On Ovarian Tissue Transplantation and the Metaphysics of Self-Recognition: A Response to Paul Lauritzen and Andrea Vicini

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IN AN ESSAY RECENTLY PUBLISHED IN THIS JOURNAL, Paul Lauritzen and Andrea Vicini (hereafter L&V) propose that state-of-the-art medical advances involving fertility preservation for cancer patients, especially ovarian tissue transplantation (OTT), challenge the boundaries of moral reflection within the Catholic tradition. (1) Specifically, they ask whether documented scenarios involving the heterologous transplantation of ovarian tissue from one identical twin to her sister, or the transplantation of ovarian tissue from nonidentical sisters, both followed by natural conception, reveal a tension at the heart of the Catholic Church's opposition to heterologous procreation: "Is this opposition rooted in the tradition's nondualistic view of the body and a natural law understanding of the necessary integration of marriage, sex, and procreation? Or ... is it rooted in a theological understanding of marriage and procreation that makes genetic connection essential?" (2)

I respond to L&V by proposing that the tension they perceive within the Catholic moral tradition can be easily resolved by clearly articulating the metaphysical link between a person's identity and her genetic constitution. I begin by clarifying the truth that for the Catholic tradition, a person's identity--what constitutes self rather than nonself--is specified not by her genes but by her soul informing her matter. Thus, metaphysically speaking, a woman's organs and cells, including her eggs, are hers not because they are genetically identical to each other--though in most cases they are--but because they are animated by her soul. Next, I propose a metaphysical theory that posits that this common ensoulment shared by all the cells in a woman's body is manifested in several biological realities, most importantly in her immune system's ability to distinguish her own cells from those of another. Thus, I propose that human procreation, as understood within the Catholic moral tradition, if it is to be morally licit, has to involve the giving of one's gametes, defined not by their genetic constitution, but by their being part of the immunologically defined self that is given in the mutual self-gift that is conjugal love.

A METAPHYSICAL THEORY TO EXPLAIN IDENTITY AND SELF-RECOGNITION

For the Catholic tradition, the human being is best described as an embodied soul, where the soul is the form of the body:

The unity of soul and body is so profound that one has to consider the soul to be the 'form' of the body: i.e., it is because of its spiritual soul that the body made of matter becomes a living, human body; spirit and matter, in man, are not two natures united, but rather their union forms a single nature. (3)

As I have argued elsewhere, this account of the human being that posits that she is composed of form and matter--a metaphysical theory called "hylomorphism"--remains a coherent and compelling philosophical solution to the challenge of describing the human organism as a dynamic yet stable being, especially when it is rearticulated using the insights of system biology. (4) Thus, any discussion of the moral dimensions of ovarian OTT within the Catholic tradition has to begin with this philosophical anthropology.

How then would hylomorphism explain the difference between self and nonself? As the form of the body, the soul is the cause of its unity, its integrity, and its nature. It explains why a human body is a single, unified organism, rather than a diverse, random collection of carbon, hydrogen, oxygen, and nitrogen molecules. It also explains why a human body is a human body rather than a gorilla body. Thus, from the perspective of hylomorphism, a person's identity--what constitutes self rather than nonself--is specified not by one's genes but by one's soul informing one's particular matter.

As a formal cause of the body's unity and integrity, the human soul informs every part of an individual's body. …