Yes, in all instances of IVF, the human child is a product born from a commercial transaction.
Last week, I wrote a short post opposing IVF. After receiving firm pushback in the comments, I responded to some of the most common objections in a much longer article. Predictably, there were more counterarguments posed to my follow-up article. I won’t do a point-by-point response, but there is one sort of “whataboutism” that keeps coming up, which indicates that people have misunderstood some of my key points. Perhaps I was unclear, and that’s my fault, so I’ll explain further.
Here’s a brief summary of one section that proved to be the most controversial: I argued that, in all instances of IVF, “the human child is still a product born from commercial transaction.” I further explained that “IVF technology — even when controlling for secondary effects in a complex hypothetical — necessarily treats human beings as a commercial product and property, and this dynamic cannot be changed by any policy.” In more plain language, I summarized that “lengthy terms and conditions pages must be signed [in IVF] for the child to be conceived.” I distinguished this from custody disputes and adoption, which do not affect whether the child exists.
People seized on the phrase “terms and conditions,” and a lot of comments focus on the “transactional” or “commercial” terminology. They used this as a jumping-off point to respond with objections along these lines: (1) All medical treatments are commercial transactions, (2) Plenty of types of prenatal care, like ultrasounds, are commercial transactions, (3) An IVF-made child isn’t a “product” or “commodity” or “property,” and (4) All transactions involve human beings. As a result, charges ensued along the lines of, Abigail, your position on IVF surely means you also oppose all medical appointments, along with every type of other transaction, because those all involve human beings.
That’s not right, for a few reasons.
First, a more general but relevant point: IVF isn’t really “medicine” or a “treatment” because it is a purchased service that does not cure anything, nor does it try to do so. As I previously said, IVF circumvents the underlying causes of infertility, and the better alternative is to pursue treatment for what causes difficulty conceiving. In some instances, that isn’t possible, or necessary, or it would be extremely unethical. For instance, menopause isn’t an “illness” that we should “cure.” We all understand that a 75-year-old woman isn’t sick because she cannot conceive.
The purpose of all health care and medicine is (or should be) to heal while inflicting the least possible harm — not satisfy whatever wishes we have (“I want to sever my left arm”), nor optimize our health solely for unnecessary improvement (“my heart is fine but there’s a better heart available from a donor”). Healing requires treating what already exists, whereas IVF aims to create a new human being. If a woman undergoes surgery to treat endometriosis (a reproductive disease that can cause infertility), then she has legitimately sought health care to treat an illness — and maybe she will get pregnant later. But the surgery would be considered successful if she wakes up after the anesthesia and the endometriosis is removed, not if she gets pregnant.
Yes, in the real world, treating a reproductive disease — like other applications of medicine — involves transactions and forms. But payments and paperwork are involved in a process aimed at restoring health, not specifically creating a new person (although that may be a desirable and motivating secondary result achieved later).
By contrast, IVF commercializes procreation itself and human beings themselves without attempting to fix underlying health issues (whatever those may be). IVF is a financial transaction to purchase services oriented toward creating a product, namely a human baby (although a baby doesn’t always result). A successful IVF cycle is when a baby is born; a failed cycle is when that doesn’t occur. For those unconvinced that IVF turns a human child into a commodity, it might be clearer in the form of a question: What are payments for at an IVF clinic? What are couples hoping their money will buy, even if the odds aren’t favorable? If you don’t believe that a baby is the advertised product of IVF, then please open an IVF clinic that says on its website that “none of our services will result in the live birth of a child.” I’m fairly confident that exactly zero people will make an appointment there.
Another way to see the same moral issues is in this surrogacy hypothetical: A man wants a baby, so he pays a young fertile woman to have sex, and the contract says that the entire aim of the endeavor is so that she bears his child, which will fall under his custody after birth. (This scenario removes the problems of artificial conception, eugenic selection, and spare embryos.) I still have a problem with this scenario, and it isn’t because of anything having to do with a laboratory. As is the case in IVF, a human being is reduced to a commercial product — even though the conception itself was traditional and “natural.”
But there’s another critical distinction that explains why my commerce-related terminology applies to IVF but not other prenatal services or medical interventions: the mere existence of a particular human being. A child in utero exists whether or not its pregnant mom gets an ultrasound, whether or not she goes to the hospital for birth, or whether or not it is put up for adoption later. If an ob-gyn discovers during an ultrasound that the baby in utero (tragically) does not have a heartbeat, the baby still exists. The contractual agreements, paperwork, insurance forms, and all that jazz in these scenarios have no bearing on the existence of the child. In an alternative example, a patient preexisted the appointment, the procedure, and the signing of forms for a tumor removal; therefore the patient isn’t a “product” of paying for a tumor removal. IVF, on the other hand, requires contractual agreements in a transaction as a precondition to creating the desired product, a child. If the contract isn’t signed in an IVF clinic, the child never exists — hence the “terms and conditions” language I used.
People saying that “my [friend/child/spouse/grandkids/etc.] wouldn’t exist without IVF” are actually reinforcing my point. In some cases, it might be true to say “my child wouldn’t be alive without my great ob-gyn” or “my friend’s daughter would have died during childbirth without the hospital’s excellent staff,” but the state of being alive or dead is different from an existential claim.
Apart from philosophical or ethical debates, maybe just consider this simple observation: There’s a reason why we sometimes read and hear the words “clients” or “customers” for people who use IVF, but we say “patients” when referring to pregnant women getting check-ups at an ob-gyn or giving birth in a hospital.
One final point, on the “property” part specifically. Yes, the customers (not necessarily a married couple, or even a couple) at an IVF clinic generally “own” (per contractual agreements) the embryos they purchased, which are human beings that are functionally treated as property. The property and ownership dynamics become much more transparent in IVF cycles where there is a third party like an egg donor, sperm donor, or surrogate; who can do what to the embryos and with the embryos is explained in painfully nuanced contracts. But if folks don’t want to hear the “property” word from me, they can find it in some court cases. McQueen v. Gadberry treated preserved embryos as “marital property of a special character,” while a court in Roman v. Roman said that the preserved embryos of a divorcing couple were “community property.”
Anyway, hopefully I’ve explained why my rhetoric is accurate, even if it might be jarring. And I hope this clarified how one can object to IVF without opposing fertility-related medicine, let alone all medicine. Just as a general note: I am always open to debating, and people can email me at aanthony@nationalreview.com (though I can’t respond to everyone, and I’m off on vacation next week).