For those who undergo it, infertility treatment is costly, time-consuming, invasive, and emotionally and physically arduous, yet technology remains the focus of most public discussion of the topic. Drawing on concepts from medical ethics, feminist theory, and Roman Catholic social teaching, Maura A. Ryan analyzes the economic, ethical, theological, and political dimensions of assisted reproduction.

Taking seriously the experience of infertility as a crisis of the self, the spirit, and the body, Ryan argues for the place of reproductive technologies within a temperate, affordable, sustainable, and just health care system. She contends that only by ceasing to treat assisted reproduction as a consumer product can meaningful questions about medical appropriateness and social responsibility be raised. She places infertility treatments within broader commitments to the common good, thereby understanding reproductive rights as an inherently social, rather than individual, issue. Arguing for some limits on access to reproductive technology, Ryan considers ways to assess the importance of assisted reproduction against other social and medical prerogatives and where to draw the line in promoting fertility. Finally, Ryan articulates the need for a compassionate spirituality within faith communities that will nurture those who are infertile.

Maura A. Ryan is associate provost at the University of Notre Dame and coeditor of The Challenge of Global Stewardship: Roman Catholic Responses.

CHAPTER ONE
THE ECONOMICS OF INFERTILITY                                   16
Myths and Realities in the Economics of Infertility        17
Intersection: Ethics and Economics                         30
Distributive Justice and Assisted Reproduction             30
CHAPTER TWO
THE ETHICS OFASSISTED REPRODUCTION                            42
The Ethics of Assisted Reproduction                        43
What about Adoption?                                       56
Reproduction and the Common Good                           60
CHAPTER THREE
ASSISTED REPRODUCTIONAND
THE GOALS OF MEDICINE                                         66
Infertility, Suffering, and the Goals of Medicine          68
Living with Infertility                                    70
Inside/Outside: The Medical Construction of Infertility    74




Some Preliminary Conclusions                                78
Reflecting on the Goals of Medicine                         80
CHAPTER FOUR
RECONCEIVING PROCREATIVE LIBERTY                               91
John Robertson and the Meaning of Procreative Liberty       93
Rights Talk and the Critique of Procreative Liberty, American-Style 96
Border Tensions                                            101
Procreative Liberty and Catholic Social Teaching           106
Conclusion                                                 115
CHAPTER FIVE
ASSISTED REPRODUCTION AND
ACCESS TO HEALTH CARE                                         122
Human Dignity and Access to Health Care                    125
A Decent Minimum                                           127
Sufficiency                                                129
Investments in Reproducing                                 132
Equity and Access                                          134
At the Boundaries                                          139
Setting Limits                                             142
Conclusion                                                 144
CHAPTER SIX
FAITH AND INFERTILITY                                         150
Mixed Messages and Missed Opportunities                    151
Creating a Context                                         158
From Spiritual Crisis to Spiritual Quest                   160
Conclusions and the Work Yet to Be Done                    164
CONCLUSION                                                    171
INDEX                                                         177