Life and Death: Key Ideas » Childlessness, Fertility Treatment and Genetic Engineering

Childlessness and decisions not to have children

Many people hope to have children one day. Childlessness means not having children. For some people it is not their choice. For others it is.

Some couples find they cannot have a child. This is called infertility: being unable to conceive (start a pregnancy) after trying for a long time. It can have a medical cause in either partner, and sometimes no cause is found. Many people find infertility very painful. They may feel sadness, grief, stress or a sense of failure, and it can put strain on a relationship.

Religions and societies have often placed great value on having children. Children are seen as a blessing, as the future of the family and, in many religions, as the way the faith is passed on. Because of this, couples who cannot have children may feel pressure, or feel that something is missing. Many religious people teach that a childless couple should be treated with kindness and should not be judged.

Other people decide not to have children. Common reasons include:

• Career: they want to put their time and energy into their work.
• Cost: bringing up a child is expensive.
• Health: a health problem may make pregnancy or parenting hard.
• Inherited conditions: they may not want to pass on a serious illness that runs in the family.
• Concern for the planet: they worry about the effect of a growing population on the environment.
• Personal choice: they simply do not want children.

Attitudes differ. Some religious people believe that having children is part of what marriage is for, so a decision never to have them needs a good reason. Others say couples have the right to decide for themselves and can serve others in different ways. Non-religious people, such as humanists, generally say that it is a personal decision and that a couple can live a full and meaningful life without children.

Key terms:

• Childlessness: not having children, either by choice or because it has not been possible.
• Infertility: being unable to conceive a child.

Fertility treatments

Fertility treatments are medical ways of helping people to conceive. You need to know these:

Some of these treatments use the couple's own egg and sperm. Others need a donor, which means a third person is involved. Religious views often depend on this: many believers find treatment within a married couple easier to accept than treatment that involves a donor or a surrogate.

Genetic engineering

Every human cell carries genes, the instructions that shape how our bodies grow and work. Genetic engineering means changing, replacing or selecting genes. In this lesson we look at its use with human embryos. You need to know these forms:

• Screening embryos: embryos made by IVF are tested before one is placed in the womb, so that a family with a serious inherited condition can choose an embryo that does not carry it.
• 'Saviour siblings': an embryo is chosen so that the baby will be a close match for a brother or sister who is seriously ill. Cells from the baby, such as those from the umbilical cord, may then help to treat the ill child.
• Mitochondrial donation: a technique, allowed in the UK, that replaces faulty parts of an egg's cell (the mitochondria) with healthy ones from a donor egg, to avoid passing on a serious inherited illness.
• 'Designer babies': a worry, not a treatment. It is the fear that, one day, parents might choose features like looks or intelligence. UK law does not allow this.

In the UK, fertility treatment and work with embryos are controlled by the HFEA (the Human Fertilisation and Embryology Authority). It licenses clinics and decides which uses of embryos are allowed.

Key terms:

• Embryo: the very early stage of human life, from when an egg is fertilised.
• Donor: a person who gives sperm, eggs or an embryo to help someone else have a child.
• HFEA: the UK body that regulates fertility treatment and embryo research.

The issues raised

Religious and non-religious attitudes

Attitudes vary a lot, so use words like "some" and "many", not "all".

• Supportive: many believers welcome fertility treatment as a way of helping couples to have a family, especially when it uses the couple's own egg and sperm. They see doctors as using God-given skills to heal. Many also support screening for serious inherited illness, as it prevents suffering.
• Cautious: some believers accept some treatments but not others. They may object to donors, surrogacy or any treatment that creates embryos that will be discarded.
• Against: some believers think that all or many of these treatments go against the natural way of conceiving a child, or that any embryo is a human life that must not be destroyed or used.
• Non-religious: humanists tend to support fertility treatment and genetic engineering to prevent serious illness, as it increases happiness and reduces suffering. They want careful rules, so that people are not harmed and parents do not choose a child's features.

Exam-style question

(a) Identify three fertility treatments. [3 marks] (Paper 1, AO1)

(b) Outline two reasons why some people decide not to have children. [4 marks] (Paper 1, AO1)

(c) Explain why some people have different attitudes to genetic engineering. [6 marks] (Paper 1, AO1 and AO2)

(d) 'Couples who cannot have children should use any medical help available.' Evaluate this statement, showing you have considered different points of view. In your answer you should refer to at least one religion. [12 marks] (Paper 1, AO1 and AO2)