“There is no right to a child”

How far do we want to (may) go when it comes to an intervention in nature or. the act of God's creation? At the invitation of the Bildungswerk, experts gave answers in Cologne on Wednesday. Cardinal Woelki also took a clear position.

In the end, some questions remained unanswered. And many partial aspects of this complex ie surrounding prenatal diagnostics, its possibilities, but also medical and psychosocial effects on those involved, as well as final consequences – thought one way or the other – could only be touched upon. (Video recording here)

However, it became clear during the discussion with a gynecologist and obstetrician, a human geneticist, a psychologist and a moral theologian on Wednesday evening in the Cologne Cathedral Forum that there can only be one approach to the controversial topic of "the 'ordered' child," i.e. the so-called designer baby according to one's own individual ideas, in all its facets, and that decisions made by parents with an unfulfilled desire to have children also have a lot to do with one's own conscience and can hardly be brought down to a common denominator – certainly not to a consensusable. A "right" or "wrong" – this also became obvious – is in any case too short-sighted when it comes to such an existential topic.

"How far do we (may) want to go?"was the initial question, along which moderator Gisela Steinhauer first gathered a lot of information on the current state of medical-technical development, which is currently also being discussed in society and which is bringing both proponents and determined opponents of these latest scientific options onto the scene. The fact that this is a "field of tension between desire and reality," as the subtitle of the panel event put it, in which there can be very controversial views and experiences – above all also depending on one's own consternation – was shown not least by the very moving requests for the floor from the audience.

Cardinal Woelki: No programming of hereditary dispositions

Unambiguously put first Rainer Maria Cardinal Woelki The Pope explained his position and warned against overstepping the bounds of medical feasibility. What was celebrated as a sensation in 1978 – namely the first human being conceived outside the womb – is now normal 40 years later. About every 40. Birth meanwhile goes back to an artificial insemination, the Cologne archbishop explained. Worldwide, there would now be over five million people created through in vitro fertilization. Even if many couples with an unfulfilled desire to have children have been given a great deal of happiness as a result, this is offset by "a large number of surplus embryos that have to be created with this procedure," he pointed out.

Increasingly precise diagnostic methods reveal the life of the unborn child in its biological constitution. While the Praena test could determine the trisomies 13, 18 and 21, another challenge is the so-called gene scissors – with the technical term CRISPR/Cas9. "With this procedure, it will be possible in the future, depending on the therapeutic benefit, to precisely cut out certain sections of the genetic material that are known to cause certain diseases in the future."However, according to Woelki, further technical development will lead to the healing and manipulation of human beings being closer together in the future. This benefit then also means being able to be "creative," for example, in the color of a child's hair or eyes or desired talents. Even if the desire for a healthy child is all too understandable, the cardinal explained, it should not come to a "programming" of hereditary traits, which would then guarantee a healthy child, but would also open the door to further interventions regarding the choice of sex or appearance.

On the way to a designer baby

God knows no relativization of human life, Woelki said in this context. In this question, there would therefore be no relativizing "actually" for believers. For Christians, says Cardinal Woelki, "God says: I have called you by your name.". Whoever starts to keep a list of life criteria, will in the long run have no limit at all and will ensure that parents of a handicapped child will increasingly be confronted with the sentence: Something like that really doesn't have to be the case today. Nevertheless, Woelki expressly emphasized, he was not concerned with pessimism about technology, and certainly not with raising a moralizing finger. Rather, he said, the question is where to draw the line between healing and the desire for a designer baby.

How difficult it can be to make moral judgments or even to formulate generally valid standards was also shown by the other participants in the event. Dr. Jens Pagels, gynecologist and obstetrician at St. Joseph Hospital in Moers, explained the common prenatal diagnostic standards in his clinic, their benefits and risks for mother and child. In addition, the father of six children admitted – "I would have said a clear 'yes' even to a child with disabilities" – that there is an inflationary approach to the possible tests. During counseling sessions with pregnant women, he said, women in conflict situations can be guided toward a path that puts them on a healthy decision-making footing. "One must always look at the human being in everything and, under certain circumstances, involve other professions in making recommendations. In the end, however, a woman has to live with the results of an examination – whatever they may be."Pagel, who also advises the German Bishops' Conference on these ies, said that decisions should not be made ad hoc and in a panic, but only at the end of a longer process. The physician considers pre-implantation diagnostics, when fertilized eggs are examined for their genetic material before they are placed in the uterus, to be "reprehensible. "Here we are strongly on the way to a designer baby."

Create space and time for those affected

Also Professor Elisabeth Godde, human geneticist and medical psychotherapist in Recklingshausen, Germany, relies on intensive counseling in its work with pregnant women who seek genetic screening techniques. Especially when it is foreseeable that a child cannot survive in the womb, good care and "calm medicine," including prenatal palliative care if necessary, must take effect, she said. The diagnosis of serious damage to the child can lead to a burden that can break up partnerships and entire families. Even with good will, it is not always possible to cope with such an intrusion, which destroys the image of a healthy child. In addition, the discussions are about finding out how much deviation from normality a couple can endure when they decide to have a sick child. "As a rule, people are severely affected and very challenged to face this experience."Ultimately, couples who use "in vitro" are not comparable in their sensitivity and resilience to those who spontaneously become pregnant.

How great the distress is for couples whose wish to have a child is not fulfilled or whose dream of having a healthy child is shattered, described Gunther Bergmann, director of a Catholic marriage, family and life counseling center in Cologne, Germany. Then, first of all, a lot of time and space is needed for those affected, but psychological support can help them find a solution. According to the qualified psychologist, who also works as a spiritual advisor, it is important to act with an open mind and not to play off the commandment of the Church on the one hand against the woman's right to self-determination on the other, but to arrive at a solution that is good for the couple through trust in a longer discussion process.

Child as gift

There was a clear commitment to the doctrine of the Catholic Church from the Bonn moral theologian Professor Jochen Sautermeister. "A child is a gift and must not be used as a means to fulfill one's own interests," he stressed. Rather, the attitude toward human limitation and finiteness must be critically questioned. And crucially, how can we help people to live with their limitations?? After all, the desire to have a child after artificial insemination is fulfilled for only 20 percent of people. In addition, he said, in the context of reproductive medicine, the best interests of the child must remain in view as the definitive guiding principle. There is clearly a limit when selection is made according to characteristics and value of life. Sautermeister argued for more psycho-social counseling in light of existing regulations "so that people can come to a responsible decision".

"There is no right to a child," Woelki countered the desire of homosexual couples to adopt during the discussion. This topic was also briefly touched upon. "A child is more than the product of a procreative process of whatever kind, more than just a wishful thinking," the cardinal argued. "People who want a child decide to participate in the idea of creation."Repeatedly he urged to be aware that in reproductive medicine for one child "a multitude of real existing human beings would be killed at the same time". Who decides on a child's right to live, he asked the group as he did so. "We would not put people with disabilities at our disposal either. Therefore we are not allowed to do so in this phase."

Beatrice Tomasetti (DR)

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