Selective Reduction: A Morality Tale

by Susan E. Wills

August 19, 2011

A recent cover story in The New York Times Magazine explores the "ethical dilemma" parents and doctors face when fertility treatments produce two or three children and parents desire only one (Ruth Padawer, "The Two-Minus-One Pregnancy," Aug. 14, 2011).

The most curious aspect of the 5,000-word article is what the Times did not deem "fit to print." But before we discuss what's missing, readers may be interested to learn some little-known facts about the $3 billion fertility industry.

The great majority of children created through in vitro fertilization (IVF) end up dead, either before implantation or before full-term birth.

To achieve a plausible "success rate," IVF technicians fertilize several eggs (and often fertilize many) at the same time. While some of the resulting embryos are transferred to the uterus, many die or are discarded immediately. Others may be frozen for later attempts, but many will not survive the thawing process.

Fifty percent of the babies conceived by IVF who do survive are part of a "multiples" pregnancy because doctors, trying to ensure that at least one baby survives, have transferred several embryos to the womb at once.

What to do when only one child is desired, but twins or triplets continue to thrive at 12-14 weeks' gestation? Some doctors offer parents "selective reduction," aborting all but one of the babies for reasons that are social, not medical. Others refuse to act as such hired guns.

The article goes into great length describing the intentions and motivations of mothers who want to "reduce the pregnancy" to one child and the circumstances that they believe support their decision: twins would take up all their time, leaving nothing for their older children; one mother didn't want to "juggle two newborns or two screaming infants" while her husband was deployed; others don't want to be "worrying about two tempestuous teenagers or two college-tuition bills" when they reach their 60s; and most revealingly, "the pregnancy was all so consumerish to begin with, and this became yet another thing we could control."

The author gives some odd reasons why "terminating half a twin pregnancy … seems more controversial than … aborting a single fetus," but two parents hint at the real dilemma: They want to be able to deny that a human life is being deliberately taken, yet the child who is allowed to be born will remain a permanent witness to the humanity of the child who was killed.

The missing piece? The article never mentions a decisive factor in determining whether a "selective reduction" is morally wrong: Objectively, what is the doctor doing and what is he deliberately aiming at?With the parents' consent or urging, he is injecting a needle containing a fatal dose of potassium chloride into the heart of an unborn child. Clearly, his moral object is to kill an "unwanted" innocent and helpless child. The best intentions and the most compelling circumstances cannot change an intrinsically evil act into one that is morally right.

Clearly, such an object contradicts love of neighbor as well as love of God, and therefore counts among the kinds of actions that Catholic morality sees as intrinsically evil. There is no real dilemma here, once we understand what abortion (including "reduction") really entails. Part of the evil practiced by the IVF industry is to desensitize parents into losing sight of this.

Susan Wills is Assistant Director for Education & Outreach, U.S. Conference of Catholic Bishops' Secretariat of Pro-Life Activities. For more information on the moral issues raised by IVF, see the bishops' statement on reproductive technologies: Life-Giving Love in an Age of Technology.