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Bioethics and the Catholic moral tradition

10 May, 2012

Pádraig Corkery's book gives an ethical evaluation of some of the more controversial developments in medical practice over the past few decades.


THE BOOK
corkeryThis book gives an ethical evaluation of some of the more controversial developments in medical practice over the past few decades, including assisted human reproduction, embryonic stem cell research, personal conscience and morality and the civil law from the perspective of the Catholic moral tradition.

THE AUTHOR
Pádraig Corkery is Head of the Department of Moral Theology and Dean of the Faculty of Theology in the Pontifical University, Maynooth. He is the author of Companion to the Compendium of the Social Doctrine of the Church (Veritas 2007). CONTENTS

Introduction

Section One: Catholic Moral Teaching: The Sources

1. A Catholic Christian Approach to Bioethics

Section Two: The Content of Catholic Moral Teaching

2. Assisted Human Reproduction
3. Embryonic Stem Cell Research
4. Ethical Issues at the End of Life
5. The Administration of Nutrition and Hydration to Persons in a Permanent Vegetative State (PVS)

Section Three: Catholic Moral Teaching and the Individual

6. The Nature and Role of Personal Conscience

Section Four: Catholic Moral Teaching and Society

7. Morality and the Civil Law

143 pp. Veritas Publications. To purchase this book online go to www.veritas.ie.

CHAPTER TWO

ASSISTED HUMAN REPRODUCTION

Over the past decades there has been an increase in the occurrence of childlessness in the world, particularly in the Western world. Several different reasons have been proposed to explain this phenomenon, including couples postponing starting a family until their mid-thirties; the use of the contraceptive pill over many years; and the presence of increasing amounts of additives in our diet. For many couples, this experience is the source of great heartbreak and disappointment. The scientific and medical community have responded to this reality by both investigating the causes of childlessness and striving to overcome it through direct intervention.

Louise Brown, in 1978, was the first person born through in vitro fertilisation (IVF) and since then there has been a phenomenal increase in the availability and variety of reproductive technologies. All countries in the European Union, including Ireland, now offer a range of reproductive technologies that enable couples who previously could not have children to have a family of their own. In some countries, legislation allows for the donation of genetic material and embryos and for the treatment of women who are post-menopause. These technologies raise important ethical, social and legal questions that previous generations never had to ponder: What is the nature of human parenthood? Is there a right to have a child? Should science enable women to procreate beyond the age of menopause? Does the donation of genetic material (sperm, ova or embryo) have an impact on our understanding of parenthood? What value or status should we give to human life at the earliest stage of its development? Is the fertilised ova deserving of more respect inside the womb than outside of it? What impact does surrogacy have on the well-being of a child? How do we evaluate human actions that are motivated by the best of intentions and yield positive consequences? These questions are important ones that have serious implications for individuals and societies. For this reason, many countries established select committees to investigate the ethics of reproductive technologies. The reports published by these groups often provided the framework and foundation for legislation in this area. One of the best known of these reports is the Warnock Report, which provided the framework for legislation in Britain.

Ireland, surprisingly, is one of the few countries that have failed to produce legislation to regulate the various aspects of reproductive technologies. These technologies are now only regulated in Ireland by the codes of conduct of the various medical professions involved. A Commission on Assisted Human Reproduction was established by the Irish Government in March 2000 to identify the central ethical, social and legal issues and to make recommendations on the content of civil legislation in this area. This Commission issued its report in April 2005 (1). The Commission made over forty recommendations governing the whole area of the regulation of assisted human reproduction (2). At the time of writing, this report has not been acted upon and Ireland is still without legislation in this important area.

The response of the Catholic moral tradition
The questions raised by the advances in reproductive technologies are important ones. They challenge us to reflect on issues that are at the core of our humanity. Because of the importance of these questions, the Catholic moral tradition, at both the universal and local level, has engaged with them in a serious and reflective way. At the level of the universal Church, these reflections were first articulated in Donum vitae (3), published nine years after the birth of Louise Browne. Later publications of the universal Magisterium built on the moral analysis of this document (4). Local Churches, including the Irish Church, have developed their own responses in light of this universal teaching (5).

The basic building block of many of the new technologies is in vitro fertilisation (IVF). This process involves the surgical removal of ova (by laparoscopy) and their mixing with sperm. Once fertilisation has occurred, the developing embryo is placed in the uterine cavity to continue its journey towards maturity. In most fertility programmes many ova are fertilised, three are usually implanted and the surplus embryos are used in a variety of ways. Since the success rate of IVF is still modest, many couples have to repeat the procedure before the successful birth of a child. To facilitate this possibility, and to avoid a repeat laparoscopy, surplus embryos are frozen in a significant number of cases. These can be retrieved if, and when, the need arises.

A second possible use of these surplus embryos involves their donation to other couples. This eventuality could arise if, for a host of reasons, a woman/couple could not create an embryo but could successfully carry an embryo to birth.

Finally, many jurisdictions allow for the donation of surplus embryos to the scientific community for research purposes. Such research, it is argued, could benefit the human family by yielding information about infertility and the life of the early embryo (6). The use of such embryos to advance stem cell research will be examined in the next chapter.

In their response to the developments in reproductive technologies over the past thirty years, ethicists have made some general points that are worth noting. Firstly, ethicists and the science of ethics would reject what is called ‘the scientific imperative’ This is formulated in many different ways but its essence is transparent in the following phrase: ‘If we can do it, then we must do it’. The discipline of ethics, in contrast, raises the ‘ought we’ question; just because, as a consequence of newfound knowledge and expertise, we can do something new and exciting, does not answer the question of whether we should do it (7).

Secondly, ethicists alert us to the reality that there can be a difference between scientific progress and human progress. Advances in the area of science and technology need not necessarily contribute to the progress of the human family. The development of atomic weaponry and ‘Star Wars’ technology clearly illustrate this distinction. Though they are the fruits of undoubted human genius and creativity, they have not contributed to the flourishing of the human family.

Discussions amongst ethicists on the merits of reproductive technologies have also highlighted the fact that individuals can approach the task of making moral decisions from very different perspectives. The robust debates in the area of bioethics over the past few decades have, with great clarity, revealed that our approach to the task of moral decision-making has a decisive impact on our moral conclusions.

Before proceeding further, therefore, I will first engage with the question of moral decision-making. In particular, I will look at the role of object, intention and circumstance in determining the morality of human actions.

The evaluation of human actions
Individuals and communities everywhere acknowledge that the birth of a child is a positive and graced event. The child born through IVF is, like all children, a child of God and a bearer of an innate dignity. As such s/he is to be respected and loved unconditionally. However, the Catholic tradition argues that there is an obligation on us to examine the means used to achieve the undeniable good that is the birth of a child.

The Christian tradition has reflected over many centuries, and in various cultural contexts, on the roots of morality. One of the fruits of this sustained reflection and study is the acceptance of the principle that ‘the end does not justify the means’. Consequently, there is a need in this context, as in all others, to examine the process of IVF in a systematic and objective way.

The Catholic tradition’s rejection of the ‘end justifies the means’ approach to morality begs the question, how then does one evaluate human actions? In response to this central question, the Catholic moral tradition has embraced what is called the three-font principle (8). In this understanding there are three dimensions of a human act that need to be examined in order to get an adequate picture of the act. These are the act in itself (finis operis), the intention of the person doing the act (finis operantis) and the circumstances, including consequences, of the act. Consideration of all three is necessary in order to get an accurate picture of what is going on in any human drama.

A few simple examples should help clarify this approach. Hitting your neighbour with your fist (act in itself) is an action that requires further detail before we have a full picture of the scene and before we can arrive at a moral judgement. Was the action motivated by hatred and with the intention of causing harm? Or was it motivated by the legitimate need to defend oneself from an unwarranted assault while doing the least physical harm necessary to achieve that goal? These very different scenarios, defined by the intention of the agent and the circumstances, lead us to very different moral conclusions. Likewise, for most people, the taking of human life is evaluated in light of intention and circumstances. Thus, killing another person in war or in self-defence, under certain circumstances, is deemed morally acceptable to most people.

The Catholic moral tradition maintains that other approaches to the moral evaluation of human actions are inadequate because they neglect to take into account vital aspects of the unfolding drama. These include ethical systems that focus exclusively either on the intention of the actor or the consequences of the action. At the heart of many current debates in society on the morality of specific actions is this underlying disagreement about how to approach the task of moral evaluation. The conclusions of the Catholic moral tradition are often at odds with the conclusions of others precisely because of this fundamental disagreement about method.

For the sake of completion it is important to mention that there are, in the Catholic moral tradition, a collection of human actions that can be evaluated outside of this three-font (object, intention, circumstance) approach. These have traditionally been called intrinsically evil acts and have been defined as actions that are in themselves (per se) and independently of circumstances and intention always wrong (9). These actions are always and everywhere wrong because by their very nature they are contrary to the dignity of the person and an affront to God. Traditionally, lying and adultery were
listed as such acts. The Catechism of the Catholic Church includes blasphemy, perjury and murder in this category (10). This way of categorising human actions is not, however, unproblematic and has been the subject of much theological discussion. There is no disputing the fact that there are many actions that are always immoral. Disagreement amongst theologians centres on the usefulness and coherence of the intrinsically evil category. Unfortunately, the range of actions listed under this category in the Catechism of the Catholic Church and in Veritatis splendor did nothing to contribute to clarity on the issue, since some of them appear as tautologies (11). This discussion amongst theologians, though important and interesting, need not detain us further. What is important for our purposes is that the Catholic moral tradition insists that three aspects of a human action must be taken into account before that action can be morally evaluated. Though those providing and availing of artificial reproductive technologies are motivated by generosity and love, we still need to look at the procedure itself before we can arrive at a moral evaluation. In particular, we need to reflect on, in the first place, the status and fate of the fertilised ovum, because it is the building block on which reproductive technologies are built and, secondly, on the significance of generating life without bodily intercourse. These two aspects of reproductive technologies were central to the analysis and conclusions of Donum vitae and later documents.

The status of the fertilised ovum
The process of IVF raises the question about the significance of human life at its beginning. In a dramatic way we can now observe the earliest stages of life in the palm of our hand. What value or significance should we give to life at this stage? This is, in one sense, a new question. Previous generations did reflect on the value of life in the womb but never encountered the beginning of life in such a dramatic way.

Debates across the globe about the value or significance of human life at the earliest stages have generated much passion but, unfortunately, little agreement. Philosophers, theologians, politicians and legal systems hold a range of positions on this vital question. In the Irish context, for example, the Supreme Court in December 2009 ruled that the pre-implanted (frozen) embryo does not have the protection of the Constitution under Article 40.3.3 (12). That article, amended in 1983, requires ‘the State to respect and vindicate the right to life of the unborn with due regard to the equal right to life of the mother’ The case arose when a couple, whose marriage had ended, disagreed about the fate of frozen embryos that they had created. These embryos were frozen during an earlier successful IVF treatment cycle. The mother in the case wanted the embryos implanted in her and brought to full term. The father, on the basis that they were no longer a couple, did not agree with that proposal. In deciding on what was a complex case on many fronts, the Courts had to make a determination as to the status of frozen, pre-implanted embryos.

The Supreme Court, upholding a High Court decision in 2006, ruled that pre-implanted embryos are not ‘unborn’ within the meaning of Article 40. The Constitution, under Article 40.3.3, it ruled, grants protection only to embryos within the womb (13). On the basis of this judgement, embryos are treated differently by the civil law in Ireland depending on whether they are within or outside the womb. This has important implications for the future treatment of pre-implanted embryos in Irish fertility programmes.

The Catholic tradition has, over the last century, articulated an approach to the human embryo that is both consistent and credible. It argues that human life should be  protected and revered from the beginning of its existence. It accepts that at fertilisation something new comes into existence that is biologically human, different from the ovum and sperm from which it originated, and containing all the genetic material necessary to develop into a person or persons. After fertilisation nothing new is added to the genetic package of this new living entity. The tradition accepts the evidence of the biological sciences that early human life goes through a whole range of developments from zygote to embryo to foetus. However, it argues that life should be protected, valued and treasured equally during all these stages and that a gradation in moral value (14) is unacceptable. It is worth noting at this stage that the Irish Council for Bioethics in their publication on stem cell research, which will be examined in the next chapter, adopted this ‘gradualist position’ to the status of the embryo (15). For its part, the Warnock Report proposed the ‘primitive streak’ as the stage of development that is most significant in terms of moral status. At this stage the cells of the early embryo became differentiated and assume a definite shape around a central axis.

Many contributors to the debate on the significance of human life at the very beginning of its development utilise the language of person. Some argue that because only a person can be the bearer of human rights, including the right to life and the right to be free from assault, the central question to be addressed is whether, or when, the embryo becomes a person. If the embryo is not a person, so the argument runs, then the question of its treatment or destruction is not problematic from a moral perspective. How has the Catholic moral tradition responded to this approach? Does it believe that the newly fertilised ovum is a person and, therefore, a bearer of rights? Donum vitae acknowledges that the question of personhood is a difficult and complex one. Questions about the nature and scope of personhood spring easily to mind: What is necessary to become a person? Is a newborn baby a person? Can personhood be lost through a debilitating illness or serious injury? Donum vitae does not take a position on the various philosophical approaches to the nature and content of human personhood. Rather, it argues that being a member of the human family is synonymous with personhood. It asks rhetorically, ‘How could a human individual not be a human person? (16). Given that the fertilised ova is biologically human, and has its own unique genetic package to direct its future development, it argues that it should be ‘treated as a person’ from the first moment of its existence. Consequently, the rights of the embryo, among which, ‘in the first place, is the inviolable right of every innocent human being to life’ (17) must be recognised. The latest text from the Congregation for the Doctrine of the Faith, Dignitas personae, adopts a similar approach, arguing that the’human embryo has from the very beginning the dignity proper to a person’ (18).

With regard to reproductive programmes that utilise IVF, this understanding has significant consequences. If our starting point is that human life is deserving of respect from the first moment of its existence, then several features of many reproductive programmes appear unethical. The discarding of ‘surplus embryos’ the manipulation of embryos or their donation for research purposes are all inconsistent with respect for human life (19). It can, indeed, be argued that these practices contribute to an erosion of respect for human life at all its stages. They contribute to a culture that places little value on human life at the earliest stages of its development. From a Catholic Christian perspective, which believes that all life should be treasured and valued because it is a gift from God, this culture is seriously flawed.

Using the sources of moral wisdom, outlined in chapter one, we see that the Church’s approach to and moral conclusions about the treatment of the embryo are rooted in Scripture (the general call to respect the gift of life), reason (what science tells us about the fertilised ovum) and tradition (the consistent stance of the Church and the faith community on respect for human life).

The nature of human procreation
The second pillar on which the Catholic tradition constructs its response to IVF and other reproductive technologies is that of its understanding of human sexuality and the nature of human procreation. Donum vitae begins its reflection on the process of IVF and, in particular, on the fact that fertilisation, leading to procreation, is achieved without bodily intercourse with a question: ‘What connection is required from the moral point of view between procreation and the conjugal act?’ (20)

It constructs its response to this question using three distinct, but somewhat overlapping, arguments. The first argument is based on the nature of human sexuality as understood in the Catholic moral tradition. It is self-evident that through our sexuality and sexual expression we express both love and affection and can generate new life. Our sexuality has both love-expressing and life-creating dimensions. Church teaching, however, goes further than this and ‘affirms the “inseparable connection, willed by God and unable to be broken by man on his own initiative, between the two meanings of the conjugal act: the unitive meaning and the procreative meaning” (21).

This understanding of the nature of human sexuality is, of course, central to the teaching of Humanae vitae. In that document it was argued that we should not engage in physical lovemaking other than in an environment that is not closed to new life. We should not intentionally and directly exclude the procreative dimension if that dimension is naturally present.

Donum vitae, using the same framework of understanding, argues from the other side of the coin. While Humanae vitae argues that we should not deliberately remove the procreative dimension of the conjugal act, Donum vitae argues that we should not procreate outside of physical lovemaking.

The implications of this understanding of human sexuality for family planning are, of course, well known. The insistence on the inseparability of the two dimensions of sexuality — the procreative and the unitive — has been criticised by many within, and outside, the Catholic tradition. Critics question, in particular, the inseparability argument. Why, it is asked, is it not permissible to use our skills and creativity to directly exclude the procreative dimension for serious personal or family reasons? Should not our potential to procreate be at the service of our relationships or families in their totality? The debate about the coherence and credibility of the moral conclusions of Humanae vitae on the use of artificial contraceptives has been well aired and documented over the past forty years. It is beyond the scope of this book to enter into the important theological debate generated by that document concerning, amongst other things, the natural law, moral method and ecclesiology. From the perspective of this book’s treatment of bioethical issues, it is sufficient to note that the first argument used in Donum vitae works out of the framework of understanding of human sexuality found in Humanae vitae. The implication of the inseparability argument for in vitro fertilisation is crystal clear. Science may assist the conjugal act to achieve a pregnancy, but may not replace the conjugal act (22).

The second argument presented in response to the question about the relationship between procreation and the conjugal act may appear to some people to be more robust and reasonable. This argument reflects on the significance of the human body. It argues that we are embodied creatures who express affection, love and marital commitment through our bodies. Our bodies and bodily gestures are an essential part of who we are.

Spouses mutually express their personal love in the ‘language of the body’, which clearly involves both ‘spousal meanings’ and ‘parental ones’ … It is in their bodies and through their bodies that the spouses consummate their marriage and are able to become father and mother (23).

By procreating outside of the context of bodily intercourse we are disrespecting, or, at least, not paying adequate attention to, our nature as bodily persons.

The third argument presented revolves around the dignity of the child created through IVF. It argues, firstly, that the child must be respected as an equal in dignity to the parents who gave him/her life. Secondly, it argues that the process of assisted human reproduction has implications for how we see or prize the child conceived. Every child should be the fruit of a loving conjugal act where ‘the spouses cooperate as servants and not as masters in the work of the Creator who is love’ (24).

The important point being made here is that parents are called to cooperate with God in the act of procreation rather than dominate that process. The document goes on to argue:

In reality, the origin of a human person is the result of an act of giving. The one conceived must be the fruit of his parents’ love. He cannot be desired or conceived as the product of an intervention of medical or biological techniques; that would be equivalent to reducing him to an object of scientific technology (25).

Implicit in this argument is the claim that through controlling the process of procreation the child is not seen as a gift, but more as the end product of a process of control. The difference between the language of procreation and that of reproduction may throw some light on this claim. The former expression implies that humankind cooperate with God in the act of creating new life while the latter, in using the language of industry, emphasises human domination and control of the process. However, it is unclear from the text, and from human experience, how a child conceived through IVF and clearly wanted by his/her parents would be viewed as ‘an object of scientific technology’. The argument appears, at best, strained and, at worst, incredible and, not surprisingly, does not appear in later documents.

The question of how we view the child conceived through IVF is touched on again later in the document, but in a more credible way. The context is a brief discussion on whether there is a right to have a child.

Nevertheless, marriage does not confer upon the spouses the right to have a child, but only the right to perform those natural acts which are per se ordered to procreation. A true and proper right to a child would be contrary to the child’s dignity and nature. The child is not an object to which one has a right (26).

The important point being made here is that the language of rights is inappropriate in this area because it could contribute to a culture that views children as possessions or objects. Because children are equal in dignity to their parents and all other persons, they cannot be instrumentalised in this way.

The second pillar on which the Church’s response to artificial reproductive technologies is constructed is based on the Church’s understanding of human sexuality and the nature of human parenthood, and leads it to reject procedures that replace the conjugal act, such as IVF, gamete intra-fallopian transfer (GIFT) and intra-cytoplasmic sperm injection (ICSI) (27). Procedures that, on the other hand, act as an aid to the conjugal act and its fertility – for example, surgery, drug treatment or NaPro technology – are permitted. The approach and conclusions of Church teaching in this regard are rooted loosely in Scripture (the significance of marriage as the locus for family), reason (the nature of human sexuality) and tradition (the consistent teaching of the Church).

Reproductive technologies have raised considerable questions for societies across the globe. These include questions concerning the status of human life at the earliest stage of development, the nature of human parenthood, the significance of our embodiment and the right to have a child. Societies worldwide have responded to these questions in a myriad of ways. This is reflected in the rich variety of legislative frameworks within which reproductive technologies are carried out.

During the (ongoing) debate on the ethics of reproductive technologies, the Catholic moral tradition has articulated a clear and consistent stance. It firmly argues that life should be treasured and protected from the moment of fertilisation, rather than at some later stage like implantation or at the appearance of the primitive streak. This position was clearly articulated in Donum vitae and appears even more prominently in later teaching documents (28). It concludes, therefore, that discarding, freezing or experimenting with ‘surplus’ embryos is morally unacceptable. Such activities, it contends, contribute to an erosion of respect for pre-implanted life and contribute to a culture that sees human life at that early stage as of little value.

It strongly argues, also, that the nature of human parenthood is fundamentally contradicted by third party involvement in the form of surrogate mothers or donors of genetic material. In its understanding of the Christian vision and the natural law tradition, parenthood is the prerogative of married couples. As for the process itself, whereby fertilisation is achieved without sexual intercourse, it argues that it does not adequately respect the nature of human sexuality or our reality as bodily persons. Finally, the tradition suggests that reproductive technologies can alter the ways we experience and value children – a move from accepting children as a gift from God to a mindframe that views children as a right.


DISCUSSION QUESTIONS

1 . ‘The human being is to be respected and treated as a person from the first moment of conception.’ Is this moral claim countercultural or mistaken?

2. ‘It is in their bodies and through their bodies that the spouses consummate their marriage and are able to become father and mother.’ Why should we procreate through bodily intercourse only?

3. Is there a right to have a child?


FURTHER READING

Ashley, Benedict, and Kevin O’Rourke (eds), Ethics of Healthcare (Third Edition), Georgetown University Press, 2002, chapter 9.

Congregation for the Doctrine of the Faith, Donum vitae, Veritas, 1987.

———-, Dignitas personae, Veritas, 2009.

Irish Catholic Bishops’ Conference, Assisted Human Reproduction: Facts and Ethical Issues, Veritas, 2000.

———–, Towards a Creative Response to Infertility, Veritas, 2006.

Sutton, Agneta, Christian Bioethics: A Guide for the Perplexed, Continuum, 2008, chapter 2.

Watt, Helen, Life and Death in Healthcare Ethics: A Short Introduction, Routledge, 2000, chapter 5.


 

NOTES

1. Report of the Commission on Assisted Human Reproduction, April, 2005. The text
is available on the Department of Health and Children website: www.dohc.ie.
2. For a response to these recommendations, see Pádraig Corkery,’ Reproductive Technologies echnologies – The Irish Contribution to an International Debate; The Furrow, 56 (2005), pp. 353-357; Irish Catholic Bishops’Conference, Towards a Creative Response to Infertility, Veritas, 2006.
3. Congregation for the Doctrine of the Faith, Donum vitae, Libreria Editrice Vaticana, 1987.
4. Pope John Paul II, Evangelium vitae, Veritas, 1995, paragraph 63;
Congregation for the Doctrine of the Faith, Dignitas personae: On Certain Bioethical Issues, Veritas, 2009; Pope Benedict XVI, Caritas in veritate, Veritas, 2009, paragraph 51.
5. Bishop’s Committee on Bioethics, Assisted Human Reproduction: Facts and Ethical Issues, Veritas, 2000; Irish Catholic Bishops’ Conference, Towards a Creative Response to Infertility, Veritas, 2006.
6. See, for example, the Report of the Commission on Assisted Human Reproduction, Recommendation No. 10: ‘Appropriate guidelines should be put in place by the regulatory body to govern the options available for excess frozen embryos. These should include voluntary donation of excess healthy embryos to other recipients, voluntary donation for research or allowing them to perish.’
7. ‘But what is technically possible is not for that very reason morally admissible’. Congregation for the Doctrine of the Faith, Donum vitae, Introduction, paragraph 4.
8. Richard Gula, Reason Informed by Faith, Paulist Press, 1989, chapter 18,
9. Pope John Paul II, Veritatis splendor, Veritas, 1993, paragraph 80.
10. Catechism of the Catholic Church, Veritas, 1994, paragraph 1756.
11. Murder, for example, is an unjustified killing. This judgement is made after the intention and circumstances have been taken into account. These considerations help us to distinguish murder from killing another in self-defence or accidental killing.
12. Roche v. Roche. The full text of the Supreme Court judgment is available at www.courts.ie,
13. This position was proposed in the Report of the Commission on Assisted Human Reproduction, No. 16: “The embryos formed by IVF should not attract legal protection until placed in the human body, at which stage it should attract the same level of protection as the embryo formed in vivo:
14. Congregation for the Doctrine of the Faith, Dignitas personae, Veritas, 2009, paragraph 5.
15. The Irish Council for Bioethics, Ethical, Scientific and Legal Issues Concert Stem Cell Research: Opinion, 2008, paragraph 41.
16. Donum vitae, chapter 1, question I.
17. Ibid.
18. Dignitas personae, paragraph 5.
19. Donum vitae, chapter 1; Dignitas personae, paragraphs 14-16, 18-23.
20, Donum vitae, chapter 2, question 4.
21. Donum vitae, chapter 2, question 4, quoting Humanae vitae, paragraph 12.
22. Dignitas personae, paragraph 12.
23. Donum Vitae, chapter 2, question 4.
24. lbid.
25. Ibis,
26. Ibid., question 8.
27. Congregation for the Doctrine of the Faith, Dignitas personae, paragraph 12, 17; Irish Catholic Bishops’ Conference, Assisted Human Reproducton: Facts and Ethical Issues, chapter 3.
28. For a view of the different emphases and approaches to reproductive technologies in the Irish context see Pádraig Corkery, ‘Bio-ethics and Contemporary Irish Moral Discourse’ in Contemporary Irish Moral Discourse, Amelia Fleming (ed.), Columba Press, 2007, pp. 26-39.

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