argument that they are non-sentient or dependent carries no weight. Personhood — the recognition of human worth and dignity — is not based on IQ or on any cognitive measure or any standard of independence at all. A newborn baby and a grandmother with end-stage Alzheimer’s disease are highly dependent yet fully persons, with the same basic human rights and dignity as a healthy young adult. In fact, the default in bioethics has long been that human beings who are dependent and vulnerable — the helpless, the handicapped, the very young or very old — deserve enhanced ethical protection. To deny the humanity and personhood of embryos in an IVF laboratory is to deny the moral foundation of bioethics.

On to the human Industrial Revolution

The manufacture of human persons by IVF is a 21^st century industrial revolution — a human industrial revolution. With the manufacture of artificial wombs, of even more precise genetic testing, of genetic manipulation and potentially human cloning, IVF presents humanity with dangers on an industrial scale. The human industrial revolution will be used someday to produce children selected for purposes — for aggressiveness (military), for obedience (chattel slavery), for physical attractiveness (sexual slavery), and for histocompatibility (organ transplantation).

In a world beset by war, enslavement, sex trafficking, and a growing chasm between the strong and the weak, IVF offers technology to manufacture men and women on scale and on special order. To stand against IVF is not easy, because it provides infertile couples the blessed opportunity to conceive children. But IVF is the gateway to the human industrial revolution, and it is the door into new and hellish bioethics.

References:

1. https://www.hhs.gov/about/news/2024/03/13/fact-sheet-in-vitro-fertilization-ivf-use-across-united-states.html
2. https://mindmatters.ai/2024/03/are-ivf-human-embryos-children-a-recent-court-decision/
3. https://publichealth.jhu.edu/2024/the-alabama-supreme-courts-ruling-on-frozen-embryos
4. https://www.reuters.com/legal/us-supreme-court-rejects-ivf-clinics-appeal-alabama-embryo-ruling-2024-10-07/
5. https://www.cam.ac.uk/stories/reproduction