Bioethics Education

Bioethics Education:

Guided tour of AEATH students at the "Iakentro" assisted reproduction center

 Bioethical issues are becoming increasingly urgent for society and for our Church. Many of them, on a personal level, end up at the very heart of the spiritual. This fact makes the need for bioethical information for Orthodox clergy and clergy imperative. A large part of bioethics consists of technical, biological and medical knowledge, that is, specialized, constantly changing and completely modern knowledge, which one cannot find through the study of classical theological texts. One must refer to special scientific areas, specialized fields and the corresponding and increasingly enriched bibliography.

The Church of Greece understood this very early on. It held conferences, seminars, workshops in this direction and issued official texts through the Synodal Committee on Bioethics, on the initiative of its president, His Eminence Metropolitan of Mesogaia and Lavreotiki, Mr. Nikolaos, and prominent scientists in medicine, law, philosophy and theology.

As a continuation of this reasoning, bioethics was included as a mandatory course in the Priestly Studies program of the Higher Ecclesiastical Academies, with four hours of mandatory attendance per week during the eighth semester of studies. With relative certainty, we can say that these are the only higher educational institutions in which bioethics is taught as an autonomous mandatory course at the undergraduate level. In other higher educational institutions, it is taught as an elective or as a postgraduate course or integrated into the courses of ethics or medical ethics.

In this context, the eighth-semester students of the Higher Ecclesiastical Academy of Thessaloniki (AEATH), at the initiative of the associate professor of Christian Ethics and Bioethics, Mr. Nikolaos Koios, visited the Assisted Reproduction Center of Thessaloniki "Iakentro", in order to be informed in person about the technical part of Assisted Reproduction and to submit their questions to the scientific staff of the center.

The students were welcomed by the responsible obstetricians and professors of the Aristotle University of Thessaloniki. After the reception and introductory information, the detailed briefing of the students was undertaken by the biologists-embryologists associates of Iakentros, Ms. Evangelia Kasapi and Mr. Achilleas Papatheodorou.

Initially, a film was shown in which one could follow the entire process of in vitro fertilization, from the egg retrieval phase, to artificial insemination, preimplantation diagnosis and finally implantation. The two assisted reproduction techniques that are used – almost exclusively now – are IVF (in vitro fertilization) and ICSI (in vitro fertilizationThe first is usually applied when the infertility problem concerns the woman's side and the second mainly when there is a problem with the quality of the sperm.

Following this televised briefing, students raised questions regarding the indications and causes of infertility, the potential physical and psychological risks of assisted reproduction, success rates and costs. The discussion also extended to ethical issues such as the borrowing of eggs, sperm or embryos, the cryopreservation of surplus embryos and the rejection of embryos with diagnosed genetic abnormalities through preimplantation diagnosis.

It was pointed out to medical scientists that for Orthodox theology, the beginning of man exists from the "end of conception" which, according to current scientific data, is identical to fertilization. This means that any rejection of an embryo, even at the preimplantation stage, is morally equivalent to abortion, that is, to feticide.

The "Iakentro" collaborators responded that with the latest technical and scientific developments, implantation rates have increased drastically compared to the past and the need for surplus embryos has also been greatly reduced. The goal, they explained, is to reach the point of implanting only one embryo and achieving pregnancy.

Regarding preimplantation genetic diagnosis, they stated that embryos are rejected if they have chromosomal abnormalities that deprive them of any chance of survival and a healthy pregnancy. These are embryos that the body would reject anyway, which happens very often in nature. The only exception to chromosomal abnormalities that can lead to pregnancy and childbirth is trisomy 21, which causes the well-known Down syndrome.

When asked by students whether embryos with this abnormality are implanted, they replied that no couple desires such a thing, so they are rejected. This fact, of course, creates additional concerns for orthodox bioethics.

The students, divided into two groups of six people each, then visited all the areas where IVF is performed: the egg retrieval, sperm retrieval and embryo transfer rooms, the sperm quality control room through the microscope, the cryopreservation ovens for sperm, eggs and embryos, the area where IVF, in vitro fertilization and preimplantation diagnosis take place. Throughout the tour, they had the opportunity to ask questions of a technical, procedural, legal and ethical nature, regarding all stages of IVF.

Another point that focused the interest of the students of the AEATH was how stressful this whole process is, which essentially replaces the marital love relationship with laboratory intervention. The experts answered that there is clearly great psychological pressure, which often develops into tension between the couple. The reason is both biological and social factors that shape perceptions and mindsets. Of course, the personality and morals of each individual also play a large role. In general, it can be said that every couple that comes for medical assistance in reproduction is a unique case and must be treated as such. At this point, the students of the AEATH commented that there is a large scope for action on the part of the pastoral Church towards those couples who will ask for its opinion before coming to the medical centers. It was also found that the layout and decoration of all spaces, as well as the calm and friendly behavior of the staff, contribute significantly to the alleviation of psychological pressure.

Finally, after thanking the management and staff of "Iakentros", they donated, as a small token of gratitude, the Academy's yearbook, dedicated to the Blessed Archbishop Christodoulos, who was among the first in the Church to understand the importance of the bioethical training of the Orthodox clergy.