The Dispositional Decision

That's the term coined to refer to the decision in vitro fertilization (IVF) patients must make about what to do with their excess frozen embryos. A fascinating article in Mother Jones called Souls on Ice describes how the glut of cryogenically preserved in fertility clinics is forcing families and researchers to seriously reconsider their beliefs about when life begins, choice, and reproductive freedom.


The article highlights a study of 58 couples who gave birth to children conceived as a result of IVF and also had frozen embryos in storage (the average couple had seven embryos in storage with the average embryo having been in storage for four years). Dr. Robert Nachtigall, a reproductive endocrinologist at the University of California-SanFrancisco, led the study and "found that even in one of the bluest regions of the country, which is to say, among people living in and around San Francisco, few were able to veiw a three-day-old laboratory embryo with anything like detachment." Here are some other interesting quotes:

“I was like, ‘I created these things, I feel a sense of responsibility for them,’” is how one ivf patient put it. Describing herself as staunchly pro-choice, this patient found that she could not rest until she located a person—actually, two people—willing to bring her excess embryos to term. The presence of embryos for whom (for which?) they feel a certain undefined moral responsibility presents tens of thousands of Americans with a dilemma for which nothing—nothing—has prepared them.

Strikingly, Nachtigall found that even in one of the bluest regions of the country, which is to say, among people living in and around San Francisco, few were able to view a three-day-old laboratory embryo with anything like detachment. “Parents variously conceptualized frozen embryos as biological tissue, living entities, ‘virtual’ children having interests that must be considered and protected, siblings of their living children, genetic or psychological ‘insurance policies,’ and symbolic reminders of their past infertility,” his report noted. Many seemed afflicted by a kind of Chinatown syndrome, thinking of them simultaneously as: Children! Tissue! Children! Tissue!

For virtually all patients, [Nachtigall] found, the disposition decision was torturous, the end result unpredictable. “Nothing feels right,” he reported patients telling him. “They literally don’t know what the right, the good, the moral thing is.” In the fluid process of making a decision—any decision—some try to talk themselves into a clinical detachment. “Little lives, that’s how I thought about them,” said one woman. “But you have to switch gears and think, ‘They’re not lives, they’re cells. They’re science.’ That’s kind of what I had to switch to.”

“You weigh what’s best,” Nachtigall quoted one parent as saying, but what’s best is not, often, clear. This parent continued: “Are they people? Aren’t they people? In part of my mind, they’re potential people, but the point is, it seems odd to me to keep them frozen forever. It seems like not facing the issue.” A patient who had decided to donate embryos for research said, “We’ve agreed that it’s the right thing for us to do, but the final step is to get the forms notarized, and we haven’t done it. I will honestly say that it will be a day of mourning.”

The article notes that the overage of embryos has reached such proportions that companies now exist for the sole purpose of managing embryo inventory. Reading what Russell Bierbaum, the founder of one of these companies, had to say, illustrates why the church cannot afford to be ignorant of the bioethical issues involved in this and other reproductive technologies:

In a few instances, he says, he will take over abandoned embryos and attempt to track patients down. It is therefore people like ReproTech staff members—rather than, say, ministers or psychologists—who often are the ones discussing, with patients, fundamental questions touching on birth and death and life and reproduction, all the essential questions of humanity. “We end up being the counselors without the credentials,” acknowledges Bierbaum, “just answering the questions, being available.”

With the Senate debating whether to loosen restrictions on the federal funding of embryonic stem cell research this week, this is especially timely reading. The folks at Stones Cry Out have put together a helpful list of their stem cell posts from the last year worth checking out too.