Oddly, in vitro fertilization has become a campaign issue in the 2024 presidential election.
Vice President Kamala Harris and her running-mate Gov. Tim Walz (D-MN) are trying to elevate IVF to a main topic of debate, falsely claiming that Republicans plan to outlaw it. Walz has even gone so far as to falsely claim he and his wife used IVF to create their children.
Former President Donald Trump has tried to defuse the topic by promising a federal law to guarantee insurance coverage, by private insurance or the government, of IVF treatments.
While the presidential candidates compete over who loves IVF more, the rest of us ought to take a step back and ask whether we should rush headlong into subsidized IVF for everyone — and whether we’ve already rushed too far for our own good into the world of reproductive technology.
To be sure, only a small minority of the public morally objects to IVF, and those objectors are apt to be called weird. But their objections are worth listening to.
Are embryos people?
IVF was thrust onto the political stage in February after Alabama’s Supreme Court ruling on the practice. Despite the mischaracterization by Democrats and some of the news media, the Alabama judges didn’t ban IVF or do anything remotely like that. The victorious plaintiffs were IVF customers who sued the clinic for allowing their stored embryos to be destroyed through negligence.
The ruling reaffirmed that wrongful death statutes applied to embryonic humans, including those who resided in petri dishes. This imposed a heavier duty on IVF clinics to protect the embryos they told clients they would protect.
Alabama’s lawmakers responded with a law basically exempting IVF clinics from consumer protection laws.
While Democrats have a political incentive to make the Alabama ruling a story about Republicans attacking women’s rights, it was nothing of the sort.
But we shouldn’t ignore the Alabama case. Instead, we should understand the case itself and Alabama’s new IVF law as representative of the whole undertaking: Lawmakers codified indifference toward parents, would-be parents, and their nascent children. It’s a statutory declaration that IVF businesses may do what they please.
The near-total lack of regulation in this industry ought to be enough to give us pause about it, especially given the ethical thickets around it.
Ethical thicket
First, IVF involves the creation of “excess embryos.” IVF customers typically have many embryos created, and they only implant some of them in utero. The rest are frozen and stored.
Sometimes, these leftover humans, especially those found to have genetic abnormalities, are deliberately destroyed. This is abortion, but outside of the mother’s womb. Occasionally, biomedical researchers use these embryonic humans for experiments or for tissue. Mostly, though, the excess embryos are stored indefinitely.
About one million tiny Americans are currently frozen in cryostorage, bioethics expert Carter Snead of Notre Dame estimates.
This presents a profound ethical problem. These are humans. We haven’t killed them, but we’ve prevented them from developing. For many of them, their biological parents have no ability or interest in bringing them to maturity.
They are frozen indefinitely, and one U.S. court, adjudicating a custody dispute, declared these frozen embryos to have “intermediate status” between property and personhood. Surely, some of these frozen children have no living parents. Someday soon, they will have outlived their siblings and their nephews.
Are we going to simply leave them in cryostorage until the meteor hits? Or maybe until the company holding them decides that the electric bills are too high? Until, like those babies in Alabama, some accident leads to their in vitro demise?
These hundreds of thousands of embryos have already created nascent demand in multiple markets. Researchers and the biotech industry see these embryos as an unused supply of pluripotent stem cells that should be used to develop new treatments or medical products. Should the parents — or the clinics — be allowed to sell these embryos to aspiring parents?
Already, IVF and similar technologies have created markets in sperm and eggs from supposedly desirable donors — tall, athletic, high-IQ. Bespoke frozen embryos are also available from companies like California Conceptions. “Prospective patients can browse the catalogue of gamete donors in the hopes of having a baby with preferred traits,” Snead explains.
Genetic screening is standard in IVF, to weed out babies with genetic disorders, but mostly to select for sex. Some parents have selected for children whose blood type is compatible with their big brother, who will need the cord blood for a transfusion.
Introducing capitalism and profit motive so deeply into conception and pregnancy ought to worry us—and surrogacy takes it to another level. Surrogacy in America typically involves a wealthy older couple paying a poorer, single woman to carry a baby for months before handing the baby over.
IVF is mostly a tool used by couples struggling with infertility — they see it as their only or best chance for having a child of their own flesh. But increasingly, it is used not to overcome fertility issues, but simply to allow couples to better select a child.
Anthropology
Technological shocks often change our view of ourselves without us realizing it. When the technology in question involves reproduction — literally how humans come into existence — the shift in anthropology is especially profound.
The developments of the past 60 years — birth Control, IVF, surrogacy, abortion, and the abandonment of Judeo-Christian sexual morays — were all solvents. Over the last two generations, our scientists, cultural taste-setters, and policymakers have worked tirelessly to dissolve the natural bonds that connect love, marriage, sex, pregnancy, childbirth, and parenthood.
This campaign has won not only political and scientific victories, but also a psychological one. Modern reproductive technology has reshaped the human psyche. A birth-control-to-IVF conveyor belt reflects a particular view of humanity. It’s a medicalized view of the individual, which is ubiquitous once you start looking for it.
It’s not uncommon to find a millennial or member of Gen. Z whose self-identity seems to be mostly medical markers — immunocompromised, neurodivergent, chronic Lyme.
The pandemic fully revealed this medicalized view of humanity. Commentators and researchers called school children “little vectors.” Medical masks became not mere personal protective equipment, but something of a uniform — an expression of one’s self. Being “vaxxed and boosted” became an identity.
This medicalized view of the self replaces a more natural, organic view — that our body’s rhythms and reactions are not mere annoyances or obstacles but instead are important signs that tell us something about ourselves.
Wholehearted embrace of IVF not only tries to dissolve the natural connection within an individual between sex, pregnancy, and childbirth, it also threatens to dissolve our bonds with one another. Reproductive technology can break down the idea of humans as ultimately social creatures who can best be understood in relation with others.
“Mandating taxpayer coverage of IVF for any individual seeking a child,” writes Patrick Brown, “sets the federal government firmly on the side of viewing parenthood as an individual right, rather than as something properly existing within the context of a couple.”
The natural progression of universal IVF is to deliberately expand parenthood outside of couplehood.
Where single parenthood is generally considered an unchosen and unfortunate occurrence, IVF can increasingly transform it into a choice — just another lifestyle choice made by autonomous individuals.
Add in the complications of surrogacy and you have the ingredients for moral and cultural convulsions.
Will surrogates, who get paid for carrying implanted babies, be subsidized in Trump’s plan? Will this create a market whereby unmarried men cheaply acquire their own child, with Uncle Sam subsidizing the whole process?
Again, there’s a philosophy behind all of these technological and social changes.
“Assisted reproduction is squarely rooted in the anthropology of expressive individualism,” Snead writes.
The totally unregulated world of IVF brings forth “a very particular kind of freedom,” Snead argues. “It is the singular freedom of the unencumbered self, lacking constitutive attachments and unchosen obligations, for whom relationships are either transactional or adversarial, but always instrumental.”
Snead points out that the legal and medical framework of assisted reproduction in America today flows from the ideas of professor John Robertson, author of a book titled Children of Choice. Robertson said IVF and other technologies were about “‘procreative liberty,’ which in his words is ‘first and foremost an individual interest.’”
As Robertson sees it, abortion, birth control, and IVF “are the means to achieve or avoid the reproductive experiences that are central to personal conceptions of meaning and identity.”
This philosophy transforms children into lifestyle choices — almost accessories. This view would replace the Judeo-Christian view that sees every child as a gift. A gift is unearned, even undeserved. It is a blessing to be cherished. That this blessing flows from the love of a husband and a wife tells us something about ourselves. It reminds us that we aren’t just free-floating bundles of rights that happen to have bodies. We are instead body and soul. Who we are is not merely a matter of self-expression, but is instead determined by our relations with others and our given, unchosen traits.
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The problem with IVF isn’t that it changes the nature of the child. It doesn’t. Every child conceived through IVF is still an infinitely valuable gift and, as Leon Kass put it, a marvelous stranger.
The problem is that if we let IVF and other reproductive technology quietly reshape our psyches and our society, we run the risk of forgetting what children are, and thus what we are.