WEEK 2 BIOMED
Butterfly003
Week2_CONTRA-IVF.pptx
CONTRACEPTION & NON-THERAPEUTIC STERILIZATION
BRIEF HISTORY OF THE PILL
HUMAN SEXUAL INTERCOURSE
2 DIMENSIONS OF SEXUAL INTIMACY
CONTRACEPTION / DIRECT STERILIZATION
BIOETHICAL ANALYSIS
PRINCIPLE OF DOUBLE EFFECT
ECTOPIC PREGNANCY / CANCEROUS UTERUS
BRIEF HISTORY OF THE CONTRACEPTIVE PILL:
MARGARET SANGER (1879-1966):
6th of 11 siblings (18 pgs), nurse @ 20, suffragist, eugenicist, absol control over repr, utilitarian
GREGORY PINCUS (1903-1967): Biologist, Harvard, Hormones; progestins
JOHN ROCK (1890-1984): OB/GYN, Harvard, Catholic, Clinical Trials
CLINICAL TRIALS: Enovid; Puerto Rico, Haiti, Mexico, Los Angeles
FDA APPROVAL: 1957 menstrual regulator, 1960 contraception
PAPAL COMMISSION:
Pope John XXIII 1963 (6 members), Pope Paul VI (72 members) report 1966
HUMANAE VITAE (POPE PAUL VI, 1968): 2 dimensions, intrinsic evil, serious reasons, NFP
HUMAN SEXUAL INTERCOURSE, UNIQUE:
PHYSICAL LEVEL
PSYCHOLOGICAL LEVEL
SPIRITUAL LEVEL
Mammals: intercourse (mounting) -> naturally essential for achieving fertilization
In animals, strictly for reproduction (not face-to-face)
Unitive and Procreative Dimensions of Married Love
unitive: bonding, the blending, the intertwining that occurs between spouses
in the mutual expression of their love
The human call to love is universal
unique to marital love is the physical sexual intimacy,
which has radical implications
first implication: married couple, unlike any other familial or friendship love,
share their naked bodies
Human nature: nakedness does not belong between people who have not made
a mutual life-long commitment
Ex: when a spouse shares that nakedness with someone other than his or her spouse,
and the other spouse finds out, a deep sense of betrayal sets in
Human nature: sexual intimacy be exclusive because,
alongside with the physical intimacy there comes also a spiritual intimacy
that “seals” those two souls in a very unique and abiding way
Ex: sharing daily experiences,
which molds the couple into a new reality that was not there before,
and could not be there even if each individual went through the same experience alone
second implication: spiritual intimacy,
the spiritual intercourse that also happens when the physical intercourse
is honestly lived and properly understood
Unitive significance of marriage = new reality, double bonding
―physical & spiritual―
mutual surrender: 2 naked bodies + 2 naked hearts (Gn 2,24-25)
flows natural desire to make that bond fruitful,
with nothing less than creating a new human life = procreative significance
Mammals: intercourse -> naturally essential for achieving fertilization
However, humans don’t reproduce; we procreate
Human intercourse: 2 dimensions are inseparable (complex unity) ex, coin
Regarding the procreative dimension, however,
what is inseparable from the unitive dimension is not so much
the actual begetting of a child,
but rather the desire for doing so
Whether the children actually happen or not,
that’s up to the Author of life, the Creator of life
CONTRACEPTION & STERILIZATION
Definition
(sexual intercourse only within valid marriage)
intentional avoidance of having children without serious reason
“default” position in human sexual intercourse is the desire for having children
For grave reasons, it is justified to try to avoid conceiving:
finances
relocation
emotional instability
medical
many other children
etc.
mature and honest conscience is required for determining what serious reasons are
Various Methods of Artificial Contraception
3 categories: mechanical, chemical and surgical (or combo)
Mechanical:
male and female condom
cervical sponges and caps
Diaphragms
intrauterine devices (IUD)
Chemical:
synthetic estrogens and progestins (oral Pill, “minipill”)
injectable doses
subdermal patches
Surgical:
vasectomy (men)
tubal ligation (women)
hysterectomy (women)
In theory, some surgical sterilizations are reversible;
in practice much depends on what type of surgery was done,
how long ago, and even fiscal considerations
Some contraceptives are also abortifacient, such as the IUD and possibly the Pill
POSSIBLE ABORTIFACIENTS:
“MORNING AFTER” PILL (PLAN B)
CONTRACEPTIVE PILLS
IUD
Effectiveness, Risks and Side Effects
Most claim success rates 97% ~ 99%
assumes perfect and consistent use, which seldom is the case with humans
risks:
blood clots
Cancer
high blood pressure
Depression
etc
side effects:
Nausea
Vomiting
Dizziness
Headaches
vaginal infections
abdominal pain
irregular bleeding or “spotting”
The Catholic bioethical analysis of contraception is not based on its risks or side effects
diminished desire for sexual activity
weight gain
increase or decrease in acne
appetite changes
tender breasts
increase or decrease in body hair
vaginal discharge
bone density loss
ectopic pregnancy
Moral Evaluation: Means and Ends
2 dimensions to marriage: unitive and procreative
The unitive dimension involves the generous mutual love expression
of the spouses
The procreative dimension involves their openness to having children
in each act of sexual intercourse
If either one of these two dimensions is truncated,
the marital act is not truly and fully human
Intrinsic Evil
Contraception: introduces a radical separation ÷ unitive <-> procreative
Unitive love w/o procreative love
even unitive: truncated, defective, pseudo-unit
act of selfishness and/or of fear (conscious or subconscious)
betrays a lack of trust in God’s Providence for that couple
Today’s lifestyles = much control over our daily decisions;
the more control we have, the further control we want to have
engendering a new human being = God is in control
The role of the couple is to cooperate with God in creating that new life
The couple is given the gift and privilege of being co-creators with God
God decides
God intends: intimate sexual act of husband and wife
love-giving
simultaneously
life-giving
Contraception frustrates all this
UNFAIR DYNAMICS OF ARTIFICIAL CONTRACEPTION:
LIBIDO DIFFERENTIAL
TURNS SEXUAL INTERCOURSE INTO ENTERTAINMENT
BURDEN ON THE WOMAN
PROMOTES CONTRACEPTIVE MENTALITY IN SOCIETY
SEXUALLY TRANSMITTED DISEASE (STD) EXPOSURE
2,334,382 TOTAL CASES IN 2017 ALONE
TOTAL US POPULATION 2017 = 325,700,000
~ 1 IN EVERY 14 AMERICANS HAS AN STD
US STD EPIDEMIC:
STDs in U.S. 2017 Reach Record Highs (CDC website)
Chlamydia = 1,708,569
Gonorrhea = 555,608
HIV = 38,643
Syphilis = 31,562
Bad Medical Practice
contraception and sterilization seek to render a healthy organ inoperative
Thus contraception, honestly speaking, goes against sound medical practice: mutilation
contraception = act of arrogance against God’s created plan
Alternative: develop a deep trust in God’s Plan and Providence
The Church calls God’s Plan and Providence for a married couple a VOCATION
Therapeutic sterilization justified for serious medical reasons
PRINCIPLE OF DOUBLE EFFECT
good
act -> 2 simult effects
bad
conditions:
the act to be done must be good in itself or at least morally indifferent
(independently of its consequences)
2. the good effect must not be obtained by means of the evil effect
(evil an incidental by-product, not an actual factor in the accomplishment of the good)
3. the evil effect must not be intended for itself but only permitted
(evil desire not permitted)
4. there must be a proportionately grave reason for permitting the evil effect
5. Last resort (no other action w/o evil effect available)
All five conditions must be fulfilled. If any one of them is not satisfied, the act is morally wrong.
ECTOPIC PREGNANCY:
REMOVAL OF TUBE W LIVE UNBORN OK (SALPINGECTOMY)
REMOVAL ONLY OF LIVE UNBORN NOT OK (SALPINGOSTOMY)
CANCEROUS REPRODUCTIVE SYSTEM w PREGNANCY:
THERAPY AND/OR HYSTERECTOMY OK (DOUBLE EFFECT)
IN VITRO FERTILIZATION (IVF)
BIOLOGICAL / CLINICAL
Ampulla
Endometrium
DAY 1
DAY 7
IN VIVO FERTILIZATION
IN VITRO FERTILIZATION (IVF)
INTRA-CYTOPLASMIC SPERM INJECTION
(ICSI)
LABORATORY: FERTILIZATION
MICRO-
MANIPULATORS
HYPEROVULATION (HYPER-STIMULATION, SUPEROVULATION)
Fertility drugs = Clomid or others
NORMAL HUMAN OVARY
HYPEROVULATED OVARY
~12
INCUBATION: 3 ~ 5 DAYS; ZYGOTE TO BLASTOCYST
37 O C
ATTEMPTED IMPLANTATION
INSERTION OF CANULA TRHOUGH CERVIX
RELEASE OF EMBRYOS INTO UTERUS
CRYOPRESERVATION; liquid Nitrogen
± - 200 O C = - 300 O F
SECOND ATTEMPTED IMPLANTATION
CANULA INSERTION
THREE HUMAN EMBRYOS IN UTERO
“SELECTIVE REDUCTION”
?
?
QUALITY CONTROL
PRE-IMPLANTATION GENETIC DIAGNOSIS (PGD)
MORULA
BLASTOMERE
IVF QUALITY CONTROL
BEFORE IMPLANTATION: PGD
AFTER IMPLANTATION: PROCURED ABORTION
IN VITRO FERTILIZATION (IVF)
BIOETHICAL ANALYSIS
Ampulla
DAY 1
DAY 7
Endometrium
IN VITRO FERTILIZATION (IVF)
DONE IN A LAB
IN VIVO FERTILIZATION
WHAT OCCURS NATURALLY
IVF Considerations of practice:
Risk to women due to ovarian hyper-stimulation and egg extraction
Typical sperm collection by masturbation
Abortions due to failed implantations
Abortions due to freezing and thawing of embryos
Creating and feeding the problem of ~ 1 million frozen human embryos
What to do with frozen embryos when parents divorce or abandon them
Denying the child and the human species natural selection
WHAT IS THE END / GOAL OF IVF?
WHAT ARE THE MEANS?
BIOETHICAL ANALYSIS
DO THE ENDS JUSTIFY THE MEANS?
2 MAIN BIOETHICAL CAMPS
UTILITARIAN: YES, THEY DO
PRINCIPLED: NO, THEY DON’T
UTILITARIAN BIOETHICS
ENDS JUSTIFY THE MEANS: A GOOD END JUSTIFIES USING ANY MEANS AVAILABLE,
AS LONG AS IT’S LEGAL.
IVF: ALL HARDSHIPS / KILLINGS / MANIPULATIONS ARE JUSTIFIABLE
FOR GETTING THE INFERTILE COUPLE WHAT THEY WANT; A CHILD
DRIVEN BY MARKET ECONOMY MENTALITY:
COUPLE WANTS A PRODUCT
COUPLE CAN PAY FOR THE SERVICES
IVF INDUSTRY CAN DELIVER THE SERVICE / PRODUCT
FLUORISHING, BUT BOUTIQUE MEDICINE -> CATER TO RICH
IVF INDUSTRY = MULTI-BILLIONS $$$ NATIONALLY AND INTERNATIONALLY
UTILITARIAN BIOETHICS: ENDS JUSTIFY THE MEANS
EX. STUDENT LOANS -> I STEAL / ROB
BUT, STEALING IS ILLEGAL; I SHOULDN’T DO IT
NOT BECAUSE IT’S WRONG IN ITSELF,
RATHER, BECAUSE IF I GET CAUGHT, I GO TO PRISON.
THEREFORE, UTILITARIAN BIOETHICS IS LEGALISTIC
THE LAW ESTABLISHES MY MORALITY
YET, LAW IS MINIMAL: MANY HUMAN SITUATIONS ARE NOT COVERED BY THE LAW
TYPICALLY, SITUATIONS OF INTEGRITY
PERSONAL
FAMILY
SOCIETY
BOTTOM LINE: UTILITARIANISM ENDS UP MANIPULATING PEOPLE
ESSENTIALLY, THE ONE WITH THE MOST MONEY, POWER, WHO SHOUTS THE LOUDEST,
OR EVEN JUST PHYSICALLY STRONGER, WILL GET HIS/HER WAY.
ALTERNATIVE: PRINCIPLED BIOETHICS
ENDS DO NOT JUSTIFY THE MEANS; MEANS NEED TO BE JUSTIFIED IN THEMSELVES
iow, NOT SUFFICIENT FOR THE END/GOAL TO BE A GOOD THING
THE MEANS TO ACHIEVE THAT END SHOULD ALSO BE GOOD MEANS.
EX: A COUPLE WANTING TO HAVE A CHILD
THIS IS WHERE IVF FAILS, @ LEVEL OF NOT GOOD MEANS:
HUGE MANIPULATION OF HUMAN LIFE, ESPECIALLY OF WOMEN
HYPEROVULATION
PGD: SELECTING OUT THE FEMALE EMBRYOS
EARLY ABORTIONS DUE TO FREEZING AND THAWING EMBRYOS
EARLY ABORTIONS DUE TO FAILED IMPLANTATIONS
SELECTIVE REDUCTION
IVF ALSO FAILS THE CHILD AND HUMANITY AT LARGE:
DENIES NATURAL SELECTION TO THE CHILD
DENIES NATURAL SELECTION TO THE HUMAN SPECIES
IVF -> ARTIFICIAL PROCESS:
BYPASSES NATURAL SELECTION; @ FERTILIZATION AND @ IMPLANTATION
(SEPARATE SELECTION EVENTS)
SELECTIVE PRESSURE VS FERTILIZATION ~ 100,000,000 : 1
SELECTIVE PRESSURE VS IMPLANTATION ~ 2 : 1
BIOETHICAL CONCLUSION:
IVF IS BIOETHICALLY WRONG B/C IT’S A GROSS / HUGE MANIPULATION OF HUMAN LIFE,
ESPECIALLY @ OUR MOST VULNERABLE STAGE –> THE EARLY HUMAN EMBRYO.
A STAGE WHEN WE RADICALLY DEPEND ON OTHERS (THE BORN, ADULTS) TO DEFEND
AND UPHOLD OUR NATURAL RIGHTS, INCLUDING THE RIGHT TO NATURAL SELECTION
AND TO NOT BE MANIPULATED, MANUFACTURED, BOUGHT / SOLD
AS A PRODUCT ON THE SHELF OF A SUPERMARKET.
EUGENICS
NUREMBERG TRIALS
HUMANNESS DOES NOT ACCEPT GRADATION
